Darryl ODonnell

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Measuring success in HIV prevention in NSW
Darryl ODonnell A/Associate DirectorAIDS/Infecti
ous Diseases Branch November 2007
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Content

• Measuring success in HIV prevention in NSW
• what are we aiming for and what data do we have
  to track achievements?
• The Impact of HIV/AIDS in NSW morbidity,
  mortality and economic impact
• Oversight of the project the importance of the
  project

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Measuring success in the NSW health system

• Current drivers in the health system
• State Plan
• Embedding the principle of prevention and early
  intervention into Government service delivery in
  NSW reduced avoidable hospital admissions
• State Health Plan
• Make prevention everyones business
• Balanced score card (Area Health Services)
• Outcomes (population)/clients (individual)
• Internal processes
• Learning and growth
• Financial performance

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Goals of the NSW HIV Prevention Program

• Prevention of infection important
• Individual quality of health, quality of life,
• Collective wellbeing
• Health services utilisation
• NSW HIV/AIDS Strategy 2006-2009
• Prevention Targets
• Reduce newly acquired HIV by 25
• Annual reductions in prevalence of STIs
• Other targets address quality of life/health
  PLWH/A, late diagnoses, AIDS related deaths,
  number of s100 prescribers

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Measuring success in HIV prevention in NSW

• Patchwork quilt
• Social change occurs at different levels within
  society and needs to be measured at different
  levels
• Health outcomes, particularly for priority
  populations
• Client satisfaction
• Quality and effectiveness of service delivery
• Stakeholder satisfaction
• Capacity to innovate and improve
• Organisational capacity Adequacy of internal
  processes and resources Match between values and
  capabilities of staff and outcomes Financial
  performance

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Existing data

• Keeping an eye on measures is strongly connected
  to performance ? organisations and programs need
  processes for measuring the changes they aim
  for/achieve
• Mid term and final evaluation of the Strategy
• Notification data total annual notifications,
  trends. Can map population trends for MSM, IDU,
  CALD, Aboriginal, ? Sex workers
• Behavioural data trendable data on rates of
  unprotected sex MSM and rates of sharing
  injecting equipment single data points on other
  behavioural indicators
• Occasions of service, including alignment with
  priority populations
• Social research
• Client consultation

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The Impact of HIV/AIDS in NSW

• Gap in data relating to health economic impact
  and affect of prevention program on health
  services utilisation
• Joint project undertaken by Health Outcomes
  International and the National Centre in HIV
  Epidemiology and Clinical Research
• Commissioned to map historical investment in
  HIV/AIDS prevention, particularly re priority
  populations, comment on infections averted and
  project impact of scaling back investment in HIV
  prevention efforts
• Overseen by a reference group chaired by Dr Roger
  Garsia and including ACON, Albion St Centre,
  HARPM, Department (AIDB, Communicable Diseases,
  Centre for Research Ethics, Intergovernment and
  Funding Strategies Branch

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Why this Report is important

• Principle of economics that Resource scarcity
  (forces) decisions about different ways of using
  resources. At a program level and organisational
  level, all face the question of what will we do
  and what wont we do
• Changes to the needs of priority populations ?
  ongoing need for review and development of
  prevention programs
• Principle that funds should align with current
  need ie that shift in need should ? shift in
  investment
• Priorities within health system determined by
  incidence, prevalence, equity and health services
  utilisation. HIV/AIDS is not currently
  considered one of the the National Health
  Priorities.
• Decline in media profile and community awareness
  of HIV/AIDS, reduced sense of imminent threat
  posed by HIV/AIDS ? onus on program to
  demonstrate need/value of ongoing investment

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The Impact of HIV/AIDS in NSW

• Powerful evidence on the health and economic
  impact of prevention programs, particularly in
  relation to MSM and IDU. Data on the critical
  success factors eg NSP and the impact of
  disinvestment
• Will inform ongoing review and development of the
  prevention program
• Will inform the Department, the Minister, senior
  Area Executives and the HIV/AIDS partnership on
  the effectiveness of HIV/AIDS programs in NSW and
  the contribution of the HIV/AIDS program to goals
  of the NSW State Plan and State Health Plan
• Contribution to the body of evidence re the
  effectiveness of the program conference
  presentations and published paper/s

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