Factors Associated with Incomplete Reporting of HIV/AIDS by Uganda’s Surveillance System

Abstract

Background: With support from the United States government, Uganda introduced the District Health Information Software 2 (DHIS2) in 2012 to improve surveillance for better prevention and treatment of HIV/AIDS. However, districts have yet to fully adopt this system given a 70.2% reporting completeness achieved nationally between April-June 2013. Methods: The study has one dependent variable: Districts’ reporting completeness and four independent variables. 1) Number of client visits; 2) Number of district health units; 3) Number of NGOs delivering HIV/AIDS services; and 4) Regional location. We used cross-sectional study design which allows researchers to compare many different variables at the same time. HIV/AIDS program data that were reported by districts into DHIS2 during the period of April to June 2013 were used to assess for statistical analysis. Findings: Districts reporting the lowest number of client visits (under 2500) achieved the highest mean reporting completeness (81.6%), whereas a range of 2501 – 5000, or over 5001 client visits recorded 72.4% and 51.7% respectively. The higher the number of client visits the lower the reporting completeness (p <0.05). Districts that were receiving support from only one NGO recorded a mere 56.7% whereas those from two recorded 67.2%. Districts supported by over three NGOs had the highest (80.6%) mean reporting completeness. The number of NGOs was statistically associated with reporting completeness (p <0.05). The number of health units operated by a district was also significantly associated with reporting completeness (p <0.05). The regional location of a district was not associated with reporting completeness (p =0.674). Conclusion: Results of this study suggest that districts with higher patient volume for HIV/AIDS services should be identified and targeted with additional NGO support. Newly funded NGOs should be established in districts operating over 40 health units. Incomplete reporting undermines identification of HIV- affected individuals and limits the ability to make evidence-based decisions regarding program planning and service delivery for HIV prevention and antiretroviral therapy for this needy population.