Site Improvement through Monitoring Systems Assessment: Feedback Report for Heartland Alliance Nigeria’s Accelerating Control of the HIV Epidemic 6 Project in Lagos State, Nigeria

The assessment aimed to review whether processes for the provision of HIV services adhered to U.S. President's Emergency Plan for AIDS Relief (PEPFAR) standards. The assessment results provided information to support strengthening structures and processes for quality service delivery. The SIMS team assessed all required and relevant supportive core essential elements (CEEs) at Badagry General Hospital, highlighting strengths and weaknesses observed at the site. Copies of the dashboards containing a summary of the assessment findings were provided to the site and the implementing partner's (IP) representatives. The SIMS 4.2 tool was deployed during the assessment, which has a total of 13 new CEEs added. A complete set (Set 1D with 4 CEEs) was added, set 1C has one CEE added, whereas Sets 1A, 1C, 2B, and 7 each have two CEEs added. The assessment identified several strengths, including the availability of staff training records on patient rights and protection from stigma and discrimination, the availability of job descriptions for staff involved in the delivery of HIV services, proper tuberculosis (TB) infection control practices, and proper injection safety procedures. However, the assessment also identified several weaknesses, including waste management at both the laboratory and HIV testing services (HTS) unit and HTS for biological contacts of HIV index clients and partners of HIV-positive clients, which required remediation. Feedback was provided to the HAN ACE 6 team and facility management after the assessment, and the IP was encouraged to work with the site staff to develop a remedial action plan for all CEEs that scored yellow or red to improve the quality of services in the program areas. A comparative analysis of the FY22 and FY23 comprehensive SIMS assessments was done to identify whether there had been improvements or whether gaps persisted in the quality of services over time. The result showed that there were still gaps, with Set 6 remaining unchanged and Set 8 scoring worse than in the FY22 assessment. The SIMS team engaged the site teams and IP staff in the importance of addressing all identified gaps within the stipulated timelines. The assessment highlighted the need for continued improvement in the quality of services at Badagry General Hospital. The SIMS team provided feedback to the HAN ACE 6 team and facility management, and the IP was encouraged to work with the site staff to develop a remedial action plan for all CEEs that scored yellow or red. The assessment results will be used to support strengthening structures and processes for quality service delivery at the site.