Human Resources for Health Inventory Tool to Assess Donor-Supported HIV Workers


PEPFAR, The Global Fund, and other donors have invested millions of dollars to supplement the budgets of governments for human resources for health (HRH) and health worker staffing. Yet, there is a need for greater data to inform who the donor-supported workers are, where they are located, related costs, and status of alignment with existing host-country government structures and policies.  Donors and host governments need better tools to understand the scope and nature of staffing investments in order to optimize health worker utilization to advance epidemic control and to inform sustainability planning once epidemic control is achieved.


The HRH Inventory Tool provides countries with a wealth of information about donor investments in HRH, from the job titles of health workers supported to the names of facilities where health workers are based, and includes detailed information on health worker gender, experience, compensation, and professional development. By inventorying donor investments in HRH, development partners and host governments can more easily track and analyze investments in HRH staffing, down to the site level, which can be utilized for more robust sector-wide performance monitoring and program planning. It also can support a mapping of donor-supported workers to host government cadres and pay bands, where available, to inform stronger alignment of donor support. The HRH Tool does not require that users collect all of the elements within the tool, but rather should be customized to meet the needs of the country’s program based on subject matter expert and country Chair feedback.

The HRH Inventory Tool is available online for donors and host governments to download. An accompanying two-page overview and webinar recording are available to guide donors and host governments through the inventory process. Using the HRH inventory, donors and host governments can:

  • Customize the HRH Inventory Tool - Users can customize the tool with information specific to a country’s health sector, such as drop downs for localities, facilities, technical areas, and to reflect local context and programming needs;

  • Populate the HRH Inventory Tool – Users work with implementing partners and principal recipients who directly support health workers to populate, clean and validate the data entered into the tool capturing the current donor-supported workforce;

  • Map donor-supported staff to Government Equivalencies -  Users can map the donor-supported workforce to government cadre and pay scales, to determine if the investments are well-aligned with public service;

  • Analyze donor-supported investments – Users can analyze the HRH Inventory data, down to the site level, for sector-wide performance monitoring, program planning and MER reporting. Examples of possible analytic visualizations/dashboards are included below.

To date, the HRH inventory tool has been populated and those data have been analyzed in 5 countries. In Tanzania, the HRH Inventory is used to track and manage PEPFAR-supported investments in over 16,000 healthcare workers nationally. In Lesotho, the HRH Inventory revealed how donors collectively are amplifying government staffing, and highlighted the need to rationalize lay cadres to support governments’ HIV policies and task sharing models. In Eswatini, the HRH Inventory Tool is influencing government-led HRH transition analysis and plans, and raised the visibility of facility-based lay cadres. In Namibia, the HRH Inventory is supporting stakeholders’ consultations on sustaining gains in HIV epidemic control, even as donors withdraw. 

Some additional information can be found here!

HRH Inventory Tool (Excel)

The Botswana Combination Prevention Project (BCPP) Data Linkage Tool

What was the problem?

Data management systems that support individual-level patient tracking are often neither affordable nor easy to implement. However, being able to track patients at the individual level can facilitate timely and accurate HIV service delivery to those in need. For example, real-time follow of antiretroviral treatment (ART) patients who have not picked up their medications reduces the amount of time an ART patient is without medication.

Researchers in a large-scale, PEPFAR-funded project in Botswana (known as the Botswana Combination Prevention Project, or BCPP), needed to follow project participants over time, using an electronic platform, in order to measure the impact of offered HIV services. That is, researchers needed data demonstrating that persons diagnosed with HIV were linked to treatment, initiated and retained on ART, and are virally suppressed in a timely and efficient manner. As such, the requirements of the electronic tracking system included:

  • Trace persons who tested positive for HIV, but did not initiate ART (i.e., persons who were lost to follow up)

  • Monitor individuals through the clinical cascade, from HIV testing through viral suppression

  • Uniquely identify persons (either through unique identifiers (UIDs) or another approach)

  • Monitor movement of persons across communities and geographic spaces

  • Record age and sex at the individual level

The investigators undertook an extensive search to identify and purchase an affordable data management system that supported individual patient tracking over time. However, they were not successful in finding a system that met their needs. As a result, the Botswana Harvard AIDS Institute Partnership developed a system rather than purchasing one.

What is the tool?

The flexible, affordable open-source data management system supported the longitudinal tracking of patients on an individual basis for the duration of the project.

Key steps in building the data linkage system included:

  1. Data Security

    Key elements to ensure data security include a firewall, hash keys to ensure encrypted data cannot be unencrypted, user logins, physical security and access, and routine data back-up measures.

  2. Data Quality

    Tablets have built-in validation tools to limit errors (e.g., invalid, implausible numbers). Staff are also trained to review data for completeness and errors.

  3. Confidentiality of Data

    Data were ‘hashed’ or encrypted to protect the privacy of patients in this project. As a result, data became “unusable, unreadable, or indecipherable” when unauthorized persons attempted to view the data. An Omang, the Botswana national identification card for citizenship, UID was encrypted with a one-way hash prior to being transferred to the project server. When there was consent, or a waiver of consent, from the client to extract identifiable data from the clinic medical record systems (electronic and web-based), clinic data were linked with HIV testing data using the ‘hashed’ Omang.

  4. Costing

    The average costs for establishing the project’s infrastructure for the 30 communities was $14,394 per community (total = $431,815). The annual bandwidth and maintenance cost for each of the three communities where this was implemented was $4,974 (total = $14,922). The project bought 18 laptops in 2016 to replace agency laptops at the project sites. The cost was $20,625, or $1,146 per laptop for the 18 Dell Latitude 3470 laptops purchased. Estimates for the total cost of the equipment used for the database hardware were as follows:  $5,500 for Ubuntu server, $1,200 for tape backup and $3,500 for UPS for a total of $10,200.  Please note, with typical information technology systems, the standard replacement cycle for hardware is approximately every 3 years.  The annual cost to maintain the hardware and network is $28,000/year.

Figure 1. BCPP Data Linkage System

Figure 1. BCPP Data Linkage System

How to Use the System:

After BCPP research assistants completed their daily data entry of patient level data collected at the community level, they reported to BCPP ‘base operation village’ trailers (i.e., their main community-based headquarters). The research assistants’ laptops automatically connected to the secure Wi-Fi when in 15 meters range. Data were synchronized, uploaded, and transmitted to the server at the Botswana Harvard AIDS Institute Partnership offices.

Complete details on this data linkage approach can be found at: Countries can access the BCPP data management system (Python modules) at GitHub (

Key Outcomes:

This BCPP data linkage management system facilitated the rapid examination of the effects of HIV clinical interventions on timely patient-level linkage to treatment, retention, and viral suppression rates; and follow-up of patients within 24 hours as opposed to months later.

Figure 2. Flow of information from the first test of HIV to cleaning and analyzing the data.

Figure 2. Flow of information from the first test of HIV to cleaning and analyzing the data.

TB Preventive Treatment (TPT) Implementation Tools

what is the problem?

TB Preventive Therapy (TPT) should be given to any person living with HIV in a country with high burdens of both diseases. It is logistically and financially practicable, and is considered a routine standard for HIV care and treatment. In many countries with high dual burdens, TPT is recommended and included in national guidelines. However, it has not been well-implemented or widely scaled up in most countries. There are many different reasons for this, including clinician concerns about adverse events or engendering drug resistance, or programmatic concerns about administrative leadership and procurement.

what is the tool?

These tools are a fairly comprehensive set of response/aids intended to address the many different concerns or obstacles that HIV programs may face when scaling up TPT. They constitute a library that programs may select from and adapt as needed to fit the local context. The following graphic lists the tools and indicates where in the planning and execution each might be useful:


Index and Partner Notification Testing Toolkit

What is the problem?

Index testing and partner notification is a core intervention used to efficiently and effectively identify HIV-positive individuals. However, tools that helped ensure index testing programs were implemented with appropriate quality, scale, and fidelity were not readily available.

What is the tool?

The following Job Aids (ppt) lists 6 recommended steps to follow when implementing the Index and Partner Notification Testing Toolkit. These are:

Step 1: Use  Talking Points & Scripts for Index Testing Services (doc) to introduce partner/family testing to the index client and complete the Index Client Information Form (page 1 of Tools for Documenting & Monitoring Partner Notification Services (doc)).

Step 2: Use the Partner/Child Elicitation Form (page 2 of Tools for Documenting & Monitoring Partner Notification Services (doc)) to record partner(s)' names and contact information.

Step 3: Use the Partner Information Form (pages 3-4 of Tools for Documenting & Monitoring Partner Notification Services (doc)) to document results of IPV screening and preferred partner notification method and/or child testing method.

Step 4: Determine preferred method of partner notification: client referral; contact referral; provider referral; or dual referral. Additional tips and scripts for the referral processes can be found in Patient Information & Handouts (doc).

Step 5: Contact all named partners using the preferred approach.

Step 6: Record partner notification outcomes on the Outcome of Testing Forms (pages 5-6 of Tools for Documenting & Monitoring Partner Notification Services (doc)).

Step 7: Provide appropriate services for children and seroconcordant/discordant partners based on HIV status.

All forms and documents listed above, along with other useful handouts, can be found in the Index Testing Handouts (doc).

Additional information regarding this toolkit and helpful case studies can be found in Partner & Family-Based Index Case Testing SOP Slides (ppt) and Case Studies for Index Testing (doc). Also, the following spreadsheets can be used when implementing Index and Partner Notification Testing: