Monitoring & Evaluation
A History Of Innovation
CHAPS was founded on the cutting–edge and pioneering research that evolved from the Orange Farm Voluntary Medical Male Circumcision (VMMC) research programme in 2005. This randomized con trolled trial demonstrated that medical male circumcision led to a 60% reduction in HIV acquisitions in heterosexual males. This contribution by South Africa to the global body of knowledge concretized the WHO’s subsequent adoption and recommendation of VMMC as a proven biomedical HIV prevention strategy.
CHAPS research extends broadly to the public health sector, monitoring and evaluation and other sociological and health care related topics. Our expertise further includes efficient clinical scale-up and social uptake of services in multiple public health priority areas. Our research is aimed at clinical trials, proof of concept and implementation science. With resident clinical trial expertise, and an in-depth knowledge of regulatory frameworks and GCP principles, coupled with access to clinics and laboratories, CHAPS is ideally placed to undertake all spheres of research with high standards. To date CHAPS is the only organization that has the expertise and technical capacity to prepare the dossier for prequalification to the WHO. The following paragraph explains the recommendations and process followed by CHAPS for compilation of a product dossier prequalification of male circumcision devices.
The WHO Technical Advisory Group on Innovations in male circumcision recommended that the pivotal clinical studies be conducted independently from the manufacturer in at least two countries representative of the intended use setting. The clinical phase only began once the safety and acceptability had been established. That meant a small pilot was conducted to establish this and for it to be representative of the population. Once the safety and acceptability was established, the Randomized Control Trial commenced and was officially termed “Phase 1”- but a baseline had to be established through the safety and acceptability study (see ISO 14155-1:2003).
The following are some of CHAPS Research highlights:
- VMMC Randomised Control Trial – Orange Farm (2002-2005)
- Community Impact of VMMC Study – Orange Farm (2007-2010)
- SYMMACS Study (2011-2012)
- Demand Creation Study (2012)
- EIMC Acceptability Study (2013)
- Training Follow-up Study (2013)
- A Case Series, Non-Comparative Study in South Africa: CircumQ (2014-2015)
- The Randomized Control Trial for CircumQ Surgical Aid (2015 – 2016)
- HIV Self-testing Kit Study (2014- 2015)
- Prepex Study (2014-2017)
- TB / Health Survey (2000)
- EIMC Pilot Study (2015-2017)
Voluntary Medical Male Circumcision
CHAPS is most recognized for its pioneering work in researching and promoting the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in the sub-Saharan region. With both programmatic and research expertise in VMMC, CHAPS is well positioned to work closely with the governments and private stakeholders to implement and systematically improve VMMC, including Early Infant Male Circumcision (EIMC) programmes.
CHAPS prides itself in delivering high quality services to patients within our network of clinics and partnerships across sub-Saharan Africa. We have circumcised more than 700 000 men and have influenced all aspects of VMMC services through technical training and policy development. Through our expansive network of VMMC service delivery within the South African Department of Health’s (SA DoH) sites and mobile units, we provide combination prevention services inclusive of HIV counselling and testing, risk reduction counselling, condoms, TB and STI screening and access to treatment where necessary. Our services ensure increased linkages to HIV care and treatment for our beneficiaries and a strong relationship with Local Department of Health (LDoH) to provide easy access to ART through government facilities.
Early Infant Male Circumcision
CHAPS has undertaken a pilot study with support from UNICEF and the SA National Department of Health (NDoH) to explore the feasibility, costing and potential integration of EIMC into routine public health services. As part of this pilot, CHAPS has undertaken training for Medical Officers and Registered Nurses on the surgical techniques suitable to EIMC. Furthermore, due to our expertise, we have advised regional Ministries of Health on the inception and scale-up of EIMC within countries.
Our community-based differentiated service delivery platforms enable us to reach rural and under-served communities with routine health screening. CHAPS’ roving model of services utilize community camps and outfitted mobile units access far-lying communities that do not often have access to routine services. Our health screening comprises physical examinations, HTS, TB and STI screening, screening for chronic illnesses, and psycho-social counselling. As part of our model, CHAPS seek to provide long term prevention of disease and prompt linkages to treatment.
The foundation of our training portfolio is using innovation to accelerate best practices in the respective health disciplines. Our training is interactive and geared towards internalization of the practical implementation of theory. We use digital interface coupled with practical clinical training and follow-up mentorship of trainees to ensure achievement of training milestones.
We believe that well-trained healthcare professionals prepared for the diverse set of conditions experienced in Africa’s health systems are the backbone of successful and impactful health service.
CHAPS is an accredited provider under the Health and Welfare Sector Education and Training Authority (HWSETA) of South Africa and provides training and in-service assessments for HIV related programs and MMC (including EIMC) in Africa. This intensive training programme is offered to a variety of medical personnel interested in providing VMMC services in their medical facilities.
We have trained over 8 633 health care professionals on how to offer safe MMC services in South Africa. Both theoretical and practical components of medical male circumcision are covered, not only enabling trainees to acquire the necessary technical skills, but also providing them with on-going support and guidance to successfully, safely and efficiently roll-out their own neonatal circumcision processes.
Based on our technical expertise and experience, we also offer training in the following fields:
- Human subjects protection and ethical regulations in the medical and research fields
- Public Health survey methods
- Good clinical practice (accredited in South Africa)
- Quality assurance for health programming
CHAPS Technical Assistance
Voluntary Medical Male Circumcision
CHAPS served at the forefront of Technical Support and Guidance to the SA NDoH in the inception and roll-out of the VMMC across South Africa. Having contributed to the development of the systems and policies currently in place, we have entrenched knowledge of the field. CHAPS is dedicated to guiding and supporting other NGOs, local, provincial and national government entities and private partners on how to set up and manage cost-effective voluntary medical male circumcision services.
Health Programmes and Health Systems Strengthening Voluntary Medical Male Circumcision
Beyond VMMC, CHAPS supports general practitioners, government health facilities and health-care partners in strengthening public health program quality through assessment, technical training and quality improvement models. We strive to create an enabling environment for health system strengthening for partners and practitioners. Our model follows a sustainability approach whereby our clients are upskilled on specific topics including quality management and improvement metrics. This empowers the MoH to take ownership of their programme and address future gaps within their own expertise.
Our services comprise rapid baseline assessment, gap analysis, relevant employee training, quality improvement model and specific metrics; and follow-up assessment.
Data Management, Monitoring and Evaluation
Data serves as the foundation for programme implementation. Data drives programme decisions and serves as an invaluable yard-stick for proactive programme performance management
CHAPS has a dedicated Data and MER Department staffed with trained data monitors and MER Specialists, and we use interactive software to monitor and report data in real time. Our programme managers have full access to their data at all times. As part of our data solutions, we provide high- quality data and ensure appropriate handling of data at all steps of a project to assure high-quality databases ready for analysis.
As part of our Data Solutions, we provide Monitoring and Evaluation support, complete with Reporting and learning feedback-loop. Our experienced MER team are proficient in:
- Data design for programmes
- Network and capturing
- Storage in compliance with Good Clinical Practice (GCP) for data management and integrity, Good Distribution Practice (GDP), and US Code of Federal Regulations (CFR)
- Programme progress analysis
- Statistical analysis of project variables
- Project reports and progress metrics
- Support for project performance management through data analysis
Occupational Health and Safety
Occupational Health and Safety (OHS) is a multidisciplinary field concerned with the safety, health, and welfare of people at work, with the objective to foster a safe and healthy work environment. OSH may also protect co-workers, family members, employers, customers, and many others who might be affected by the workplace environment. OHS is guided by an industry expert to confidently identify industry regulations, establish and implement workplace safety measures and manage occupational health and safety in your workplace.
CHAPS provides OHS solutions to workplaces in various fields such as small to medium enterprise construction and engineering, manufacturing, transport, public service and private and public health organizations. We have expertise in OHS and regulations governing chemicals, biological agents, manual labour, physical hazards, adverse ergonomic conditions and a broad range of psychosocial risk factors. Our model promotes the highest degree of physical, mental and social well-being of workers in all occupations and protection of workers in their employment from risks. We provide the regulatory framework of OHS governing the industry, establish the relevant protocols and undertake training and assessment of the employees in understanding OHS protocols and internalizing these. We further provide continuous support to our clients in oversight, routine assessments and submission of compliance certificates to the governing authorities.
We also offer the option of complete outsourcing of OHS to CHAPS. This enables the client to focus on their core business while we focus on employee health, occupational risk and safety and optimize productivity through a seamless integration of OHS principles into workplace activities.