Evaluating Spectrum model input data for Mozambique’s HIV care cascade, 2020–2023

Introduction: In 2023, the estimated HIV prevalence among individuals aged 15 years and older in Mozambique was 12.5%. The national response to the epidemic is monitored through HIV care and treatment cascade indicators for people living with HIV. The Spectrum model is widely used globally to estimate these indicators by integrating data from various sources, including routine health system reports. This study evaluated the input data used in the Spectrum model for Mozambique from 2020 to 2023. Methods: We assessed the input data modelled in Spectrum to generate the HIV care cascade for individuals aged 15 years and older from 2020 to 2023. Qualitative and quantitative attributes of the data were evaluated using guidelines adapted from the United States Centers for Disease Control and Prevention. Results: At the national level, the Monitoring and Evaluation Information System and Electronic Patient Registration System recorded 2,046,936 and 1,989,030 individuals on treatment, respectively, a 2.8% difference. Among men, the absolute difference was 6.9% (708,804 vs. 660,239), and among women, 0.7% (1,338,132 vs. 1,328,791). Median provincial-year inconsistency was 6.7% (range: 0.2–21.8%) for men and 2.5% (range: 0.0–11.1%) for women, with four provinces showing marked discrepancies. While the Spectrum tool is representative and timely, it lacks interoperability with routine data systems despite its adaptation to new input sources. Conclusions: Although the data were valuable, the observed inconsistencies affected the indicators generated by the Spectrum model. Enhancements are recommended to improve the tool’s interoperability and flexibility, thereby accelerating the modelling of the HIV care cascade.