Promoting a culture of data use for evidence-based decisions in HIV programming:

INTRODUCTION Background: Quality data is critical for public health decision-making; however, adequate, high-quality data required to answer public health questions is not always available, particularly at sub-national levels. Triangulation is the practice of arraying different types of existing data from diverse sources to answer public health questions.The Tanzanian Triangulation Project was implemented to enhance understanding of the HIV epidemic at sub-national levels and promote a culture of data use among providers. Methods:We conducted triangulation workshops with regional-, district-, and facility-level HIV/AIDS service providers. Workshops included building capacity in MS Excel, DHIS2, and mapping software to produce visual data displays; support in carrying out the triangulation process; and the development of regional HIV triangulation reports to assess and address challenges affecting service provision.Results:Twenty-one workshops were completed covering 24 regions of Tanzania (mainland and Zanzibar) from 2009-2016. Participants were enthusiastic about seeing their data displayed visually in tables, charts and maps, often for the first time. Every workshop had data quality challenges and resulted in recommendations to improve data quality. Most (83%) participants reported learning new Excel skills, and among those, 86%reported using these skills after the workshop. Decision-makers at regional and district levels reported using their triangulation reports for strategic planning and decision-making. Conclusion: Triangulation is an effective means of using existing data when exhaustive data is not available to understand the HIV epidemic at sub-national levels. While more work is needed, triangulation promotes a culture of data use for evidence-based decisions in the HIV response in Tanzania.