NASTAD Global Supports Data for Action in Central America, Part I

By Luisa Pessoa- Brandão October 23, 2015

“Data is much more than a collection of facts and figures…Data enables us to do more with each dollar we invest, reaching more individuals, families and communities with lifesaving HIV prevention, care, and treatment services.”

- Ambassador Deborah Birx, U.S. Global AIDS Coordinator, Inaugural Africa Open Data Conference, 2015

In order for a country to have the ability to effectively respond to their HIV epidemic, quality data must be available, reviewed, and used to generate that response. Epidemiological surveillance data define where the greatest needs and gaps are so that government knows what to do, where, and when. Having strong systems and process in place that can generate reliable data in a routine manner—and human resources to use and manage them—ensures that evidence-based public health interventions can be planned to “do the right things, in the right places, at the right time.”

NASTAD Global is supporting four countries in Central America, Belize, Costa Rica, Guatemala, and Panama, to strengthen and institutionalize their surveillance methods such that epidemiological trends can be assessed and critical HIV service and program gaps can be identified and addressed.  This is the first post in a two-part series on NASTAD Global's many surveillance related activities throughout the region.


Once home to a major Mayan population numbering two million between 250-900 AD, today Belize is a country of about 350,000 with an economy driven primarily by tourism. An estimated 3,200 people are living with HIV (PLHIV) in Belize today; the HIV prevalence rate among adults aged 15-49 is 1.2%, the highest prevalence in the Central America region and the fourth highest in the Caribbean region.

NASTAD staff and our Belize Ministry of Health partners.

In 2004 the Belize government implemented an electronic medical record system called the Belize Health Information System (BHIS), which was designed to support evidence-based clinical decision making with reliable health data. The Belize Epidemiology Unit has used the BHIS in the years since for HIV case-based surveillance, allowing for the collection of individual-level HIV data and an understanding of each individual’s progression through the continuum of care. 

While case-based surveillance has generated strong, high quality data for clinical decision making in the past years, the case surveillance data collection and reporting processes had never been documented or standardized. The Belize Ministry of Health sought NASTAD’s technical support in developing a Standard Operating Procedure Manual (SOP) for the HIV case surveillance system, in order to document, standardize, and provide necessary information and guidance on the management and utilization of the HIV case surveillance system.

Over the past six months, NASTAD has worked with the Belize Epidemiology Unit to develop an SOP and accompanying job aides, which will be used for routine management of the HIV case surveillance system and data, and ultimately as teaching tools to ensure transfer of knowledge to new staff. The SOP will provide a foundational reference document to be continuously refined and developed as the Belize HIV case surveillance system expands and matures.

Costa Rica

Costa Rica is another Central American country known for its lush, beautiful landscapes and strong tourism industry. However, Costa Rica stands apart from its Central American neighbors due to its strong political stability, high standard of living, and expansive social benefits system. The Costa Rican governments seeks to provide universal access to health care for its population of 4.8 million, among which an estimated 8,800 people are living with HIV (prevalence among adults aged 15-49 is 0.3%).

Costa Rica has had name-based HIV reporting since the beginning of the epidemic, however the data is currently kept in several separate datasets, making it challenging to analyze the progression of an individual through the HIV infection continuum. NASTAD Global staff and TA provider Christian Hague, an epidemiologist at the Massachusetts Department of Health and Human Services, are working in partnership with the Epidemiology Unit of the Costa Rica Ministry of Health (MoH) to consolidate these datasets into one unified, de-duplicated dataset. Once the data has been de-duplicated and consolidated, NASTAD will assist the MOH with uploading the existing information to the new electronic surveillance system that all public clinics will be using to report. The new system will allow Costa Rica to more easily and effectively generate a national HIV Care Continuum and identify HIV service and program gaps that need to be addressed.  

If you are interested in learning more about NASTAD Global’s efforts supporting data for action in the Central America region, please check back next week for Part II of this series, or contact Luisa Pessoa-Brandao.

Visit to learn more about NASTAD Global.