The VIVA Process

A step-by-step program in 4 phases, 12 steps

VIVA systems are built through the collaboration of experts from government ministries of health and statistics, in partnership with global organizations.

The 12-step process for mortality surveillance begins with establishing governance, data ownership, stakeholder engagement, and mobilizing resources. It moves to assessing data needs, identifying gaps, and defining mortality indicators. A surveillance plan and sampling design are developed, followed by tool creation, testing, and ethical approvals. Digital systems and IT infrastructure are set up and tested while equipment and supplies are procured. Human resources are organized through recruitment and training. Clusters are mapped, and baseline households are listed with geo-coordinates. Routine data collection and transfer are initiated, leading to data analysis, integration, dissemination, and use. The process moves into a continuous cycle of assessment, adjustments, sustainability planning, and ongoing resource mobilization.

STEPS 1 - 3

Conception

STEPS 1 - 3

Phase 1: Conception

Decision makers determine the need for a data system and begin building strategies for system leadership, data ownership, and data collection. Stakeholders are identified and engaged.

STEPS 4 - 8

Planning

STEPS 4 - 8

Phase 2: Planning

An assembled team begins designing the system and identifying resources to bring it to life. Both human and digital resources are established, as well as mobilization of funds and allocation of infrastructure.

STEP 9

Launch

Phase 3: Launch

STEP 9

Staff begin data mapping efforts in clusters, as well as baseline household and population data collection.

STEPS 10 - 12

Maintenance

Phase 4: Maintenance

STEPS 10 - 12

Data collection is carried out in a stepwise manner until continuous collection is achieved. Data are continuously analyzed and shared with stakeholders, and reviewed for data accuracy. Sustainability should be prioritized throughout.

The 12 Steps - A step by step guide

  • This initial step lays the groundwork for engaging stakeholders and facilitates subsequent steps in implementing the system. It is important to obtain buy-in from in-country government leadership and stakeholders, and to consider budget and financing options to ensure continuous and long-term implementation. Institutional capacity, financial and human resources, and strategies for sustainability should be discussed and determined. 

  • This second step encourages a deeper understanding of the existing mortality data systems in-country, and how the new VIVA system will fit within the country’s current data landscape. You will determine key mortality indicators to be measured, and whether formative research activities should be carried out to identify community monitoring strategies and key actors. 

  • Various design options and strategies support continuous data collection: relying on an existing civil registration system, conducting annual household surveys, and continuously monitoring vital events in randomly selected geographic clusters.

  • Statistics measured, such as mortality rates, may be representative at the national and subnational (provincial/regional, or district) levels. It is important to define the sampling frame and the domains of statistical estimation. Once these are defined, a sample size can be calculated.

  • The tools needed for data collection are determined by the type of data that will be collected. Examples include a household population listing form, household registration form, and vital event recording forms.

  • Selecting the appropriate hardware and software is crucial for ensuring effectiveness. IT needs should be considered at the system’s central, provincial/regional, and community levels. 

  • Other equipment and supplies must be procured prior to the system’s launch. Items such as vehicles, motorbikes, bicycles, laptops and tablets, printers and office space should be considered. 

  • An organizational structure is required to manage staff, and a team of specialists at the central, provincial/regional, and community levels. Capacity building must be considered to ensure system longevity.

  • Prior to routine data collection and data monitoring, cluster mapping and population enumeration must be conducted. Cartography and baseline population activities must be carried out to create the foundation for routine system data collection.

  • Routine data collection may consist of household data and verbal autopsy interviews. Household data includes information on events such as pregnancies, pregnancy outcomes, and deaths.

  • Data analysis is important for monitoring incoming data, improving data collection, and for sharing results with national and international stakeholders.

  • To ensure data quality, system assessment processes should be incorporated into the design. This includes reviewing the data collection process, data quality and completeness, and its comparability with other data. The population listing, sample, and design may also be updated during this step.

Receive a Link to the Tools

Start implementing the VIVA program in your country? This step-by-step guide and set of tools will give you everything you need to successfully track mortality data and its causes and empower you to take meaningful action to prevent deaths and improve the health of your community. Just complete this form and you will receive a link by email. If for some reason you do not receive the link within a few minutes, please email us directly at viva@jh.edu.

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