Innovations in health and demographic surveillance systems to establish the causal impacts of HIV policies

Curr Opin HIV AIDS. 2015 Nov;10(6):483-94. doi: 10.1097/COH.0000000000000203.


Purpose of review: Health and demographic surveillance systems (HDSS), in conjunction with HIV treatment cohorts, have made important contributions to our understanding of the impact of HIV treatment and treatment-related interventions in sub-Saharan Africa. The purpose of this review is to describe and discuss innovations in data collection and data linkage that will create new opportunities to establish the impacts of HIV treatment, as well as policies affecting the treatment cascade, on population health and economic and social outcomes.

Recent findings: Novel approaches to routine collection of biomarkers, behavioural data, spatial data, social network information, migration events and mobile phone records can significantly strengthen the potential of HDSS to generate exposure and outcome data for causal analysis of HIV treatment impact and policies affecting the HIV treatment cascade. Additionally, by linking HDSS data to health service administration, education and welfare service records, researchers can substantially broaden opportunities to establish how HIV treatment affects health and economic outcomes when delivered through public sector health systems and at scale.

Summary: As the HIV treatment scaleup in sub-Saharan Africa enters its second decade, it is becoming increasingly important to understand the long-term causal impacts of large-scale HIV treatment and related policies on broader population health outcomes, such as noncommunicable diseases, as well as on economic and social outcomes, such as family welfare and children's educational attainment. By collecting novel data and linking existing data to public sector records, HDSS can create near-unique opportunities to contribute to this research agenda.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Anti-Retroviral Agents / therapeutic use*
  • Data Collection / methods*
  • Demography
  • Epidemiological Monitoring*
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control
  • Health Policy*
  • Health Services Research*
  • Health Status*
  • Humans


  • Anti-Retroviral Agents