Enhancing ART Monitoring and Evaluation with Biometric Data Capture: A Success Story from Adamawa State, Nigeria.


The Adamawa ACE1 program, dedicated to providing antiretroviral therapy (ART) to HIV clients, encountered a significant challenge in ensuring the accountability of all clients reported on ART. By January 20, 2023, 8,423 active clients, constituting 22% of those on treatment, had not undergone biometric data capture. To address this, the program initiated a focused effort to capture the biometrics of all outstanding active clients within a strict two-week time frame.


The team embarked on a multifaceted approach, deploying the principles of Total Quality Leadership and Accountability (TQLA) across three strategic prongs:

Prong 1: Evaluation of biometric capturing devices’ availability and functionality in facilities with pending client captures. 

Prong 2: Establishment of a 3-layered biometric drive management committee, facilitating coordination and daily/weekly performance reviews, and addressing challenges at the state, facility, and community levels.

Prong 3: Strategic deployment of resources across identified facilities for on-site client captures and community-based efforts, integrating financial, human, and material resources efficiently.

Budget allocation was meticulously planned based on service data, covering biometric captures, viral load sample collection, ARV refill, and extending support to communities unreachable by phone calls. This integrated approach optimized financial, human resources, and time management, aligning seamlessly with the TQLA methodology.

Results: Despite a slow start, the initiative gained rapid momentum by day 4, leveraging community teams and mobile biometric devices. Within 10 days, 60% (5,088 of 8,423) of the biometric gap was bridged, achieving an astounding 97.8% client capture by February 28, 2023 (Figure 1.0).

Figure 1.0 Chart highlights the steep rise in biometric capture after the community teams and mobile biometric devices were deployed on day 4.

Impact: This initiative, rooted in the principles of Total Quality Leadership and Accountability (TQLA), revolutionized ART accountability in Adamawa State, setting new standards for program monitoring and evaluation. Notably, it played a pivotal role in achieving the UNAIDS 95-95-95 targets, crucial for HIV control. The success story serves as a testament to the power of TQLA in driving transformative change and ensuring exceptional standards of care and accountability.

Call-to-Action: The success of this initiative can be replicated in other states and countries facing similar challenges with ART accountability. The use of biometric data capture can significantly improve the monitoring and evaluation of HIV programs, leading to better health outcomes for clients.