1. February 4-6 2002 Dakar, Senegal
STRENGTHENING MONITORING and EVALUATION of NATIONAL AIDS PROGRAMMES in the CONTEXT of the EXPANDED RESPONSE
February
Dakar, Senegal

2. Monitoring AND Evaluation
Monitoring: What are we doing?
Tracking inputs and outputs to assess whether program are performing according to plans
(e.g. people trained, condoms distributed)
Evaluation: What have we achieved?
Assessment of impact of the programme on behaviour or health outcome
(e.g. condom use at last risky sex, HIV incidence)
Surveillance: monitoring disease
Spread of HIV/STD
(e.g. HIV prevalence among pregnant women)

3. A FRAMEWORK for Monitoring and Evaluation
Input Process Output Outcome Impact
People
money
equipment
policies
etc.
Services
Service use
Knowledge
HIV/STI
transmission
Reduced
HIV impact
Training
Logistics
Management
IEC/BCC
etc.
Behaviour;
Safer
practices
(population
level)

4. DATA COLLECTION for Monitoring and Evaluation
Input Process Output Outcome Impact
HIV/STI
surveillance
Household
Surveys
Facility
surveys
Programme Monitoring

5. INITIATIVES for Monitoring and Evaluation
Input Process Output Outcome Impact
Household Surveys
Facility surveys
Programme Monitoring
HIV/STI
surveillance
Multi-sectoral AIDS (MAP) program
Monitoring and Evaluation
Second generation
surveillance
USAID / CDC Expanded response
Monitoring and Evaluation
United Nations General Assembly Special Session (UNGASS)
Monitoring and Evaluation

6. Senegal Jamaica Thailand Uganda
MONITORING and EVALUATION at the NATIONAL LEVEL: NATIONAL SUCCESS STORIES
Uganda
Senegal
Jamaica
Thailand

7. behaviour be attributed to interventions / programs?
Did the National Response Make the Difference?
Input Process Output Outcome Impact 1
HIV
prevalence
changing! 2
Can the changes
in HIV prevalence
be attributed
to changes in
behaviour?? 3
Can the changes in
behaviour be attributed to
interventions / programs?

8. The components of AIDS programmes
Input Process Output Outcome Impact
IEC programs: knowledge, attitudes
Condom promotion and distribution
School programs: adolescent KAP
Targeted interventions (e.g. CSW, IDU)
Control of STDs
Voluntary counselling and testing
Reduction of mother-to-child transmission
Blood safety, prevention nosocomial transmission
Care & support programs (including ARV)

9. Global Initiative to Improve M&E of AIDS programs at the National Level
Goal: To help countries develop sustainable and effective M&E systems
Coordination: UNAIDS, WHO, USAID, CDC in collaboration with World Bank, European Commission, FHI, MEASURE and many others

10. Global Initiative to Improve M&E of AIDS programs at the National Level (2)
Process:
1998 Review of existing practices, systems and instruments (13 countries);
: four consensus-building / technical meetings with stakeholders
2000: Publication of UNAIDS guide (English)
2001: Publication of UNAIDS guide (French)
Country workshops (Africa - 25 countries)
April Entebbe
Feb Senegal
Apr Kampala (training in M&E)
Apr Dakar
Coordination: MERG, GAMET

11. Lesson Learned: 5 Elements of a Good Monitoring and Evaluation System
Presence Monitoring and Evaluation unit
Clear goals and objectives of the program
A core set of indicators and targets
A plan for data collection and analysis
A plan for data dissemination

12. Monitoring and Evaluation Unit
Not so
good
GOOD
Established M&E unit within the NAC and MoH
Specific expertise in or affiliated with the unit: (M&E, epi, behavioural, statistics, data dissemination)
Budget (10% of the national AIDS budget with national contribution)
Formalised links with the research institutions, leading NGOs and donors
No functioning unit for M&E
1 or 2 persons responsible for the whole country
Very limited resources for M&E
No formalised links with technical and other resources

13. Clear goals and objectives
Not so
good
GOOD
Well-defined national programme goals and targets - M&E plan
Regular reviews/evaluations of the progress of the implementation of the national programme plans
Guidelines and guidance to districts and regions or provinces for M&E
Guidelines for linking M&E to multiple sectors
Co-ordination of national and donor M&E needs
National strategic plan has no specific goals and objectives
No system of ongoing assessment with programs reviews and built-in evaluation
Limited coordination with districts and regions
Limited coordination between sectors
Donor-driven M&E system

14. A set of indicators (and targets)
Not so
good
GOOD
A set of priority indicators and additional indicators that cover programme monitoring, programme outcomes and impact - M&E plan
Selection of indicators through process of involving multiple stakeholders and maintaining relevance and comparability
Utilization of past and existing data collection efforts to assess national trends (e.g. DHS)
No indicators or indicators that cannot be measured
Indicators that cannot be compared with past indicators or with other countries
Indicators are only used for donors and each donor has its own set of indicators
Indicators are irrelevant to those who collect the data
Each district or sector uses its own indicator

15. Data collection and analysis plan
Not so
good
GOOD
An overall national level data collection and analysis plan, linked to the national strategic plan
A plan to collect data and analyse indicators at different levels of M&E (programme monitoring)
Second generation surveillance, where behavioural data are linked to HIV/STI surveillance data
M&E is an ad hoc activity without a plan, mostly driven by donors
Data are collected but not analysed sufficiently / utilized
There is no systematic monitoring of programme inputs and outputs

16. Data dissemination plan
Not so
good
GOOD
Overall national level data dissemination plan
Well-disseminated informative annual report of the M&E unit
Annual meetings to disseminate and discuss M&E and research findings with policy-makers and planners
Clearinghouse / Resource centre at national level
Dissemination is ad hoc and not planned or coordinated
Annual surveillance report is much delayed not user friendly and not well disseminated
Dissemination to the districts and regions is not done
Dissemination activities are donor driven