1. OVC Monitoring, Evaluation and Reporting Strategy (“the MER”)
Feb 20-21, 2014
Pretoria, South Africa
OVC HQ Technical Working Group
©USAID/ Tash McCarroll

2. OVC MER Strategy – Moving Towards Outcomes
New OVC MER strategy is a critical and positive shift toward a comprehensive, outcomes based strategy for showing impact
USG investments in OVC programs substantial, but impact mostly undocumented.
Challenges to understanding impact: lack of standardized measures and tools tailored to OVC population & child well-being
OVC TWG & Measure developed set of core quantitative child outcomes and caregiver/ household outcomes tools
Toolkit formed strong foundation to build a new set of indicators and global strategy when OGAC commissioned a new MER strategy.
Pilot-tested in Zambia and Nigeria; Translations to French in progress

3. Specific Shifts in Data Collected
Emphasize program effectiveness & outcomes
Reflects 2012 PEPFAR OVC Guidance- developmental milestones across ages/stages
Track coverage: active beneficiaries for OVC
Track contribution to Continuum of Response
Elevate core indicators from OVC Survey toolkit
Emphasize program effectiveness and outcomes—child, caregiver, household
There are 3 output indicators and all the rest are outcome indicators
Systems Indicators
For workforce, social protection, finance)

4. OVC Indicators in the MER
MER Code
NGI Code
Indicator Description
Reporting Level
FY 14
Targets and results
FY 15
OVC_SERV
New. Replacing C1.1.D <18
Number of active beneficiaries served by PEPFAR OVC programs for children and families affected by HIV/AIDS 1 √
OVC_ACC
N/A –new indicator
Number of active beneficiaries receiving support from PEPFAR OVC programs to access HIV services
OVC Outcome Indicators Package (special studies)
OVC_HIVST
N/A- new indicators
Percent of children whose primary caregiver knows the child’s HIV status 2
Budget and Plan
No Targets required
OVC_NUT
Percent of children <5 years of age who are undernourished
OVC_SICK
Percent of children too sick to participate in daily activities
OVC_BCERT
Percent of children who have a birth certificate
OVC_SCHATT
Percent of children regularly attending school
OVC_PRGS
Percent of children who progressed in school during the last year
OVC_STIM
Percent of children <5 years of age who recently engage in stimulating activities with any household member over 15 years of age
Child Protection Indicator
OVC_CP
% eligible households able to access money to meet important family needs

5. REPLACED C1.1.D- OVC_SERV
Number of active beneficiaries served by PEPFAR OVC programs for children and families affected by HIV/AIDS
Indicator REPLACES Umbrella CARE starting in FY14
Implications:
Overall intent is comparable to old indicator: Measures coverage
More specific: uniquely OVC-related vs. overlap with clinical care
Defines “active beneficiary” as receiving quarterly contact-aligns with criteria needed to meet direct support definition
Clarification of who is counted is anticipated to improve quality of data
Targets will still be set at country level to ensure good coverage (i.e. there will be an expected consistency of numbers going forward) however they will not be tracked against a global number.
-          New indicator is comparable to old - refined rather than retired fully. Will highlight - tracking coverage rather than looking for global number
-          This is a positive shift for OVC programs since this allows for an emphasis on outcomes rather than ultimately meaningless outputs (numbers) as well as a shift toward systems strengthening and country ownership without concerns over achieving a target based only on head count.

6. OVC Level 1 Indicators-OVC_SERV
Indicator code:
OVC_SERV 1
Number of active beneficiaries served by PEPFAR OVC programs for children and families affected by HIV/AIDS
NGI Mapping:
C1.1.D <18 disaggregation continuing – significant modification in definition; trend analysis will be impacted
PEPFAR Support Target/Result Type:
Both Direct Service Delivery (DSD) and Technical Assistance-only (TA-only) targets and results should be reported to HQ
Numerator: 1
Number of active beneficiaries served by PEPFAR programs for children and families affected by HIV/AIDS
Denominator:
N/A
Disaggregation(s):
Sex: Male, Female
Age: <1, 1-4, 5-9, 10-14, 15-17, 18+
Data Source:
Registers, organization records, or other program monitoring tools
Data Collection Frequency:
Data should be collected continuously as part of service delivery. Data analysis and review should be done semi-annually, in time for PEPFAR reporting cycles to monitor progress towards achieving the targets and to identify and correct any data quality issues.
PEPFAR MER Introduction 2013_11_21

7. PEPFAR MER Introduction 2013_11_21
OVC Level 1 Indicators
Indicator code:
OVC_SERV 1
Number of active beneficiaries served by PEPFAR OVC programs for children and families affected by HIV/AIDS
Method of Measurement:
The indicator is generated by counting the number of active beneficiaries (children or caregivers) who received at least one PEPFAR service from facilities and/or community -based organizations (see definition of an ‘active beneficiary’ below). To reduce the burden of counting on organizations providing services, registers with names of children who meet the criteria for “active beneficiary” are sufficient for generating the number included in this indicator. The types of OVC programs required to report on this indicator are outlined in the 2012 PEPFAR OVC Guidance and are those designed to address critical care needs.
Explanation of Numerator:
Active beneficiary is defined as an individual who has received program services in the last three months and who is scheduled to receive program services at least once every three months, as outlined in program guidelines or standards of practice. New beneficiaries who only registered in the last quarter will be counted as active even if they have not yet received services. Partners will report on the number of beneficiaries on their “active” registries. Partners will not be required to count the number of individuals receiving services at each reporting period.
PEPFAR MER Introduction 2013_11_21

8. OVC Level 1 Indicator: OVC_ACC
Number of active beneficiaries receiving support from PEPFAR OVC programs to access HIV services
This is a direct output indicator that measures the number of children and/or caregivers who are referred to and enabled to access HIV-related services. The data obtained from this indicator can inform cross-program planning including PMTCT, pediatric and adult HIV testing, and treatment programs.
 Learning year-2014; Report starting in FY15
PEPFAR OVC programs serve children who are at high risk of becoming HIV infected, either through mother-to-child transmission (MTCT) or sexual transmission. It is important for OVC programs to link potentially HIV-exposed infants and/or their caregivers to PMTCT programs and to connect those at risk of acquiring HIV, particularly adolescents, to HIV testing and counseling. Furthermore, it is critical for OVC programs to connect HIV-infected children with treatment, counseling and support services.
This is a direct output indicator that measures the number of children and/or caregivers who are referred to and enabled to access HIV-related services. The data obtained from this indicator can inform cross-program planning including PMTCT, pediatric and adult HIV testing, and treatment programs.
This indicator will enable PEPFAR headquarters to:
Gain a basic, but essential, understanding of the support OVC programs provide to their beneficiaries to enable them to access HIV-related services.
Provide important information to stakeholders about the OVC contribution to the clinical goals of the PEPFAR continuum of response.
Triangulate data with other OVC output indicators to track levels of OVC services provided across all PEPFAR countries over time.
At the country level, this indicator will enable PEPFAR country teams, governments, implementing partners, and other in-country counterparts to:
Help assess whether OVC support services are being delivered.
Identify programmatic gaps by analyzing the number and ages of people receiving support to access clinical services, as well as the reach of services in particular geographic areas.
Advocate for greater resources and technical assistance to enable OVC programs to contribute to the continuum of response.

9. PEPFAR MER Introduction 2013_11_21
Level 2 Indicators
PEPFAR MER Introduction 2013_11_21

10. Reminder: Distilling core indicators
Our starting point: 6+1 domains of PEPFAR OVC programming
Step 1: Extensive literature search
Step 2: Gaps (HES, PSS) filled through targeted research
 Result: >600 child/HH wellbeing questions/indicators
Step 3: Analysis against 8 criteria
 Result: shorter list of questions for discussion

11. Biennial (every two years) Greater Age Disaggregation – all indicators
Highlights of MER Outcomes Package: Data Collection for Improved Quality
Biennial (every two years)
Greater Age Disaggregation – all indicators
Utilize trained data collections external to service delivery
Relieve burden of front line service providers
Build on capacity of local research institutions

12. OVC OUTCOMES PACKAGE – LEVEL 2
Outcomes Package- Quality*
% <15 whose primary caregiver knows their HIV status
% children <5 who are undernourished
% children who are too sick to participate in daily activities
% children who have a birth certificate
% children regularly attending school
% children who progressed in school during the last year
% eligible children <5 years who engaged in stimulating activities with household members over 15 years of age
Child Protection indicator (in development)
% eligible households able to access money to meet important family needs
* See Survey Toolkit:

13. PEPFAR MER Introduction 2013_11_21
Added MER Level 2 indicators (not in current version of Survey Toolkit)
Percent of children whose primary caregiver knows the child’s HIV status
Child Protection Indicator (in development)
PEPFAR MER Introduction 2013_11_21

14. STAY TUNED FOR…
OVC SPECIFIC MER SUPPLEMENTAL: TECHNICAL GUIDANCE FOR PLANNING AND IMPLEMENTING SPECIAL STUDIES (Forthcoming, May 2014)
* See Survey Toolkit:

15. Indicator Reference Sheet (Level 2)
Indicator: NC.1
Percent of < 15 whose primary caregiver knows their HIV status
Indicator Type
Outcome
Numerator:
Number of active beneficiaries <15 years of age whose primary caregiver knows the child’s HIV status
Denominator:
Number of active beneficiaries surveyed
Disaggregation(s):
Required:
Sex: male, female
Age group: <1, 1-4, 5-9, years, 15-17
Data Source:
Special Study
Data Collection Frequency:
Biennially

16. Indicator Reference Sheet (Level 2)
Indicator: CW.1
Percent of children <5 years of age who are undernourished
Indicator Type
Outcome
Numerator:
Number of active beneficiaries <5 years of age with physical growth below international growth standards
Denominator:
Number of active beneficiaries <5 years of age surveyed
Disaggregation(s):
Required:
Sex: male, female
Age group: 6-11 months, 1-4 years of age
Data Source:
Special Study
Data Collection Frequency:
Biennially

17. Indicator Reference Sheet (Level 2)
Indicator: CW.4
Percent of children too sick to participate in daily activities
Indicator Type
Outcome
Purpose:
Numerator:
Number of active beneficiaries who are too sick to participate in daily activities
Denominator:
Number of active beneficiaries surveyed
Disaggregation(s):
Required:
Sex: male, female
Age group: <5 years, 5-9 years, 10-14, years
Data Source:
Special Study
Data Collection Frequency:
Biennially

18. Indicator Reference Sheet (Level 2)
Indicator: CW.9
Percent of children who have a birth certificate
Indicator Type
Outcome
Numerator:
Number of active beneficiaries who have a birth certificate
Denominator:
Number of active beneficiaries surveyed
Disaggregation(s):
Required:
Sex: male, female
Age group: <1, 1-4, 5-9, 10-14, 15-17
Data Source:
Special Study
Data Collection Frequency:
Biennially

19. Indicator Reference Sheet (Level 2)
Indicator: CW.11
Percent of children regularly attending school
Indicator Type
Outcome
Numerator:
Number of active beneficiaries aged 5-17 years of age regularly attending school
Denominator:
Number of active beneficiaries aged 5-17 years surveyed
Disaggregation(s):
Required:
Sex: male, female
Age group: 5-9 years, years, years
Optional:
Further disaggregation by age, particularly within the 5-9 age group may be useful at the national level as often children do not begin school until the age of 6 or 7.
Data Source:
Special Study
Data Collection Frequency:
Biennially

20. Indicator Reference Sheet (Level 2)
Indicator: CW.12
Percent of children who progressed in school during the last year
Indicator type
Outcome
Numerator:
Number of active beneficiaries aged 5-17 years of age who progressed in school during the last year
Denominator:
Number of active beneficiaries surveyed who were enrolled in school during the previous year
Disaggregation(s):
Sex: male, female
Age group: 5-9 years, years, years
Optional:
Further disaggregation by age, particularly within the 5-9 age group may be useful at the national level as often children do not begin school until the age of 6 or 7. It may also be useful to disaggregate by primary and secondary school.
Data Source:
Special Study
Data Collection Frequency:
Biennially

21. Indicator Reference Sheet (Level 2)
Indicator: CW.13
Percent of children <5 years of age who recently engage in stimulating activities with any household member over 15 years of age
Indicator Type
Outcome
Numerator:
Number of active beneficiaries <5 years who have engaged in stimulating activities with any household member over 15 years of age during the last 3 days, as reported by an adult
Denominator:
Number of active beneficiaries <5 surveyed
Disaggregation(s):
By sex: Male, Female
By age group: 0-11 months, months, 2-4 years
Data Source:
Special Study
Data Collection Frequency:
Biennially

22. Indicator Reference Sheet (Level 2)
Indicator: HW.2
Percent of households able to access money to meet important family needs
Indicator Type
Outcome
Numerator:
Number of active beneficiary households able to access money to meet important family needs
Denominator:
Number of households surveyed that contain at least one active beneficiary
Disaggregation(s):
Optional:
Location: urban, rural
Data Source:
Special Study
Data Collection Frequency:
Biennially

23. Indicator Reference Sheet (Level 2)
Indicator: CW.14
Child Protection Indicator (to be defined)
Indicator Type
Outcome
Numerator:
Denominator:
Disaggregation(s):
Data Source:
Special Study
Data Collection Frequency:
Biennially

24. LET’S KEEP DISCUSSING!