NDPHS Expert Groups' meeting Vilnius Proposal for indicators for projects submitted and implemented under NDPHS Pauli Leinikki chairman of the expert group for HIV/STI

NDPHS Expert Groups' meeting Vilnius Example: HIV EG/Policy priorities defined by the expert group and approved by CSR: Priority areas: 1.Surveillance 2.General awareness, policy development 3.Legislation, national policies 4.Prevention 5.Treatment, care and support

NDPHS Expert Groups' meeting Vilnius Promote effective VCT with special emphasis on reaching the vulnerable groups. (low-threshold centers, outreach activities, anonymous testing, technical improvements) How many VTC sites have special activities/ programmes (define!) for vulnerable groups? (P)* Which groups are included (IDU, CSW, MSM, young people, migrants, prisoners, other?) (P) To what extent rapid testing or comparable services are provided for clients? (Op) Access to (anonymous) VCT should be easy and nondiscriminating and coverage should be monitored on a regular basis. Surveillance should cover the entire country/region with equal efficacy How big proportion of IDU:s and CSW:s are covered by the easy access activities? (Op) Are there agreements with law-enforcing officials to get undisturbed function? (P) How many regions/municipalities have VTC-sites with special programmes towards vulnerable groups? (Oc) Second generation surveillance should be promoted to receive information about changes in risk behavior and other, societal exposing factors. How many VTC sites collect information within the frame of second generation surveillance? (Oc) Example : Surveillance: Objectives:Criteria: *P= Programmatic indicator, Op = Output i, Oc = Outcome i

NDPHS Expert Groups' meeting Vilnius Example 2: Treatment, care and support: Develop a network of diagnostic laboratories to enable monitoring of disease progression, evaluation of treatment success and resistance testing in case of treatment failure. List and describe diagnostic laboratories.(P) Common EQA established? (Op) Activitites and training programmes lilnked to them? (Op, Oc) Strengthen NGOs and communities in their role in supporting home-based care and clinical management of infected persons Support to self-help groups? (P) Support to home-based care? (P) Need for DOTS-type arrangement? (Oc) Establish and develop effective education of HCW in counseling and care of HIV-infected people and AIDS patients Education and training of professionals (Op, P) Objective:Criteria: *P= Programmatic indicator, Op = Output i, Oc = Outcome i

NDPHS Expert Groups' meeting Vilnius Why predefined indicators? Project design: –compliance with ”political” objectives of the program –harmonisation of project structure and design Financing: Easy access to objectives and expected outputs Monitoring and evaluation: standardised procedures and criteria

NDPHS Expert Groups' meeting Vilnius Three levels of indicators: 1.Programmatic 2.Output 3.Outcome

NDPHS Expert Groups' meeting Vilnius Programmatic indicators Demonstrate activities that have been completed to establish or enhance implementation Examples: Training seminars, consultative meetings, established counceling of individuals

NDPHS Expert Groups' meeting Vilnius Output indicators Demonstrate outputs that have been achieved that help the project to reach its overall objectives. Examples: Training material that has been produced, new administrative structures, new resources, number of individuals counceled etc.

NDPHS Expert Groups' meeting Vilnius Outcome indicators Demonstrate that a desired change has taken place as a result from the activities of the project. Examples: Decreased incidence of infections among IDU:s, new legislation adopted to support the rights of PLWHA.

NDPHS Expert Groups' meeting Vilnius Use of indicators The project objectives and expected outputs and outcome are linked with the overall objectives and priorities of NDPHS through predefined indicators Project design should include suggestions for monitoring and evaluating the indicators

NDPHS Expert Groups' meeting Vilnius A practical example Project: Establish a low-treshold support center for injecting drug users in M to decrease the spread of HIV and alleviate the medical and social problems. Programmatic indicators: Training system organised, political discussions, site visits Output indicators: establishment of operating LTC:s in M, performance indicators for them. Outcome indicators: Change in HIV epidemiology, changes in legislation, collaboration established with Tb-programme

NDPHS Expert Groups' meeting Vilnius Practical proposal The expert groups produce a simple list of objectives/priorities for their own field/work and a list of indicators in each of the before mentioned ”class”. This list is then published in the web and when projects are submitted, links to individual items on the lists are given.