1 Programmatic and M&E Risk Identification, Management, and Mitigation LFA M&E Training February 2014

Session objectives 1.Share best practices related to programmatic/M&E risks and mitigation actions 2.Familiarize with main tools (i.e. CAT) that can be used to identify and manage risk 3.Understand the standard LFA Scopes of Work for programmatic/M&E risk management 2

Session structure 1.Exercise: Best Practices in programmatic and M&E risk identification – 15 min discussion 15 min report back 2. Exercise: the CAT in action – 30 min discussion; 30 min report back 3. Standard LFA SOWs for Risk Identification Tasks – 30 min presentation 4. Q and A / Discussion 3

Exercise: Experiences in programmatic and M&E risk identification 4

Objectives of the exercise Brief overview presentation Break into 3 Thematic Sub-groups –Program design for coverage/impact –Quality and delivery of services –M&E and Data quality LFAs share Top 3 to 5 key risks and best practice Mitigation Actions, and discuss collective actions required Choose one rapporteur per Thematic Sub-group to report back to the plenary on: Top 3 to 5 key risks and Mitigation Actions, and collective actions required 5

Overview: program design for coverage/ impact What is the risk of poor program design? The possibility of: Not using data in future planning lack of good quality data --> lack of use of data --> poor program design Poorly designed implementation/service delivery arrangements Selected interventions being/becoming programmatically irrelevant Improper targeting of key affected populations Epidemiological changes not addressed by interventions Inadequate linkages between programs (e.g. TB/HIV) Insufficient level of coverage to reach impact Lack of or improper interventions to address structural barriers to access at community level “Right organization doing the right activities in the right place for the right populations” 6

Overview: quality and delivery of services 7 What is the risk of poor quality and delivery of services? The possibility of: Stock-outs of health products Insufficient links between communities and health providers Poorly defined and non-standardized service packages for community interventions Poor adherence to recognized guidelines Irrational use of health products Poor patient adherence and high lost to follow up Monitoring of adverse events Inadequate identification and activities to meet beneficiary needs

Overview: M&E and data quality What is the risk of poor M&E and Data Quality? The possibility of: Inadequate basis for target setting and performance-based funding Delayed reporting, potential delays in disbursements Inappropriate basis for forecasting health commodities Insufficient supervision and monitoring of risks Insufficient progress being made on agreed M&E systems strengthening activities Routine data collection systems are unable to capture time-sensitive health data Lack of analysis and data use Using data generated by routine systems in program reviews and/or evaluations 8

Directions for exercise 1.Please review and comment on the key risks identified for your Thematic Sub-group 2.Do you agree or disagree with the identified risks? Are any risks missing, if so, which ones? 3.What are some best practice actions to mitigate these risks? 4.What are the collective actions required, and by whom, to mitigate these risks? 5.What is the specific role of the LFA in mitigating each of these risks? 9

Exercise Feedback Template 10 QuestionResponse from each Sub- group Top 3 to 5 key risks Mitigation Actions Collective actions required

Group Work: The CAT in Action 11

Group work: the CAT in action A completed fictitious CAT has been developed and provided Please review the section completed by the PR and LFA Your task will be to generate recommendations based on the findings from this CAT There are three different completed CATs: -fragile state -CSS grant -large national program 12

Group work: the CAT in action Guiding Questions 1.How will the completion of a CAT differ based on the context of the grant, country, PR, etc.? 2.What are the challenges the LFA foresees in completing the CAT? 3.How can the LFA overcome these challenges? 13

Linking to M&E Systems Strengthening 14

Linking CAT to systems strengthening Assess systems Identify gaps / weaknesses Identify strengthening measures Follow-up on implementation CT experience LFA input CCM assessment of PR Document review (M&E plan, prog review, etc) OSDV/RSQA CAT rating and explanation Minimum standards Comprehensive assessment Ongoing dialogue Verification at PU/DR Conditional to use of funds CAT action plan Capacity building measures Risk mitigating actions Reprogramming 15

LFA Scopes of Work for Additional Targeted Tasks 16

1. Purpose of LFA targeted tasks Repeated difficulties in certain areas of M&E and program implementation SoW based on identified risk areas or areas in which more information is needed Intended purpose: strengthening M&E systems and addressing implementation bottlenecks 17

2. Purpose of LFA targeted tasks Intended use: case-by-case basis upon request from the Country Team LFA – as the entity on the ground – is well placed to conduct the assessment and provide specific recommendations SoW based on areas not covered by the current LFA Scope of Work 18

Specific areas Spot Checks HMIS Implementation Rollout Patient and Commodity Tracking Monitoring Services to Key Affected Populations Vital Registration 19

LFA Targeted Tasks SoW Document focuses on: −Importance of task −How to conduct the task −Deliverables −Additional requirements (as needed) 20

Deliverables All deliverables for the Targeted Tasks in the form of a concise report No templates developed (yet) Recommendations to be: −Detailed – with all the relevant information included −Specific and contextualised (country and grant) −Time-bound −Identifying the main entity responsible for implementation −Precise and prescriptive 21

Relevant expertise LFA Programmatic Health and M&E Expert to carry out the majority of the tasks outlined Should be complemented by inputs from the Procurement and Supply Management Specialist and/or Team Leader 22

Q&A 23