Moldova national M&E system in HIV and AIDS Liliana Caraulan HIV Program Coordinator Center for Health Policies and Studies June 27, 2011

Rationale Government-based and Government-led National M&E System One of the 3-Ones of the National Response to HIV and AIDS Aim: provide quality data for evidence-informed strategic planning for the national response Legal basis – National M&E Plan approved by Government as integral part of NAP (GD no.1143 of ) Goal of the National M&E Plan: guide and coordinate the effective collection, analysis, aggregation and use of data for the assessment of progress trends in the national response to HIV/AIDS and for enhanced decision making process

Legal Framework NAP National M&E Plan M&E Operational Manual M&E Work Plan M&E calendar includes measurable and time-bound objectives with multi-year targets for both banks (Transdniester region included) includes indicators to track progress towards NAP results, baselines and targets; data sources; roles and responsibilities of stakeholders operationalizes M&E Plan describing a Framework of Results Hierarchy and associated indicators to track progress towards such results; includes annual targets for impact and outcome indicators costed and time-bound; including stakeholders roles and contributions

M&E system strengthening Regular M&E system participatory self-assessments – based on 12 Components Tool (2008, 2011) M&E system assessed at MTR and final Program Evaluation – Response Analysis 2010 Ongoing assessment for the M&E system performance Strengths and weaknesses – basis for developing and updating National M&E Plan, OM & WP Assess M&E system Develop/review M&E Plan/Work Plan Implement M&E Plan and Work Plan Follow-up

M&E System organizational framework 12 functional components

Organizational structures with function in HIV M&E National AIDS Center – coordination of program monitoring and internal data audits National Center for Health Management, M&E of National Programs Unit – data quality control and external audit Joint HIV/TB M&E TWG under the auspices of NCC – coordination of M&E Plan implementation Comp 1

Human Capacity for HIV M&E Capacity Building Strategy 2010 – 2013 as outlined in OM – revision planned in 2011 Annual NAP Capacity Building Plan 2011 – includes capacity building in M&E National capacity building register under development – database of trainings, persons trained and facilitators Capacity building register available at PR level Institutionalization of M&E training – M&E module in distance learning on HIV (SMPH); M&E module within MPH program Comp 2

Partnerships to plan, coordinate and manage the M&E system Operational M&E TWG Multi-sectorial participation as TWG members and invitees – including NGO and sub-national level TWG TOR under revision Quarterly meetings + ad-hoc meetings Meetings planned and minutes placed on Comp 3

M&E Plan and Costed M&E Work Plan National, multi-sectorial HIV M&E Plan Integral part of the NAP and specifies principles and organizational arrangements for monitoring and evaluation Aligned with the existing policies Developed through a participatory process Based on the findings of M&E system assessments Stipulates principles of data collection, aggregation, analysis and use for program implementation, provides information on key indicators, main data sources, information flow, information products and institutional responsibilities Includes tables with indicators definitions and roles & responsibilities of stakeholders Comp 4&5 National M&E Plan

M&E Plan and Costed M&E Work Plan (cont.) Structured around 12 components of the national HIV and AIDS M&E System Goals and objectives of national M&E plan Levels of M&E system, roles and functions across levels/sectors Data flow Target setting principles and methods, based on Universal Access principles Results framework, NAP & M&E plan, Indicators definitions by program area Data source for national indicators Comp 4&5 M&E Operational Manual

M&E Plan and Costed M&E Work Plan (cont.) National data depository (SIDATA) Systems for data quality assurance Supportive supervision and oversight Information products Dissemination of data for enhanced data use Capacity building strategy Advocacy and communication for HIV and AIDS M&E in Moldova Work Plan and budget estimates for M&E Implementation Cycle for National M&E Action / Work Plan Comp 4&5 M&E Operational Manual

M&E Plan and Costed M&E Work Plan (cont.) Biennium Costed National HIV M&E Work Plan Planned performance reviews – MTR, final evaluation Planned major data collection activities – IBBS, GPS, epidemiological studies including estimations & projections Time-bound and costed interventions to address M&E system weaknesses, structured around the 12 components Budgetary shortfalls estimated Implementing institution and partners indicated for each intervention Comp 4&5 M&E Work Plan M&E calendar

Communication, Advocacy and Culture for HIV M&E M&E Advocacy Plan for as annex to OM Information products detailed in OM (Ch.8), include: annual HIV and AIDS M&E report annual and semiannual report to GF annual UA, biennial UNGASS, MDG contribution (MDG 6) ad hoc information, etc. Dissemination channels described in OM ( , relevant websites, events and workshops, (e-)newsletters, etc.) Regular update of etc Commitment for M&E at decision making level Comp 6

Routine HIV Program Monitoring Data sources for national indicators - described in OM (Ch.4): administrative statistics and surveys Most program areas – IS: SIME-TB; SIME-HIV/STI; VCT; Unique Identifier; Methadone Register Most data collection at service-providers level – standardized, based on line protocols Inter-sectorial & NGO reporting – under development with good practices (MoLSPF, DPI of MoJ, SFM as an NGO Umbrella) Comp 7

Surveys and Surveillance Epidemiological surveillance - described in OM (Ch.4) New National Protocol on HIV Surveillance developed and currently under approval Regular data collection among: MARPS (2001, , 2007, ) - BSS Youth (2006, 2008, 2010) - KAP General population (2005, 2007, 2009, 2010) - KAP Surveys in: MARA ( ), PLHIV (2008), Migrants (2006, 2010), Employees (2008), Uniformed services Financed almost exclusively by donors Comp 8

National and Sub-national HIV databases National data depository (SIDATA) concept developed through extensive consultations and review of stakeholders data needs Data flows, roles and responsibilities described in National M&E Plan Piloting planned based of PR indicator sets Transdniester region - specific sub-national indicator set under development Comp 9

Supportive Supervision and Data Auditing Yet, most underdeveloped component OM – framework for data quality assurance and supportive supervision (Ch.6) Roles of NAC & NCHM in, respectively, internal and external audit Data validation mechanisms for routine program monitoring institutionalized Supportive supervision and data quality auditing in the framework of GFATM grants Supportive supervision - oversight functions of National AIDS Center for labs, VCT, epidemiologists Data quality guide developed Comp 10

HIV Evaluation and Research Agenda Evaluation and research outlined in the OM, WP Regular participatory performance reviews – MTR, final program evaluation Sector evaluations - Prevention; PMTCT Lessons learnt through complex multi-sectorial evaluations of former NAP (MTR, RA) & sector evaluations (Prevention; PMTCT) fed into development of NAP M&E TWG – coordination of research and evaluation Comp 11

Data Dissemination and Use Dissemination of data to stakeholders for enhanced data use is outlined in OM (Ch.9) , websites, e-newsletters, NCC Bulletin Media Formal dissemination workshops and events – feeding into national decision-making processes (example MTR, triangulation dissemination workshops followed by action plan development) Comp 12

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