1. Effective HIV & SRH Responses among Key Populations in Myanmar
Module 4: Monitoring and Evaluation

2. Monitoring and Evaluation M&E and Using Data for Decision Making
Session 1
Monitoring and Evaluation
M&E and Using Data for Decision Making

3. Overview Monitoring & Evaluation – Why? The Core Package M&E Overview
Monitoring & Evaluation of Integrated Services - How?
The Data Feedback Cycle
Unique Identifier Codes
Defining true targets
Data Presentation
Using Data for Decision Making

4. Monitoring & Evaluation
Power of numbers
best practice
Resource
mobilisation
Stories behind statistics

5. The Core Package for HIV Prevention Amongst Key Populations in Myanmar
“Monitoring and Evaluation provides implementers, programme managers, decision makes and donors with information to assess the extent to which programmes are being implemented and objectives and impact achieved.
This information can demonstrate whether resources are being effectively employed, and inform the planning and design of future responses and resource allocation”

6. The Core Package for HIV Prevention Amongst Key Populations in Myanmar
Monitoring & Evaluation is recognised as a fifth element in the Core Package
All M&E Activities and Indicators are guided by Myanmar’s National M&E Plan which describes core indicators used to assess the performance and results of the national response
Recommends use of UIC system
Notes that national guidelines outlining
the frequency that key populations
should receive services still need
to be developed
Set of indicators at end of
each element chapter.

7. The Core Package for HIV Prevention Amongst Key Populations in Myanmar

8. Monitoring & Evaluation
Programme M&E systems are driven by:
Local data demands
Funding agency requirements
National M&E systems: The Three Ones
All work under different sets of indicators:
PEPFAR, USAID, DFAT Australian Aid
Global Fund, UNAIDS, UNGASS
National Indicators
“Rarely do you need to design new indicators. Resist the temptation. If you think it will be a better indicator than any other existing indicator, ask why no one else has used it before.”
David Pencheon

9. M&E of Integrated Services
Monitoring & Evaluation of Integrated Services
Avoid duplication of numbers
Establish early M&E framework among services
Align with one national system & reporting
Align with funding reporting requirements
Validate data through established mechanisms
Complete data feedback cycle with integrated service information distribution to KAPs

10. The Data Feedback Cycle
Data Collection
Data Management
Data Validation
Data Analysis
Data Translation
Data Feedback

11. The Data Feedback Cycle
Global Guidance
Group Check In:
The Data Feedback Cycle
Which steps of the Data Feedback Cycle are the strongest in organisations in Myanmar?
Which steps of the Data Feedback Cycle are the strongest for the national response in Myanmar?
Which steps of the Data Feedback Cycle require attention to improve HIV and SRH data quality and flow?

12. Unique Identifier Codes
Provide an anonymous and reliable system for tracking key populations through prevention, treatment and care services
A unique code for each individual is created, based on a combination of answers to 4-8 questions that are relevant to the specific context and epidemic of the country
M&E systems support monitoring of individuals, not absolute numbers, within and across outreach programs and health services.

13. Unique Identifier Codes
Promote monitoring of key populations and accurate tracking against targets by: Creating a confidential client recognition system that minimises barriers to HIV services for key populations Avoiding duplication in counting of clients attending services Identifying new individuals engaging with services Enabling analysis of treatment cascades Assessing mobility of key populations through outreach and health services Assisting reorienting of services to meet needs and attendance patterns of key populations

14. Unique Identifier Codes
Developing a UIC system
Establish a set of questions that elicit a unique code from individual (<2% repeat)
Mixture of letters and numbers is ideal
Easy to recall, consistent data that is acceptable to key populations and supports required disaggregation
Example questions:
First two letters of family name?
First two letters of mother’s maiden name?
First two letters of birthplace?
Right or left handed?
Gender (Male 1, Female 2, TG 3)
Last two digits of birth year?

15. Unique Identifier Codes
Developing a UIC system requires national dialogue and collaboration between health and programmatic local,
sub-national and national organisations.

16. Unique Identifier Codes
National Dialogue → National Implementation
Define the objective, the key populations and the UIC
Define method of data collection & develop tools
Pilot the UIC in defined outreach sites
Train pilot staff
Establish confidentiality and pilot study dialogue
Collect pilot data on feasibility & acceptability of UICs
Revise UIC protocol based on pilot study findings
Rollout UIC to outreach programs with training & tools
Pilot the UIC in defined health sites
Create connections between outreach and health data
National system tracking coverage of key populations
Reorient health and programme services to meet needs and mobility of key populations – minimum package of services
Ongoing evaluation, follow up & support for scale-up.

17. Unique Identifier Codes
Challenges with UIC systems
Initiating National Dialogue & Funding
Collaboration between national, sub-national and local health and programmatic partners
Change management: a new way of thinking
Setting realistic reach based targets
Transliteration in countries with multiple language scripts
Establishment of revised M&E systems and databases.
Establishing trust with key populations and assurance of confidentiality & anonymity

18. Unique Identifier Codes
Successes with UIC systems
Increased engagement of key populations with health and outreach services
Improved service focus on key populations
Population size estimates
Coverage data for individuals and populations
Minimum package of services targets:
Individuals receiving defined outreach and health services
Referrals and reporting collaboration
Definition of coverage required to reduce risk behaviours
Project partnerships and advocacy (regional response).

19. Unique Identifier Codes
COUNTING PEOPLE, NOT NUMBERS

20. Unique Identifier Codes
Group Check In:
Experience of Unique Identifier Codes?
Which programmes are using UICs?
What are the questions that form the UIC?
Challenges and opportunities of implementing UICs?
How has the programme addressed confidentiality?
How is the UIC data collected and managed?
How is the UIC data used?
Have UICs improved experience of services by key populations?

21. Treatment Cascade Where does data for each level generate from?
Key Populations Living with HIV
KPs with HIV that access testing
KPs with HIV that know and understand their result
KPs with HIV that are linked to treatment, care and support services
KPs with HIV start ART
KPs with HIV maintain viral suppression
Where does data for each level generate from?

22. Defining True Targets Use of UICs demands revision of targets
Lower targets justified by greater accuracy (no duplication)
Aim for SMART targets in line with national guidelines
In absence of national guidelines, speak
with other local programs, funders
and review international guidelines
Grade targets and celebrate milestones
Improve systems to improve data

23. Conclusion
Monitoring & Evaluation of Integrated Services presents challenges and opportunities for measuring engagement of key populations across prevention, treatment and care
Indicator sets should align with national and funding systems
Population Size Estimates provide a denominator in measurement of programme success
A Comprehensive Package of Services defined interventions to be monitored
Reduced targets are not negative reflections of practice but positive steps towards accurate measurements
Good M&E is innovative and supports the complete data feedback cycle

24. Monitoring & Evaluation
THANK YOU

25. References
Baldwin, S., Boisen, N., & Power, R. (2008). Managing information: Using systematic data collection to estimate process and impact indicators related to harm reduction services in Myanmar. The International Journal of Drug Policy, 19S, S74-S79. doi: /j.drugpo
DDRP. (2007). DDRP Best Practice Collection: Unique Identifier Code.
Fielden, S. (2013). Protocol: Creating the UIC Code & Evaluation Plan. Tools for Establishing UIC in HIV Outreach for Key Populations in Morocco.
Gray, R. & Hoffman, L. (2007). Tracking coverage on the silk road: Time to turn theory into practice. The International Journal of Drug Policy, 19S, S15-S24. doi: /j.drugpo
Thien Nga, N., Jacka, D., Van Hai, N., Kieu Trinh, N., Boisen, N., & Neukom, J. (2012). Innovative data tools: a suite for managing peer outreach to key affected populations in Viet Nam. WPSAR, Vol.3, No.3, doi: /wpsar
UNAIDS. An introduction to indicators.