Strategies for M&E by a Global Fund PR: CHAZ experience Catherine Mulikita 23-26 February 2009 Kampala Uganda www.chaz.org.zm 2009

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Content CHAZ profile History of the CHAZ GF Programmes M&E Strategies - Key M&E indicators for the Programmes - Data collection and management: data flow mechanisms - Challenges - Solutions to challenges “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 CHAZ Profile 1970 CHAZ was established in 1970 as an interdenominational (Catholic and Protestant) Umbrella organization for 131 Church Health Institutions (CHIs) and Community Based Programmes. CHIs are located in all the 9 Provinces of Zambia, in 54 Districts. The CHAZ membership comprises of 31 Hospitals (inclusive of The 9 Training Schools), 74 Rural Health Centres and 26 Community Based Programmes (including 9 Catholic Dioceses). CHAZ provides 30% of Health Services in Zambia and over 50% in rural areas. We are in 9 Provinces and 54 Districts CHAZ signed a Memorandum of Understanding with the GRZ (MoH). Through it, the MoH has been seconding Health Workers to CHIs and providing 75% of funds for their running cost. Establishment 2008 Membership Coverage CHAZ-GRZ Partnership “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 GF Health Programmes Components HIV/AIDS Malaria Tuberculosis Control IGA Programmes “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 History of CHAZ GF Programmes PR CHAZ became one of the GF’s 4 PRs in 2003. Framework CHAZ has its own systems which feed into the national system Implements its GF programmes within the framework of the national programmes. Role To contribute to the national reduction of the 3 disease burdens (ATM). M&E Has scaled up services in CHIs and their respective communities. Monitors GF programmes in line with the national monitoring and reporting systems. “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 M&E Strategies Key Indicators Each disease component has key indicators which are tracked from community to health facility to CHAZ. The key indicators feed into the national system. M&E Monitoring and collection of community level indicators is facilitated by Community Based Volunteers who are supervised by Health Workers in the respective CHIs “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 GF Programmes Key Indicators GF Key Indicators HIV/AIDS Malaria Tuberculosis ITNs Distributed TB Cases Successfully Treated PLWHAs on ART PLWHAs on Nutritional Supplement U5 All Cause Mortality HIV+ with TB HIV+ Women on MTCT Prophylaxis New Smear Positive TB Cases Detction PLWHAs on HBC OVC Supported “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Data Flow Mechanism Provincial Health Office MoH District Health Office Health Workers in Health Facilities CHAZ LFA Community Volunteers “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Selection & Training of Community Volunteers Selection of Community Volunteers (CV) selected from the community: People who have been cured of TB PLWHAs Ordinary community members Capacity Building The CVs are trained by health workers in Church Health Institutions (CHIs) near their respective communities in: TB DOTs ART Adherence Support How to conduct awareness campaigns “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Data Flow Mechanism Community- CHI Level Each disease has its own community tools used by CVs. These tools save as reports and are submitted to the CHI on a monthly basis. The CHI incorporates this data in their quarterly reports submitted to CHAZ/District health office/provincial health office CHAZ Level CHAZ aggregates CHI reports The process includes report analysis Feed back “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Challenges Reports Poor record keeping Incomplete reports Late reports Global Fund demands Human Resource Staff attrition/turnover “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Solutions to Challenges Report Bi-annual review meetings/workshops Technical support visits Data quality audits/verification Prompts to trigger reporting Human Resource Incentives Capacity Building “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Thank You and God Bless “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2