Roll Back Malaria Monitoring & Evaluation Reference Group (MERG) RBM 12 th Partnership Board Meeting Geneva, May 10-11, 2007 Bernard Nahlen Bernard Nahlen US President’s Malaria Initiative US President’s Malaria Initiative

2 nd RBM Partnership Board Meeting Geneva, February 2000

Evaluation of Roll Back Malaria Specific recommendations for M&E: Strengthen M&E capacity Establish transparent system for assessing data quality and standardization across countries, esp. for core indicators Establish clear guidelines for data collection protocols and sampling strategies Establish and maintain a plan and timeline for RBM M&E reports Establish a format for annual reporting on progress with standardized indicators & timeframe Establish global malaria database, including documentation of data sources and representativeness Global malaria reports every few years Establish reference group for periodic consultation on technical issues

Monitoring and Evaluation Reference Group Established May, 2003 Active membership (Core members) Endemic country representatives NMCP/MOH/National Statistical Offices WHO, UNICEF, World Bank, Global Fund Health Metrics Network USAID/PMI PATH/MACEPA INDEPTH Network of demographic surveillance sites Research institutions with expertise in the area of malaria M&E (e.g., MACRO/DHS, Malaria Consortium, CDC, Millennium Project etc.) Others invited, depending on venue and agenda General meeting every 6 months next in Washington DC, June 2007

Functions Develop and provide technical guidance on appropriate indicators, data collection methods, analytic strategies, and dissemination of recommendations Identify critical technical questions arising from M&E activities Organize smaller working groups to address the questions and provide technical feedback on issues Develop and maintain consensus around M&E strategies across partners and institutions Identify and recommend strategies for addressing the needs for capacity building at all levels Key Elements of MERG TOR

MERG Task Forces 1.Mortality – Chair: UNICEF 2.Morbidity – Chair: WHO 3.Anaemia – Chair: WHO 4.Survey and Indicator Guidance – Chair: ORC-Macro 5.Capacity Building Task Force – Chairs: Malaria Consortium, WHO/AFRO 6.Economics – Chair: World Bank

MERG Task Force Products Mortality Task Force Recommendations for mortality monitoring for African countries Report on baseline 2000 burden of mortality directly attributable to malaria for children <5 years of age in Africa Morbidity Task Force Method for estimating incidence of clinical malaria episodes in all countries Anaemia Task Force Recommendations for use of anaemia in children < 5 years as impact indicator in stable malaria-endemic settings

MERG Task Force Products MERG Task Force Products Survey and Indicator Task Force Core HH Survey Indicators Guidelines Malaria Indicator Survey (MIS) package:  Zambia first country to conduct MIS  Senegal, Angola, other PMI focus countries Consensus on standardized IRS indicators Guidelines for parasite prevalence testing M&E package for rapid assessment of malaria in pregnancy

MERG Task Force Products Capacity Building Task Force “Building Capacity in M&E for RBM in Africa: A Conceptual Framework ”  based on review of M&E capacity in NMCPs in Africa Standard M&E framework developed Purpose: To provide country M&E partners with technical guidance on monitoring programmatic performance in delivery of key malaria interventions ­useful for assisting M&E units within NMCPs in measuring progress for results ­used to provide guidance for Round 6 and Round 7 Global Fund proposal preparation

Data, Data, Everywhere ….

“Global malaria reports every few years”

MERG Work Plan Products Goal : Harmonization around single national malaria M&E plan into which all partners contribute (“Three Ones”) Mortality Task Force Validation mortality monitoring model at country level (“Lancet Model”) Validation and finalization of Spectrum-based mortality modeling software for use at country level Publication of MERG paper on “Options for Evaluating the Impact of Malaria Control Efforts on Mortality in Africa” Link to GF impact evaluation efforts Morbidity Task Force Recommendations for standardization of country-level malaria endemicity maps Produce standardized country-level estimates of disease burden and risk populations Link to GF impact evaluation efforts

MERG Work Plan Products Anaemia Task Force Review and analysis of anaemia date collected in DHS and MIS surveys Survey and Indicator Guidance Task Force Facilitation of conduct, analysis and reporting of survey data Finalize guidelines for IRS indicators Recommendations for standardized guidelines for laboratory testing of anaemia and parasitaemia as part of household surveys Consensus of use of other potential methods for generating coverage data (e.g., LQAS, EPI Contact Method) Consensus on priorities and analytic approaches for further analysis of household survey malaria data Series of “white papers” resulting from secondary analysis of MICS, DHS and MIS malaria data for publication in peer-reviewed journals

MERG Work Plan Products Capacity Building Task Force Finalization of package of M&E tools for use by NMCPs Work with GF and PMI to hold national stakeholder workshops to implement “M&E Systems Strengthening Tool” in 6-10 countries Economics Task Force Review: “Estimating the cost of malaria in sub-Saharan Africa: notes on methods and results of past studies” (Dion Filmer and Elisabeth King) Guidance on measuring economic impact of malaria control on cost-saving at household level RBM Partner Database Consensus on principles, format and mechanism for linked joint partner database on core malaria date for access and use by all

MERG Focus 2007 Consensus on monitoring trends in health and economic burden of malaria Data collection on coverage and impact (MIS and other methods) Guidance on M&E framework for NMCPs Advocacy for M&E systems strengthening Joint partner database and joint reporting

MERG Challenges and Opportunities SUFI and GF performance-based funding model impose new demands for urgent improvement in country malaria M&E systems No RBM partner has capacity to respond to this individually– need for strong partnership infrastructure In the context of the HWG developing an expanded role in implementation support, should MERG link with the HWG and develop an “operational arm” to facilitate joint partner response to assisting NMCPs to strengthen M&E? ☺ This would require significant new resources, including dedicated staff

Options for MERG Future Work 1.Strengthened role with system with adequate resources and partnership engagement to undertake a specific expanded work plan  Or, implementation support provided by HWG and SRNs? 2.Unchanged role with clear limited/focused tasks  Still would include clear engagement and responsibilities of partners 3.Other?

Summary RBM MERG provides effective mechanism to build consensus and provide tools to address core M&E technical issues MERG functions due to core group of key partners committed to effective collaboration in support of country malaria M&E efforts Further significant investment would be required if work plan were to take on expanded role in support of capacity strengthening in M&E for NMCPs Reporting to the country-level and global RBM partners critical both for continued support for local program activities and for keeping malaria on the global health agenda

Board Requested Decision Points Endorse Terms of Reference Endorse areas of focus for 2007 Approve the initial work plan Request Secretariat to explore options for an implementation arm of the MERG (linked to HWG), including expanded TOR, work plan and budget