1. Module 6: Monitoring & Evaluation
Effective HIV & SRH Responses Among Sex Workers and other Key Populations
Module 6: Monitoring & 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?
Monitoring & Evaluation Concepts
Data Flow and the Data Feedback Cycle
National M&E Framework for Bangladesh and Data Flow
Update on National M&E Assessment from National HIV M&E Workshop on 26th August 2015
Talk through what this M&E session will include – and objectives of the session.

4. Monitoring & Evaluation
Power of numbers
best practice
Resource
mobilisation
Click mouse to bring up each statement.
POWER OF NUMBERS: Data is required to inform programming planning, design, implementation and evaluation. There is power in numbers – program and service data can be used for advocacy, funding proposals and to demonstrate project outputs, outcomes and impact.
BEST PRACTICE: Throughout the workshop, global guidance has been presented, but we need to know how this fits and what works best in Bangladesh. Data enables measurement and analysis of how people are accessing programs and services, and in doing so enables us to determine best practice – at global, regional, national, provincial and local level.
RESOURCE MOBILISATION: Data enables us to ensure programs and services have the right resources, in the right places, for the right people, at the right time. In the absence of data, resource allocation is estimated, programs and services are not able to forecast requirements and supply of resources is unable to be mobilised effectively.
STORIES BEHIND STATISTICS: Behind every number is a story – a story of an individual. Data represents people – 100 condoms distributed is 100 opportunities for people to engage in safer sex.
Stories behind statistics

5. Monitoring & Evaluation
Programme M&E systems are driven by:
Local programme and data demands
Funding agency requirements
National M&E Framework: The Three Ones
National M&E system is driven by:
National & international reporting requirements
Different sets of indicators:
PEPFAR, USAID, Global Fund, UNAIDS, UNGASS
National Indicators
There are many competing demands in M&E systems.
“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

6. Monitoring & Evaluation Data Flow & the Data Feedback Cycle
Data Collection
Data Management
Data Validation
Data Analysis
Data Translation
Data Feedback
Talk through the data feedback cycle and how every step of the cycle is essential to encourage good quality data flow.
There is often a focus on the data collection, management and validation components of the data feedback cycle – we need to ensure that data is analysed, translated and fed-back to ensure effective use of information and informed programs that are reoriented to better meet the needs of key populations.

7. Monitoring & Evaluation Global Guidance & Tools
UNAIDS Three One’s Principles:
Global level alignment
Core national system linked to National HIV/AIDS Framework
Agreed investment strategies for data quality
Investment in national capacity
Key Principle 3:
One agreed M&E framework for overall national monitoring and evaluation
Global level alignment
Commitment should be made by partners at global level to make every effort to align their need for M&E to ensure accountability for funds and programme development based on results, as well as agreement on core elements of a country-level M&E system that can address these needs.
Core national system linked to the National HIV/AIDS Action Framework
Each National HIV/AIDS Action Framework should be accompanied by a core system for monitoring progress towards controlling the epidemic under the leadership of the National AIDS Coordinating Authority.
Agreed investment strategies for data quality
National-level stakeholders within the HIV/AIDS Action Framework should make assessments of existing M&E systems a priority. Stakeholders should agree on how systems can be improved and how a shared core system can be established that provides high-quality data for analyzing country performance.
Investment in national capacity
National governments, AIDS authorities and the associated development and AIDS action partnerships must make the case for necessary investment in building essential human capacity to meet national M&E needs.

8. Monitoring & Evaluation Global Guidance & Tools
Global Tools for M&E and Key Populations:
Quantitative:
Population Size Estimates and Treatment Cascades
Unique Identifier Codes
Qualitative
Stories of Change
Questionnaires and Quotes
Triangulation
Integrated bio-behavioural surveys (biological & behavioural surveillance)
Quality of Services:
Patient Satisfaction Surveys and Scorecards
Advisory Committees and Focus Groups

9. National M&E Framework
Fewer new infections
(Both HIV and STIs)
Longer survival of PLHIV
Biological and
Behavioral
Surveillance/
Evaluation Studies/
Assessments/
Research
Impact
With
Improved knowledge on HIV; Reduced risk behavior among MARPs, People with emerging risk and higher vulnerability and general population
Outcome
Indicators
Increased coverage for prevention, treatment, care and support services Strengthened sector wide management, coordination and M&E systems and overall HR capacity, Strengthened Health System response
Program Monitoring
Data/HIV MIS
Treatment
Database
Periodic review/
assessment
With
Output
Increased govt. expenditure, policy and leadership support, Availability of adequate service centers, prevention commodities, ARTs, Training Programs for HR capacity, improvement
Inputs

10. National M&E Framework
Data Sources: Bio and Behavioral surveillance; BDHS, MICS
Research, Evaluation studies, Program Monitoring Report/ Qtrly Reports/ HIV-MIS
Modeling and other data sources
HIV Interventions
Interventions for MARPs
Interventions for people with emerging risk and higher vulnerability
Interventions for general populations including youth
Health care set up based services
Blood Safety; Infection Control; PEP; PPTCT; STI Management
Provide
Program
monitoring
data
Collected and analyzed by
National AIDS/STD Programme (NASP)
Ministry of Health and Family Welfare
And/or Designated agency/entity
Provide funding for implementation
Generates
M&E Reports: Quarterly Monitoring Reports, Annual Reports, Surveillance Reports (annual/ biennial), Periodic updates, country reports, NASP websites, Reported No. HIV cases annually
Stakeholders at national and global levels, Policy level forums, Civil Society, National Annual Congress, Global meetings/forum (e.g. GARPR)
Disseminated to

11. Indicators for FSW Intervention
% of female sex workers who are HIV infected
% of female sex workers reporting the use of a condom with their most recent client
# of FSWs reached with HIV Prevention Program, # of condoms distributed, # of BCC materials distributed, # of education sessions held, # of FSWs tested and counseled (VCT) for HIV and received results, # of episodes of STIs, # of MCH services received by FSWs, # of staff trained, # of stakeholders reached at national, district and community levels through advocacy initiatives

12. Data Flow Implementers to National MIS
M&E unit of NASP (National MIS)
Principle Recipient under
The Global Fund (SC-MIS)
Recipients under
HPNSDP
Implementers under
The Global Fund
Implementers under HPNSDP
DICs for FSWs
DICs for FSWs

13. Data Flow DIC level

14. Summary from MESA Workshop

15. MESA Workshop Recommended Actions
Need more permanent M&E positions at NASP
Need to review existing salary structure and other facilities for M&E staff for implementing NGOs
Need more formal and informal training on M&E and data management for M&E staff
Need to develop a standard and comprehensive national HIV M&E curriculum
Need to develop a linkage with formal teaching institutions
Need to reduce supply gap for equipment for M&E
Behavioral and biological surveillance need to carry out regularly

16. 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
NASP. (2009). National M&E Plan
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.