Monitoring and evaluating the response to children affected by HIV and AIDS

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Monitoring and evaluating the response to
children affected by HIV and AIDS
Mary Mahy, Sc.D. Division of Policy and
Planning UNICEF Technical Consultation on
Children Affected by HIV and AIDS London,
February 7-8, 2006
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Overview of presentation

• Global goals and targets for children
• What are the barriers to successfully reporting
  on these targets? and meeting targets
• Barriers at global level
• Barriers at national level
• Barriers at project level
• Steps to strengthen ME at all levels
• Example of Rwanda
• Paediatric AIDS and PMTCT ME are not covered

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Global Goals and Targets

• Millennium Development Goals
• UNGASS Declaration of Commitment
• Universal Access
• Children Affected by AIDS Campaign
• etc.
• However, very few countries have data available
• Progress report

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Current mechanisms to monitor targets for
children affected by HIV and AIDS

• Coverage Survey (Policy Project)
• Population based surveys (DHS, MICS, AIS)
• Routine project progress reports
• Define vulnerability

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Barriers at global level

• Vulnerable children - varies by community and
  intervention
• 2003 Coverage Survey showed variety of
  definitions for vulnerable children
• Choosing 1 or 2 indicators to summarize impact
  and response
• Summarize across different epidemics, and all
  types of interventions

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Barriers at national level

• National definition of vulnerable child for
  monitoring purposes
• Coordinating information gathered to compile into
  a complete picture of the national response
• Multi-sector response

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Barriers at project level

• Building capacity to monitor and evaluate
  projects
• Requirement to report to district or national
  level and how to use feedback
• Prioritizing monitoring and evaluation in a
  hectic, crisis-driven environment
• Information and action tool (Richter)

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Key actions needed to improve ME

• Build capacity of implementing organisations to
  use ME to strengthen effectiveness and
  efficiency of projects
• Collaborate among stakeholders
• One monitoring and evaluation framework
  (Principles of Three ones)
• Integrate into existing ME systems
• Evaluate programmes and interventions to better
  understand outcomes and impact

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Example Rwanda

• Goal Protect the rights and ensure physical and
  psychosocial development of orphaned and
  vulnerable children
• 7 Strategic objectives to reach this goal (legal
  health education psycho-social support support
  to family, child, and community socio-economic
  support coordinate at central and decentralized
  levels)

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Example Rwanda

• Challenges
• Establishing baseline
• Double counting
• Which services to count?
• Who handles the data? (decentralization)
• Gaps
• Minimum package of needs for OVC
• Quality of care

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• English and French versions of the
• Guide to Monitoring and Evaluation of the
  National Response for Children Orphaned and made
  Vulnerable by HIV/AIDS
• are on the display table upstairs.

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How can we improve ME skills of CBOs

• Provide ethical guidelines on collecting data
  with and from children
• Explain the need for comparability over time
  (baseline, endline data) thus need scientific
  sampling
• Provide guidance and training on sampling
  strategies
• Good guidance on tool development - dont
  overload questionnaires, keep it simple
• Other types of data collection techniques to
  triangulate findings