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CHAPTER 3: M&E IMPLEMENTATION STRATEGY AND COORDINATION

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3.1 Data Collection Strategy for M&E

3.2 Country Response Information System (CRIS)

3.3 M&E Reporting Levels and Information Flow

3.5 Donors’ Support for M&E

3.6 Information Dissemination on HIV/AIDS

3.1 Data Collection Strategy for M&E

The M&E Framework clearly defines indicators for the specific HIV/AIDS intervention areas, sources of data to generate the indicators, measurement tool, frequency of data collection, responsible body for data collection (or data source), and the method of measurement. The selection of indicators has been made through a serious of consultations with different stakeholders; and due attention has been paid to characteristics of a good indicator and elements of a good M&E system outlined in chapter 2. In this document “responsible body” refers to an entity/entities that is/are accountable for developing data collection methodologies, designing tools and/or collection, processing and analysis of data for the specified indicator.

HAPCO will work with all stakeholders to collect data for generating reports on the national response to HIV/AIDS. In selecting the national indicators, care has been taken to explore the possibility of utilizing all available data, routine data collection systems before suggestions are made to use survey methods. As most indicators are health related, HAPCO after a number of discussions with MoH has determined that the data collection system need to be simple and use both surveys and routine program reports. In the early stage of the M&E system development in the country it is agreed not to overburden the MoH HMIS by gathering data for indicators through routine data collection only but to explore structured surveys.

For some of the indicators, baseline data is currently available from the DHS, BSS, ANC Sentinel Surveillance, program records and UNGASS 2003 report. At national level, indicators will be collected on regular intervals as specified in chapter 6 (HIV/AIDS indicators’ reference page).

Data for measuring the indicators will be obtained from four main sources:

a) Routine national level surveys like the DHS, BSS and HIV Sentinel Surveillance data; Population Census, and Blood Bank data (The HIV Sentinel Surveillance data is based on antenatal clinics including women of all age groups)

b) Routine reports on identified indicators from all project/program implementers

c) Health Facility Surveys (HFS)

d) Special studies, e.g. HIV/AIDS impact assessments, policy and guideline assessments

Indicators that will be assessed based on routine reports require the determination of all stakeholders that are implementing/supporting HIV/AIDS activities. Stakeholders should regularly report on indicators that are relevant to the type of project/program they are implementing/supporting. In order to facilitate data flow, HAPCO will implement the Country Response Information System (CRIS) at National and Regional levels. The frequency of reporting and how reports should flow are described in subsequent sections.

3.2 Country Response Information System (CRIS)

CRIS, developed by UNAIDS, is an information system for national responses. The System consists of a database of standardized indicators on HIV/AIDS situation, impact and response. The CRIS platform will enable electronic communication of data from districts to regions, from regions to national level and from national to international level. It can also be electronically updated. Some of the benefits of CRIS are listed below.

Benefits from CRIS

  • Rapid establishment of an information system at a country level

  • Strengthening of existing systems

  • Enhanced ability to monitor National Strategic Plan and national response

  • Improve ability to report to funding sources e.g. Global Fund and WB

  • Supports global indicator standardization process, transmission format and prioritization

  • Support next generation indicator development process

  • Manages large volumes of information

  • Streamlines information flows and greater local access

Even though the CRIS system consisted of internationally standard indicators, it is quite possible to put additional indicators for National, Regional and Woreda consumption. The M&E Team at HAPCO will customize CRIS to local needs and establish the System for use at National and Regional levels.

3.3 M&E Reporting Levels and Information Flow

Stakeholders implementing HIV/AIDS projects/programs are expected to regularly report on program indicators (Annex 2) that are relevant to the type of activity they are undertaking. For all program indicators, the data collection formats at all levels (from lowest to National level) will be developed and included in the M&E Operational Manual and distributed to all stakeholders. The proposed information flow between the different stakeholders and HAPCO are summarized in figures 3 and 4.

3.3.1 Kebele level to National HAPCO

Standard reporting formats that summarize the program indicators will be supplied to Government Offices (Woreda, Region and National level), Kebeles, NGOs, CBOs, FBOs, Civil Associations, Multilateral and Bilateral Organizations.

Frequency and hierarchy of reporting (all program indicators, including health):

  • Kebeles will gather data relevant to program indicators in the National M&E Framework from local CBOs and Civil Associations working in the Kebeles on HIV/AIDS. A copy of the report should be submitted monthly to the Woreda HIV/AIDS Committee (in Addis Ababa to Kefle Ketema HIV/AIDS committee)

  • Woreda HIV/AIDS Committees (in Addis Ababa, Kefle Ketema HIV/AIDS committees) will produce quarterly reports by compiling and analyzing data/reports received from Kebeles, Woreda sector offices (including Woreda Health Office), NGOs, CBOs, FBOs and Civil Associations, working in the Woreda. Then

      i) If Zonal structures exist in the Region and the Regional HAPCO has an HIV/AIDS coordinating committee at Zone level, then:

      • The Woreda HIV/AIDS Committee will send a copy of the report quarterly to the Zonal HIV/AIDS Committee, and

      • Zonal HIV/AIDS Committee will produce quarterly reports by compiling and analyzing data/reports received from Woreda HIV/AIDS Committees and Zone sector offices (including Zonal Health Department), NGOs, CBOs, FBOs and Civil Associations, working in the Zone. A copy of the report should be submitted quarterly to the Regional HAPCO

      ii) Otherwise (i.e., if Zonal structure does not exist in the Region), the Woreda HIV/AIDS Committee will send a copy of the report quarterly to Regional HAPCO

  • Regional HAPCOs will produce quarterly report by compiling and analyzing data/reports received from Woreda HIV/AIDS Committees (or Zonal HIV/AIDS Committees), Regional sector offices (including RHBs), NGOs, and FBOs working in the Region and Regional Civil Associations. A copy of the report should be submitted quarterly to the Federal HAPCO

  • Federal Sector Ministries (including MoH), Agencies, Authorities, Commissions; Multilateral and Bilateral Organizations should send quarterly reports on relevant program indicators to Federal HAPCO

  • The Federal HAPCO will produce annual reports by compiling and analyzing data/reports received from Regional HAPCOs, Federal Sector Offices (including MoH), National Civil Associations, Research Institutions/Associations and Multilateral and Bilateral organizations. A copy of the report will be submitted to the Prime Minister Office

  • Research institutions, associations, Universities, NGOs, UN agencies, Sector ministries, Agencies, Authorities, Commissions etc. are expected to send a copy of HIV/AIDS related study reports to Federal HAPCO. Federal HAPCO will make all collected research results centrally available for reference to users.

    • Figure 3: Report/information flow: Kebele level to Federal HAPCO



    Key:


    Note: The M&E Operational manual will include mechanisms to minimize duplication of data/information which may
    occur due to reports gathered from different sources

    3.3.2 Health related indicators

    Most of the indicators in the M&E Framework are health related. Health related program indicators will originate from health facilities (health posts, clinics, health centers, and hospitals). It is expected that private heath institutions working at different levels will also send reports on relevant program indicators to MoH or RHBs. For all program indicators in the M&E Framework, standardized reporting formats will be developed and distributed to all actors including to health facilities. The formats will avoid any duplication of reporting that may occur.

    Frequency and hierarchy of reporting (health related program indicators):

  • Higher health facilities (district and rural hospitals) will produce monthly reports based on their own data and from reports received from lower health facilities (health posts, clinics, health centers). A copy of the report should be send monthly to Woreda Health Office

  • Woreda Health Offices will compile and analyze data received from higher health facilities. A copy of the report will be submitted quarterly to the Woreda HIV/AIDS Committee and, if it exists in the Region, to the Zonal Health Department

  • Woreda HIV/AIDS Committees will produce overall quarterly reports by compiling and analyzing data/reports received from Woreda Health Office and others. Then:

      i) If Zonal structures exist in the Region and the Regional HAPCO has an HIV/AIDS coordinating Committee at Zone level, then:

      • The Woreda HIV/AIDS Committee will send a copy of the overall report quarterly to the Zonal HIV/AIDS Committee, and

      • Zonal HIV/AIDS Committee will produce overall quarterly reports by compiling and analyzing data/reports received from Woreda HIV/AIDS Committees and Zonal Health Department (if it exists in the Region); and a copy of the overall report submitted quarterly to the Regional HAPCO

      ii) Otherwise (i.e., if Zonal structure does not exist in the Region), the Woreda HIV/AIDS Committee will send a copy of the overall report quarterly to Regional HAPCO

  • Zonal Health Department, if it exists in the Region, will compile data received from Woreda Health Offices. A copy of the report should be sent quarterly to Zonal HIV/AIDS Committee if it exists; otherwise to Regional Health Bureau

  • Private Health facilities will compile and send reports on relevant indicators to RHBs on a quarterly basis

  • RHBs will produce quarterly reports by compiling and analyzing data/reports received from Woreda Health Offices or Zonal Health Department and private health facilities. A copy of the report should be send quarterly to Regional HAPCO and MoH

  • Regional HAPCOs will produce overall quarterly reports by compiling and analyzing data/reports received from Woreda or Zonal HIV/AIDS Committees, RHBs and others. A copy of the overall report should be send quarterly to Federal HAPCO

  • Teaching hospitals and some central/specialized hospitals will send quarterly report to MoH

  • MoH will produce quarterly report by compiling and analyzing data/reports received from RHBs, teaching hospitals/specialized centers. A copy of the report should be send quarterly to Federal HAPCO.

  • The Federal HAPCO will produce an overall report annually. A copy of the report will be submitted to the Prime Minister Office.

    • Note: Currently the teaching and/or specialized hospitals are Tikur Ambessa, Gonder, Dilla, St. Paul, St. Peter, Police,
    Army and Jimma.

    Figure 4: Report/Information flow of health related indicators



    Key:

    *

    In Addis Ababa, Kefle Ketema HIV/AIDS Committee

    **

    Higher health facilities: Health centers, District hospitals and Rural hospitals

    ***

    Lower health facilities: Health posts and clinics

    Note: The M&E Operational manual will include mechanisms to minimize duplication of data/information which may
    occur due to reports gathered from different sources

    3.4 M&E Coordination Functions

    Proclamation No. 276/2002 mandates HAPCO to coordinate the national response to HIV/AIDS. This role would involve bringing together all stakeholders who are involved in combating the epidemic for the harmonious implementation of HIV/AIDS activities. Efficient implementation of the M&E Framework also requires well established coordination mechanisms at all levels of monitoring and evaluation.

    3.4.1 National coordination for M&E

    HAPCO will convene coordination meetings to bring together key implementers of HIV/AIDS projects/programs and Regions to discuss the modalities of implementing the national M&E Framework and to address whatever challenges may have arisen during the process. HAPCO will also use the National Partnership Forums to update stakeholders on the requirements of the National M&E Framework and to solicit their support for its implementation.

    3.4.2 Region/Woreda level coordination for M&E

    The indicators included in the National M&E Framework are primarily selected to measure progresses made at National level. Most of the programmatic indicators can only be measured after aggregation of data from Regions. These same indicators are useful for decision making at Regional and lower levels. However, Regions and Woredas can have their own additional indicators based on local needs. To harmonize data collection for indicators required at national level as well as for additionals for local consumption, it is necessary for Regional HAPCOs and Woreda HIV/AIDS Committees to hold regular meetings with all stakeholders working in their area. The Regions and Woredas themselves will determine the frequency of the meeting. However, semi-annual and quarterly meetings are suggested at Regional and Woreda levels, respectively.

    3.5 Donors’ Support for M&E

    Donors’ support will be very important to ensure effective and efficient implementation of the National M&E Framework. Most donors oftentimes require more information than is necessary for national level M&E. HAPCO will use the National Donors Forum to update them on the National M&E Framework so that Donors’ information requirements are not very much different from indicators included in the Framework.

    3.6 Information Dissemination on HIV/AIDS

    HAPCO will produce annual National M&E reports, containing indicators that would show the multi-sectoral response to HIV/AIDS, results achieved or not achieved and lessons drawn. National level M&E results/findings will also be disseminated through annual HIV surveillance reports, HIV/AIDS fact sheets, brochures, print and electronic media and panel discussions. Federal Sector Ministries/Offices and Regional HAPCOs will also undertake dissemination of M&E results within their sectors and regions, respectively, in-order to supplement the efforts by the Federal HAPCO.

    Dissemination of M&E results is expected to serves the following key purposes:

  • Share the data and information for better planning of HIV/AIDS interventions

  • Give feedback on the efforts and resources committed to the national response and highlight issues that still require intervention

  • Increase public commitment to the national response to HIV/AIDS

    Figure 5: The National HIV/AIDS M&E System




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