CHAPTER 6: HIV/AIDS INDICATORS’ REFERENCE PAGES (cont.)

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National Commitment and Action

Monitoring and evaluation

Capacity Building

Financial utilization

National Commitment and Action

PS5: Government funding for HIV/AIDS

Definition
Amount of National funds spent by Government on HIV/AIDS

Purpose

To monitor the flow of national funding for HIV/AIDS as a measure of National Government’s economic commitment to fight HIV/AIDS

Measurement tool

Document review

Frequency

Every 2 years

Responsible body

HAPCO

Method of measurement

Survey of National Government expenditure on HIV/AIDS programs. The cost of any multilateral or bilateral international donor-funded government programs should be excluded. Similarly, all local NGO programs should be excluded, except for programs (or part of programs) that are funded by the national government.

Allocated national funds comprise expenditure on the following four categories of programs, totals for each of which should be specified separately:

1. STD control activities

2. HIV prevention

3. HIV/AIDS clinical care and treatment

4. HIV/AIDS impact mitigation

Note:

It may be difficult to disaggregate Government fund by the above four categories. Even though, effort will be made to disaggregate the indicator, in the early stage of compiling the indicator lump sum will be accepted.

Remark

UNGASS indicator

PS6 & CST11: National policy

Definition
National composite policy index

Purpose

To assess progress in the development of national-level HIV/AIDS policies and strategies

Measurement tool

Country assessment questionnaire (UNGASS)

Frequency

Annual (for policies/strategies not yet in place)

Responsible body

HAPCO

Method of measurement

The composite index covers four broad areas of policy:

A. Strategic plan

B. Prevention

C. Human rights

D. Care and support

A number of specific policy indicators have been identified for each of these policy areas. A separate index is calculated for each policy area by adding up the scores (yes = 1, no = 0) for the relevant specific policy indicators and calculating the overall percentage score. The composite index is calculated by taking the average of the scores for the four components.

Where appropriate, the score for a specific policy indicator should be assessed with reference to the standard criteria provided (Annex 3, UNGASS)

Note:

As it has been reported to UNGASS in 2003, most of the policy index elements listed below have been addressed in Ethiopia. Therefore, only those elements not addressed yet will be checked annually. When it is ensured that all elements are in place, measuring the indicator on regular basis will become unnecessary.

A. Strategic plan

1. Country has developed multi-sectoral strategies to combat HIV/AIDS

2. Country has integrated HIV/AIDS into its general development plan

3. Country has a functional national multi-sectoral HIV/AIDS management coordination body

4. Country has a functional national HIV/AIDS body that promotes interaction among government, the private sector and civil society

5. Country has a functional HIV/AIDS body that assists in the coordination of civil society organizations

6. Country has evaluated the impact of HIV/AIDS on its socioeconomic status for planning purposes

7. Country has a strategy that addresses HIV/AIDS issues among its national uniformed services (including armed forces and civil defense forces)

Yes

No

B. Prevention

1. Country has a general policy on strategy to promote IEC on HIV/AIDS

2. Country has a policy or strategy promoting reproductive and sexual health education for young people

3. Country has a policy or strategy that promotes IEC and other health interventions for groups with high or increasing rates of HIV infection

4. Country has a policy or strategy that promotes IEC and other health interventions for cross-border migrants

5. Country has a policy or strategy to expand access, including among vulnerable groups, to essential preventive commodities

6. Country has a policy or strategy to reduce MTCT

C. Human rights

1. Country has laws and regulations that protect against discrimination of people living with HIV/AIDS

2. Country has laws and regulations that protect against discrimination of groups of people identified as being especially vulnerable to HIV/AIDS

3. Country has a policy to ensure equal access for men and women to prevention and care, with emphasis on vulnerable groups

4. Country has a policy to ensure that HIV/AIDS research protocols involving human subjects are reviewed and approved by an ethics committee (at the Science and Technology Commission of Ethiopia)

D. Care and support

1. Country has policy or strategy to promote comprehensive HIV/AIDS care and support, with emphasis on vulnerable groups

2. Country has a policy or strategy to ensure or improve access to HIV/AIDS-related medicines, with emphasis on vulnerable groups

3. Country has a policy or strategy to address the additional needs of orphans and other vulnerable children

Remark

UNGASS indicator

PS7: Existence of policies, strategies, guidelines and frameworks

Definition
Existence of policies, strategies, guidelines and frameworks produced at national level

Purpose

To assess progress in the development of national-level HIV/AIDS policies, strategies, guidelines and frameworks

Measurement tool

An assessment questionnaire/checklist

Frequency

Annual (for policies, strategies, guidelines and frameworks not yet in place)

Responsible body

HAPCO

Method of measurement

Sectors where the policies, strategies, guidelines and frameworks are expected to be issued will be listed. A checklist will be prepared. Observation of the written policies, strategies, guidelines and frameworks is also necessary to confirm for existence.

Note:

Once it is confirmed that written policies, strategies, guidelines and frameworks are available, it will not be necessary to measure the same in the following year.

Policies, strategies, guidelines or frameworks

Yes

No

If “Yes”, specify as policy, strategy, guideline and/or framework

BCC

Condom quality control

VCT

PMTCT

Universal precautions

PEP

Blood safety

STI management

Care, Support and Treatment

- ARV

- HBC

- Adult clinical care

- Pediatric clinical care

- OVC

Nutrition and HIV

Human rights of PLWHA

Surveillance and Research

Monitoring and Evaluation

HIV laboratory support

Mainstreaming

Remark

PS8: Operationalization of policies, strategies, guidelines and frameworks

Definition
Operationalization (at all levels) of policies, strategies, guidelines and frameworks produced at national level

Purpose

To assess whether or not policies, strategies, guidelines and frameworks that are endorsed/developed are being implemented

Measurement tool

Special study (using assessment questionnaire/checklist)

Frequency

Every 2 years

Responsible body

HAPCO

Method of measurement

Operationalization of policies, strategies, guidelines and frameworks are measured based on whether:

a) The policies, strategies, guidelines and frameworks are distributed to all concerned implementers at all levels (sectors, regions, health facilities, NGOs, etc.)

b) Training/orientation has been given to staff involved in execution of the policies, strategies, guidelines and frameworks

c) Policies, strategies, guidelines and frameworks are translated into the local language where it is being implemented

d) Any measures/actions are taken if policies, strategies, guidelines and frameworks are not properly implemented

For existing policies, strategies, guidelines and frameworks, the concerned sectors will be approached and assessed on the above points (a-d)

Note:

The indicator should also be reported for each component
(a-d)

The indicator will be assessed at all level

Remark

Monitoring and evaluation

PS9: Stakeholders spending for M&E

Definition
Percentage spending for M&E by HAPCO in the last 12 months

Purpose

To monitor HAPCO’s commitment to support and strengthen M&E activities

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

HAPCO’s expenditure on M&E include all expenses on the following areas:

Personnel

HIV Sentinel Surveillance

Researches/studies (including program evaluations) on HIV/AIDS

Training on M&E

Materials/equipment purchase in support of M&E activities

Field supervision

Numerator: Total amount of money spent for M&E activities
by HAPCO in the last 12 months

Denominator: Total amount of money spent for HIV/AIDS
by HAPCO in the last 12 months

Remark

PS10: Stakeholders reporting

Definition
Proportion of all stakeholders implementing/supporting HIV/AIDS projects/programs that submit timely reports to HAPCO using standard reporting formats

Purpose

To assess commitment and capacity of stakeholders in timely reporting HIV/AIDS activities

Measurement tool

Program report

Frequency

Quarterly

Responsible body

HAPCO

Method of measurement

A database will be established at HAPCO in which reports coming from stakeholders will be entered (including the time when reports were received and quality of reports).

Numerator: Number of stakeholders implementing HIV/AIDS
projects/programs that submit quarterly reports
timely and using nationally agreed upon
reporting formats

Denominator: Number of stakeholders implementing HIV/AIDS
projects/programs

Remark

Capacity Building

PS11: National level HIV/AIDS forum and joint review meetings

Definition
Number of National Partnership Forum and Joint Review meetings organized by HAPCO in the last 12 months

Purpose

To assess progress on information sharing among stakeholders working in the area of HIV/AIDS

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

Follow-up and keep a record of national level HIV/AIDS Forum and Joint Review meetings organized by HAPCO

Remark

PS12: Regions that installed CRIS and have online access

Definition
Number of Regional HAPCOs that have installed CRIS and established an online access with National HAPCO

Purpose

To assess progress on development of electronic communication between HAPCO and Regional offices

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

Record Regions that installed CRIS and that have electronic communication system with National HAPCO

Remark

PS13: Training on M&E and Project Management

Definition

Number of staff at Regional and Woreda level trained on M&E and Project Management by HAPCO in the last 12 months

Purpose

To review the M&E and Project Management capacity of Regions and Woredas

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

Document all M&E and Project Management Training at Regions and Woredas by HAPCO

Remark

Financial utilization

PS14: Financial utilization

Definition
Financial allocation and utilization in the last 12 months (disaggregated by component: BCC, Condom promotion and distribution, etc.)

Purpose

To assess efficiency of HIV/AIDS interventions in achieving their targets

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

All stakeholders implementing/supporting HIV/AIDS projects/programs are expected to report to HAPCO all financial resources allocated for and utilized by the project/program

Remark


PS5: Government funding for HIV/AIDS
Definition	Amount of National funds spent by Government on HIV/AIDS
Purpose	To monitor the flow of national funding for HIV/AIDS as a measure of National Government’s economic commitment to fight HIV/AIDS
Measurement tool	Document review
Frequency	Every 2 years
Responsible body	HAPCO
Method of measurement	Survey of National Government expenditure on HIV/AIDS programs. The cost of any multilateral or bilateral international donor-funded government programs should be excluded. Similarly, all local NGO programs should be excluded, except for programs (or part of programs) that are funded by the national government. Allocated national funds comprise expenditure on the following four categories of programs, totals for each of which should be specified separately: 1. STD control activities 2. HIV prevention 3. HIV/AIDS clinical care and treatment 4. HIV/AIDS impact mitigation Note: It may be difficult to disaggregate Government fund by the above four categories. Even though, effort will be made to disaggregate the indicator, in the early stage of compiling the indicator lump sum will be accepted.
Remark	UNGASS indicator


PS6 & CST11: National policy
Definition	National composite policy index
Purpose	To assess progress in the development of national-level HIV/AIDS policies and strategies
Measurement tool	Country assessment questionnaire (UNGASS)
Frequency	Annual (for policies/strategies not yet in place)
Responsible body	HAPCO
Method of measurement	The composite index covers four broad areas of policy: A. Strategic plan B. Prevention C. Human rights D. Care and support A number of specific policy indicators have been identified for each of these policy areas. A separate index is calculated for each policy area by adding up the scores (yes = 1, no = 0) for the relevant specific policy indicators and calculating the overall percentage score. The composite index is calculated by taking the average of the scores for the four components. Where appropriate, the score for a specific policy indicator should be assessed with reference to the standard criteria provided (Annex 3, UNGASS) Note: As it has been reported to UNGASS in 2003, most of the policy index elements listed below have been addressed in Ethiopia. Therefore, only those elements not addressed yet will be checked annually. When it is ensured that all elements are in place, measuring the indicator on regular basis will become unnecessary.
	A. Strategic plan	1. Country has developed multi-sectoral strategies to combat HIV/AIDS 2. Country has integrated HIV/AIDS into its general development plan 3. Country has a functional national multi-sectoral HIV/AIDS management coordination body 4. Country has a functional national HIV/AIDS body that promotes interaction among government, the private sector and civil society 5. Country has a functional HIV/AIDS body that assists in the coordination of civil society organizations 6. Country has evaluated the impact of HIV/AIDS on its socioeconomic status for planning purposes 7. Country has a strategy that addresses HIV/AIDS issues among its national uniformed services (including armed forces and civil defense forces)	Yes	No

	B. Prevention	1. Country has a general policy on strategy to promote IEC on HIV/AIDS 2. Country has a policy or strategy promoting reproductive and sexual health education for young people 3. Country has a policy or strategy that promotes IEC and other health interventions for groups with high or increasing rates of HIV infection 4. Country has a policy or strategy that promotes IEC and other health interventions for cross-border migrants 5. Country has a policy or strategy to expand access, including among vulnerable groups, to essential preventive commodities 6. Country has a policy or strategy to reduce MTCT
	C. Human rights	1. Country has laws and regulations that protect against discrimination of people living with HIV/AIDS 2. Country has laws and regulations that protect against discrimination of groups of people identified as being especially vulnerable to HIV/AIDS 3. Country has a policy to ensure equal access for men and women to prevention and care, with emphasis on vulnerable groups 4. Country has a policy to ensure that HIV/AIDS research protocols involving human subjects are reviewed and approved by an ethics committee (at the Science and Technology Commission of Ethiopia)
	D. Care and support	1. Country has policy or strategy to promote comprehensive HIV/AIDS care and support, with emphasis on vulnerable groups 2. Country has a policy or strategy to ensure or improve access to HIV/AIDS-related medicines, with emphasis on vulnerable groups 3. Country has a policy or strategy to address the additional needs of orphans and other vulnerable children
Remark	UNGASS indicator


PS7: Existence of policies, strategies, guidelines and frameworks
Definition	Existence of policies, strategies, guidelines and frameworks produced at national level
Purpose	To assess progress in the development of national-level HIV/AIDS policies, strategies, guidelines and frameworks
Measurement tool	An assessment questionnaire/checklist
Frequency	Annual (for policies, strategies, guidelines and frameworks not yet in place)
Responsible body	HAPCO
Method of measurement	Sectors where the policies, strategies, guidelines and frameworks are expected to be issued will be listed. A checklist will be prepared. Observation of the written policies, strategies, guidelines and frameworks is also necessary to confirm for existence. Note: Once it is confirmed that written policies, strategies, guidelines and frameworks are available, it will not be necessary to measure the same in the following year.
	Policies, strategies, guidelines or frameworks	Yes	No	If “Yes”, specify as policy, strategy, guideline and/or framework
	BCC Condom quality control VCT PMTCT Universal precautions PEP Blood safety STI management Care, Support and Treatment - ARV - HBC - Adult clinical care - Pediatric clinical care - OVC Nutrition and HIV Human rights of PLWHA Surveillance and Research Monitoring and Evaluation HIV laboratory support Mainstreaming
Remark


PS8: Operationalization of policies, strategies, guidelines and frameworks
Definition	Operationalization (at all levels) of policies, strategies, guidelines and frameworks produced at national level
Purpose	To assess whether or not policies, strategies, guidelines and frameworks that are endorsed/developed are being implemented
Measurement tool	Special study (using assessment questionnaire/checklist)
Frequency	Every 2 years
Responsible body	HAPCO
Method of measurement	Operationalization of policies, strategies, guidelines and frameworks are measured based on whether: a) The policies, strategies, guidelines and frameworks are distributed to all concerned implementers at all levels (sectors, regions, health facilities, NGOs, etc.) b) Training/orientation has been given to staff involved in execution of the policies, strategies, guidelines and frameworks c) Policies, strategies, guidelines and frameworks are translated into the local language where it is being implemented d) Any measures/actions are taken if policies, strategies, guidelines and frameworks are not properly implemented For existing policies, strategies, guidelines and frameworks, the concerned sectors will be approached and assessed on the above points (a-d) Note: The indicator should also be reported for each component (a-d) The indicator will be assessed at all level
Remark


PS9: Stakeholders spending for M&E
Definition	Percentage spending for M&E by HAPCO in the last 12 months
Purpose	To monitor HAPCO’s commitment to support and strengthen M&E activities
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	HAPCO’s expenditure on M&E include all expenses on the following areas: Personnel HIV Sentinel Surveillance Researches/studies (including program evaluations) on HIV/AIDS Training on M&E Materials/equipment purchase in support of M&E activities Field supervision Numerator: Total amount of money spent for M&E activities by HAPCO in the last 12 months Denominator: Total amount of money spent for HIV/AIDS by HAPCO in the last 12 months
Remark


PS10: Stakeholders reporting
Definition	Proportion of all stakeholders implementing/supporting HIV/AIDS projects/programs that submit timely reports to HAPCO using standard reporting formats
Purpose	To assess commitment and capacity of stakeholders in timely reporting HIV/AIDS activities
Measurement tool	Program report
Frequency	Quarterly
Responsible body	HAPCO
Method of measurement	A database will be established at HAPCO in which reports coming from stakeholders will be entered (including the time when reports were received and quality of reports). Numerator: Number of stakeholders implementing HIV/AIDS projects/programs that submit quarterly reports timely and using nationally agreed upon reporting formats Denominator: Number of stakeholders implementing HIV/AIDS projects/programs
Remark


PS11: National level HIV/AIDS forum and joint review meetings
Definition	Number of National Partnership Forum and Joint Review meetings organized by HAPCO in the last 12 months
Purpose	To assess progress on information sharing among stakeholders working in the area of HIV/AIDS
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	Follow-up and keep a record of national level HIV/AIDS Forum and Joint Review meetings organized by HAPCO
Remark


PS12: Regions that installed CRIS and have online access
Definition	Number of Regional HAPCOs that have installed CRIS and established an online access with National HAPCO
Purpose	To assess progress on development of electronic communication between HAPCO and Regional offices
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	Record Regions that installed CRIS and that have electronic communication system with National HAPCO
Remark


PS13: Training on M&E and Project Management
Definition	Number of staff at Regional and Woreda level trained on M&E and Project Management by HAPCO in the last 12 months
Purpose	To review the M&E and Project Management capacity of Regions and Woredas
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	Document all M&E and Project Management Training at Regions and Woredas by HAPCO
Remark


PS14: Financial utilization
Definition	Financial allocation and utilization in the last 12 months (disaggregated by component: BCC, Condom promotion and distribution, etc.)
Purpose	To assess efficiency of HIV/AIDS interventions in achieving their targets
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	All stakeholders implementing/supporting HIV/AIDS projects/programs are expected to report to HAPCO all financial resources allocated for and utilized by the project/program
Remark