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AIDS: M&E and Human Rights. Overview. Information versus privacy Necessity of M&E Key human rights issues Finding a balance. There is an increased understanding of the AIDS in Asia. The principal modes of HIV transmission HIV is generally concentrated among certain populations.

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AIDS: M&E and Human Rights

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AIDS: M&E and Human Rights


  • Information versus privacy

  • Necessity of M&E

  • Key human rights issues

  • Finding a balance

There is an increased understanding of the AIDS in Asia

  • The principal modes of HIV transmission

    • HIV is generally concentrated among certain populations.

    • Infections appear first among IDUs, SWs and Clients, and MSM, but then it spreads to wives and children

  • The driving forces of Asian epidemics

    • sharing of needles during Injecting Drug Use – kick-starts and accelerates the epidemic

    • unprotected Commercial sex – gives it range and power

    • Sexual networking among Asian men markedly higher than women

  • Projections into the future based on various scenarios indicate that the spread could be slowing

Functions of Frameworks for M&E

  • Roadmap to program planning, monitoring and evaluation

  • Delineate clear pathways to program goals & objectives

  • Define relationships between program inputs, processes, outputs, and outcomes

  • Describe how program factors interact with external context (environmental factors)

  • Lead to sound implementation and good M&E plans

Frameworks and Indicators

  • Understand how indicators are linked to frameworks

  • Describe how to operationalize indicators

  • Identify the role of indicators at different levels (national, sub-national, project) and the linkages between them

  • List sources of indicators that are international standards

  • Select indicators and define indicators for an M&E plan

M&E system and plan

  • Theoretical Basis: Global Fund and UNAIDS Guidelines

  • Routine Reporting: reporting tool, financial & narrative

  • Surveillance System:

    • Repeat biological and behavioural surveys

    • Facility surveys

  • Research:

    • Evaluations of existing interventions

    • Evaluations of new interventions

    • Other Research: to inform programme development & planning

  • Overall System: Flowchart and database, M&E plan, Log frames with indicators

Indicators provide critical M&E data at every level (and stage) of program implementation

  • Inputs, Process

    • Was the program carried out as planned?

      • How well was it carried out?

  • Outputs, Results

    • Did the expected change occur?

      • How much change occurred?

  • Outcome, Impact

    • Has the outcome changed in desired direction?

      • Does the change signal program “success”?

Issues for M&E practitioners

  • Challenge of identifying trends and changes

  • Comparability of samples

  • Ensuring methodological consistency (documentation, staff turnover)

  • Attributing changes to programmes and interventions (impossible)

  • Role of stakeholders / programme managers in interpretation of findings

  • Consider how to optimise the data and investment in research (e.g. advanced analysis)


All indicators have limitations, even those

commonly used:

  • Blood safety: cannot monitor private facilities adequately

  • Sexual behavior(e.g. condom use, number of partners): self reporting bias

  • Sero-surveillance: get biased population (pregnant women and other populations)

  • Population-based HIV prevalence: refusal bias , sampling bias

Particular HIV/AIDS Issues


  • Quality of reporting of sensitive behaviors

  • Identifying size of most-at-risk population

    Voluntary Counseling and Testing

  • Measuring impact

  • Quality of services

  • Service cascade

Particular HIV/AIDS Issues

Care and Support

  • Little M&E experience

  • Often community-based

  • Minimum care standards

  • Integration with TB-tracking referrals


  • Patient-level tracking systems

  • Adherence

Stigma and Discrimination

  • Definitions

  • Measurement tools – validity in different contexts

  • Selection bias – only disclosed PLWHA observed

  • Psychosocial support measurement

  • Ethical & methodological issues in data collection

  • Sensitive data, public perceptions

  • IFRC Code of Conduct, Principle 2: “aid is given regardless of the race, creed, or nationality of the recipients and without adverse distinction of any kind. Aid priorities are calculated on the basis of need alone”

  • Good Humanitarian Donorship Initiative: “humanitarian action should be guided by… impartiality… without discrimination between or within affected populations”

Human Rights and Humanitarian Principles

  • Human rights instruments are aspirational

  • It is not always possible for governments to adopt policies that respect all human rights at all times

  • But it is possible to incorporate a human rights dimension into planning and operations

Facing Trade-Offs in Practice

  • Starts with a vulnerability and needs assessment

  • Provides non-discriminatory assistance that is:

    • (i) available

    • (ii) accessible

    • (iii) acceptable

    • (iv) adaptable

Human Rights as a Framework in AIDS programming

Rights issues

PLWA organizations



Exclusion from family and community

Loss of livelihoods

Balancing M&E and Rights

  • General public communication on AIDS

  • Staff Training

  • Communication with PLWA

  • Engagement with PLWA organizations

  • Consistency in M&E procedures

  • Management of information/confidentiality

Moving forward

  • Behavioral surveys are necessary for identifying and characterizing the risk factors.

  • M&E helps identify effective interventions which can bring down new infections effectively have been demonstrated.

  • Countries understand the need for information and are starting to generate more data and fill data gaps.

  • Stronger health system support for treatment and PMTCT programs results in fast scale up.

  • Social environment changing across the region: communication regarding AIDS and perceptions of PLWA remains necessary and a continual requirement for effective national programs

What needs to be done next?

  • Understand the characteristics of the epidemic and tailor the response.

  • AIDS should get to the top of the agenda for activists and social reformers

    • It provides a platform for civil society no other movement was able to provide earlier.

  • Focus on programs that produce impact and results, and do not spend limited funds on low impact interventions.

  • Coverage and scale up is the key - Attempt and attain more than 80% coverage of populations who need prevention and treatment services.

  • In the long term,

  • impact mitigation is the key

    • special focus on vulnerable groups

    • AIDS related stigma and discrimination should be addressed through a variety of channels

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