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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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Presentation Transcript

Overview
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.

    • 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
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
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
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
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
Issues for M&E practitioners stage) of program implementation

  • 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)


Limitations
Limitations stage) of program implementation

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
Particular HIV/AIDS Issues stage) of program implementation

Prevention

  • 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 issues1
Particular HIV/AIDS Issues stage) of program implementation

Care and Support

  • Little M&E experience

  • Often community-based

  • Minimum care standards

  • Integration with TB-tracking referrals

    ARV

  • Patient-level tracking systems

  • Adherence


Stigma and discrimination
Stigma and Discrimination stage) of program implementation

  • 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


Human rights and humanitarian principles

  • 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


Facing trade offs in practice

  • Human rights instruments are 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” 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


Human rights as a framework in aids programming

  • Starts with a vulnerability and needs assessment 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”

  • Provides non-discriminatory assistance that is:

    • (i) available

    • (ii) accessible

    • (iii) acceptable

    • (iv) adaptable

Human Rights as a Framework in AIDS programming


Rights issues

Rights issues 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”

PLWA organizations

Confidentiality

Stigma

Exclusion from family and community

Loss of livelihoods


Balancing m e and rights
Balancing M&E and Rights 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”

  • 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 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”

  • 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 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” 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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