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Cambodia Experiences in Relation to M&E for PR/MoH-GFATM. Presented by Dr. Or Vandine, PN, MD, MPH Deputy-Director, CDC Department Manager, PR/MoH-GFATM The Eighth MERG Meeting, Geneva, Switzerland 25 - 26 October, 2004. I. Background Information:.

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Cambodia Experiences in Relation to M&E for PR/MoH-GFATM

Presented by Dr. Or Vandine, PN, MD, MPH

Deputy-Director, CDC Department

Manager, PR/MoH-GFATM

The Eighth MERG Meeting, Geneva, Switzerland

25 - 26 October, 2004

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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I. Background Information:

* : In September 2004, the TRP of GF approved the clarification provided by the CCC in August 2004.

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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I. Background Information (Cont...):Multiple Sub-Recipients (SRs)

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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II. Roles & Responsibility of PR in Relation to M&E

  • Prepare all plans, reports and requests to be sent to the GF including the preparation of quarterly progress reports (financial/implementation);

  • Assist SRs with their reports and/or M&E plans (as needed);

  • Organize PRTRT meetings to review plans/reports;

  • Monitor SRs’ program activities on quarterly basis and/or as frequent as needed during the course of implementation;

  • Participate in national efforts to strengthen national M&E processes/systems;

  • Facilitate the LFA’s assessment process.

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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III. PR’s Key M&E Activities in 2004 :

Jan 2004 M&E Plans for Round 2 developed for 3 components: HIV/AIDS, Malaria, TB

Feb 2004 M&E training for SRs R1 & 2; Finalized the PR’s M&E assessment reports; Field visits

Mar 2004 Field Monitoring Visits to R1 SRs

April 2004 Meeting with SRs and Quarterly Report preparation and hosted the Asia Regional Conference for GFATM

May 2004 Revisions of the field monitoring approach; activity-specific checklists & issue-oriented reports;

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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III. PR’s Key M&E Activities in 2004 (Cont...) :

June 2004 Revisions of TB & Malaria M&E Plans; 2nd Quarter Field Monitoring visits to SRs (R1 & R2)

July 2004 Meeting with SRs and Quarterly Report preparation; Field visits; M&E presentation at AIDS Conference in BKK

Aug 2004 Finalized reports sent to the GF; Working draft of 2nd Edition M&E Guidelines developed; Presentation to CCC Sub-Committee

Sept 2004 Round 4 M&E Orientation Meeting for SRs; Presentation to CCC Sub-Com.; 3rd Quarter Field monitoring visits to SRs (R 1 & R2)

Oct 2004 Meeting with SRs and Quarterly Report preparation; Finalization of M&E Guidelines 2nd. Edition; Finalization of M&E Plans for Year 2 of Round 1; Work on the M&E Plans for Round 4; M&E Presentation to 8th. MERG Meeting in Geneva

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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IV. PR’s M&E Guidelines :

  • Developed with WHO TA ; largely adapted from and drawn upon other GF, UNAIDS & USAID’s documents, MoH M&E Framework, and other relevant documents at national level

  • Introduce key M&E concepts and framework

  • Provide guidance for development of SRs’ M&E plans

  • Provide instructions on GF reporting forms and requirement

  • Introduce GF’s performance-based disbursement concept

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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V. PR’s M&E Plans

1. Developed with WHO TA & key stakeholders at national level engaged in an intensive participatory & consultative process

2. All M&E plans developed

  • first by each SRs, next cumulative PR’s (GF formats)

  • Indicators selected via consensus, ensuring consistency with the approved proposal and the MOH M&E framework

  • Existing data collection systems incorporated whenever possible

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VI. Quarterly Reports Sequence :

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VII. Issues and Challenges :

1. Complexity of GF structure in Cambodia

  • Multiple players interdependent (SSRs, SRs, PR, CCC, LFA, GF)

  • Communication delays: multiple responses/approvals pending – unclear timelines – information sharing internally and read?

    2. Lack of transparency in assessment procedures and lack of clear expectation

  • Role & capacity of LFA in M&E unclear

    3. Limited M&E experience among some SRs

  • Delays in submitting final reports

  • Non-compliance of few SRS will penalize all

  • Extensive assistance from PR required

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VII. Issues and Challenges (Cont...) :

4. Requirement of M&E Plans and Reports based on the GF formats sometimes makes PR’s responsibility to “provide rigorous monitoring of program implementation” rather challengingdueto lack of direct linkage between indicators and activities

5. Quarterly Report with 45 days submission requirement  light reporting vs. more burden to the PRand even more difficult for some SR such as national program

6. Confusion of cumulative versus actual number in reporting requirement for process indicators

7. Monitoring visits by the PR to SRs

  • difficult to organize due to frequent changes by some SRS

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VII. Issues and Challenges (cont…):

8. Issue of “additionally” raised by the CCC-Sub-Committee

  • difficult to identify by PR

    9. Issue of “Partnership” versus “Ownership” in implementing the GFATM Program at country level

  • How to apply this in the reality at the grass-root level when implementing it

    10. Adjustment of actual implementation with original proposal

  • Unclear – how to do?

    11. Criticism about creating parallel M&E system just for the GF reporting purposes: cannot find 1 system covering all needed information to be reported to the GF?

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VII. Issues and Challenges (cont…):

12. Evolving of M&E New Formats by the GF

  • Need for adjustment in the middle way of implementation and time consuming in doing so (especially very difficult for the large number of SRs)

    13. Delays in the approval of Procurement Plan

  • Significant adverse effect on program involving ARV drugs and anti-malarial drugs

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VIII. Recommendations :

  • GF to speed up the approval process

  • LFA to communicate and discuss with PR before sending recommendations to GF

  • GF to reconsider the frequency of reporting from quarterly to semi-annually

  • GF to reconsider the deadline of 45 days for report submission (may be from 45 days to 60 days?)

  • GF to provide clear guidance on proposal adjustments based on actual needs

  • GF to inform the PR with clear guidance and timeline if there is any change or need to use the new formats

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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VIII. Recommendations (Cont...) :

  • How to MONITORING THE ADDITIONALITY OF GF’S FUNDS ?

  • Multiple SRs (especially large ones) receive funding from multiple sources and report results as a “joint effort” ; It is difficult to ensure and demonstrate the additionally of GF funds in such cases

    • OPTION 1:

      • Request that results are reported as GF-exclusive; that would require setting a separate reporting system (contrary to GF guidance)

    • OPTION 2:

      • Request that SRs program GF funding in a distinct manner, either by specific results, or geographically from THE ONSET OF THE PROGRAM

        CLEAR GUIDANCE FROM GFATM-HQ NEEDED!!!

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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IX. Recent M&E Accomplishments :

  • Strengthening monitoring visits

    • Developed and implemented 8 activity-specific (1 page) M&E tools

    • Feedback at the filed and to SRs

    • Using information from reports and filed visits to provide special intervention/support to weaker and/or link those with stronger SRs for improvement (feedback loop)

  • Revised M&E Guidelines  2nd. Edition

    • Incorporated lesson learned and adapted with M&E Guidelines issued by GF (M&E Tool Kit of June 2004)

    • Included all 3 diseases

    • Introduced PR’s new QA M&E Tools

    • Added Annual Workplan to promote more effective program monitoring

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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IX. Recent M&E Accomplishments (Cont...) :

  • Reorganized Regular Quarterly Meeting with SRs

    • Group them by program sub-component that provided a chance for SR of Round 1 and Round 2 to interact and to share experiences

  • Requested for Changing Reporting Sequence

    • Change from quarterly to semi-annually (on going process)

    • Maintain regular quarterly reporting with SRs

    • Extension of Annual Report for Round 1 (through December 2004)

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004


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Thank You!

MERG Meeting Geneva - Cambodia GFATM M&E; October 2004