M&E-The Ethiopian Experience - PowerPoint PPT Presentation

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M&E-The Ethiopian Experience

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  1. M&E-The Ethiopian Experience MERG Meeting Geneva,Switzerland Oct. 25-26,2004 Dr. Wuleta Lemma, CDC/Tulane/WB M&E and Surveillance Advisor, HAPCO/MoH

  2. Outline • Background • M&E---Case Study • After Bangkok • New Development

  3. Status of HIV/AIDS

  4. Background-Ethiopia • People living with HIV/AIDS ……..…………….….. 1.5 million • Estimated percent of adults (15–49) infected with HIV ….. 4.4% • Rural = 2.6%; Urban = 12.6% • Cumulative deaths due to AIDS ………………..…... > 1 million • Children infected and living with HIV ………………... 96,000 • Cumulative number of children orphaned by AIDS …... 540, 000 • Number of pregnant women living with HIV …………. 130,000 • Number of PLWHA needing ART ……………………. 245,000

  5. Weighted urban HIV prevalence: 12.5%

  6. : 2.8% (2004) 2004 prevalence range: 1.0% - 5.2% Assumed start of rural HIV epidemic: 1984

  7. No. HIV-pos, 2003: Female: 810,000 Male: 650,000 Total: 1.5 million

  8. M&E-The Ethiopia experience

  9. Challenges to “One M&E System” • No M&E unit at the national level • Indicators not harmonized- Everybody have their own – Ministries, Donors, CSO etc • No unified data collection formats- Organizations have their own different formats for similar indicators- “Same person ” at lower fills it all !!!! • Different report-Information Flow • Limited not unified capacity building plan -- including training and human capacity at all levels to role out a national M&E system • Non existence of an integrated data base (including HMIS) • Surveillance more developed than Program Monitoring • Limited Budget for M&E • Non-existent and disjointed Evaluation plan • Infrastructure (road, telecommunication, networking, etc) varies from region to region

  10. M&E-2003-present • M&E Department at national ( 5 Staff ), Regional HAPCOs and district focal persons. M&E team includes MoH • Secured budget (MAP,GF, PEPFAR and Others) • Comprehensive training plan for all regions developed – ToT manual to follow • Equipment (Computers & accessories) for all regional M&E Departments and all new ART sites- Take advantage of Woreda net • National M&E Framework (with indicators, methods of data collection, Information flow, who collects what etc) after extensive consultation published in December 2003 and distributed to all Regions, NGOs, FBOs & Donors

  11. M&E 2003-present • National M&E Operational Plan with detail M&E Formats for all program activities • Assessment of National Financial Monitoring System of NHAPCO • Harmonization of GF requirement with national Indicators • Consolidated Surveillance and M&E resourcemapping for MoH completed • Expanded Surveillance : 66 sites for 2003, almost twice the number sampled in 2001 (34 sentinel surveillance sites in 2001) • first BSS done/report distributed nationwide (>27,000 sample) • BBS-2 starting

  12. After Bangkok

  13. University Students • 2003/4 (1996 ET) M&E data collected • 2 University Students/ Region plus • ~2 per District (606 district) • Most regions completed • Information includes at Federal level --Sector Ministries, Bilateral, Multilateral and NGOs

  14. Example-Forms

  15. M&E Operational Manual-12 modules-meeting in Nov, 2004 (>150 people)

  16. Other-Opportunity/Challenge • Ethiopia approved for the largest GF (GF2+GF4 > $600M, PEPFAR around 50M/year) • ~10-12% for M&E(inc. HMIS) and Surveillance/year • FMoH- HMIS (HMIS and M&E Advisory Committee formed-Work stared) • LMIS • Lab Information system • Patient monitoring system • M&E National/Regional ToT training • Training on Medical Record

  17. The Network Model Formal Health System Levels Service Components ART Specialty care Acute Illness Care HIV Counseling and Testing Pain Management Tertiary Referral Hospitals ( 5) C O M M U N I T Y Regional / Zonal Hospital Uniformed Services District Hospital District Hospital District Hospital Health Center HIV counseling and testing, PMTCT, OI treatment and prophylaxis, TB dx , ART follow up, nutrition counseling and support, psychosocial support [ pain management] Health Center Health Center Health Center Transporters CSW Health Posts HEP: basic general health care CHWs Basic care, including pain and symptom relief Home based Care

  18. New Development/Strategies • HAPCO to Report to MoH • Implication on M&E not clear (assumed not much as the National M&E Framework was accepted in SPM) • Implication on structure not clear • Health Extension Workers (23,000 to be deployed in 5 years). 2005 M&E training planned • Performance based District Block grants

  19. Thanks!!!