Presented by Stephanie Watson-Grant, Kolawole Oyediran, and Tariq Azim at the MEASURE Evaluation End-of-Phase-III Event.

1. Building Sustainable Country-
Owned M&E Systems: From
Principles to Practice
Stephanie Watson-Grant, Kolawole Oyediran,
and Tariq Azim
MEASURE Evaluation
End-of-Phase-III Event, May 22, 2014

2. Outline of Session
 Principles of sustainable country
ownership
 Practice from selected countries
 Nigeria
 Ethiopia

3. UNAIDS “Organizing Framework for a
Functional National HIV M&E System”

4. Situating Sustainable Country Ownership
People, Partnerships and Planning

5. What does it mean
to have a sustainable
country-owned M&E system?

9.  PRISM Assessments completed 9
times in 7 countries and M&E
systems assessments 12 times in
7 countries over Phase III
 79 cross ministry/
department coordination
mechanism working/groups
established
 19 instances of requests for
funding resulting from M&E
activities

10.  106 M&E system
related plans
developed
 In 4 countries, requests
for technical assistance
for clearer leadership
structures
 72 documents for
system strengthening
developed

11.  34 instances of
demonstrated
independent M&E
capacity
 16 capacity building plans
for bridging gaps
developed
 In Rwanda and Ethiopia a
specific budget line item
for the HMIS unit added
by the Government

12.  25 data capture and
collation instruments
developed
 In Kenya standardized
community health
information system data
collection instruments
used in all facilities
 In 3 countries
information products
developed with national
partners

13. Painting to Brush Strokes
The Nigeria and Ethiopia stories…

14. A Country-developed,
Country-owned M&E System:
A Road to Creating Developing Nigeria’s National HIV
Monitoring and Evaluation System

15. Assessment Overview

16. Stakeholders
 National Agency for the Control of AIDS (NACA)
 National HIV Division (NASCP), Federal Ministry of Health
 Orphans and Vulnerable Division, Federal Ministry
of Women’s Affairs and Social Development
 Federal Ministry of Education
 Federal Ministry of Defense
 Sub-national levels – represented by six states
 Nigeria Business Coalition Against AIDS (NIBUCAA)
 Civil Society for HIV/AIDS in Nigeria (CiSHAN)
 Development Partners --- UN-systems, DfID,
World Bank, and USG

17. Stakeholders’ Decision
 After consultation
and consensus
building, UNAIDS’
Organizing
Framework for a
Functional National
HIV M&E System
(12 Components
Tool) to be used to
assess NNRIMS
Assessment of the
NNRIMS

18. Setting-up of Steering Committee
 Chaired by NACA-SKM
 Provided oversight roles
 Developedconcept notes or
activityproposal
 Secretariat coordinated
by NACA

19.  Facilitators and
stakeholders
reviewed
existing
documents and
materials
Assessment
Workshop Planning

20. Assessment Workshop

21. M&E Assessment Workshop:
Checklist

22. M&E Assessment Workshop:
Checklist

23. M&E Assessment Workshop:
NACA Dashboard

24. Outcomes
 Developed a multi-
year, multi-sectoral,
costed work plan
 Improved coordination
and collaboration
 Understanding of the
systems enhanced

25. Challenges and Lessons Learned
 Competitive environment
 Engage stakeholders to laydown
partnership framework will help in
establishing ownership for M&E
 Human Resource Gap
 Building local capacity will help is
sustaining partnerships and ownership
for M&E

26. Challenges and Lessons Learned
 Donor’s expectations and local priorities
 Partnership framework with clear define
roles and responsibilities will play vital roles
in sustaining ownership for M&E
 Allocation of resources
 Development of costed workplan will
ensure ownership for M&E

27. SNNP REGIONAL HEALTH
BUREAU
Sustainable Country
Ownership In Practice
Evidence-based Story of
HMIS Scale-up in Ethiopia

28. Training Mentoring
IT System Development
Guidelines, Indicator Revision
HMIS Data Collection, Reporting
Use of HMIS for Decisions
eHMIS Use
LevelofResponsibility
Time
Overall Strategy: Shared
Responsibility
SNNP RHB
MEASURE
Evaluation
Capacity Building Owning & Leading
DataQuality Assurance

29. Developing HMIS Training Skills
Potentialtrainerschosen
basedontheirproactive
participationandspeaking
skills
Regional, Zonal and
Woreda Process
Owners
Use HMIS and support HMIS
within their respective
program area
Training ofTrainers
Regional, Zonal and
Woreda Process Owners
Assisttheprojecttrainers
infacilitatingnexttraining
event
Actively facilitate sessions;
project trainers support
them
Take over the role of
prime trainers

30. HMIS Capacity Building
30,670 trained on various HMIS skills

31. Capacity Building – HFs Implementing HMIS
317 415
566
696
478
672
1679
2142
2487
3536
3825 3689
657
2005
2802
3073
4216
4464 4511
4408
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
HCs
HPs
Total Hosp, HCs &
HPs submitting
HMIS Reports in
SNNPR

32. Capacity Building – RHB Managing Every
Aspect of CHIS Scale-up in Oromia
6423
5055
3826
2969
2214
5187
4354
3211
2762
0
1000
2000
3000
4000
5000
6000
7000
Total Health
Posts (HP)
HPs with
trained HEWs
HPs with
Family
Folders
HPs
completed
Household
registration
HPs reporing
using CHIS
Jan-14
Feb-14

33. Going Electronic….
33
ZHD
WoHO
RHB Server
WoHO
Offline data entry
InternetPerformance
Report
Decision Support
System
Master Health
Facility List
Data Entry
District, Regional
Aggregation
ReportTracker
eIDSR & eMCS

34. Results…. Commitment
“ThisweekendI amat Soddodiscussingwithpeople
fromWolaita,DawroandKontasp.Woredato
improvedataqualityandtostrengthenuseof
informationat lowerlevel.”
….Ato Firew (Plan and M&E Process Owner,
SNNPRHB)

35. Results…. Accountability
“The points raised are correct and
we have tried investigate and we
are taking actions accordingly.”
….Ato Kare (SNNPRHB Head)

36. Results….Taking Over the Lead Role
“...wehavetoevaluateitas soonas possibleandwe
havetoproceedforthescale-up. I proposethatto
startoncluster1 by Tikimtandthencluster2 & 3
HidarandTahisasrespectively”
….Ato Firew (Plan and M&E Process Owner,
SNNPRHB)

37. Training Mentoring
IT System Development
Guidelines, Indicator Revision
HMIS Data Collection, Reporting
Data QualityAssurance
Use of HMIS for Decisions
eHMIS Use
LevelofResponsibility Shared Responsibility – Where Are We?
SNNP RHB
MEASURE
Evaluation
Capacity Building Owning & Leading
Time

38. Closing Thoughts
 The dimensions are symbiotic and require a
holistic approach
 Strong but respectfulpartnerships with joint decision
making is critical
 Tangible demonstrationof commitmentto and
responsibility forM&E systems including leadership and
governancestructuresis vital
 Mutually reinforcingcapacity is necessaryfordeveloping
and managing M&E systems
 Processes that ensure accountability will contribute to
strong and lasting M&E systems.

39. www.measureevaluation.org/eop