MEASURE Evaluation has contributed significantly to the global M&E agenda. There is now greatly increased funding and emphasis on HIV monitoring. MEASURE Evaluation has improved data collection and quality at both the global and country levels through new guidelines, tools, and field interventions. Capacity building efforts have increased the number of national M&E plans and units, though capacity remains low. While more and better quality data is available, progress is still needed on evaluation to understand what works best.

1. Si ân Curtis Project Director Where are we now? MEASURE Evaluation’s Contribution to the Global M&E Agenda

2. What is different in Phase II? Greatly increased funding and emphasis on HIV Many global players, especially in HIV “ Three Ones” High demand for information for accountability and emphasis on targets MDGs, PEPFAR 2-7-10, WHO 3 by 5 Growing interest in M&E for other disease-specific programs (malaria, TB, avian influenza)

3. MEASURE Evaluation Conceptual Framework

4. Data Demand and Information Use Conceptual framework Embeds the decision-making process within the information use cycle Participatory approach to strengthen decision-maker involvement integrated from the beginning “ Start with the use in mind” Tools & approaches with field applications Decision calendar, assessment of data use constraints, information use mapping, stakeholder engagement

5. Improving Data Collection: Global Level New/updated guidelines and standards Population, health & environment, avian influenza Monitoring of patients on ART Data quality improvement tools M&E System Strengthening Tool, Data Quality Assurance Tool for Program Level Indicators, Data Quality Assessment Tool Performance of Routine Information System Management (PRISM) toolkit Development of improved data collection methods Sample Vital Registration with Verbal Autopsy (SAVVY)

6. Improving Data Collection in the Field Global initiatives have to be implemented in the field to improve data collection in practice Opportunities to implement field interventions to improve country level M&E and health information systems C ôte d’Ivoire – incorporate HIV/AIDS data into RHIS – first ever HIV/AIDS national report in 2005 Nigeria – Nigeria National Response Information Management System – 10 states able to produce state-level reports Improving data collection and quality takes time

7. Making Information More Available Ongoing data collection and analysis to provide actionable findings Improved information systems, discrete surveys, secondary analysis Effective and appropriate communication of information Mapping Use-oriented dissemination Emerging technologies

8. Capacity Building M&E and HIS capacity almost universally low Gains made do not keep pace with rising demand for M&E and HIS expertise Building individual and institutional M&E and HIS capacity is an intervention itself and takes time Increasing attention to national M&E capacity M&E and HIS capacity assessments

9. Capacity Building in the Field: Are we making any difference? National M&E plans now exist for many national programs, particularly HIV Increasingly accompanied by operational plans M&E units now common in many national institutions USG Strategic information teams established in PEPFAR focus countries Improved capacity of PEPFAR implementing partners to provide data for PEPFAR

10. Training Partners Five regional training partners INSP, Mexico; CESAG, Senegal; Mahidol University, Thailand; University of Addis Ababa, Ethiopia; University of Pretoria, South Africa Most sessions in regional M&E short courses taught by partner faculty Partners now holding workshops independently Partners involved in field TA TA in West Africa, ASAP partnership, Coverage Plus survey

11. Coordination and Collaboration: Global Level Several joint publications with global agencies ART patient tracking guidelines, UNAIDS M&E Guide for Concentrated epidemics, etc. Participation/leadership in global networks Health Metrics Network, UNAIDS MERG, RBM MERG, RHINO, International Health Facility Assessment Network Participation in global harmonization efforts M&E capacity assessment tools Indicators (e.g. HIV/AIDS, malaria)

12. A lot of emphasis on M but E is important too Need to think about evaluation at the beginning not at the end, but it is hard to attract attention at that point Timing – projects are already underway and it is hard to incorporate a strong evaluation design Scale – many projects are too small to expect to be able to demonstrate impact Pressure for rapid results to inform programs now Expectations of multiple stakeholders – scope, competing objectives Political will – need someone in a position of authority to buy in and advocate for evaluation Where is the E in M&E?

13. Conclusions There is rapidly growing demand for health information and M&E More and better quality data than before but still a long way to go Progress on tools to strengthen information & M&E systems and data quality M&E guidance now exists for several program areas that did not have such guidance Progress in some measurement areas such as vital events More strategic thinking on data demand and use but needs more evaluation More attention needed to evaluating what works

14. MEASURE Evaluation is funded by the U.S. Agency for International Development Through Cooperative Agreement GPO-A-00-03-00003-00 and is implemented by the Carolina Population Center at the University of North Carolina in partnership with Constella Futures, John Snow, Inc., Macro International Inc., and Tulane University.