Accelerating the response for children affected by AIDS

- Monitoring the Response

Inter-Agency Task Team on Children and HIV and AIDS

Washington 23, 24 April 2007

Arjan de WagtUNICEF NYHQ

Global Partner Forum 2006 - Recommendations on M&E

Strengthen monitoring and evaluation to improve the accountability and performance of national plans through improving data collection for children.

Ensure national monitoring disaggregates by sex and age and includes the core indicators for children affected by HIV and AIDS, and build capacity to ensure information is collected and used to improve practice and to ensure accountability increases around vulnerable children.

IATT 2006 tasks for WG M&E

Review challenges M&E including:• Challenges with regard to the use of indicators• Indicators in Progress Report• Comparability between countries• in context of universal access

Recommendations to the IATT on: • M&E National Plans of Action• The Progress Report• UNAIDS Core Indicators for monitoring

Declaration of Commitment and Universal Access

What has WG done so far

• Sharing information and discussing M&E initiatives:• Harmonization of UNGASS indicators• Draft Coverage Survey results 2006• East and Southern Africa – M&E capacity building

workshops• Child Status Index• OVC Mapping Activity

• Developing TOR:• Share information, strengthening partner collaboration and

joint initiatives• Estimating numbers of vulnerable children• Prepare 2007 Progress Report

Unite for Children.

Unite against AIDS.

2007 Progress Report– A more complete picture on the response for children affected by AIDS

Arjan de Wagt, NYHQ

UNGASS indicators

Indicator Definition Epidemic Type Measurement Tool

Current school attendance among orphans and non-orphans aged 10–14

All countries Population-based survey;Every 2 yrs, at least every 4-5 yrs

Percentage of orphaned and vulnerable children aged 0-17 whose households received free basic external support in caring for the child

High HIV-prevalence countries

Population-based surveys;Every 4-5 yrs

• 2007 review of UNGASS indicators left the two OVCs indicators as is.

• Education indicator does not require reporting of ratio

Universal Access Indicators

High Level Meeting: “setting, in 2006,…., ambitious national targets …”

• Core indicators recommended by UNAIDS 1 of 7 core indicators is on external services for.

• East and Southern Africa as of mid September 2006:

• 6/20 endorsed UA targets • 8/20 expected by the end 2006• 6/12 with advanced or final indicators had indicator on

OVC support• Coverage targets 27% - 100%

(Progress Report: Universal Access Target Setting in East and Southern Africa Report to Regional UN HIV and AIDS Team. Prepared by UNAIDS-RST for ESA, 30 October 2006. PPT)

Some data available

% of children orphaned • Data for most countries• Orphaned due to AIDS estimates for

Africa• Planned estimates for other countries

Education• 44 report on education indicator • 27 countries ratio below 95 • 24 have measured at least twice • 15/24 increased ratio of at least 0.5• 4/24 drop in ration of at least 0.5

External Support • 14 countries reported• Coverage between 1% (Senegal) and

95% (Botswana); medium 10%;• In 2007 many more DHS and MICS data

sets with OVCs module available

Ratio of the proportion of orphans attending school to the proportion of non-orphans attending school

Ratio of the proportion of orphans (mother and father both dead) ages 10-14 attending school to the proportion of non orphans (living with at least one parent) ages 10-14 attending school

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Earlier data

Most recent data

Data provided by UNICEF based on analysis of DHS, 2007

Number of countries with data currently available on two OVC indicators

Region Indicator

Orphan school attendance ratio

Percent of OVC receiving external support

East & South Africa (n=21) 19 10

West Africa (n=24) 17 7

Latin America & the Caribbean (n=36)

5 0

Central & Eastern Europe/CIS (21)

0 0

Middle East & North Africa (n=20)

1 0

East Asia & Pacific (n=27) 2 0

South Asia (n=8) 0 0

Total 44 17

Countries with planned or ongoing surveys including OVC modules

Region Country MICS III DHS

ESARO Botswana   x

ESARO Ethiopia   x

ESARO Kenya   x

ESARO Leostho   x

ESARO Madagascar   x

ESARO Namibia   x

ESARO Rwanda   x

ESARO Uganda   x

ESARO Zambia   x

ESARO Zimbabwe   x

WCARO Burkina Faso x  

WCARO Central African Republic x  

WCARO Congo, DRC   x

WCARO Côte d'Ivoire   x

WCARO Equatorial Guinea x  

WCARO Ghana x  

WCARO Guinea-Bissau x  

WCARO Mali   x

WCARO Niger x  

WCARO Sao Tome and Principe x  

WCARO Senegal   x

WCARO Sierra Leone x  

WCARO Togo x x

Countries with planned or ongoing surveys including OVC modules …

MICS III DHS

EAPRO Lao PDR x  

EAPRO Thailand x  

ROSA Bangladesh x  

TACRO Belize x  

TACRO Dominican Republic x  

TACRO Guyana x  

TACRO Haiti   x

TACRO Jamaica x  

Monitoring national response

•Guidance to Govts, Internal organizations and NGOs

•Supplements UNGASS indicators

•10 core and 7 additional

•Most through surveys, only efforts index through key informants interview

Reporting on progress

• Progress report on behalf of IATT• 15 indicators

Conclusion:•Amount of data on the response is very limited • New report planned end 2007

M&E Limitations

• Data coming from surveys – every 3-5 years • Definitions of OVCs differ:

• Between countries• In countries between partners that provide services• Between goals, objectives, targeting criteria, actual

service delivery and M&E indicators• No standardized service package: difficult to

measure, difficult to compare, difficult to contextualize

• Double counting• Counting services does not say anything about

impact on children and quality of services

Proposed TOR Working Group on M&E – Monitoring Progress

• Strengthen national M&E capacity • Regional trainings and national follow up• National coverage reports based on NPA M&E

framework• Mapping activity

• Publish 2007 Progress report children affected by AIDS based on:

• New DHS / MICS data analysis• Efforts index 2007• Coverage survey results 2005• National level NGO coverage data

OVC Mapping Activity

Goal • Use (GIS) Geospatial Mapping as a tool for planning, evaluating and monitoring

OVC activities and servicesOutputs

• GIS Maps showing distribution of OVC, coverage by OVC care providers, distribution of services and GAPS for 14 African countries

Resources• PEPFAR M&E Data, Census Data, DHS Data, Child and DevInfo Databases,

Project data, National data, Vulnerability projectionsPartners

• OGAC, USAID, State Dept.• DevInfo UN• UNICEF• BuCen• CDC• National Statistics Bureaus• Univ. North Carolina• Constella Futures Group

Discussion

• Is the TOR complete• What else can be done to improve

national M&E capacity?• Do all national partners provide coverage

data?• Monitoring national response and

publishing at regional and global level• What about lower prevalence settings?

Unite for Children.

Unite against AIDS. Presentation:

Monitoring national responses on children affected by AIDS