Project Title: Strategic Information/Evaluation (SI)
Budget: FY 2006 GHAI: $31,185,000
Implementing Mechanism: United States Government (USG) Agency (HHS, USAID, DOD, Census Bureau, State Department, Peace Corps) Cooperative Agreements, Contracts and Grants.
Contact Person(s): Kathy Marconi (OGAC)
Strategic Information measures progress toward the Emergency Plan�s 2-7-10 goals through surveillance and surveys, management information, program monitoring and evaluation. Counts of progress toward two million people supported in treatment and ten million individuals in care, including orphans, and vulnerable children are measured semi-annually. The goal of averting seven million infections is estimated using surveillance and survey data. In addition to reporting results, Strategic Information supports field target setting activities and capacity building efforts in these technical areas. Work is done in coordination with technical staff of other international donors. The SI budget funds multiple USG agencies to implement these technical efforts. USG agency strategic information work plans are defined jointly by technical workgroups that include health management information systems (HMIS), monitoring and evaluation, and surveillance.
FY 2006 Program:
In FY 2006, USG headquarter agencies have seven mutual priorities, as described below.
- Performance-based Reporting: Expanding one USG performance reporting system to all country USG offices that spend over $1 million annually on HIV/AIDS. In FY 2005, all USG agencies with programs in this set of countries agreed to a common set of performance-based reporting indicators. A subset of these countries (11 bilateral countries) set FY 2006 program targets based on these indicators. In FY 2006 USAID and HHS/CDC will take the lead in training country staff on target setting and reporting results by the end of 2006. Training and technical assistance to focus countries on target setting and reporting will continue.
- International technical collaboration: With the World Health Organization (WHO), The World Bank, UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), FY 2006 collaboration will focus on identifying common information management standards and content for use by all donors working in HIV. Given the need to build systems in the focus countries for patient medical record keeping to monitor HIV treatment and care; for one reporting system to national governments; and for feedback of this information for program improvement; support will continue for joint international efforts. For example, in FY 2006, WHO with US and other support is undertaking training on Interim Patient Monitoring Guidelines for HIV Care and Antiretroviral Therapy. These internationally agreed-upon guidelines set clinical recordkeeping standards that enable the rapid scale-up of effective HIV chronic care, treatment and prevention and facilitate standardized reporting. A joint monitoring and evaluation capacity building workshop is being planned for Asia, along with associated distance learning modules. A series of surveillance training co-sponsored with international groups continues.
- Strengthening HIV Surveillance and Surveys: Antenatal clinic sentinel surveillance and in many focus countries, population surveys, such as the Demographic Health Survey (DHS) and the AIDS Indicator Survey, provide information for (1) calculating infections averted and (2) targeting prevention efforts. The U.S. Census Bureau is responsible for estimating infections averted from surveillance and other information. By July 2006, the Census Bureau will produce baseline calculations for infections averted for each focus country. The baselines will be used in future years to calculate infections averted. Additional projects provide information and analysis for countries to use in planning HIV prevention, treatment, and care efforts. For example, further development by the U.S. Census Bureau and other collaborators of SAVVY � Sample Vital Registration and Verbal Autopsy � which provides a less costly method of assessing proportional mortality due to HIV/AIDS. HHS/CDC is initiating surveillance pilots that address HIV drug resistance surveillance and recent infection surveillance.
- Institute of Medicine Evaluation Study: The Emergency Plan�s authorizing legislation requires that, Not later than three years after the date of the enactment of this Act, The Institute of Medicine shall publish findings comparing the success rates of the various programs and methods used under the strategy described in subsection (a) to reduce, prevent and treat HIV/AIDS, TB and malaria (Sec. 101 (c) (1)). The Institute has constituted an independent, external expert scientific review panel and is conducting field work to complete an interim report in October 2006 that addresses a variety of measures of program and methodological areas.
- Support of management information systems to enable Emergency Plan planning and reporting: This consists of the HIV planning and reporting databases of the USG, which include the multi-agency headquarters database (Country Operational Plan and Reporting System (COPR)) and USG country databases. FY 2006 objectives include stabilizing and completing the COPR database for use by all participating USG agencies; completing international confidentiality patient guidelines and guidelines for country reporting systems; and providing support to the field to ensure that all focus countries have strategic investment plans for HMIS and that all countries with bilateral programs obtain necessary technical assistance in informatics.
Data use for quality improvement. The need for feedback of information to partners for quality improvement has grown in importance as prevention, treatment, and care programs scale-up to serve additional individuals. In FY 2006, resources are targeted to translate existing science and data into useful information by program implementers. For example, activities will include completing COPR database searches and easily readable results reports, conducting training on data use for partners, and assisting countries with data analyses for program planning.
- Targeted Evaluations: A number of agencies� headquarters implemented targeted evaluations in FY 2005 that focused on cross-cutting issues, including best practices in monitoring antiretroviral therapy (ART) resistance and antiretrovirals (ARV) adherence support; estimating the cost of ARV treatment; measuring the impact of prevention of mother-to-child transmission (PMTCT) programs on HIV prevalence rates in infants and the effectiveness of abstinence interventions for youth; and effective components of orphans and vulnerable children (OVC) programs targeted to children affected by HIV and palliative care programs and outcomes. FY 2006 is the second year of these two-year evaluations.
This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections; supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.
Time Frame: FY 2006 � FY 2007