4. Reporting Issues

Regardless of the level or type of intervention, successful programs must ultimately result in a reduction in vulnerability and an improvement in the well-being of OVC. To evaluate improved well-being, and to ensure effective, quality programs, the Emergency Plan requires program- and national-level monitoring and evaluation. The amount of information required by the U.S. Congress on the progress of PEPFAR is limited to national total numbers of OVCs served (direct and indirect), caregivers trained, and monies spent. However, more detailed information is needed in-country on the program level to monitor and evaluate adequate progress toward improving the well-being of children affected by HIV/AIDS. U.S. Government country teams should support implementing partners and national Governments to develop coordinated monitoring-and-evaluation plans for OVC programs and community-based efforts based upon the UNAIDS principle of having one, agreed-upon, country-level monitoring-and-evaluation system.

Output and outcome data along with other records of measurable results are needed to track improvements in the well-being of children served and the effectiveness and quality of programs. U.S. Government country teams and implementing partners should allocate funds for surveillance, monitoring and evaluation, sharing lessons learned, and the assessment and reporting of results proportional to programming resources for OVCs (normally about seven percent of total program costs for strategic information). It is important for information regarding program results to flow in both directions. Extra efforts are often required to relay important findings in local languages and digestible formats to flow back to local partners, community institutions, caregivers, and to OVC beneficiaries themselves. Such efforts will enable the principle of genuine participation in OVC programming. This section briefly discusses three specific issues that need additional consideration:

4. A. Direct and Indirect Targets

Distinguishing between direct and indirect targets can sometimes be difficult. For PEPFAR, direct results or targets are uniquely identified individuals receiving services through service delivery sites directly supported by USG programs (interventions/activities). Those individuals are counted at the point of service delivery. Indirect targets are estimates of the number of individuals served as a result of the USG?s contribution to system strengthening. System strengthening activities may includes support to national, regional, or local activities such as policy development; logistics; protocol or guideline development; advocacy; capacity building; national or regional training; national management information systems, etc. (See PEPFAR Data Quality Guidelines, 2006. ²⁸)

How to identify direct and indirect targets is further illustrated in the table below.

Distinguishing term: Direct/Indirect
Site-specific: Direct
Uniquely identified individuals: Direct
Count: Direct
System strengthening: Indirect
Estimate: Indirect

4. B. Measuring OVC Targets

There are two direct targets related to OVCs at the national level: OVCs served and Providers/Caregivers trained. Starting with the FY07 SAPR and APR, measurement of the OVCs directly served target will be divided into two subcategories: OVCs receiving primary direct support and those receiving supplemental direct support. If your country?s OVC monitoring system is not yet able to provide this breakdown, you must write a one-paragraph justification for providing only total numbers of OVCs served. Additionally, work with your partners to put such a monitoring system in place. Building on the above descriptions of direct and indirect targets, following are definitions for the OVC targets.

Number of OVCs served by OVC programs:

Direct OVC Support: Direct recipients of support are OVCs who are regularly monitored in the six core areas (food/nutrition, shelter and care, protection, health care, psychosocial support, and education) and whose individual needs are addressed accordingly. Economic strengthening should be evaluated according to its benefit to the six core areas.

Primary Direct Support: Count OVCs who are periodically monitored in all six core areas and who are receiving PEPFAR-funded or leveraged¹ support in three or more areas, in the relevant reporting period, that are appropriate for that child's needs and context.

Supplemental Direct Support: Count OVCs who are periodically monitored in all six core areas and who are receiving PEPFAR-funded or leveraged support in one or two areas, in the relevant reporting period, that are appropriate for that child?s needs and context.

Total Direct Support: Sum of Primary and Supplemental Support.

Indirect OVC Support: Indirect recipients of support are OVC who are NOT individually monitored but who collectively benefit in some way from system strengthening or other interventions. For example:

• Estimated number of OVCs benefiting from a policy change or improved system (e.g. birth registration, inheritance laws, educational system).
• Estimated number of OVCs benefiting from the training of, or support for, caregivers.

An OVC may be counted under one category only (i.e. cannot be counted under both direct and indirect). In order to provide the national-level breakdown between primary and supplemental direct support, program-level monitoring will need to be done by core service area. Tracking gender is already required; tracking by age group may also be helpful for developing appropriate service strategies. Assistance can be provided by the TWG for countries needing to develop necessary monitoring systems.

4. C. Double-Counting

Double-counting is a challenge in accounting for support provided to OVCs, since there are many interventions and, often, multiple providers. The support individuals require also varies by individual, and from sub-population to sub-population, so no one standard package of care is always appropriate or effective. Double-counting of orphans and vulnerable children served can occur within a program when the same child is counted many times as a result of receiving multiple services. It can also occur when two or more implementing partners support the same child. Double-counting can also occur because of overlap between direct and indirect support. (See the Emergency Plan guidance on data quality.)²⁹ To avoid double-counting, the monitoring and evaluation of programs demands much more detailed accounts than simply counting the number of children served. In general, the more detailed the accounts, the less likely there will be double-counting of the number of orphans and vulnerable children served.

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