The M

1
The ME of the Multi-Sectoral Response of
HIV/AIDSThe Ethiopia Experience

• Dr. Wuleta Lemma
• ME Surveillance Advisor, Ethiopia
• (CDC/Tulane,HAPCO/MoH/WB)
• First International Strategic Information
  (SI)/Monitoring Evaluation (ME)
• Field Officer Orientation
• August 9-20, 2004 Atlanta, Georgia, USA

2
Outline

• Background
• Challenges faced in starting one ME system
• Accomplishments
• Lesson Learned

3
Ethiopia
Ethiopia
4
Background

• 70 million people with 9 Regions and 2 ACs
• Home to the third largest HIV/AIDS infected
  population next to India and South Africa
• The prevalence of HIV/AIDS among adult
  population is 6.6 (2002)
• 2.2 million people are estimated to live with
  the HIV virus
• Existence of a five year (2001 2005)
  Strategic Framework for the National Response
  (currently being revised)
• Establishment of HAPCO by National Proclamation
  No. 276/2002. in June 2002

5
Challenges to One ME System

• Indicators not harmonized- Everybody have their
  own Ministries, Donors, CSO etc
• No unified data collection formats-
  Organizations have their own different formats
  for similar indicators- Same person at lower
  fills it all !!!!
• Different report-Information Flow
• Limited not unified capacity building plan --
  including training and human capacity at all
  levels to role out a national ME system
• Non existence of an integrated data base
  (including HMIS)
• Surveillance more developed than Program
  Monitoring
• Limited Budget for ME
• Non-existent and disjointed Evaluation plan
• Infrastructure (road, telecommunication,
  networking, etc) varies from region to
  region

6
Accomplishments

• Budget (MAP,GF and Others)
• ME Department at national ( 5 Staff) and
  regional HAPCOs established following mapping
• Comprehensive training plan for all regions
  developed ToT manual to follow
• Equipment (Computers accessories) for all
  regional ME Departments and all new ART sites
• National ME Framework (with indicators, methods
  of data collection, Information flow etc)
  published in December 2003 and distributed to all
  Regions, NGOs, FBOs Donors

7
Report/information flow
8
Accomplishments

• National ME Operational Plan with detail ME
  Formats for all program activities - to be
  discussed in National Consultative meeting end
  July/Aug 2004
• Assessment of National Financial Monitoring
  System of NHAPCO
• Harmonization of GF requirement with national
  Indicators
• Consolidated Surveillance and ME resource
  mapping for MoH completed
• Expanded Surveillance 66 sites for 2003, almost
  twice the number sampled in 2001 (34 sentinel
  surveillance sites in 2001)
• first BSS done/report distributed nationwide
  (gt27,000 sample)
• BBS-2 starting

9
Accomplishments

• LQAS- Sampling being done with WB, Survey to
  start in Sep/2004
• Integrated data base (with Health) to be linked
  with CRIS under development
• Plan with budget for all Surveys identified in
  the NMEF
• Integrated research plan with EPHA. 930 research
  documents collected and published
• UNGASS 2005 - implementation started

10
Accomplishments

• Initial preparation underway with CDC to develop
  an integrated data base at facility level for
  PMTCT, ARV, VCT, LAB, Pharmacy and Surveillance
  in the ART designated HFs (Patient record )

11
Lesson learned

• Need high political commitment
• Need an ME Unit at a national and Sub-Regional
  Level
• Need Champions at all level
• Need to bring all stakeholder together
• Strong relationship between NAC and MOH
• Need to address the issues in a comprehensive
  manner with a strategy also to build systems (e.g
  HMIS)
• Strong communication and dialogue at all level
• Be prepare to learn
• Budget !! Budget !!Budget!!
• Advocacy
• Innovation (use every means University Students)
• Never give up!

12
Guiding principle minimal information !
13
THANK YOU!!!!!
To a person with a hammer in their hand, every
problem looks like a nail.
Tackling HIV/AIDS