Monitoring and evaluation
The following is a transcript of an interview of Etienne Michaud during a recent visit to attend Aidspan’s Regional Roundtable in August 2015. The interview has been condensed for clarity.
Aidspan : The OIG has no presence at country level. How are you working with country-based organizations to support your work ?
Kenya in 2013 formally decentralized a series of governance responsibilities to its 47 counties, including the provision of health care. But while the original goal of devolution was to improve efficiency in service delivery and permit greater ownership and engagement at the local level, in the health sector this has not translated as well as anticipated.
I was in Nairobi recently to help Aidspan facilitate a meeting with the representatives of about 30 organizations from East and Southern Africa involved in the monitoring of global health programs.
A project being implemented under a Global Fund grant will improve Zimbabwe's health information systems by providing Internet connection infrastructure for 82 urban and rural sites. The Zimbabwe project is just one of many similar projects around the world where modern communications technology is being used to enhance data collection.
Of the approximately 80 million insecticide-treated nets distributed through Global Fund–supported programmes in 2012, about 66 million (73%) went to sub-Saharan African countries. This is well below half the 150 million insecticide-treated nets that the World Health Organisation estimates are needed annually to protect all populations at risk of malaria in this region.
TB mortality has decreased significantly since 2000 and treatment success rates have shown steady improvement. More than half of the countries that have received Global Fund support are on track to meet the international targets for case detection, treatment success, and TB disease incidence. However, multi-drug-resistant TB (MDR-TB) remains a critical threat.
In preparation for the Fourth Replenishment meetings, the Global Fund has a published an “Update on Results and Impact.” This article provides some of the highlights of the report; more details are provided in separate articles on each of the three diseases.
In some countries, PEPFAR and the Global Fund provide 90% of total funding for responses to HIV, yet the planning and implementation processes of the two donors are not always aligned. This is one of the findings of an evaluation of the US President’s Emergency Program for AIDS Relief (PEPFAR) conducted by the US Institute of Medicine.
All four principal recipients (PRs) in Cambodia established separate structures parallel to national ones to manage procurement and monitoring and evaluation (M&E) functions within Global Fund grants. The creation of parallel structures goes against the intention of core Global Fund principles that call for the use and strengthening of national systems.