Ethiopia - Country Progress Report - unaids

Report on Progress towards Implementation of the UN Declaration of Commitment on HIV/AIDS
4. Monitoring and Evaluation Environment
4.1. Overview of the M&E System
Over the years the Federal HIV/AIDS Prevention and Control Office (FHAPCO) has developed a comprehensive and
sustainable M&E system. The 2003 National Monitoring and Evaluation Framework for the Multisectoral HIV/AIDS
Response guides all partners M&E efforts in Ethiopia. This framework has been generally successful at harmonizing
the collection of data at impact and outcome level. However, lower-level indicators are not sufficiently harmonized
among the various partner-funded programmes. This situation is partly due to the fact that operational manuals
for the M&E framework were not operationalized for the entire multisectoral response. The focus has instead been
on the health sector, were there is regular facility reporting on ART, HIV counseling and testing, and PMTCT. Health
sector reporting has been further aligned by the ongoing update to the HMIS, which has seen a reduction of 19 HIV
indicators, including two on TB/HIV co-infection.
As part of this system FHAPCO, in collaboration with its major stakeholders, published its first Annual HIV/AIDS M&E
Report for 2005/06. The goal of the Annual Report was to provide the National HIV/AIDS program, its partners and
the general public with useful information on Ethiopia’s response to AIDS and other sexually transmitted infections.
The Annual Report brought together key information systems from the Ministry of Health, sector ministries, regions,
survey findings and special studies. It documented results for around 70% of the National HIV/AIDS Indicators. A
second annual report for the year 2006/07 was being finalized at the time of this writing, and the draft served as an
important source document for this report.
The M&E system has shown great improvement in 2006 and 2007. Major recent achievements include: The formation
of an M&E unit at department level within FHAPCO; improvements in human resource for M&E, including the presence
of an IT specialist, M&E officers, and data clerks at different levels, including health institutes; availability of training
and IT support to implementing institutes; and allocation of budget for M&E. The total cost of M&E is estimated to be
around 8% of the total budget.
But beyond the health system, program monitoring and evaluation in other sectors has been largely project-driven,
resulting in many indicators and little consolidation of data across projects. HAPCO’s upcoming “Manual for Project
Monitoring and Evaluation”, which was called for within the World Bank EMSAP II agreement, is meant to help address
this situation.
The M&E manual has the stated objective of outlining “the mechanisms and processes that are to be followed in
EMSAP II and Round IV of Global Fund project monitoring and evaluation in the implementation of the national
HIV/AIDS prevention and control activities”. The manual provides detailed guidance and reporting formats for 31
indicators. Eleven of these indicators are included in the national M&E framework, while the other 20 are specific to
either the EMSAP II or Global Fund project monitoring.
The manual is thus considered as a small step towards the “Third One”. An additional national M&E manual—or a
revision of the EMAP/Global Fund manual—will be required in the near future to guide reporting for the additional
national indicators not included in EMSAP, Global Fund or the HMIS. This would occur as part of a planned revision of
the national M&E framework to bring it into line with the recently revised national planning framework51. It will be
important for this revision to take into account the data needs of all major programmes, especially PEPFAR, Global
Fund, EMSAP II and UNDAF. Furthermore, an indicator review process including all major stakeholders is envisioned.
4.2. Review meetings
Federal HAPCO is now putting in place a system for quarterly review meetings that include regional HAPCOs, line
ministries and key partners. A reporting format and “integrated supportive supervisory checklist” have been developed
to gather and compile regional-level inputs.
The first-quarter, second-quarter and fourth-quarter reviews will focus on progress updates and process issues. The
results of the second- and fourth-quarter reviews will be major inputs to the semi-annual National AIDS Council
meetings that are held in February and July. The third-quarter review will be expanded to a comprehensive joint annual
review including all major stakeholders. This joint annual review is timed to support the annual planning process (the
Ethiopian fiscal year is from July 8 to July 7), and to feed into the annual review of Ethiopia’s national development
plan, known as the Plan for Accelerated and Sustained Development to End Poverty (PASDEP). In addition, HAPCO
will develop yearly M&E plans that are coordinated and synchronized with surveillance and research. The M&E plan
together with the annual review meeting will serve as a basis of the annual M&E report, as well as a major input to
annual operational planning for the AIDS response.
51 The Multisectoral Plan of Action for Universal Access to HIV Prevention, Treatment, Care and Support in Ethiopia 2007 – 2010, and the Health Sector Road Map for Accelerated Access to HIV
Prevention, Care and Treatment in Ethiopia.
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