usaid/ethiopia pepfar mid-term evaluation of the ... - GH Tech

2. HCs need trained data managers. Data management involves more than recording information inlogbooks and on reporting forms. The inability of many HCs to collect and summarize essentialdata for the evaluation team pointed out a serious deficiency in data management at the locallevel. In some cases, data clerks assigned to HCs had no idea how to summarize or evaluate thehealth data they were recording. Given the importance of data being collected, training in basicdata management should be an essential component of IMAI.3. Data entry and management at the HC level should be computerized. Obtaining data from HCs for theevaluation team required counting and hand tabulation from logbooks. Computerization of datawill facilitate the ability of HCs to summarize and analyze locally generated data. Decisions willneed to be made about the appropriate level of hardware and software supplied to HCs, whichideally should be uniform to allow for transfer of data to higher levels for reporting and analysispurposes. Moving toward computerization will also require the availability of informationtechnology support staff, computer supplies, maintenance contracts, and other services to permitsustainability. The evaluation team believes that this is a worthwhile investment that should beencouraged throughout the HC system.G. Partnering with Other Agencies and Organizations to Promote IMAIUSAID should partner with other agencies and organizations to promote IMAI and maximize availableresources. It would be extremely difficult for any single agency, even with the generous support thatthe U.S. government has allocated to this program, to address all of the issues contained withinthis report. USAID is joined by a number of partner organizations in E thiopia that are alsointerested in expanding HIV prevention, care and treatment. These include (but are not limitedto) WHO and UNAIDS, other U.S. organizations such as CDC and the National Alliance of Stateand Territorial AIDS Directors, E uropean and other organizations, the International Center forAIDS Care and Treatment Programs (Columbia University), Johns Hopkins University, theInternational Training and E ducation Center on HIV (University of Washington), implementingorganizations such as MSH, E thiopian and other nongovernmental and community-basedorganizations, and most importantly, the E thiopian government and Ministry of Heath. WHO isclearly a critical partner in implementing IMAI. IMAI represents a strategy developed incoordination with and promoted by WHO, and WHO has produced many of the tools and guidesrelated to both IMAI and IMCI. The team spent a number of hours with WHO representatives inAddis as well as during its local visits to various regions, and was impressed by the knowledge ofthese representatives concerning IMAI and other issues related to HIV/ AIDS, as well as theiroverall commitment to ensuring its overall objectives. USAID should work closely with WHO asa full partner in follow-up discussions of how to best address the issues raised in this evaluation.USAID should also work closely with other implementing partners, including the E thiopianMinistry of Health, MSH, and CDC. MSH is the currently identified implementing partner formany IMAI-related activities such as the clinical mentoring program.To help maximize utilization of limited resources, USAID may want to evaluate how all fundsrelated to PE PFAR (including those for staffing, foreign consultants, contracts, and directsupport for local care and treatment activities) are allocated. It may be possible to identifyadditional funds that can be used to provide greater support for local activities to help implementsome of the recommendations contained within this report. In follow-up discussions of how tobest address the issues raised in this evaluation, USAID will also need to work closely withmultiple partners to determine how to best collaboratively address the many critical issues thatIMAI HIV/ AIDS in E thiopia present. If this report helps to define what the most importantchallenges are for IMAI, and assists with the continued development of comprehensive andMid-term Evaluation of Ethiopia IMAI Program 51