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ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

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Page 1: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

ICAP LesothoTransition Strategy for Sustainability

M&E Technical Meeting

Page 2: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Introduction• ICAP’s supports the Lesotho MOHSW to

reduce the impact of TB/HIV• Provide technical assistance within the

framework of Lesotho TB/HIV Strategic Plan• Provide nationwide support– all 10 districts – all health facilities(21 hospitals + 184 HCs & FCs)

• All facilities are owned by the MOHSW, CHAL or are Private– no ICAP facilities

Page 3: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

LS TB and HIV/AIDS landscape

• STI, HIV and AIDS Directorate (SHAD)– HIV/AIDS programs

(HTC, PMTCT, Care, Treatment, BCC, etc)

– Nascent M&E system– EGPAF main partner

• Department of PHC – Dept. of Disease Control• National TB Program (NTP)• Strictly TB activities only• Fairly well developed TB

surveillance system

– ICAP main partner

HIV/AIDS patient TB/HIV patient TB patient

Page 4: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Current (inherited) TB/HIV Surveillance System

Partner support

Partner support

HC1

Hospital B

HC2 HC3 HC4 HC5

DHMT/District hospital(maintenance of district TB Rx reg, ETR, dispatches, reports, backups)

National TB Program (data cleaning, analysis,

dissemination)

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Page 5: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Why the parallel M&E system?

• No data collection tools at the beginning of support

• No dedicated MOHSW data personnel• Meet reporting requirements

• internal ICAP, URS, PEPFAR• Tight deadlines

• Indicators not harmonized• ‘Pre-transition era’

Page 6: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Effects of the parallel M&E system

• Undermined the national M&E system• Threatened relationships with MOHSW• Not sustainable

• One positive - Lesotho has embraced data personnel– Plan to have at least 1 data clerk in each health

center– 65 recruited for the northern districts to date

Page 7: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Major shift in new program

• MOHSW is (rightly!) insisting on ownership: – partners must support the ONE M&E system– no ICAP sites, so no parallel systems

• PEPFAR/CDC promoting transition– “If not a local indigenous organization, the

applicant must articulate a clear exit strategy which will maximize the legacy and sustainability of this project…..”

Page 8: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Strategy for sustainability

Remove the parallel M&E system and support the NTP’s TB/HIV surveillance system

What comes out of the NTP goes to partners and funders

• Surveillance System Strengthening• Data Quality• Data feedback• Data appreciation and use• Monitoring of community activities

Page 9: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Strengthening the TB/HIV Surveillance System

Maintenance of site tools (TB cards, suspects, Rx)

ICAP support

ICAP support

ICAP support HC1

Hospital B

HC2 HC3 HC4 HC5

DHMT/District hospital(maintenance of district TB Rx reg, ETR, dispatches, reports, backups)

National TB Program (data cleaning, analysis,

dissemination)

ICAP LS

WHO

URSCDC

GFCU

Page 10: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Surveillance System Strengthening

• Human resources (2 SO)• Regular supervision & follow-up• Data collection & reporting tools– Advocate for incorporation of TB variables in HIV

tools• Enhance Electronic TB Register– Eradicate errors, improve report generation– Train HCW– Ensure regular updating– Ensure regular data dispatches to NTP

Page 11: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Data Quality

• Routine supervision of paper tools at sites and ETR at district level

• Improved validation criteria in the ETR• Quarterly data verification exercises– NTP, DHMT, partners

• Annual structured QDA• NTP, DHMT, partners

Page 12: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Data Appreciation and Use• PERFORMANCE

FEEDBACK• Quarterly district

progress review meetings

• Annual Joint Review (national)

• Identify “star” HCW or sites and use them as “peer-educators”

Page 13: ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

Rea Leboha (Thank You)