Girls are counting on us to count them
The Sustainable Development Goals (SDGs) call for action against the disadvantage and discrimination borne by girls. As we work towards this goal, ensuring that quality gender data is collected, analyzed, and used for decision making continues to be a challenge. The theme for this year's International Day of the Girl (October 11) is Girls' Progress = Goals' Progress: What Counts for Girls. We cannot continue to promise a better, healthier world for girls if we cannot distinguish them in the data that drives our decision making.
What’s needed is girl-centered, gender-sensitive, and sex-disaggregated data to track progress towards the international promises made. MEASURE Evaluation is a leader in the field of gender-sensitive monitoring and evaluation (M&E). We work to increase the capacity of individuals and organizations to collect, analyze, and use gender-related health information for better program and policy decision making at local, national, and global levels.
In 2015, The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launched an initiative known as DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe). Its goal is to reduce HIV infections among adolescent girls and young women (AGYW) in 10 sub-Saharan African countries. MEASURE Evaluation is supporting DREAMS in South Africa, Mozambique, and Swaziland to strengthen existing health information systems and use innovative data collection methods to effectively design and target programs and to make course corrections to reach PEPFAR’s test, treat, and retain goals.
MEASURE Evaluation Strategic Information for South Africa (MEval-SIFSA) is providing technical assistance to the South African DREAMS M&E task team, which consists of representatives from key stakeholders in the South African and United States governments. Several programs are currently implementing interventions similar to DREAMS. MEval-SIFSA reviewed all programs whose objectives were aligned to the DREAMS objectives and collaboratively—with stakeholders—came up with an M&E framework featuring a core package of DREAMS indicators.
With the DREAMS indicators fully aligned and synchronized, the challenge became that the clinical data source did not have the required fine age disaggregation. MEval-SIFSA, through the DREAMS M&E task team, devised a strategy to standardize data collection tools, define roles and responsibilities, and develop standard operating procedures to collect and report data with the finer age- and sex-disaggregation into an integrated monitoring and reporting system.
MEval-SIFSA customized and developed the DREAMS Integrated Monitoring and Evaluation System (DIMES) for management of all DREAMS activities in South Africa, where stakeholders can access the consolidated DREAMS data. DIMES is used for monitoring DREAMS performance against targets and producing stakeholder-specific reports, at facility, enumeration area, ward, district, provincial, and national levels. In order to promote better quality data, MEval-SIFSA has established a data exchange process for DIMES with the systems used by implementing partners and stakeholders.
Similar to South Africa, Swaziland’s effort is to leverage existing information systems to align with and collect DREAMS indicators. The Swaziland HIV/AIDS Programme Monitoring System (SHAPMoS) routinely collects community-level information on non-health HIV services. MEASURE Evaluation is working with the National Emergency Response Council on HIV and AIDS to update the indicators in SHAPMoS to meet the requirements of PEPFAR 3.0 and DREAMS. By using SHAPMoS data, implementers will be able to overlay estimated HIV positivity across the country with location and type of community-based services that are available.
Additionally, in support of DREAMS in Swaziland, MEASURE Evaluation is using its innovative Priorities for Local AIDS Control Efforts (PLACE) method in key priority areas to understand where adolescent girls and young women socialize and meet new sexual partners. Certain elements of behavioral data are also collected from AGYW and their partners, in order to provide essential data on underlying, proximate, and biological determinants of risk for HIV infection.
Similarly, in Mozambique, MEASURE Evaluation is assisting in the collection of information to support DREAMS programming by conducting a PLACE study to characterize male partners of AGYW. The objective of this study is to fill information gaps regarding male sexual partners of AGYW aged 15–24 years in order to increase these partners’ access to HIV testing services, antiretroviral therapy (ART), and voluntary medical male circumcision (VMMC), and, thereby, also reduce HIV incidence among AGYW.
Much more can and needs to be done to harness the data required to ensure that programs, policies, and services effectively respond to the specific needs of girls. By strengthening already existing health information systems to collect better and more relevant data, and using innovative means to fill the data gaps, we can help accelerate progress for women and girls around the world.