HIV and AIDS
The President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2004 to combat a widespread epidemic, constituting a crisis in which people – especially in Africa – were dying by the thousands. Few may have thought then that only a decade later, many countries – even in Africa – would report a decline in HIV prevalence and that the strategy would shift to what PEPFAR calls its Impact Agenda, focused on providing “the right things in the right places right now.”
Building on the success of its investments to combat HIV that have led to stronger public health systems in resource-poor settings, PEPFAR is implementing a data-driven approach focused on geography and key populations through site monitoring, strengthening program quality, and scaling up effective interventions to maximize impact. These strategies will continue to teach lessons in how to respond effectively to chronic health conditions – a hoped-for outcome but one not without challenges.
As PEPFAR enacts this strategy to achieve the promise of an AIDS-free generation, national health programs face shrinking funds and increased expectations for measurable impact. PEPFAR programs in partnership with other development partners, such as DREAMS, which seeks to empower adolescent girls to live determined, mentored and safe, AIDS-free lives; and the Accelerating Children's HIV/AIDS Treatment initiative (ACT) are part of the picture. Also, data collection systems like DATIM (Data for Accountability Transparency and Impact) that bring together a consistent set of elements from PEPFAR Monitoring, Evaluation and Reporting (MER) indicators, site improvement through monitoring system (SIMS), and expenditure analysis (EA), present both an opportunity and a challenge.
The MEASURE Evaluation project – USAID’S flagship mechanism for strengthening health information systems in developing countries – is one of USAID’s means of helping missions capitalize on these opportunities while improving capacity to deliver results.
MEASURE Evaluation works with missions and their partners to strengthen systems for collecting and using health data, including for HIV programming. We help plan and conduct studies and evaluations in line with PEPFAR and USAID evaluation policies for rigorous design and assessment of the complexities of real-world settings. In helping missions we focus on:
- Capacity building and organizational development to support governments and local institutions to collect, analyze, and share data through national or district health information systems (HIS) and research implementation; and also capacity building to conduct surveys and develop data standards to support HIS planning and electronic medical records.
- Technical assistance to write and implement protocols to produce size estimates and mapping of key populations.
- Technical assistance to implement systems (e.g., DATIM, SIMS) so that real-time data are used for decision making and program planning.
- Evaluating effective strategies and identifying barriers and challenges to scaling up programs, strategic information, and health systems strengthening activities, and estimating costs to aid in investment decisions.
- Improving orphan and vulnerable children programming by collecting and using data to determine what works.
- Developing methods to track mother-infant pairs to improve child survival.