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Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2002.  p.A 100% condom use programme (100% CUP), targeting female sex workers in entertainment establishments, is important in prevention and control of STIs, including HIV. Monitoring and evaluation to measure the progress of the programme is one of its essential components, and requires appropriate indicators. An indicator is a way in which to quantify or measure the magnitude of progress toward something one is trying to achieve in a programme, whether it is a process, an outcome or an impact. Indicators are just that - they simply give an indication of magnitude or direction of change over time. They cannot tell managers much about why the changes have or have not taken place. While a single indicator cannot measure everything, knowing the magnitude and direction of change in achieving a programme objective is critical information for a manager. A good indicator for monitoring and evaluation needs to be: relevant to the programme; feasible to collect and analyse; easy to interpret; and able to measure change over time. Identifying an indicator to be followed in a 100% CUP also demands attention to how that indicator will be defined, the source of the information needed for it, and the timeframe for its collection and analysis. (excerpt)
Geneva, Switzerland, UNAIDS, 2004. Prepared for the 4th Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 23-25, 2004. 7 p.This paper explores issues and approaches relevant to the assessment of the application of a rights based approach to the planning and implementation of HIV/AIDS strategies. It builds on the premise that the Reference Group may wish to recommend to UNAIDS a set of practical steps towards integrating human rights in HIV/AIDS policies and programs and monitoring the compliance of HIV/AIDS policies and programs with international human rights principles and guidelines, in particular those that have been explicitly promoted by UNAIDS in its publications and other work. Some suggested key issues are highlighted and, HIV testing strategies will be used as an example to the extent necessary to clarify concepts. (excerpt)
Working document on monitoring and evaluating of national ART programmes in the rapid scale-up to 3 by 5.
Geneva, Switzerland, WHO, . 20 p.Currently, five to six million people infected with HIV in the developing world need access to antiretroviral (ARV) therapy to survive. Only 400,000 have this access. The failure to deliver ARVs to the millions of people who need them is a global health emergency. To address this emergency, WHO is fully committed to achieving the "3 by 5" target - getting three million people on ARVs by the end of 2005. This is a means to achieving the treatment goal: universal access to ARVS for all who need them. WHO will lead the effort, with UNAIDS and other partners, using its skills and experience in coordinating global responses to diseases such as the effective and rapid control of SARS. The monitoring and evaluation (M&E) of the 3 by 5 initiative is a high priority. It will be crucial to know how countries are meeting the agreed goals and objectives and how local levels (districts, Regions or Provinces) are monitoring progress and identifying any problems they may encounter. The need for a substantial amount of country input and ownership of the process will require a refinement of the M&E strategy in close consultation with countries. However, key components of the M&E strategy can be developed now, with further refinements and developments to come later. This document is a work in progress. It represents the best effort to describe a coherent approach to the monitoring and evaluation of scaling up to the reach the goal of 3 by 5 that is possible at this time. This working document is best viewed as a step in a process that will include field testing, the gathering of additional experience, additional review, the validation of indicators presented and subsequently refinement. If inadequacies are found in this working document, they are mostly the result of incomplete information and experience on which to base decisions. That will be corrected as experience mounts. (excerpt)
Chennai, India, Voluntary Health Services, AIDS Prevention and Control Project, . 43 p.In Tamil Nadu, India, there are no research studies undertaken to establish the prevalence of HIV among women in prostitution. However, the clinical data from various sources reveal that a significant proportion of them are infected with HIV. The situational assessment conducted by the nongovernmental organization (NGO) partners facilitated by AIDS and Prevention and Control (APAC) revealed various factors, which made women more prone to the infection. It was mainly due to the inconsistent usage of condoms; various myths and misconceptions; lower empowerment; lower social status and educational level. To this effect, the APAC project adopted the implementation of holistic, participatory gender specific and culture sensitive prevention programs among women in prostitution. It provides relevant information to risk population groups, promotion of quality condoms, enhancement of sexually transmitted disease and counseling services, and explorative research for increasing the effectiveness of the project. It is noted that APAC supports six NGOs in six towns in Tamil Nadu to implement the targeted intervention among women in prostitution.
Reproductive Health Matters. 2001 Nov; 9(18):191.In 1997 UN International Children's Fund, WHO, and UN Population Fund developed guidelines for monitoring obstetric services, offering relevant process indicators which used proxy measures for maternal mortality, because counting deaths had been highly inaccurate. The Malawi Safe Motherhood Project covers half the country's population of 5 million and was the first large project to adopt the use of the recommended indicators within routine monitoring procedures, albeit with significant adaptation. Development of the monitoring process required: a needs assessment, including identification of sources of data and definition of terms, such as for obstetric conditions; development of tools for data collection: and actual operations research. The research considered patient flow in obstetric clinics; recording of complications; and identification of maternal deaths, referral systems and the origin of patients, in order to determine the catchment populations for each service point. Subsequently, when the new monitoring system was deemed to be feasible and effective, training programs were conducted by trainers from each district, and information was disseminated. The intention is that the Safe Motherhood information system training modules will eventually be incorporated into all basic and in-services training for maternity staff. Introduction of the indicators in Malawi was characterized by wide consultation, systematic clarification of all definitions, rigorous testing and use of already established systems. All of these steps were required to gain support and motivate staff involved in data collection and analysis. (full text)
Adverse events monitoring as a routine component of vaccine clinical trials: evidence from the WHO Vaccine Trial Registry.
Bulletin of the World Health Organization. 2000; 78(9):1167.This article assesses whether and how investigators are monitoring adverse events following immunization (AEFI) in vaccine trials, using evidence from the WHO Vaccine Trial Registry. It is noted that the Registry includes all vaccine trials sponsored since 1987 by the WHO Expanded Programme on Immunization, Global Programme for Vaccines and Immunization, and Department of Vaccines and Biologicals. For each trial, records include internal documents, reports of visits to trial sites, and publications. Based on the records from 68 trials, completed or in progress, analysis indicates that only few investigators included detailed AEFI monitoring in their study reports and publications. However, an increasing trend to include AEFI monitoring in vaccine clinical trials was noted. Since many vaccine trials are conducted by independent investigators, and AEFI monitoring methods and results deserve to be included in any publication, along with vaccine efficacy methods and results, it should be the responsibility of the study investigators, rather than of the vaccine manufacturer and the national control authority, as suggested. Several practical points for monitoring AEFIs in vaccine clinical trials are cited.
In: Evaluation and development: proceedings of the 1994 World Bank conference, edited by Robert Picciotto and Ray C. Rist. Washington, D.C., World Bank, 1995. 54-6. (World Bank Operations Evaluation Study)This article focuses on the nature of the questions that need to be asked in the evaluation of poverty programs, and on the role of participation in answering them. To answer some of the questions pertinent to the evaluation of poverty reduction projects requires knowing the reasons behind why people are poor. Poverty is caused by political, economic, or social factors, and each of these factors is important. Development takes place within a set of interrelationships that are mutually reinforcing and continually changing, and economic development cannot occur without corresponding changes in the political, institutional, and cultural norms of the countries involved. Hence, poverty programs cannot be evaluated unless the full spectrum of issues that contribute to the success of such programs are understood, and unless specific interventions are evaluated in their wider social and political context. Furthermore, participation, which is the involvement of beneficiaries and stakeholders in development efforts, should begin at the initial stage of the project. Participation at this stage improves the quality of information available for decision-making and strengthens stakeholders' commitment to monitoring and evaluation, while it enhances the sustainability of interventions by leaving behind the capacity, or social learning, needed to address such issues.
Global medium-term programme. Programme 13.11: Sexually transmitted diseases (venereal diseases and treponematoses).
[Unpublished] 1991. Presented at the 1st International Course on Planning and Managing STD Control Activities in Developing Countries, Antwerp, Belgium, September 9-21, 1991. 12 p.This paper outlines the World Health Organization's global medium-term program to prevent and control sexually transmitted diseases (STDs) during 1990-95, in an effort to reduce the impact of their complications and sequelae, such as infertility, congenital and perinatal infections, and genital cancers. The program has progressed considerably during the 7th General Program of Work, with the control of STDs enjoying higher priority in many countries because of the HIV/AIDS pandemic. The program will be promoted in accordance with the general principles outlined in the 8th General Program of Work, with specific emphasis upon the implementation of intervention strategies within primary health care. Priorities during the current period will include support of the application of practical and simple technologies to assess the extent and impact of STD morbidity; support of planning and implementing practical and low-cost STD control technologies at the primary health care level; better understanding of the behavioral patterns associated with STD transmission; development and application of cost-effective standard treatment regimens; transfer of simple diagnostic and therapeutic techniques to the peripheral level; refinement of technical skills for STD control workers; and support for research, including the cost-effectiveness evaluation of STD control strategies in different settings.