1380_m&e training needs report - tanzania

8/2/2019 1380_M&E Training Needs Report - Tanzania

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TANZANIA COMMISSION FOR AIDS[TACAIDS]

Training Needs Assessment on M&E, MIS andResearch in the MDA and DistrictsCouncils


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TABLE OF CONTENTS

LIST OF ABBREVIATIONS ................................................................................................V

EXECUTIVE SUMMARY .................................................................................................. VI

1. INTRODUCTION............................................................................................................1

1.1. BACKGROUND.............................................................................................................1

1.2 OBJECTIVES OF THE STUDY.........................................................................................1

1.3 SCOPE .........................................................................................................................11.4 LAYOUT OF THE REPORT.............................................................................................2

2. METHODOLOGY ..........................................................................................................3

2.1 INTRODUCTION ...........................................................................................................3

2.2. POPULATION ...............................................................................................................3

2.3 SAMPLE.......................................................................................................................3

2.4 DATA COLLECTION PROCESS AND TOOLS...................................................................4

2.5 DATA ANALYSIS .........................................................................................................4

3. ASSESSMENT OF MIS FOR HIV/AIDS .....................................................................5

3.1 INTRODUCTION...........................................................................................................5

3.2 EXISTING SYSTEM FOR DATA COLLECTION,DATA ANALYSIS,DATA STORAGE .........5

3.3 THE DATA COLLECTION FORM DESIGNED BY TACAIDS...........................................6

3.4 COMMUNICATION LINK ..............................................................................................6

3.5 USE OF DATA CURRENTLY COLLECTED......................................................................7

3.6 CRITICAL INFORMATION REQUIREMENTS ...................................................................7

4. ASSESSMENT OF THE STATE OF COMPUTERIZATION...................................8

4.1 INTRODUCTION...........................................................................................................8

4.2 DIGITAL CONVERGENCE .............................................................................................8

4.3 AVAILABLE ICTFACILITIES (HARDWARE AND SOFTWARE) .......................................8

4.4 ICTSKILLS AND TRAINING NEEDS .............................................................................8

4.5 FUNDING FOR ICT.....................................................................................................15

5. ASSESSMENT OF MONITORING AND EVALUATION CAPABILITIES.........16

5.1 INTRODUCTION .........................................................................................................16

5.2. HIV/AIDSPLANNING...............................................................................................16

5.3. MONITORING AND EVALUATION CAPABILITIES ........................................................19

5 4 FUNDING OF HIV/AIDS ACTIVITIES 23


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6.6. MAJOR PROBLEMS EXPERIENCED IN CONDUCTING HIV/AIDS RESEARCH..............37

6.7 RESEARCH AREAS/THEMES ON HIV/AIDS...............................................................38

6.8 CONDUCIVE FRAMEWORK FOR RESEARCH ON HIV/AIDS .......................................38

7. MINISTRIES AND NATIONAL NGOS ROLES IN MIS, M&E AND

RESEARCH AT THE DISTRICT LEVEL ...............................................................40

7.1 INTRODUCTION .........................................................................................................40

7.2 INFORMATION MANAGEMENT SYSTEMS ...................................................................40

7.3. MONITORING AND EVALUATION...............................................................................44

7.4 RESEARCH ON HIV/AIDS.........................................................................................50

8. CONCLUSIONS AND RECOMMENDATIONS.......................................................55

8.1 INTRODUCTION .........................................................................................................55

8.2 CONCLUSIONS...........................................................................................................55

8.3 RECOMMANDATIONS ................................................................................................56


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Acknowledgements

Tanzania Commission for AIDS (TACAIDS) would like to give special

appreciation to the lead consultant, Bureau of Industrial Consultancy (BICO) of

the University of Dar Es Salaam who carried out the study and come up with this

valuable result.

Appreciation goes to the division of Monitoring, Evaluation, Research and

Management Information System lead by Joyce Peters Chonjo (Director), Aroldia

Mulokozi, Sophia Luhindi, Charles Mashauri and Isabela Ndatu for providing

guidance and leadership towards developing this curriculum.

TACAIDS would collectively like to thank all M&E technical Working Group

members (M&E -TWG), institutions, organizations and individuals who

contributed in many ways to a successful development of this study.

Tanzania Commission for AIDS- TACAIDS

Old Boma Building, Sokoine Drive/Morogoro Road

P.O.BOX 76987

Dar Es Salaam

Tanzania

Tel. +255 22 2122651/ 2125127

Fax; +255 22 2122427


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LIST OF ABBREVIATIONS

AIDS Acquired Immunodeficiency SyndromeAMREF African Medical Research FoundationARVs Anti-RetroviralBICO Bureau for Industrial CooperationCBOs Community Based OrganizationsCDO Community Development OfficersCMAC Council Multi-Sectoral AIDS CommitteeCSOs Civil Society OrganizationsDAC- Health District AIDS Coordinator-HealthDACC District AIDS Control CoordinatorDCDO District Community Development OfficerDEDs District Executive DirectorsDMO District Medical Officer

DPLO District Planning OfficerDToT District Training of TrainersEMIS Education Management Information SystemFBOs Faith Based OrganizationsHBC Home Based CareHIV Human Immunodeficiency VirusHoDs District Heads of DepartmentsICT Information Communication Technology

IFM Institute of Finance ManagementIFM Institute of Finance and ManagementIT Information TechnologyLGA Local Government AuthorityM&E Monitoring and EvaluationMAC Multi-Sectoral Aids CommitteeMCH Mother Child HealthMIS Management Information System

MSM Men having Sex with MenNACP National AIDS Control ProgrammeNGOs Non Governmental OrganizationsNMSF National Multi-Sectoral Strategic FrameworkPC Personal ComputerPLHA People Living with HIV/AIDSPMTCT Prevention of Mother to child Transmission


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EXECUTIVE SUMMARY

Introduction

Tanzania Commission for AIDS (TACAIDS) commissioned this study on Training NeedsAssessment on Monitoring and Evaluation (M&E), Management Information Systems (MIS)and Research in the districts. The study was conducted during July to Novermber, 2004 andcovered selected districts in Kigoma, Manyara, Morogoro, Mtwara/Lindi, Mwanza andTanga. It also covered a number of Ministries in Dar es Salaam.

The overall objective of the study was mainly to assess training needs in M&E, MIS andResearch in the districts. The specific objectives included:

(i) To assess existing MIS systems in all its aspects; that is, HIV/AIDS data collectionsystems, analysis, storage, retrieval, and reporting.

(ii) To assess the state of computerization in terms of hardware, software and technical

backup capacity.(iii) To assess existing M&E capabilities i.e. skills/knowledge, systems and also to

identify M&E gaps/problems and remedial interventions.(iv) To carry out a needs assessment aimed at identifying research needs at the district

level and existing research capabilities and gaps.(v) To identify possible research areas the districts can conduct.(vi) To define training needs and related capacity building interventions i.e. designing

realistic training strategy and implementation plan on M&E, MIS and Research on

HIV/AIDS in the districts.

Scope

The study focused on MIS, computerization, M & E and Research. It covered seven (7)Regions, i.e., Dar es Salaam, Kigoma, Manyara, Morogoro, Mtwara/Lindi, Mwanza andTanga. With exception of Dar es Salaam, in each selected region a number of district andmunicipal councils were selected.

Conclusions

The major conclusions the studies are as follows:


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(b) State of Computerization

(i) Letter writing was the principal means of communication at the District Levelfor HIV/AIDS.

(ii) Districts rarely use computers and the Internet for HIV/AIDS informationmanagement although about 90% of the District have computers at the HQ.

(iii) The districts rarely use other types of media such as newspapers, Radio andTelevision for HIV/AIDS activities.

(iv) The Microsoft Office is the most commonly available software, which can beused for the information management needs of HIV/AIDS activities. There is

very limited capacity at the Districts in terms of skills to use computerizeddatabase management systems.

(v) In general, there are critical training needs for the application of ICT inHIV/AIDS and other functions at the District level.

(vi) Funding of ICT investments at the District levels is largely done through localgovernment funding although donor funding is also involved

(c) Monitoring and Evaluation

(i) The culture of HIV/AIDS planning at the District Level is rather weak and theimportance of having effective M & E systems linked to HIV/AIDS planning isnot fully appreciated.

(ii) The priorities in District HIV/AIDS response to some limited extent correspondto those in the NMSF. But, there is clearly a need to get the District to focusmore directly on the key areas in the NMSF.

(iii) District M&E systems are not yet adequately developed. Furthermore, noclear effort to link /relate them to the National M & E Framework. Critical

capacity gaps exist in terms of developing and managing effective M& Esystems at the District Level.

(iv) There exists some useful structural and managerial mechanisms at theDistrict Level-which support or can facilitate HIV/AIDS M&E. Examples,include formation of MACs, existence of planning officers, health officers tomention but a few. However, the structure for coordinating HIV/AIDS activitiesincluding M& E needs to be designed in a comprehensive manner with theroles and responsibilities of key actors from the village to District Level clearly

articulated.(v) The critical problems facing existing management of M&E of HIV/AIDS

activities are funding, transport; delays in reporting information andinadequate M& E skills/experts.

(vi) There are no uniform guidelines and reporting formats at District to village)level. In fact, the HIV/AIDS M&E systems were yet to be formally designed in


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(d) Research

(i) Districts are facing critical research capacity deficiencies i.e. funding, skillsand facilities

(ii) There are very few research activities related to HIV/AIDS at the district level.(iii) There is limited understanding of the research issues related to HIV/AIDS in

the Ministries and especially in relation to the roles of the ministries in thedistricts.

(iv) There is limited dissemination of existing research findings on HIV/AIDSresearch.

Recommendations

The main recommendations of the study are:

(a) Management Information Systems (MIS)

TACAIDS

(i) Assist districts in proposing a comprehensive framework for computerizedHIV/AIDS management information systems. TACAIDS should commission aconsultancy to develop the framework.

(ii) Assist in coordinating and harmonizing HIV/AIDS Strategic Plans of ministrieswith those at the districts. This can be done by supporting ministriestechnically and financially in reviewing their HIV/AIDS action plans with theinvolvement of the districts.

DISTRICTS

(i) Develop comprehensive MIS for HIV/AIDS in line the National M&Eframework. This should address data collection from village to district leveland from other actors. TACAIDS to provide technical assistance and aguiding framework on request.

MINISTRIES

(i) Strengthen coordination links between the respective ministry and districts into enhance HIV/AIDS information sharing. This links can include:

Planning fora which involve the districts


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(b) State of Computerization

TACAIDS

(i) Coordinate the training of district authorities in the application of ICT tofacilitate the information management needs of HIV/AIDS programmes (esp.M&E). This will entail contracting a competent training institution to developthe training.

(ii) Identify appropriate software, which can be informally applied by the districtsand TACAIDS for MIS needs of HIV/AIDS programmes.

(iii) Develop a comprehensive data collection framework (tools, etc) that can beused by the districts, right from the Kitongoji level to ministry level. Theseformats should lend themselves for easy computerization in line with theneeds of any chosen software for information management.

DISTRICTS

(i) Train all key personnel at all levels of the local authority people involved in

coordinating the application of ICT to support the information managementneeds of HIV/AIDS programmes. TACAIDS shall provide technical andfinancial support on request.

(ii) Allocate resources for providing more ICT facilities to support the M&E needsof HIV/AIDS programmes.

(iii) Install Internet connection, which can be used among other needs, to supportthe communication between the districts, TACAIDS and other stakeholders ofHIV/AIDS information management.

(iv) Liaise with TACAIDS on establishing and applying a compressive but userfriendly and uniform data collection tools for HIV/AIDS activities.

MINISTRIES

(i) Strengthen HIV/AIDS information management skills of the respectiveMinistry especially the use of appropriate software and communicationfacilities.

(c) Monitoring and Evaluation

TACAIDS


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DISTRICTS

(i) Strengthen HIV/AIDS M&E skills and resources at all levels from top toKitongoji /Mtaa levels. With the backstopping support of TACAIDS, train MACmembers, HIV/AIDS coordinators, health officers, CBOs, NGOs and otherswho directly related to HIV/AIDS monitoring and evaluation. The capacitybuilding in M&E should cover basic principles of M&E; research and datacollection skills; report writing skills; designing data collection tools andcomputerized database management

(ii) In close collaboration with TACAIDS define an appropriate and

comprehensive structure for coordinating and implementing M&E at theDistrict Level.(iii) In close collaboration with TACAIDS develop comprehensive but workable,

M&E system with user-friendly and uniform data collection and reportingtools.

(iv) Increase the districts use of a variety of available media especially electronicmedia for the purposes of communication related to HIV/AIDS activities.

(v) Strengthen district capacity to mobilize resources to support HIV/AIDSactivities (including MIS & M & E and Research) from the Kitongoji to DistrictLevel.

MINISTRIES

(i) Strengthen the HIV/AIDS information reporting structure from the district torelevant Ministries.

(ii) Harmonize the Ministrys HIV/AIDS Strategic Plans with those of Districts.(iii) Strengthen the internal capacity for HIV/AIDS strategic Planning.

(iv) Continue to train HIV/AIDS coordinators in mainstreaming HIV/AIDS and M &E.

(v) Strengthen HIV/AIDS information sharing with other Ministries, TACAIDS andDistricts

(vi) Strengthen the understanding and use of HIV/AIDS indicators

(d) Research

TACAIDS

(i) Coordinate and facilitate Districts and Ministries to have relevant HIV/AIDSresearch agendas and programmes.

(ii) Provide (where possible) funding to districts for buying HIV/AIDS research


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(iii) District should build research capacity among their staff - a short term trainingin HIV/AIDS Research Methodology for district functional staff would build

research capacity at district level and enhance the interaction betweenHIV/AIDS and other functional areas.(iv) Procure needed HIV/AIDS research equipment e.g. Computers, Printers,

Photocopiers, Camera etc and transport.(v) Address in a more formalized manner research constraints such as policy,

agenda, funding, skills, manpower and facilities.

MINISTRIES

(i) Prepare research agendas, which should among other things addressrelevant research issues/ problems at the district level.

(ii) Evolve a predictable and pro- active system of funding relevant to HIV/AIDSby the Ministries.

(e) Essential Training Programme

An essential training programme to be implemented by TACAIDS to support thecapacity of building of districts and ministries has been proposed and is contained inAppendix 1 of the main report.


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1. INTRODUCTION

1.1. Background

The Bureau for Industrial Cooperation (BICO) of the University of Dar es Salaam wascommissioned by the Tanzania Commission for AIDS (TACAIDS) to undertake a TrainingNeeds Assessment on Monitoring and Evaluation (M&E), Management Information Systems

(MIS) and Research in the districts. The study was conducted during July to September,2004 and covered selected districts in Kigoma, Manyara, Morogoro, Mtwara/Lindi, Mwanzaand Tanga. It also covered selected representative Ministries and national NGOs in Dar esSalaam. This document is a report on the study.

1.2 Objectives of the Study

The overall objective of the study was mainly to assess training needs in M&E, MIS and

Research in the districts. The specific objectives included:

(i) To assess existing MIS systems in all its aspects; that is, HIV/AIDS data collectionsystems, analysis, storage, retrieval, and reporting.

(ii) To assess the state of computerization in terms of hardware, software and technicalbackup capacity.

(iii) To assess existing M&E capabilities i.e. skills/knowledge, systems and also to identifyM&E gaps/problems and remedial interventions.

(iv) To carry out a needs assessment aimed at identifying research needs at the districtlevel and existing research capabilities and gaps.(v) To identify possible research areas the districts can conduct.(vi) To define training needs and related capacity building interventions i.e. designing

realistic training strategy and implementation plan on M&E, MIS and Research onHIV/AIDS in the districts.

1.3 ScopeThe study focused on MIS, computerization, M & E and Research. It covered seven (7)Regions, i.e., Dar es Salaam, Kigoma, Manyara, Morogoro, Mtwara/Lindi, Mwanza andTanga. With exception of Dar es Salaam, in each selected region a number of district andmunicipal councils were selected.


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1.4 Layout of the Report

The report has nine chapters in including Chapter One:

Chapter 2: Presents the methodology used for data collection; Chapter 3: Gives the findings on the assessment of MIS system for HIV/AIDS; Chapter 4: Gives the findings on the assessment of the state of computerization; Chapter 5: Presents the result of the assessment of district monitoring and

evaluation capabilities; Chapter 6: Contains the results of the assessment of district research capabilities

and needs; Chapter 7 Presents the findings on relationship between and roles of Ministries

and National NGOs in MIS, M&E and Research at the District level; Chapter 8: Provides a summary of the major conclusions and recommendations

of the study. These covered a summary of the major gaps/needsidentified by the study and an essential capacity building programme.


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2. METHODOLOGY

2.1 Introduction

The study covered four aspects that is, Management Information Systems, State ofComputerization, Monitoring and Evaluation and Research as they relate to HIV/AIDS in the

districts. This chapter presents an overview of the methodology which was used. Thechapter is organized as follows: Population of the study, Sampling Approach, DataCollection Process and Tools and Data Analysis.

2.2. Population

The population of interest in this study was the Districts, Ministries and National NGOs withspecific reference to HIV/AIDS activities at the district level. The Ministries and NationalNGOs were covered because of their influence on HIV/AIDS activities at the district level.

2.3 Sample

TACAIDS decided that the most effective respondents for the study would be eight (8)

regions and the specified districts within the Regions are shown in Table 2.1. In Dar esSalaam the TACAIDS decided that only Ministries and some National NGOs would becovered.

Table 2.1: Regions, Districts Covered by the Study

S/NRegions

Districts1 Tanga Korogwe

Tanga

LushotoPangani

2 Mtwara /Lindi MtwaraMikindaniMasasiNachingwea

3 M M


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S/NRegions

Districts7 Dar es Salaam Ministries and National NGOs:

The Ministries were MoH/NACP;MoLYDS, MoCDGC, MoEC,MoLHSD, & MoW;

The NGOs were AMREF andPoverty Africa

2.4 Data Collection Process and Tools

The main data collection method used in districts was semi-structured questionnairecomplemented by interviews and review of documents. In the Ministries and National NGOs,a semi- structured questionnaire was also used.

The data collection instruments focused on the issues delineated in Table 2.2

Table 2.2: Issues covered by the data collection tools

Areas Issues

MIS

Data structure and data types

Types ands amounts of HIV/AIDS data collected

Appropriateness of the existing systems for data collection, dataanalysis, data storage, retrieval and reporting.

Digital convergence

Communication links

Use to which the data currently collected is put Critical information requirements from the Districts by the Districts,

Regions, TACAIDS and other stakeholders

State of Computerization Characteristics of the type of existing hardware, software and

technical backup

Appropriateness of the existing computer hardware software andtechnical backup

Type of reporting and the frequency of reporting Opportunities and challenges for improving the computer hardware,

software and technical backup situation Appropriate hardware, software and technical backup investment

building

M&E Existing planning process and plans related to HIV/AIDS Existing M&E capabilities (frameworks, systems, tools, skills and

facilities) and process/activitiesM i t k h ld d th i M&E l


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3. ASSESSMENT OF MIS FOR HIV/AIDS

3.1 Introduction

This chapter describes the assessment of MIS systems with regard to HIV/AIDS in the sevenregions covered by this study. The responses used in the assessment came from districtofficers responsible for planning, research and information systems; for ICT facilities; and for

coordinating HIV/AIDS activities.

3.2 Existing System for Data Collection, Data Analysis, DataStorage

3.2.1 Type of Data/Information

The districts were asked to explain the kind of data/information on the HIV/AIDS pandemic,which they collect on a regular basis. The responses indicate that the districts collect regularinformation/data on the following:

Testing and counseling (tested HIV and STI cases); New and old HIV/AIDS cases; Deaths due to HIV/AIDS; People Living with HIV/AIDS (PLWHA); Voluntary blood donors screening; Extent of condoms use; Progress reports on HIV/AIDS activities (focusing on problems and achievements

and other relevant aspects of programme implementation); Training, counseling, and awareness campaigns; Care for the sick and Home Based Care (HBC) activities; Pregnant women and Prevention of Mother to Child Transmission (PMTCT); NGOs activities, training and support;

Sources of funding for HIV/AIDS activities;

3.2.2 Frequency of Data Collection

The districts were further asked to show the frequency of preparation of the informationabove. The majority of the replies show that the above information is collected quarterly.


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hospital data and thus one had to undergo the difficult task of picking out information thatwas relevant to HIV/AIDS activities.

3.2.5 Data Storage

The respondents were asked to explain how the districts store the HIV/AIDS data for quickretrieval and reporting. The replies show that data storage is done in manual files, whichmake the data storage and data retrieval difficult. It was only Masasi district where theyshowed that they have computerized storage of data.

3.2.6 Use of Electronic Media for HIV/AIDS Information Management

The study investigated how the districts use electronic media, telecommunications, andcomputing (as part of their MIS Infrastructure) for HIV/AIDS data collection, transfer, andsharing. The findings have shown that the data collected from various facilities were storedin hard copies and transferred to other users by letters, as well as reports. They post thedocuments to the other users of the information. Telephone was used but access waslimited. For Kigoma District Council, they had formed AIDS committees at ward level and at

District level which made it easy to share HIV/AIDS data/information.

3.2.7 Main Weaknesses of Current Data Collection Systems

The following main complaints were registered by the districts regarding the current systemof data collection, storage and retrieval:

Inadequate facilities for data collection, storage and retrieval;

Inadequate means of transport for reaching the various data sources especially therural areas; Incompleteness of data due to poor reporting; Lack of VCT Centres especially in the rural areas; HIV/AIDS data are mixed up with other patient information; Delay of reports from Health Centres; and

Lack of specific and uniform instruments for data collection.

3.3 The Data Collection Form Designed by TACAIDS

The respondents at the District level were asked to make comments on the TACAIDSPROGRAMME ACTIVITYS TRACKING COMMENTS FORM NO1 as it applies to theirrespective districts. The majority of the responses show that, it was the first time to see the


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Tanga municipal, Ulanga and Kibondo districts that showed that there were some Internetcommunications between the districts and the regions.

3.5 Use of Data Currently Collected

The researchers were interested to know who was the main user of the data on HIV/AIDS,which were currently being collected and the main purpose or what were the uses of thedata being collected, and whether or not there were any complaints from the data users. Itwas shown that, the main users of the data collected were the district councils.

The data colleted were mainly used for:

Controlling, monitoring, evaluation of HIV/AIDS activities in the districts; Assessing the magnitude of HIV/AIDS pandemic in the districts; Setting new HIV/AIDS strategies and improving old strategies; Coordination with other departments especially for budget allocation; Preparation of District plans,

Knowing the number of children born who were infected from their mothers; Knowing HIV infection in different groups example Youth Marriage couples; Knowing the existing sexual diseases and proper ways of preventing them; NACP progress of districts, Villages and Wards; Presenting the status on efforts on VCT; Presenting the status on efforts on STIs; Presenting the status on efforts on blood screening; Presenting the status on efforts on HBC.

The findings thus show that there are significant efforts to collect and put to use HIV/AIDSdata. However, these efforts need to be streamlined and coordinated much better andsupported with improved data collection frameworks and tools.

3.6 Critical Information Requirements

The districts were asked to indicate types of information on HIV/AIDS that were required

from the Districts by the Districts, Regions, TACAIDS and other stakeholders, which shouldbe produced by a comprehensive MIS at the district level. The common commonlymentioned kinds of information were:

Number of HIV /AIDS cases; The magnitude of Mother to Child infections;

Ri k i f ti


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4. ASSESSMENT OF THE STATE OF COMPUTERIZATION

4.1 Introduction

This chapter describes the extent of computerization in the surveyed districts. It hasconsidered the general availability of computers in the districts and how computers couldfacilitate HIV/AIDS monitoring and evaluation activities. The respondents included: districtofficers responsible for planning research and information systems; ICT facilities and

coordinating HIV/AIDS activities.

4.2 Digital Convergence

Analysis of digital convergence refers to the coming together (or fusion) of media,telecommunications, and computing as part of the modern MIS. In this regard therespondents were requested to show how they use the media, telecommunications, and

computing (as part of MIS Infrastructure) for data collection, transfer, and data sharing. Thesummary of the result is as shown on Table 4.1(a & b). From the table it has clearly beenshown that the type of communication between the village to wards, from wards to districts,from districts to regions and from regions to TACAIDS was through letter writing. The use oftelephone was restricted. The computer and Internet were rarely used. It was only four outthe twenty-four surveyed districts that indicated that they use the Internet. The districts in donot use other media such as Newspapers, radio and television to disseminate HIV/AIDSinformation.

4.3 Available ICT Facilities (Hardware and Software)

Almost 90% of the surveyed districts have computers in the districts headquarters. However,the computers were used for other office works, especially in the DEDs office. The DCDOoffices, which were responsible for coordinating HIV/AIDS activities, do not have computers.Except for two districts, which showed that there was networking and a server, the remaining

were just stand-alone computers. Table 4.2 summarises the availability of computers in thedistricts. Internet connections were reported in only 2 districts. Despite the fact that in thedistricts townships there were some Internet cafes, in the government buildings there wereno Internet connections. Various international donors donate most of the computers in thedistricts. It was only in two of the districts whereby the Government of Tanzania had suppliedthe computers.


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Skills and Training needs in the surveyed districts. According to Table 4.3 the target groupsfor ICT training include the following:

District AIDS Control Coordinators (DACCs); District Community Development Officers (DCDO); District Heads of Departments (HoD); Council Multi-Sectoral AIDS Committees (CMAC); District Medical Officers (DMO); Wards Executive Officers (WEO); Health Educators; Planners and Analysts; Accountants; Secretaries.

Table 4.1 (a) Digital Convergence

Media

Newspaper Radios Television

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

Kigoma Kasulu

Kibondo

Kigoma

Manyara Babati

Hanang

Kiteto

Simanjiro

Morogoro KilomberoKilosa

Municipal

Ulanga

Mtwara Masasi


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Media

Newspaper Radios Television

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

DistricttoRegion

RegiontoTACAIDS

VillagetoWard

WardtoDistrict

Tanga Muni

Table 4.1(b) Digital Convergence

Telecommunication Computer

Region District Fax Letter Telephone Internet

DistricttoRe

gion

Regionto

TACAIDS

VillagetoW

ard

WardtoDistrict

DistricttoRe

gion

Regionto

TACAIDS

VillagetoW

ard

WardtoDistrict

DistricttoRe

gion

Regionto

TACAIDS

VillagetoW

ard

WardtoDistrict

DistricttoRe

gion

TACAIDS

Kigoma Kasulu

Kibondo

Kigoma

Manyara Babati

Hanang

Kiteto

Simanjiro

Morogoro Kilombero

Kilosa

Municipal

Ulanga

Mtwara Masasi

Mikindani

Mt


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62

Table 4.2 Available ICT facilitiesType of facility

Region

District

Software

Computer

Server

Printer

Internet

connection

Scanner

Specifications/

capacity

Working

condition

Usage

Provider/

supplies

Problems

Kigoma Kasulu MS 5 4 Good Data Storage Various Donors Not enough

Kibondo nil nil nil nil nilKigoma MS 1 Good Data Storage Not enough

Manyara Babati MS 4 4 GOOD LAMP

Hanang MS 8 6 GOOD LGRP

Kiteto MS 18 New LAMP

Simanjiro

Morogoro Kilombero MS 5 5 1 reports

Kilosa MS 15 2 13 Good reports Irland Aid Not enough

Municipal MS 13 3 1 reports USRP

Ulanga MS 33 30 2 Good reports JICA, Irish Aid

Mtwara Masasi MS 3 3 Good TAMISEMI

Mikindani MS 9 1 1 Good Presidents OfficeMtwara MS 4 1 3 1 Good Data storage and analysis MTUHA

Nachingwea MS 4 3 Data storage and analysis No expert

Mwanza Geita MS 1 1 40 GB HDD

Magu MS 11 10 2 GB HDD Office work Various Donors

City NIL


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62

Type of facility

Reg

ion

District

Softw

are

Comp

uter

Se

rver

Printer

Inte

rnet

connec

tion

Scanner

Specific

ations/

capa

city

Working

condition

Usa

ge

Provider/

supp

lies

Problems

Ukerewe MS 5 5 40 GB HDD Good Typing SIDA

Tanga Lushoto MS 2 2 64 MB RAM, GOOD Typing MUKADA

Korogwe MS 9 9 GOOD Typing

Pangani MS 11 10 x86 Family Office work Upendo MATTanga Municipal MS 2 2 Good Reports NIMR, GTZ

Table 4.3 ICT Skills and Training Needs

ICT Skills and Training Needs

Target Groups Present Skills ICT Skills Gaps

Kigoma Kasulu DACC DCDO Accountants NIL Management Information System

Kibondo

Kigoma CMACs Computer Management Management Information System

Manyara Babati All Staff NIL Basic Computer Knowledge

Hanang All Staff NIL Basic Computer Knowledge, PC mainten.

Kiteto All Staff NIL Basic Computer Knowledge

Simanjiro

Morogoro Kilombero DACC CDO Secretaries NIL Computer Management

Kilosa All Staff Computer Management

Municipal DACC CDO Health Educators NIL Computer Management

Ulanga All Staff NIL Computer Management


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62

ICT Skills and Training Needs

Target Groups Present Skills ICT Skills Gaps

Mtwara Masasi DACC HBC NIL Basic Computer Knowledge

Mikindani IT Officer CMACsIT

Computer Applications IT, Data storage, Internet

Mtwara DACC CDO CMACs NIL Basic Computer Knowledge

Nachingwea CMACs DAU DAU NIL Basic Computer Knowledge

Mwanza Geita DACC CDO DCDO MO NIL Information and CommunicationMagu DACC DAC-Health CMACs DToT NIL Basic Computer Knowledge

City DACC CDO WEO DMO NIL Basic Computer Knowledge

Ukerewe DACC DAC-Health DCDO DToT NIL Basic Computer Knowledge

Tanga Lushoto DCDO CDO Planners and Analyst NIL Information and Communication

Korogwe DACC DAC-Health NIL Computer Management

Pangani DACC DAC-Health CMACs HoDs NIL Information and Communication

Tanga Muni DACC CDO Health Educators NIL Computer Management


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Table 4.4 shows the priority ICT training needs which are directly related to M & Eactivities.

Table 4.4 Proposed ICT Training

Region District Proposed Training

Kasulu Computer basics and advanced level skills

Kibondo

Kigoma Kigoma Data processing and dssemination

Manyara Babati MS application sftware

Hanang Data collection, processing and storage

Kiteto MS Application Software

Simanjiro

Morogoro Kilombero Basic Computer Knowledge

Kilosa Information Education and Communication

Municipal Information Education and Communication

Ulanga Information and CommunicationMtwara Masasi Computer Management, Internet

Mikindani IT, Data storage, Internet

Mtwara Computer Management, Internet

Nachingwea IT and Computer Applications

Mwanza Geita Basic Computer training

Magu Computer Management, Internet

City MD Applications

Ukerewe Basic Computer Knowledge

Tanga Lushoto Management Information System

Korogwe Management Information System

Pangani Computer Management, Internet

Tanga Muni Information Education and Communication

The training needs according to their the surveyed districts include Management InformationSystem, Basic Computer Knowledge, PC Maintenance, Computer Management, IT, DataStorage and Analysis, and Internet.

The information on the ICT skills training needs has been interpreted by the researchers into


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4.5 Funding for ICT

Regarding funding for ICT the respondents were asked to explain the sources of funding forICT provisions, i.e., to explain who is paying for computer costs, such as toner, repair,networking, etc. The majority of the responses showed that the district council wasresponsible for the funding for ICT. The summary of the responses is shown on Table 4.5. Inaddition to the councils, there were donor funds e.g (Irish Aid, UNICEF), organizations e.g(LAMP, KDDP, Tracoinal Initiatives), and basket funds, which were also funding ICT.

Table 4.5 Funding for ICTRegion District ICT Facility Problems

ICT Autonomies Repair Networking

Kigoma Kasulu Council Council

Kibondo

Kigoma Council Council

Manyara Babati Council Council CouncilHanang Council Council Council

Kiteto LAMP, Council LAMP, Council LAMP, Council

Simanjiro

Morogoro Kilombero Council, KDDP Council, KDDP Council, KDDP

Kilosa

Council, Irish Aid,

Tracoinal Initiatives

Council, Irish Aid,

Tracoinal Initiatives

Council, Irish Aid,

Tracoinal InitiativesMunicipal Municipal Municipal Municipal

UlangaCouncil, Irish Aid,UNICEF

Council, Irish Aid,UNICEF

Council, Irish Aid,UNICEF

Mtwara Masasi Council Council Council

Mikindani Basket Fund Basket Fund Basket Fund

Mtwara Council, Basket Fund Council, Basket Fund Council, Basket FundNachingwea Council Council Council Lack of funds

Mwanza Geita Council Council

Magu Basket Fund Basket Fund

Ci NA NA


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5. ASSESSMENT OF MONITORING AND EVALUATION

CAPABILITIES

5.1 Introduction

This section of the report presents the main findings on the assessment of HIV/AIDSmonitoring and evaluation capabilities at the district level.

The section is organized into the following sub-sections:

(i) HIV/AIDS Planning(ii) Monitoring and evaluation capabilities(iii) Funding of HIV/AIDS activities(iv) Major stakeholders and their M&E Roles(v) HIV/AIDS M&E information flow(vi) Management and use of HIV/AIDS M&E information

(vii) Training needs and incentives in M&E(viii) Readiness to strengthen M&E systems

5.2. HIV/AIDS Planning

5.2.1. Importance of HIV/AIDS Planning to Effective M&E

The foundation of an effective monitoring and evaluation function for HIV/AIDS activities atthe district level is a good culture of planning HIV/AIDS activities. The survey has shown thatin general the culture of HIV/AIDS planning at the district level was rather weak and theimportance of having effective M&E systems linked to HIV/AIDS planning was not fullyappreciated. There is therefore a need to enhance the capacity of the districts in planningHIV/AIDS activities.

5.2.2. Main Characteristics of District HIV/AIDS PlanningTable 5.1 presents the main characteristics of the current approach to planning for HIV/AIDSactivities by the districts.

Table 5.1: The main characteristics of the District HIV/AIDS Planning


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S/N Characteristics Frequency1 (out of 22)

7 Existence of Multi-Sectoral HIV/AIDS Committee at the

Council level

12

8 Appointment of HIV/AIDS Focal Point at LGA level 39 Training in HIV/AIDS Planning Skills 5

10 Links to the National Multi-Sectoral Strategic Frameworkfor HIV/AIDS (NMSF)

1

11 Stakeholders at the district level deliberate on HIV/AIDSPlans

3

The results in Table 5.1 show that the districts were not paying adequate attention to thefollowing issues:

Training in HIV/AIDS planning skills Developing comprehensive HIV/AIDS Action plans Involving all stakeholders in HIV/AIDS planning Putting in place HIV/AIDS Focal Points to coordinate activities. Linking of the District council plans to the NMSF. Incorporation of NGOs and CBOs plans in District plans

5.2.3. Priorities Areas in District HIV/AIDS Response

The districts were requested to indicate what they consider to be their priority areas in theHIV/AIDS response. The most common areas mentioned have been shown in Table 5.2.The findings generally indicate that the districts were not paying adequate attention to the

priority areas identified in the National Multi- Sectoral Strategic framework.

Table 5.2 District HIV/AIDS Priority Areas

S/N Priority Area as per the NMSF Frequency (out of 22)1 Advocacy 12 Fighting stigma and discrimination 23 District /Community responses 64 Mainstreaming HIV/AIDS 55 HIV/AIDS and development /poverty reduction policies 56 STIs control case management 17 Condom promotion and distribution 38 Voluntary HIV/AIDS Counseling and Testing 89 Prevention of Mother to Child Transmission 210 Health promotion for specific population groups: children 5


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5.2.4. Responsiveness of District HIV/AIDS Planning to the National levelFramework

The districts were asked to indicate how their HIV/AIDS planning responded to the directionprovided by the National level HIV/AIDS framework as outlined in the National AIDS Policyand the National Multi-Sectoral Strategic Framework. The nature of the response has beensummarized in Table 5.3. The findings suggest a strong need to get/enable the districts todevelop HIV/AIDS plans which are linked to the national level framework.

Table 5.3: Responsiveness of District HIV/AIDS Planning to the National

Framework Aspects Frequency (out of 22)1 Integration with the National AIDS Policy 62 Integration with the NMSF 113 Integration with the National M&E Framework 04 Integration with NACP 2

5.2.5 Main Strengths and Weaknesses of District HIV/AIDS Planning

Table 5.4 and 5.5 list the main strengths and weaknesses of HIV/AIDS Planning asperceived by the districts. Inadequate planning skills and resources are the major constraintsfacing HIV/AIDS Planning at the district level.

Table 5.4: Strengths of District HIV/AIDS Planning

S/N Major Strengths Frequency (out of 22)1 Willingness of the community to participate in HIV/AIDS

activities6

2 Existence and roles of Multi-Sectoral AIDS Committees at LGAlevel

3

3 Multi-Sectoral approach to planning 34 Availability of information for planning purposes 35 Availability of resources 26 Involvement of stakeholders 37 Awareness on the importance of planning 48 Seriousness in implementing the plans 1

Table 5.5: Weaknesses of District HIV/AIDS Planning

S/N Major Weaknesses Frequency (out of 22)1 Inadequate participation in planning and implementation 2


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Table 5.6: Proposed Ways of Improving District Level HIV/AIDS Planning

S/N Proposed improvement Frequency (out of 22)

1 Capacitating HIV/AIDS Committees at Village, Ward andDistrict level

2

2 Strengthening bottom up approach on planning 13 Facilitating wards and villages in drawing up plans and

M&E systems3

4 Improving communication links between all levels (village,ward, district, TACAIDS and other stakeholders related toplanning)

3

5 Training all levels and stakeholders in HIV/AIDS planning 10

6 CMACS to include technical; experts from the healthsector

2

7 CMACS to be trained further on various aspects ofHIV/AIDS

4

8 Ensuring firm ways of funding HIV/AIDS plans 29 Increasing the number of community development officers 210 Enhancing networking with NGOs, FBOs, CSOs and

CBOs1

11 Working closely with the Health Sector 2

5.3. Monitoring and Evaluation Capabilities

5.3.1. Existing Management Mechanisms for District HIV/AIDS M&E

Table 5.7 provides a picture of the management mechanisms for monitoring and evaluation

of HIV/AIDS activities at the district level. The findings indicate that there was a goodnumber of management mechanisms for facilitating monitoring and evaluation of HIV/AIDSactivities. But, there was a critical need for a comprehensive development of themanagement structure so that roles and responsibilities for HIV/AIDS activities including M &E were well defined.

Table 5.7 District Mechanisms for HIV/AIDS M&E

S/N Area Mechanism Frequency (out of22)

The Community DevelopmentDepartment

3

VEO, WEO and CDOs 9

MAC t Kit ji Vill W d 6

1 Accountability andcoordination


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S/N Area Mechanism Frequency (out of22)

MACs (village, ward, districts 3

DCDO 10

Health Officer 6

Table 5.8 lists the main problems related to the management of M&E for HIV/AIDS at thedistrict level in relation to information collection, reporting, analysis and feedback.

Table 5.8: Problems with Existing Management of M&E

S/N Problem Frequency (out of 22)1 Transport for M&E activities 52 Funding of M&E 63 Delays in collecting information/data 24 Delays in reporting 45 Inadequate number of M&E experts 4

5.3.2 Existing Guidelines and Reporting for HIV/AIDS

Districts were requested to indicate the kind of guidelines and reports for monitoring andevaluation which exist at the District/Ward /Village levels and the main problems faced.Their major responses have been presented in Tables 5.9 and 5.10. The findings clearlyindicate a need for assisting/getting the districts to be able to develop and implementcomprehensive and relevant guidelines for M&E.

Table 5.9 Existing HIV/AIDS Guidelines and Reporting at the District LevelLevel Types of guidelines/reports Frequency (out of 22)

No guidelines/reports 5Monthly meetings of Village MAC 1

Village

National Multi-sectoral Strategic Framework 2No guidelines 6Regular meeting of ward MAC 2Ward HIV/AIDS Action Plan and National HIV/AIDS

Policy

3

Ward

National Multi-sectoral Strategic Framework 2No guidelines 5Regular Meetings of District or Council MAC 1National HIV/AIDS Action Plan 2

District

National Multi-sectoral Strategic Framework 2


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Level Problem Frequency (out of 22)

Transport problems 1

Irregularity of reporting1

No M&E system in place 2

Lack of supportive supervision 2

Inability to collect required data 1

Lack of guidelines 3

Lack of basic knowledge and skills in M&E 4

No developed format for reporting 3

Ward


Irregularity of reporting 1

No M&E system in place 2

Lack of supportive supervision 2

Inability to collect required data 2

Lack of guidelines 4

Lack of basic knowledge and skills in M&E 3

No developed format for reporting 5

DistrictCouncilLevel


5.3.3 Existing Routine Data Collection Systems

Table 5.11 shows the routine data collection system for example those which were part ofnational surveillance activities, which could be used to support M&E activities at thedistrict/national levels.

Table 5.11 Existing Routine Data Collection Systems for M&E

S/N System Type of data/information District where the systemavailable / is operating (outof 22)

1. MTUHA(Ministry of HealthManagement Information

System)

HIV/AIDS case Blood donors

STIs VCT MCH

14

2. Education ManagementInformation System (EMIS)

6


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Table 5.12 Critical HIV/AIDS M&E Knowledge/Skills Gaps

S/N Knowledge /Skills Gap Target groups Frequency (out of

22)1. Understanding of basic principles of

Monitoring and EvaluationDistrict level 13

2 Managing the forms and mechanismsfor data collection

Village; Ward; Districtlevels

6

3 Report writing skills Village; Ward; Districtlevels

2

4 Designing data collection tools District level 55 Data analysis skills District level 36 Computerized database management District level 4

5.3.5 Desired Frequency for Reporting on HIV/AIDS to TACAIDS

Districts were requested to suggest the most convenient and practical frequency forreporting on HIV/AIDS activities to TACAIDS. They gave the following factors asdetermining the appropriate frequency:

Need to allow enough time for collecting the required data. Need to consider the communication constraints facing the districts. Need to consider the difficult environment related to transport, manpower, geographical

location of wards and villages and availability of funds.

Table 5.13 presents the views on the desired frequency. The most preferred frequency ofreporting seems to be quarterly reporting (63.6% of the surveyed districts).

Table 5.13 Desired Frequency of Reporting on HIV/AIDS to TACAIDS

S/N Frequency Frequency (out of 22)1 Monthly 32 Quarterly 143 Semi-Annually 44 Annual 3

5.3.6 Ways of Getting M&E Information from Kitongoji and Ward levelsThe study investigated the current methods used by Local Government Authorities to getM&E information from the lower levels, i.e. Kitongoji and Ward levels. The results have beenshown in Table 5.14. Furthermore, Table 5.15 has provided a list of problems faced ongetting information from village/Ward levels


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Level Ways of Getting Information Frequency (out of 22)Meetings 5Health Centres 7

Participatory Rural Appraisal (PRA) 1

Table 5.15 Problems in Getting M&E Information from the Village/Ward levels

S/N Problem Frequency (out of 22)1 Report inconsistencies 22 Delays in collecting information 3

3 Lack of data collection facilities 14 Transport and communication constraints 15 Lack of HIV/AIDS coordinators 26 Lack of uniform data collection tools 27 Funding constraints 2

5.3.7 Proposed Measures for Strengthening HIV/AIDS Monitoring andEvaluation

Table 5.16 presents some general measures proposed by the surveyed districts in order tostrengthen the capacity for HIV/AIDS Monitoring and Evaluation.

In order to strengthen HIV/AIDS Monitoring and Evaluation, Local Government Authoritieshave proposed measures to train all key actors in Monitoring and Evaluation from Kitongojito district levels. Other measures include improving funding, strengthening the M & Esystems and introducing uniform data collection forms from Kitongoji up to the District level.

Table 5.16: Proposed Measures to Strengthen HIV/AIDS Monitoring and Evaluation

S/N Proposed Measure Frequency (out of 22)1 Introduce uniform data collection forms from Kitongoji to

District level5

2 Support resource use the Kitongoji and Ward HIV/AIDScommittees so that they can collect and report appropriately

2

3 Improve funding of HIV/AIDS activities including M&E 5

4 Train all key actors in M&E from Kitongoji to district level 125 Improve working facilities computers, internet, vehicles 46 Strengthen HIV/AIDS Planning at all levels 17 Assist all levels so that they have appropriate M&E systems 9

5.4. Funding of HIV/AIDS Activities


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Table 5.17: Sources of Funding for HIV/AIDS ActivitiesS/N Source Frequency (out of 22)1 TACAIDS 16

2 Global Fund 13 Basket Fund 54 Central Government 55 Local Government Authorities 56 Development Partners/Donors e.g. UNAIDS, UNICEF, etc. 87 NACP 18 Private sector 29 NGOs (AMREF, TANESA, CARE International) 12

5.4.2 Mechanisms for Monitoring Funding

Table 5.18 shows some of the existing mechanisms in place to monitor the utilization offunding for HIV/AIDS activities at the district level.

Table 5.18: Mechanisms for Monitoring FundingS/N Mechanism Frequency (out of 22)1 CMACs 52 District Financial Reports 13 Some funds are released though the government

system/rules2

4 TACAIDS external auditing 15 DISTRICT internal auditing 1

5.4.3 Problems Facing Funding

Table 5.19 gives the views of the surveyed districts regarding the factors/problems facingfunding of HIV/AIDS in general and of M&E activities in particular.

Table 5.19: Problems Facing FundingS/N Problem Frequency (out of 22)1 Weak collaboration between key stakeholders 22 Poor transparency in financial matters 13 Inadequate community participation 1

4 Inadequate funding 125 Funds usually arrive late for implementation 16 Poor fund raising/mobilization skills amongst

stakeholders/actors6

7 Inadequate computerization or financial managementsystem

3


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Table 5.20: Ways to Improve Funding for HIV/AIDS activities

S/N Proposed Measure Frequency (out of 22)

1 LGA to increase networking with NGOs 42 Get community development departments to also spend

time on raising funding for HIV/AIDS1

3 District planning to give HIV/AIDS more priority 44 Strengthen fund mobilization skills of key actors at all

levels3

5 Work with funding sources for timely release of funds 26 Districts should have funds raising 4

5.5 Major Stakeholders and their M&E Roles

Effective Monitoring and Evaluation of HIV/AIDS activities at the district level dependsgreatly on each key stakeholder/actor playing his/her role well. The study thereforeattempted to identify the main stakeholders and their perceived M&E roles. It also assessed

the involvement of these stakeholders in the Districtlevel planning of HIV/AIDS activitiesand the problems being experienced.

5.5.1. The Major Stakeholders and their Roles

Table 5.21 lists the key stakeholders related to effective monitoring and evaluation ofHIV/AIDS activities at the district level. Table 5.21 also indicates the roles of thestakeholders as perceived by the districts.

Table 5.21 Key Stakeholders and Perceived M&E Roles

S/N Stakeholder Perceived M&E Roles1 Kitongoji /Village

Reporting on HIV/AIDS activities Data collection

2 Ward Reporting on HIV/AIDS activities Data collection

3 District Council Planning in coordination with all stakeholders Brings together all stakeholders Preparation of quarterly M&E reports

4 Central Government (NACP,TACAIDS)

National level M&E reporting Funding of districts


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Table 5.22: Elements of Present Coordination of Civil SocietyS/N Coordination Approach Frequency (out of 22)

1 Direct involvement of RAS office 22 Meetings involving the Civil Society 113 NGOs/CBOs/CSOs required by district authorities to

report on HIV/AIDS2

4 Incorporation of Civil Society in CMACs 85 Regular stakeholders conference 16 A shared system of information dissemination 27 Visits by leaders at all levels 18 No coordination at all 1

5.5.3. Problems Related to Coordination of NGOs/CBOs/CSOs

NGOs/CBOs and CSOs which offer HIV/AIDS related activities are very central to thesuccess of the district response. The surveyed districts have outlined in Table 5.23 themain problems needing urgent attention in order to strengthen the coordination of theactivities of NGOs / CBOs/ CSOs.

Table 5.23: Problems Facing NGOs/CBOs/CSOs CoordinationS/N Problem Frequency (out of 22)1 Lack of effective coordination mechanisms 42 Political and other forms of interferences 13 Leaders of NGOs/CBOs/CSOs lack appropriate

management/Skills4

4 Inadequate funding 55 Inadequate pro-activeness on the part of Local

Authorities in all issues related to responding to theHIV/AIDS pandemic.

6

5.6 M & E Information Flow

In all the districts surveyed, information flow start from the Kitongoji or ward level. All districts

had means and ways to capture information but relatively in different ways as explained inTable 5.24. Districts need to be assisted to develop new / additional means ofcommunication such as the Internet.

Table 5.24: Means of CommunicationMovement of Information Means of Communication Other means yet to be


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Movement of Information Means of Communication Other means yet to beapplied

Fax

Telephones

E-mails

Region to TACAIDS Reports

Letters and other meansthrough the Postal office

Internet

Radio Programmes

TelevisionProgrammes

E-mails

Radio Programmes Television

Programmes

E-mails

5.7 Management and Use of HIV/AIDS M & E Information

The study generally found out that HIV/AIDS data was collected by most of the Districts butanalysis was partially done by only a few of them - namely Masasi District and KasuluDistrict. Thus, there is need to empower the district councils on how to analyze HIV/AIDS

data and use the result to improve the planning of HIV/AIDS activities.

The respondents had the opportunity to detail out some of the major problems facing dataHIV/AIDS collection and management. In summary the following were the problems pointedout by the respondents:

Lack of funds for research Limited or shortage of facilities especially related to ICT and laboratory equipment

Limited capacity to conduct research i. e. Only few researchers were available Limited experience and skills for most staff Lack transport facilities in some of the districts Limited capacity to conduct data analysis and interpretation

The respondents proposed the following remedial measures to address the above shortfalls:

Provide budget line for research activities Avail computers and related ICT facilities

Conduct training on data management Provide transport where necessary Recruit more personnel with relevant qualifications Develop strategies to improve data collection

5 8 A R l t d t Mi i t i I fl i M & E t th Di t i t


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Research data collection Consultancies done

5.8.2 Problems Influencing M & E at the District Level

As regards problems noted to influence M & E at the district level, respondents pointed outthe following:

Too many or endless consultancies Uncoordinated research activities Too many questionnaires needing sometimes the same information

Too many visits from the ministries and national NGOs Too regularly changing report formats which sometimes are confusing

Different organs conducting the coordination function

5.8.3 Proposed Remedial Measures to Improve M & E at the District Level

Respondents provided some remedial measures to improve M & E at the district. Among the

proposed remedial measures pointed out were: Introduce facts and figures booklet for each district and subsequently for each region. Provide better coordination and harmonize research and consultancy activities

Refine and adopt a uniform reporting format Provide coordination under one roof and let the other national NGOs use the same

route.

Conduct regular and tailor-made training to district staff

5.9 Training Needs and Incentives in M & E

5.9.1 Training needs and M & E for Key Actors

Table 5.25 indicates the main training needs in M & E. They are basically in terms of themain elements and processes of monitoring and evaluations as well as reporting writing.

Table 5.25 Identified Training Needs

S/N Type of Training Target Group1 Process/Approach of M & E Councilors

Council Staff

Health OfficersW d ff


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Funds to support planned activities including M & E; Provision of working facilities; Provision of topping up allowances for key staff but based on performance

Provision of regular tailor made training Provision of reliable transport facilities Provision of support experts where need arise


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6 ASSESSMENT OF RESEARCH CAPABILITIES AND

NEEDSThis chapter presents an assessment of the research capabilities and needs of the districtsas regards HIV/AIDS. It looks at the existing and required research literature; the researchprojects undertaken or being undertaken; the available staffing for research activities; theavailable research equipment/facilities; the institutions currently doing research; the majorproblems being experienced; the major research areas/themes; and the nature of theexisting framework for supporting research.

6.1 Existing and Required Additional Literature on HIV/AIDS

The surveyed districts pointed the need for additional literature in a number of areas. Table6.1 provides details of available literature as well as additional literature requirements

Table 6.1: Existing and Required Literature

Available Literature Additional Literature

Knowledge on STI diseases How to use condoms

Full diet for people infected with the HIV virus

HIV/AIDS stigma HIV/AIDS policy

Home based care guidelines

VCT guidelines STIs management guidelines

National guidelines for management of HIV/AIDS

Health Sector Strategic Plan for HIV/AIDS

Guidelines for reproductive health

Male and female relationships

HIV/AIDS and the new generation

Drugs and drug abuse

Video tapes Zawadi na Rama

Annual reports on HIV/AIDS Syphilis sentinel surveillance

HIV/AIDS and the Youth

Mother to Child Transmission of HIV

Video film Dira ya Taifa

World trends on HIV/AIDS infection

Sexually transmitted diseases

Brochures/leaflets on HIV/AIDS National policy on HIV/AIDS in Swahili

version

Impact of HIV/AIDS on the communities HIV/AIDS prevention

Home based care

HIV/AIDS situation Worldwide

Counseling

Care for people infected with HIV/AIDS


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6.2. Research Projects on HIV/AIDS

Information obtained from the 22 districts/municipal councils as summarized in Tables 6.2and 6.3 suggests that districts/municipalities have considerable experience in conductingresearch on HIV/AIDS. The surveyed districts/municipalities recorded 24 completedresearch projects (Table 6.2) between 1998 and 2004 plus 9 ongoing projects (Table 6.3).TACAIDS should consider assisting districts/municipalities to establish databases forHIV/AIDS research. Both Table 6.2 and 6.3 show a list of organizations and individualsconducting research on HIV/AIDS. There is need for districts / municipalities to set asidefunds for research on HIV/AIDS and to encourage both institutions and individuals toconduct research on HIV/AIDS through training in research skills, research competitions,and provision of funds for these purposes.

Table 6.2: Completed Research Projects on HIV/AIDSS/n District Project Title Researchers Date

Completed

1. Lushoto DistrictCouncil

Primary school andsecondary education

MEUSTA 2002

High transmission areas(HTAs)

GTZ 1998

PULIS (health) NORPLAN 1999

2. Korogwe DistrictCouncil

Mpango wa Elimu yaUkimwi Mashuleni(MEUSTA)

NORWAY NURSES 2002

Elder people and HIV/AIDS TEWOREC 2004AIDS Education in PrimarySchools

MEUSTA 20033. Tanga Municipal

Council

Research on TraditionalMedicine

TAWG 2004

Mpango wa Elimu yaUkimwi Mashuleni(MEUSTA)

Norgion NursesAssociation

20024. Pangani District

CLASTOR Tanzania Aids Project(TAP)

1999

5. MorogoroMunicipalCouncil

None -

HIV situation analysis AMREF 19996. Ulanga DistrictCouncil HIV/AIDS situation

analysisIfakara Centre 2003

Mr. MolelMr Mwambataswa

7. Kilosa MunicipalCouncil

Pastoralist awareness onHIV

1994


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S/n District Project Title Researchers DateCompleted

12 Mtwara District

Council

PMTCT (Prevention of

Mother to ChildTransmission)

UNICEF

13 MtwaraMikindani DistrictCouncil

MCT NACP

Community Aids care Community careOrphanage care Orphanage careCounselingLegal and Human RightsSupport

14 Masasi DistrictCouncil

Prevention peereducation

15 NachingweaDistrict Council

None provided

16 Ukerewe DistrictCouncil

None provided

17 Geita DistrictCouncil

MEMA for Youth (MKV I) AMREF 2002

18 Mwanza CityCouncil

None provided

19 Magu CityCouncil

None provided

20 Kiteto DistrictCouncil

Home based care John NathanElizabeth Ngasa

2003

21 Hanang District

Council

None

22 Babati DistrictCouncil

Rate of infection ofHIV/AIDS

Members of UDSM No reportsubmitted

Table 6.3: Research Projects on HIV/AIDS in ProgressS/n District Project Title Researchers Expected

DateCompleted

1. Lushoto District Council Pregnant Mothers andHIV/AIDS

GTZ (BomboHospital)

-

High Transmission Areas(HTAs)

GTZ -2. Korogwe District Council


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S/n District Project Title Researchers ExpectedDateCompleted

8. Kilombero District None

9. Kasulu District Council None

10. Kibondo District Council None

11. Kigoma District Council None

12 Mtwara District Council PMTCT UNICEF

13 Mtwara Mikindani DistrictCouncil

STI (Sexually TransmittedInfections)

NACP

14 Masasi District Council None provided15 Nachingwea District Council None provided

16 Ukerewe District Council None provided

MEMA for Youth 2(MKV II)

AMREF17 Geita District Council

Geita situationAnalysis on HIV/AIDS

TANESA

18 Mwanza City Council None provided

19 Magu City Council None provided20 Kiteto District Council None21 Hanang District Council None22 Babati District Council None

6.3 Staff Available for HIV/AIDS Research

6.3.1 Actual Number of Staff Available

The number of staff available for HIV/AIDS research varied from one District to anotherranging from zero to a maximum of five In districts which could not provide names of staff


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6.3.3 Proposed Solutions

There is a need to design a tailor made training in research methodology for district staff inorder to empower them to use research methods in their activities especially those relevantto addressing the HIV/AIDS challenge. Furthermore, the training should motivate them toget the Councils to prepare and implement appropriate research agendas.

6.4 Available Equipment for HIV/AIDS Research

Information obtained from the surveyed districts suggests they have a significant shortage of

equipment to help them in conducting HIV/AIDS research. Only three districts reported toown motor vehicles, computers, and printers (Table 6.4). All districts expressed the need foradditional equipment for conducting HIV/AIDS research (Table 6.5).

Table 6.4: Available Equipment for HIV/AIDS ResearchS/n District Type of

EquipmentValue When

AcquiredUsageCondition

1. Lushoto District Council None Provided - -


None Provided - -

3. Tanga MunicipalCouncil

None Provided - -

4. Pangani District None Provided - -5. Morogoro Municipal

CouncilNonesuggested

- -

6. Ulanga District Council Nonesuggested

- -

7. Kilosa District Council Motor vehicle - - Good

8. Kilombero District Nonesuggested

- -

9. Kasulu District Council Motor vehicle,computer andprinter

- -

10. Kibondo District Council None provided

11. Kigoma District Council None provided12 Mtwara District Council None provided

13 Mikindani DistrictCouncil

None provided

14 Masasi District Council None provided


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Table 6.5: Required/Additional Equipment for HIV/AIDS Research

S/n District Type of Equipment Quantity Purpose for which

Required

1. Lushoto DistrictCouncil

None Suggested - -


None Suggested - -

3. Tanga MunicipalCouncil

None Suggested - -

4. Pangani District None Suggested - -

Photocopier 1 Secretarial servicesMotor vehicle 2 Transport

Computer 3 Secretarial services

5. MorogoroMunicipal Council

Printers 2 PrintingPhotocopier 1 Photocopy services

Computer 5 Storage AnalysisMotor vehicle 2 TransportPrinters 2 PrintingScanner 1 Scanning

6. Ulanga DistrictCouncil

Camera 3 Taking photos

Camera 2Photocopier 1

Computer 3Motor vehicles 1

7. Kilosa DistrictCouncil

Mote bikes 2

Facilitating HIV/AIDSactivities

Motor vehicle 2

Motor bike 3

Transportation

Computer 2Photocopier 1Printers 2

8. Kilombero District

Scanner 1

Secretarial services

Vehicle 1 TransportationComputers 2 Data analysis and

secretarial services

9. Kasulu DistrictCouncil

Photocopier 1 Photocopying10 Kibondo District

CouncilNone suggested

11 Kigoma DistrictCouncil

None suggested

Vehicle 1 TransportICT (Computers + Printer) 2 Data processing, storage,

l i d t i l

12 Mtwara DistrictCouncil


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S/n District Type of Equipment Quantity Purpose for whichRequired

Generator 1 Power (in villages)

Vehicle 1 TransportationComputer 1 Data storagePrinter 1 Data storage (hard copy)

15 NachingweaDistrict Council

Photocopying machine 1 PhotocopyingDesktop computerLaptop computer

11

Data collection, analysis andreportingFor field work data collection

Printer 1 For printing reports

16 Ukerewe DistrictCouncil

Photocopier 1 For reproducing reports

Desktop computerLaptop computer

11

Data collection, analysis andreportingFor field work data collection

Printer 1 For printing reportsPhotocopier 1 Reproducing reports

17 Geita DistrictCouncil

Vehicles 1 Facilitating researchMwanza CityCouncil Desktop computer 1

Data storage, analysis andpresentation

18

Motor vehicle 1 Easy communication19 Magu City

CouncilNone listed

20 Kiteto DistrictCouncil

HIV kit 12 Testing HIV

21 Hanang DistrictCouncil

More HIV testingequipment

1 HIV testing

Computer 1 Data collection/Processing

Audio equipment 1 RecordingGenerator 1 Power supplyBattery 1 Power supply

22 Babati DistrictCouncil

Radio call 21 (one foreach ward)

Communication

6.5. Institutions Currently Conducting HIV/AIDS Research

6.5.1 List of Institutions Conducting HIV/AIDS Research

The study revealed that not all districts had institutions conducting research on HIV/AIDS intheir localities Among the institutions which were conducting HIV/AIDS research were:


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conducting research or possessing the capacity to do so appear to be lack of clear researchmission, inadequacy of research skills and lack of resources for conducting research.

6.5.3 Proposed Solutions

Urgently TACAIDS should design a programme to empower institutions at the district levelwhich want to conduct research on HIV/AIDS. It should could conduct tailor made researchprogrammes as well as fund some of the research areas relevant to TACAIDS.

6.6. Major Problems Experienced in Conducting HIV/AIDS

Research

Table 6.6 lists the main problems facing the HIV/AIDS research function in the surveyeddistricts. These problems range from shortage of funds, working facilities, transport, andequipment to train in research methodology.

Table 6.6: Major Problems Experienced in Conducting HIV/AIDS Research

S/n District Problems being encountered1. Lushoto District Council None listed2. Korogwe District Council None listed

3. Tanga Municipal Council None listed

4. Pangani District None listed5. Morogoro Municipal Council None provided6. Ulanga District Council Shortage of Funds

Shortage of Working facilities Shortage of Equipment

7. Kilosa District Council Few Researchers

Lack of Funds

Lack of facilities Shortage of equipment

8. Kilombero District Shortage of Funds

Shortage of Working facilities

Shortage of Equipment9. Kasulu District Council None listed10. Kibondo District Council None listed11. Kigoma District Council None listed

Lack of VCT centres12 Mtwara District Council


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S/n District Problems being encountered

Poor retrieval of data

Transportation difficulties

Inadequate capacity to conduct research17 Geita District Council

Inadequate research funding

Lack of reliable transport18 Mwanza District Council

Lack of computer facilities19 Magu City Council None listed

Inadequate facilities

Inadequate skills

20 Kiteto District Council

Transport21 Hanang District Council None provided

22 Babati District Council Lack of research funds and capacity

6.7 Research Areas/Themes on HIV/AIDS

Analysis of the district responses has indicated that their priority areas for research onHIV/AIDS include the following:

HIV/AIDS prevalence in each district The impact of beliefs and culture and HIV/AIDS pandemic Polygamy and HIV/AIDS Sexual Transmission of Infections Research on traditional medicine /Traditional healers and HIV Impact of HIV/AIDS on the economy Community behavior and HIV/AIDS Stigmatization and discrimination against people living with HIV/AIDS Community perception of the AIDS pandemic The problem of orphans due to HIV/AIDS Condom use Preventing HIV transmission Behavior change amongst high risk groups School children and HIV/AIDS Modes of HIV infection/transmission Home based care HIV/AIDS in schools


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likely to suffer from not being given adequate attention and also due to inadequatesystematic planning, documentation and dissemination. It is recommended that the researchfunction be mainstreamed into the duties of each of the Local Government Authoritys

department and coordinated by the District Planning Officer. With respect to research onHIV/AIDS, the Community Development Officers should conduct and coordinate researchactivities on HIV/AIDS as well as ensure the maintenance of a systematic data bank onHIV/AIDS research that permits systematic reconfiguration and speedy retrieval.


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7. MINISTRIES AND NATIONAL NGOS ROLES IN MIS,

M&E AND RESEARCH AT THE DISTRICT LEVEL

7.1 Introduction

Ministries deal with the districts in terms of MIS, M&E and research related to HIV/AIDSactivities. A selected number of the ministries and national NGOs were surveyed for theirviews, role and relationship with the district level on the mentioned aspects.

The Ministries included:

Ministry of Health (MoH)/National AIDS Control Programme (NACP) Ministry of Labour and Youth Development (MoLYDS)

Ministry of Community Development, Gender and Children (MoCDGC) Ministry of Education and Culture (MoEC) Ministry of Land & Human Settlement Development (MoLHD) Ministry of Works

The National NGOs were:

Poverty Africa

AMREF

The survey studied the following issues:

Information management systems Monitoring and evaluation Research on HIV/AIDS

7.2 Information Management Systems

7.2.1. Communication links which exist between the Ministries and theDistricts, Related to HIV/AIDS Activities

Table 7.1 gives a picture of the kind of communication links that exist between theMinistries/NGOs and the districts that are related to HIV/AIDS activities. These responses

S/N Mi i t /N ti l E i ti C i ti Li k


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S/N Ministry/NationalNGO

Existing Communication Links

Community Devp.,

Gender andChildren)

These are directly under the ministry and therefore the Ministry

communicates directly to them on issues relating to HIV/AIDS.

4 MoEC(Ministry ofEducation andCulture )

There are the District Chief Inspectors who report to the zonal ChiefInspectors of schools. The zonal chief inspectors communicate directto the MoEC on many issues including HIV/AIDS

5 MoLHSD(Ministry of Land &Human Settlement

Development)

There are communications in terms of meetings/seminars/workshops,letters and Internet Website.

6 Ministry of Works(MoW)

There is no linkage which exist between the ministry and the districtsas regards HIV/AIDS activities

7 AMREF Through lettersExisting project in the particular district i.e. Iringa, Mwanza, Geita,Kahama

8 POVERTY AFRICA ReportsWorkshops/Seminars

7.2.2 Problems faced by the Ministry/NGOs District Linkage

Table 7.2 indicates problems faced by the Ministries/NGOs in their relations with the Districtsas regards HIV/AIDS activities. In general, the Ministry/NGOs District linkage is weak interm of addressing HIV/ADS issues or facilitating HIV/AIDS activities. The reasons rangefrom inadequate resources to lack of properly formalized communication systems There is agood opportunity to develop Internet as an important communication links between theMinistries and the Districts. PORALG needs to work more closely with the other Ministries

with direct relations with the Districts in HIV/AIDS activities. TACAIDS should coordinate withthe Ministries which have direct relations with the Districts as well as with PORALG and theLGAs in order to evolve a unified and cost-effective communication relationships andinformation sharing arrangement.

Table 7.2: Problems Facing the Ministry/NGOs-District Linkage


Problems faced

1 NACP/MOH

Lack of transport for DACCs makes communication between thehealthy facilities and district level difficult.

Inadequate funds for data collection2 MOLYDS Inadequate data/information especially on the youths

S/N Ministry/ Problems faced


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Problems faced

6 MoW No problems7 AMREF Problems: Communication delays conflicting activities

8 POVERTYAFRICA

Inadequate skilled personnel, equipment and inadequate budgets

7.2.3. Type of data and information on HIV/AIDS being collected by the

Ministries/NGOs from the Districts

Table 7.3 provides an indication of the type of data and information on HIV/AIDS which isbeing collected by the Ministries/NGOs from the districts. The findings suggest that someMinistries and NGOs are already collecting important information from the Districts onHIV/AIDS activities and may be there is a need for enhanced coordination by TACAIDS toensure uniformity and information more directly relevant to the Core National Indicators formonitoring HIV/AIDS activities.

Table 7.3. Type of data and information on HIV/AIDS being collected by theMinistries/NGOs from the districts


Type of data/Information being collected

1 NACP/MOH AIDS case reports, sexually transmitted infections Case management reports, Blood donor reports and Antenatal

clinic reports

HIV prevalence reports, inadequate due to shortage of humanresource and transport constraints.

2 MOLYDS Youth HIV infections through their groups3 MoCDGC

There is lack of an organized way of data collection onHIV/AIDS in the folk development Colleges and communityDevelopment Training institutes. This is mainly due the fact thata proper system has no been explicitly designed and put inplace.

4 MoEC Reports on the implementation of HIV/AIDS activities done byschools

5 MoLHSD No data collection at the moment.6 MoW No formal links with the districts, however, there are formal

links with the Region level where the Ministry has workers.

good There is however a general need to strengthen computer skills especially as they


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good. There is, however, a general need to strengthen computer skills especially as theyapply to HIV/AIDS information management. There is no mention of any specializedsoftware for tracking, storage and communication of HIV/AIDS information/data.

Table 7.4 Degree of quality of computerization of MIS systems in the Ministries

S/N Ministry No. ofComputers

Type of software Internetconnection

Computerskills ofemployees

1 NACP/MOH

40 Word Processors,Spread Sheets, Databases, Statistical

packages

Wireless viaLAN

Ranges fromusers toadvanced

users.2 MOLYDS 4 - Yes Low to

average3 MoCDGC 40 In the process of

installing an MIS at theHQ

Yes Most officersare computerliterate

4 MoEC 3 Microsoft Office Yes Basiccomputerknowledge

5 MoLHSD More than150 pieces orHQ

Microsoft Office Yes Most of themare computeriterate

6 MoW Eachdivision,agency,board &institution hascomputers

which are arequirement

Microsoft Office, others No Internet Very fewemployeeshaveadequatecomputerskills

7 AMREF 100 - YES Employeesarecompetent tosome extent

8 POVERTYAFRICA

1 Excel Inadequate Inadequate

7.2.5 Problems with the existing MIS system at the Ministries/NGOs

The Ministries/NGOs were requested to indicate the major problems facing their MISsystems. Their responses have been summarized in Table 7.5. In general, a lot needs to bedesired in terms of computerized MIS at the Ministries. TACAIDS needs to provide

links to the 62 colleges are yet to be established


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links to the 62 colleges are yet to be established4 MoEC MIS is not centrally computerized thus it is accessed by a few trained

group in the policy of Planning department

5 MoLHSD The internet is very slow due to small capacity of the servers6 MoW No response7 AMREF Power problem because TANESCO is not stable8 POVERTY

AFRICAPersonnel, equipment, and budget need to be enhanced

7.3. Monitoring and Evaluation

7.3.1 Plans for HIV/AIDS Workplace Interventions

Table 7.6 indicates the extent to which Ministries and NGOs have invested in having plansfor HIV/AIDS workplace interventions. The data show that Ministries and NGOs haveHIV/AIDS action plans. May be there is need for these plans to be synchronized with thoseat the District levels and with the National HIV/AIDS Strategic Framework. The extent towhich the Ministry plans are being implemented in relation to those activities which shouldhappen at the district level could not be established clearly from the data provided.

Table 7.6: Ministerial Plans for HIV/AIDS Workplace Interventions

S/N Ministry /NationalNGO

Plans on HIV/AIDS

1 NACP/MHO There is a HIV/AIDS Strategic Framework 2003 2006

2 MOLYDS There is a comprehensive HIV/AIDS Action Plan3 MoCD, GC There is a comprehensive workplace intervention plan.4 MoEC Workplace intervent

1380_m&e training needs report - tanzania

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