Monitoring and evaluation approaches for key population programs: perils, pitfalls, and promising practices

Sharon WeirDepartment of EpidemiologyUniversity of North Carolina at Chapel HillDecember 4 2015

What is programmatic mapping?

Programmatic mapping is a collaborative method to systematically map public locations where key populations congregate, assess the availability of HIV prevention and treatment services among people at those locations, and use the results to improve service delivery.

“Focusing on the areas where the HIV epidemic is highly concentrated, identifying the places where services are lacking and reaching the people in need of prevention services, testing, treatment and support are the first steps towards achieving more efficient and effective programs.” UNAIDS Location Location Report, 2014

What is size estimation?

Size estimation methods estimate the number of people in a defined key population who can be reached at a single spot or in a geographic area over a defined period. The numbers are used by programs to set targets, provide denominators for program coverage, identify gaps in services, and advocate for funding.

Perils

1. serious and immediate danger.

2. synonyms: danger, jeopardy, risk, hazard, insecurity, uncertainty, menace, threat

Promising Practice

“Do no harm”.

Simple idea. Challenging to implement.

Operationalizing “DO NO HARM”

•Nothing about us without us. Is the key population community meaningfully engaged and supportive? Engagement

•Mapping Readiness Assessment. Based on current laws, policy and the environment, what is the risk from mapping? What do stakeholders say?

Risk Assessment

•Has the protocol received review from an ethics committee such as an IRB?Ethical Review

•Is the team prepared if a problem arises? Preparation

Operationalizing “DO NO HARM”

•Is there a process in place to monitor and address incidents that arise such as harassment?

Incident Monitoring

•Is participation voluntary ? Is there a proper process for informed consent? Informed Consent

•Are safeguards in place to keep the data secure?•Are data use agreements in place?Data Security

•Does the mapping and size estimation result in program improvement?

Programs Improvement

Pitfall

• an unforeseen or unexpected or surprising

difficulty• Falling into a hidden trap

Nepenthes_muluensis Wiki Photo

Pitfall Map

Fail to Define Populations

Fail to Engage Stakeholders, No Mapping Readiness

Bad Fix: Quick & Dirty Approaches

Poor VALUE: Findings

never used.

Questionnaires inadequate. Sampling flawed.

Promising Practices: Collaborate, Prepare, Pilot

Fail to Define Populations

Fail to Engage Stakeholders, No mapping readiness

Questionnaires inadequate. Sampling flawed.

Bad Fix: Quick & Dirty Approaches

Poor VALUE: Findings never used.

Thank-You!