New monitoring strategy to get to grips with HIV/AIDS

Swaziland has introduced a strategy for monitoring the work of multilateral anti-AIDS organisations and strengthening their response to the pandemic as more HIV/AIDS funds begin flowing to developing countries and poor communities.

The comprehensive national monitoring and evaluation plan was launched after it became clear that the myriad HIV/AIDS activities throughout the country were not being adequately supervised.

"Every stakeholder in the HIV/AIDS fight in Swaziland is expected to be a part of the M&E [monitoring and evaluation] strategy," said Majorie Mavuso, programme coordinator of the plan for the National Emergency Response Committee on HIV/AIDS (NERCHA) when the strategy was adopted at a meeting of national health organisations.

NERCHA distributes funds from the Global Fund on HIV/AIDS, Malaria and Tuberculosis, the government and the private sector to NGOs, but Mavuso emphasised that the new strategy would be applied to all HIV/AIDS initiatives and organisations, not just those funded by NERCHA.

Over the past two years a spectrum of organisations, including the government and UN agencies, contributed to drawing up the policy.

"We need to know how well projects are doing, particularly now that larger amounts of money are coming into the country to combat AIDS. How effectively are these funds utilised? What benefits are received by people living with HIV/AIDS? Is there incompetence, fraud, or lessons of effectiveness and success that, if known, can be shared by other health organisations?" an official with the health ministry asked.

"Everyone has an opinion on these issues, but we require hard statistics and verifiable data," the official noted.

AIDS groups will be given technical assistance to apply evaluation tools to their projects, while the ministry of health will require evaluation data as part of a coordinated national strategy to tackle the epidemic.

The health sector's recently established M&E unit is to be responsible for setting up and implementing the monitoring and evaluation framework for health sector programmes, including data collection, reporting and data management.

Mavuso said a new data management system for antiretroviral therapy programmes was already partly operational.

As part of the nation's first household health survey, the World Health Organisation (WHO) has been helping the health ministry develop new computer software for collecting primary data on HIV/AIDS. The survey results are expected later this year, and will assist in determining the national HIV prevalence rate, which is thought to be the highest in the world.

Critics of the health ministry's reliance on antenatal surveys for estimating the adult HIV prevalence rate - set at 42.6 percent in a sero-surveillance report released earlier this year - have said the use of pregnant women was a less reliable indicator of HIV prevalence than household surveys.

Health officials are hoping that the new monitoring framework, which becomes operational next month, will address these concerns.