Strategies to Strengthen the Implementation of HIV and AIDS Monitoring and Evaluation Framework in Limpopo Province, South Africa

Abstract

Background: Despite the success of recorded strategies developed in the fight against HIV and AIDS, the literature shows that HIV and AIDS continue to be a major global public health issue and targets are still not met because the prevalence of HIV and AIDS remai n high. The shift in the South African National Strategic Plan for HIV and AIDS to 90 90 90 has also increased demand for upscale results to achieve defined goals and objectives. Purpose: The aim of this study was to develop strategies to strengthen the i mplementation of HIV and AIDS Monitoring and Evaluation framework for Limpopo Province. Objectives: Conduct needs assessment to evaluate relevance and design of current monitoring and evaluation of HIV and AIDS programme interventions in Limpopo province; to assess the relevance of capacity building strategies and interventions towards strengthening HIV and AIDS M&E System; to determine the challenges facing the Provincial HIV and AIDS Multi sector stakeholders when implementing Monitoring and Evaluation o f HIV and AIDS programme; develop intervention strategies to strengthen the implementation of HIV and AIDS M&E framework and describe the perceived practical applicability of the developed intervention strategies through validation process with stakeholder s. Methodology: The study was explanatory sequential mixed methods conducted in two phases, namely phase 1 A, phase 1 B and phase 2, by first implying quantitative study and followed by qualitative research approach. Phase 1 A results were first analysed t o guide development Phase 1 B Qualitative interview questions in order to explore in more detail using interview guide during data collection. Whereby in Phase 1 A the researcher first conducted a situational analysis of monitoring and evaluation intervent ions focusing on HIV and AIDS programmes in Limpopo Province. In phase 1 A quantitative a self administered questionnaire ABSTRACT vi was used to collect data with a sample size of 350 participants of the total population. In phase was used to collect data with a sample size of 350 participants of the total population. In phase 11--B purposive sampling technique wasB purposive sampling technique was used to sample 30 participants for interviews. used to sample 30 participants for interviews. Integration and comparative analysis of data was done to merge and compare results in tables Integration and comparative analysis of data was done to merge and compare results in tables and discussions. In phase 2 the researcher used the Strength, Weakness, Opportunities and and discussions. In phase 2 the researcher used the Strength, Weakness, Opportunities and Threat analysis and throuThreat analysis and through Build, Overcome, Explore and Minimise to develop strategies and gh Build, Overcome, Explore and Minimise to develop strategies and also used logic model and Theory of Change approach to link and structure intervention also used logic model and Theory of Change approach to link and structure intervention strategies developed.strategies developed. Results: Results: Findings in this study revealed that 85.7% of the respondents indicated that indicators Findings in this study revealed that 85.7% of the respondents indicated that indicators are linked to 90are linked to 90--9090--90 HIV and AIDS strategic plan. In this study 83.4% of the respondents 90 HIV and AIDS strategic plan. In this study 83.4% of the respondents indicated that all HIV and AIDS data collection and reporting tools linked tindicated that all HIV and AIDS data collection and reporting tools linked to the national o the national reporting system indicators. The findings reveal that 84.6% of the respondents indicated that reporting system indicators. The findings reveal that 84.6% of the respondents indicated that set targets are linked to 90set targets are linked to 90--9090--90 Provincial HIV and AIDS strategic plan. In this study 77.7% 90 Provincial HIV and AIDS strategic plan. In this study 77.7% of respondents indicated that HIV Programme have exiof respondents indicated that HIV Programme have existing data management guidelines. In sting data management guidelines. In this study 79.4% of respondents indicated that data is properly stored, filed, up to date and this study 79.4% of respondents indicated that data is properly stored, filed, up to date and readily available. Findings from this study reveal that 72% of the respondents indicated that readily available. Findings from this study reveal that 72% of the respondents indicated that HIV Programme have up to date eHIV Programme have up to date electronic Monitoring and Evaluation databases. In this study lectronic Monitoring and Evaluation databases. In this study 72% of the respondents indicated there are procedures and mechanisms in place including 72% of the respondents indicated there are procedures and mechanisms in place including data reviews and validation meeting. Qualitative results of this study revealed that HIV M&E data reviews and validation meeting. Qualitative results of this study revealed that HIV M&E systems are essystems are established within the Department of Health. The study reveals that Limpopo tablished within the Department of Health. The study reveals that Limpopo Province Department of Health have functional electronic databases; however, Limpopo AIDS Province Department of Health have functional electronic databases; however, Limpopo AIDS Council and Department of Social Development do not have standard electronic monitoring Council and Department of Social Development do not have standard electronic monitoring and and evaluation reporting database systems to report as they are using excel. Challenges evaluation reporting database systems to report as they are using excel. Challenges affecting poor performance HIV and AIDS programme indicators include high loss to followaffecting poor performance HIV and AIDS programme indicators include high loss to follow--up up rate, lack of understanding of programme indicators, poor same day initiation anrate, lack of understanding of programme indicators, poor same day initiation and linkage to d linkage to care due to traditional beliefs & poor referral systems. Challenges related to human resources care due to traditional beliefs & poor referral systems. Challenges related to human resources include lack of monitoring and evaluation capacity building and poor M&E skills transfer as include lack of monitoring and evaluation capacity building and poor M&E skills transfer as ABSTRACT vii there is no feedback after monitoring and evaluation rel there is no feedback after monitoring and evaluation related trainings.ated trainings. Conclusions: Conclusions: Intervention strategies were developed followed by action plans. The Intervention strategies were developed followed by action plans. The researcher recommends that those strategies developed should be implemented to strengthen researcher recommends that those strategies developed should be implemented to strengthen the implementation of HIV and AIDS monitoring and evaluation framewothe implementation of HIV and AIDS monitoring and evaluation framework and to address gaps rk and to address gaps identified in this study. Rapid Implementation of developed strategies can fast track the identified in this study. Rapid Implementation of developed strategies can fast track the improvement of HIV and AIDS monitoring and evaluation systems. The developed strategies improvement of HIV and AIDS monitoring and evaluation systems. The developed strategies can help in improving achievement of 90 90 90 targets acan help in improving achievement of 90 90 90 targets and further strengthen monitoring and nd further strengthen monitoring and evaluation framework for HIV and AIDS in Limpopo Province. If the strategies can yield positive evaluation framework for HIV and AIDS in Limpopo Province. If the strategies can yield positive results in improving HIV and AIDS outcomes and impact, therefore the implementation should results in improving HIV and AIDS outcomes and impact, therefore the implementation should be expanded to other Provinces.be expanded to other Provinces.