Mid-Term Evaluation of GFATM TB & HIV Grant Round 5

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Evaluation Plan:
2009-2012, South Sudan
Evaluation Type:
Project
Planned End Date:
09/2009
Completion Date:
03/2011
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
60,000

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Title Mid-Term Evaluation of GFATM TB & HIV Grant Round 5
Atlas Project Number:
Evaluation Plan: 2009-2012, South Sudan
Evaluation Type: Project
Status: Completed
Completion Date: 03/2011
Planned End Date: 09/2009
Management Response: Yes
Focus Area:
  • 1. Poverty and MDG
Corporate Outcome and Output (UNDP Strategic Plan 2014-2017)
Evaluation Budget(US $): 60,000
Source of Funding:
Joint Programme: No
Joint Evaluation: Yes
  • Joint with Global Fund, UNICEF, UNAIDS
Evaluation Team members:
Name Title Email Nationality
Eban Taban, Dr PH Team Leader
GEF Evaluation: No
Key Stakeholders:
Countries: SOUTH SUDAN
Lessons
Findings
Recommendations
1 Currently a centralized manual M&E system exists at the PR where quarterly progress reports are filed in box files. The evaluation team recommends the established of an electronic database at the PR level where all SRs/SSRs reports can be accessed.
2 The PR needs to consolidate the SRs PUDR template to ensure there is no duplication with the narrative report.
3 The PR should re-emphasize training of staff in both M&E system and financial management systems in order to improve the quality of data and financial management reporting. The training can be one-on-one with each SR particularly on financial management systems and reporting and group training sessions/workshops for M&E staff.
4 Delays in the disbursement of funds to the PR (by GFATM), and SRs (by the PR) cause delays in implementation of activities. The evaluation team strongly recommends expedited disbursement of funds to the PR, and SRs.
5 The Technical Evaluation Panel (TRP) should expedite the revision of the ARV and home-based care indicators as a matter of urgency, especially those where targets were too high, thereby resulting in underperformance of the grant.
6 The PR should consider revising the main workplan and budget after the overestimated targets have been officially revised.
7 The PR should encourage/re-initiate the biweekly presentation to the CCM and the respective directorates of the government, where SR follow-up, CCM and progress in performance are evaluation.
8 The PR should align the SRs budget to the main grant budget to ensure that SRs can report on accurate information in terms of activities and service delivery areas.
9 All health facilities/project sites should design and implement training of health workers, community leaders and communities in general on anti-stigma-discrimination reduction strategies. For this to happen, the evaluation team proposes that SRs seeks technical assistance from NGOs in Southern Sudan.
10 Essentially, the evaluation team feels obliged to recommend to the PR, SRs and CCM that in order to receive full benefits from the TB-HIV collaborative programme, all eligible PLWHA and TB-HIV co-infected persons must be referred to receive ARVs from the nearest ART centers.
11 The PR should use any means of communication to inform SRs about accuracy of their financial reports and parts of reports that are missing but required. These means include Skype; phone calls; e-mail messages and meeting with individual SRs.
12 The evaluation team recommends that the PR ensures and guarantees regular and timely provision of medical and non-medical supplies to SRs and SSRs, through the newly recruited Supply Chain Management firm, Euro Health, and that SRs and SSRs encouraged to place medical and other supplies orders at least one month ahead of time.
1. Recommendation: Currently a centralized manual M&E system exists at the PR where quarterly progress reports are filed in box files. The evaluation team recommends the established of an electronic database at the PR level where all SRs/SSRs reports can be accessed.
Management Response: [Added: 2011/12/15]

Keeping the scope of Global Fund grants in view, with limited number of SRs and indicator-specific data, excel based sheets are a good alternative for a full fledge database. The database also has budget implications. With limited budget for M&E activities, most of the interventions are associated with improving data quality and management.

Key Actions:

2. Recommendation: The PR needs to consolidate the SRs PUDR template to ensure there is no duplication with the narrative report.
Management Response: [Added: 2011/12/15]

As part of the desk data-verification-exercise, PR is already implementing this recommendation.

Key Actions:

3. Recommendation: The PR should re-emphasize training of staff in both M&E system and financial management systems in order to improve the quality of data and financial management reporting. The training can be one-on-one with each SR particularly on financial management systems and reporting and group training sessions/workshops for M&E staff.
Management Response: [Added: 2011/12/15]

An extensive training on M&E has been organized by the PR for SRs in January 2010. The design of this workshop was based on the recommendations by different auditors, assessors and evaluators in a number of reports. The finance team has started making one to one visits to the SRs and training them on the financial reporting requirements. This exercise needs to continue in future as well.

Key Actions:

4. Recommendation: Delays in the disbursement of funds to the PR (by GFATM), and SRs (by the PR) cause delays in implementation of activities. The evaluation team strongly recommends expedited disbursement of funds to the PR, and SRs.
Management Response: [Added: 2011/12/15]

Performance based reporting is being strengthened to ensure timely reports to facilitate disbursements.

Key Actions:

5. Recommendation: The Technical Evaluation Panel (TRP) should expedite the revision of the ARV and home-based care indicators as a matter of urgency, especially those where targets were too high, thereby resulting in underperformance of the grant.
Management Response: [Added: 2011/12/15]

The TRP has approved revision of indicators.

Key Actions:

6. Recommendation: The PR should consider revising the main workplan and budget after the overestimated targets have been officially revised.
Management Response: [Added: 2011/12/15]

The PR has submitted a revised PF and is awaiting a decision on the work plan and budget.

Key Actions:

7. Recommendation: The PR should encourage/re-initiate the biweekly presentation to the CCM and the respective directorates of the government, where SR follow-up, CCM and progress in performance are evaluation.
Management Response: [Added: 2011/12/15]

The PM coordinates regular meetings with the HIV Directorate, SSAC, and the NTP. The CCM has developed a calendar of bi-monthly meetings and forms part of the PR field visit plan.

Key Actions:

8. Recommendation: The PR should align the SRs budget to the main grant budget to ensure that SRs can report on accurate information in terms of activities and service delivery areas.
Management Response: [Added: 2011/12/15]

Two of the SRs? budgets have been aligned to the PR?s template. Two other SRs are currently updating their budgets according to the PR?s template.

Key Actions:

9. Recommendation: All health facilities/project sites should design and implement training of health workers, community leaders and communities in general on anti-stigma-discrimination reduction strategies. For this to happen, the evaluation team proposes that SRs seeks technical assistance from NGOs in Southern Sudan.
Management Response: [Added: 2011/12/15]

SRs already conducting trainings and awareness sessions to reduce stigma and discrimination of TB/HIV patients. For example please refer to the success story quoted in Section 1A of the Oct 09 to Mar 2010 PUDR for R5 TB/HIV.

Key Actions:

10. Recommendation: Essentially, the evaluation team feels obliged to recommend to the PR, SRs and CCM that in order to receive full benefits from the TB-HIV collaborative programme, all eligible PLWHA and TB-HIV co-infected persons must be referred to receive ARVs from the nearest ART centers.
Management Response: [Added: 2011/12/15]

Implemented through the opening of more ART sites. Five more ART sites were opened between Feb-Jun 2010. Opening new sites ensures that many eligible PLWHA/TB-co-infected have access to ART. Two more sites are to be opened by Q16.

Key Actions:

11. Recommendation: The PR should use any means of communication to inform SRs about accuracy of their financial reports and parts of reports that are missing but required. These means include Skype; phone calls; e-mail messages and meeting with individual SRs.
Management Response: [Added: 2011/12/15]

The finance team has already taken the recommendation onboard. The finance team now visits the SR offices to explain financial requirements face to face. For example, the financial reporting formats have been improved and revised before the last PUDR. The finance team made visits to the SRs offices and explained the changes and gave a hands-on orientation.

Key Actions:

12. Recommendation: The evaluation team recommends that the PR ensures and guarantees regular and timely provision of medical and non-medical supplies to SRs and SSRs, through the newly recruited Supply Chain Management firm, Euro Health, and that SRs and SSRs encouraged to place medical and other supplies orders at least one month ahead of time.
Management Response: [Added: 2011/12/15]

The recommendation has been taken up with EH. The SCM agent has put in place new systems to ensure the regular distribution of all supplies to service delivery points.

Key Actions:

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