Module 1 Introduction Orphans and Vulnerable Children Monitoring

Module 1 Introduction Orphans and Vulnerable Children Monitoring, Evaluation, and Reporting (MER) Indicators Implementing Partner Training December 2018

Introduction Through programming for orphans and vulnerable children (OVC), PEFPAR aims to mitigate the multidimensional and acute impacts of HIV and AIDS on children, through the provision of holistic, community-based care and support services. PEPFAR’s OVC programming approach focuses on socioeconomic and health promotion and access to interventions that reduce vulnerability, contribute to prevention and risk avoidance goals, and support access to and retention in treatment. These programs provide family-centered, comprehensive care through case management and routine monitoring in partnership with civil society partners (including nongovernmental organizations, faith-based organizations, and community-based organizations), the communities they serve, and their national, district, and local government counterparts. 2

Introduction Strengthening the systems that support vulnerable children and families ensures that children living with HIV receive the support they need and that children who are affected do not acquire the virus. OVC programming is one of the ways in which the United States President’s Emergency Plan for AIDS Relief (PEPFAR) is addressing the structural drivers of the HIV epidemic, which, if ignored, could reduce the effectiveness of other PEPFAR initiatives. 3

Eligible OVC services grouped into four domains Healthy Stable Interventions that support the achievement of health outcomes, build health and nutrition knowledge and skills in caregivers, and facilitate access to key health services (especially HIV testing and care and treatment services), to enable vulnerable children (especially girls) to stay HIV-free Safe Interventions that prevent and mitigate violence, abuse, exploitation, and neglect of children and adolescents, including sexual and gender-based violence Interventions that reduce economic vulnerabilities and increase resilience in adolescents and families affected by and vulnerable to HIV Schooled Interventions that support children and adolescents affected by and vulnerable to HIV, to overcome barriers to accessing education (including enrollment, attendance, retention, progression, and/or transition), and provide vocational training for some adolescents Source: Standard Operating Procedures for Case Management, Coordinating Comprehensive Care for Children (4 Children) 2018 4

PEPFAR supports the UNAIDS global targets for 2030 • 95% of all people living with HIV (PLHIV) will know their HIV status • 95% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (ART) • 95% of all people receiving ART will have viral suppression 5

Children living with HIV who know their HIV status • On average, 54% of all PLHIV in sub. Saharan Africa (SSA) are estimated to know their status (1). • In SSA, only 20% of HIV-positive adolescent girls know their HIV status (2). • • 90% 54% 46% Combined results from populationbased HIV surveys showed that 46% of young people ages 15– 24 were aware of their HIV status (3). Despite the high risk of HIV that adolescents face, they have the lowest rate of testing of any age group. 95% 2017 PLHIV in SSA 2017 HIV+ 2017 adolescent youth girls in Malawi, in SSA Zambia & Zimbabwe 2020 UNAIDS target 1 https: //journals. plos. org/plosone/article? id=10. 1371/journal. pone. 0186316#pone-0186316 -t 003 2, 3 https: //journals. lww. com/aidsonline/Fulltext/2017/07013/Adolescents, _young_people, _and_the_90_90_90_goals_. 1. aspx 2030 UNAIDS target 6

Children with diagnosed HIV who receive sustained treatment • Globally, only 52% of children <15 years living with HIV received ART. • Without timely treatment, mortality in children with HIV is very high. 90% 52% 2018 UNAIDS. (2018). Miles To Go. www. unaids. org/en/20180718_GR 2018 95% UNAIDS report 2020 UNAIDS target 2030 UNAIDS target 7

PEPFAR 3, 096, 285 OVC in 24 countries were served in FY 2018, Q 2 Source: Cleaned USAID MER data for FY 2018, Q 2 8

Increasing the proportion of children who know their HIV status 9

65% of OVC with known HIV status or test not required in FY 2018, Q 2 Source: Cleaned USAID MER data for FY 2018, Q 2 10

Increasing the proportion of HIV+ children who receive sustained ART 11

95% of HIV-positive OVC currently on ART in FY 2018, Q 2 Source: Cleaned USAID MER data for FY 2018, Q 2 12

Overview OVC MER Training 13

General objective By the end of this training, implementing partners will gain an overview of revised M&E processes to collect data starting in FY 19 (October 2018) according to new OVC_SERV and OVC_HIVSTAT MER guidance, which will be reported in PEPFAR’s Data for Transparency and Impact (DATIM) system for FY 2019, Q 2 in late March, 2019. 14

Specific objectives 1. Understand newly revised service delivery criteria for reporting OVC_SERV disaggregates 2. Be introduced to the global minimum graduation benchmarks 3. Receive an overview of the HIV risk assessment continuum and reporting of OVC_HIVSTAT disaggregates 15

Day One Module 1: Introduction 8: 15 Welcome, overview, and introduction of participants Module 2: OVC_SERV 9: 00 10: 40 10: 50 1: 30 Definitions, reporting, eligible services Break Timing and participation status Special cases and DREAMS How to avoid double counting Review of OVC_SERV Lunch Opportunity for review and questions Module 3: Graduation 2: 30 Definitions, household composition Required graduation benchmarks Review of graduation Quiz 1 and evaluation of Day 1 4: 30 Closing Opportunity for review and questions 16

Day Two 8: 15 Welcome, discussion of Quiz 1 and evaluation of Day 1 Module 4: OVC_HIVSTAT Definitions, data quality, HIV risk assessment continuum OVC_HIVSTAT Flow Chart 10: 00 Break 10: 20 HIV Risk Assessment prototype ART treatment status, missing data Review of OVC_HIVSTAT, Quiz 2 8: 50 Opportunity for review and questions Module 5: Data use 11: 50 FY 2018, Q 2 USAID data and targets Data use exercise, best practices in data use and visualization 1: 30 Lunch 2: 30 Data presentation by IPs Conclusion Evaluation of Day 2, discussion of Quiz 2 Opportunity for review and questions 17

This presentation was produced with the support of the United States Agency for International Development (USAID) under the terms of MEASURE Evaluation cooperative agreement AID-OAA-L-14 -00004. MEASURE Evaluation is implemented by the Carolina Population Center, University of North Carolina at Chapel Hill in partnership with ICF International; John Snow, Inc. ; Management Sciences for Health; Palladium; and Tulane University. Views expressed are not necessarily those of USAID or the United States government. www. measureevaluation. org