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Stronger health systems. Greater health impact.




Strengthening M&E capacity of civil society organizations to
   improve the reach and quality Sciences for Healthcare and support
                          Management of OVC
            services: Experiences from Lesotho

Jabulani Mavudze, Megh Jagriti, Roselyn Kareithi, and Mathabo Pule

March 2013

MSH Building Local Capacity Project                                              1
Background Information

• Building Local Capacity for the
  Delivery of HIV Services in
  Southern Africa Project (BLC)
• MSH project funded by
  USAID is working in six
  countries
• In Lesotho, BLC gives small
  USAID funded grants to 12Management Sciences for Health


  CSOs to:
      • improve the coordination and
        delivery of the OVC 6 + 1 services
      • reach 25,5% OVC ( 46,585 OVC)
        and 15,972 caregivers by 2015

MSH Building Local Capacity Project                         2
Problem Statement

• Based on literature review and
  capacity assessment, OVC
                                                                   Total
  programming challenges:                                       population
                                                                 2,000,000
    National CSOs and CBOs are
     the predominant OVC service
                                                                 Children
     providers                                                1,072,974 (53%)
    The CSOs have weak M&E
     systems and capacity
    CSOs have limited funds Management Sciences for Health
                                                                  OVC
    low OVC reach and poor
                                                              182,000 (17%)
     quality of services
    weak coordination of OVC
     interventions at national,
     district and community levels
MSH Building Local Capacity Project                                             3
Methodologies and Strategies (Being) Used (1)


                                Capacity Assessment
                                • Administer capacity assessment tool
                                • Documents and literature review



                              M&E Tools Development
                              • Data collection tools (Registration and Service Provision Forms)
                              • Reporting tools (Monthly and Quarterly templates and reporting
                                guidelines)
                                                  Management Sciences for Health


                             Training of CSO Staff
                             • 30 individuals from 12 CSOs received formal training on
                               importance of M&E, M&E tools, project indicators, data quality
                               standards, data management, and reporting
                             • Training was done together with Ministry of Social Development



MSH Building Local Capacity Project                                                                4
Methodologies and Strategies (Being) Used (2)

                                      Accompaniment
                                      • Supporting CSOs to train secondary
                                        caregivers
                                      • Monitoring secondary caregivers as
                                        they provide services


                                      Coaching Sciences for Health
                                               Management

                                      • Monthly and quarterly data
                                        verification and support visits
                                      • Spot checks



MSH Building Local Capacity Project                                          5
Evidence of Success and Achievements
     (1)

 •      Improved data quality - only            Cumulative OVC and Caregivers Reached
                                      60000
        0,2% records in Dec 2012
                                                                                          53194
        were discarded compared to 50000
        12% in March 2012




                                               OVC and Caregivers Reached
 •      Overall, 53,194 OVC and       40000
                                                                                    38578

        caregivers reached against a
                                      30000
        target of 51,700
 •      By December 2012, 23,5%Management Sciences for Health
                                      20000
                                                                      16647
        (42,739) of OVC in Lesotho
        reached against a target of   10000
                                                              6826
        25,5% by September 2013
                                                                            0      186




                                                                                                                         Oct-12
                                                                                                Apr-12



                                                                                                         Jun-12
                                                                                Dec-




                                                                                                                                  Dec-
                                                                                                                  Aug-
                                                                                         Feb-
                                                                                          12




                                                                                                                                   12
                                                                                                                   12
                                                                                 11




MSH Building Local Capacity Project                                                                                               6
Evidence of Success and Achievements (2)

    •      CSOs applying               Some quotes from CSOs
                                       „‟Well I believe it has brought about the importance of M&E within the
           acquired M&E skills         organisation. Initial projects did not put much emphasis on it hence
                                       why there wasn't an M&E person . The emerging need and constant
           and knowledge               emphasis of M&E also contributed to quality service provision.”


    •      Improved quality of         “Through the BLC project, my organization now has improved capacity
                                       to carry out quality monitoring and evaluation activities, not only within
                                       the BLC project, but now also within other in-house projects.”
           services
    •      Improved data flow
    •      Reduced duplication
                                      Management Sciences for Health
           of services




MSH Building Local Capacity Project                                                                                 7
Challenges and Solutions

    • National CSOs and CBOs have few full-time staff; the
      majority are volunteers
            As a solution, BLC together with partner CSOs developed
             simple data collection tools in local language
            BLC provided long-term coaching support to CSO staff
             responsible for M&E activities

                                      Management Sciences for Health




MSH Building Local Capacity Project                                    8
Lessons Learned

    • Prioritize institutional capacity building before
      service provision

    • With adequate M&E capacity CSOs can reach more
      OVC with quality services

    • Coaching and accompaniment are effective capacity
                          Management Sciences for Health


      building approaches

    • Equal partnership with CSOs promotes ownership
      and mutual trust
MSH Building Local Capacity Project                        9
Conclusions

    Strengthening of monitoring and evaluation systems
    significantly contributes to increased quality of services
    and number of beneficiaries reached




                                           Management Sciences for Health




MSH Building Local Capacity Project                                         10
Questions & Comments




                                      Management Sciences for Health




MSH Building Local Capacity Project                                    11

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Jabulani Mavudze - MSH, South Africa

  • 1. Stronger health systems. Greater health impact. Strengthening M&E capacity of civil society organizations to improve the reach and quality Sciences for Healthcare and support Management of OVC services: Experiences from Lesotho Jabulani Mavudze, Megh Jagriti, Roselyn Kareithi, and Mathabo Pule March 2013 MSH Building Local Capacity Project 1
  • 2. Background Information • Building Local Capacity for the Delivery of HIV Services in Southern Africa Project (BLC) • MSH project funded by USAID is working in six countries • In Lesotho, BLC gives small USAID funded grants to 12Management Sciences for Health CSOs to: • improve the coordination and delivery of the OVC 6 + 1 services • reach 25,5% OVC ( 46,585 OVC) and 15,972 caregivers by 2015 MSH Building Local Capacity Project 2
  • 3. Problem Statement • Based on literature review and capacity assessment, OVC Total programming challenges: population 2,000,000  National CSOs and CBOs are the predominant OVC service Children providers 1,072,974 (53%)  The CSOs have weak M&E systems and capacity  CSOs have limited funds Management Sciences for Health OVC  low OVC reach and poor 182,000 (17%) quality of services  weak coordination of OVC interventions at national, district and community levels MSH Building Local Capacity Project 3
  • 4. Methodologies and Strategies (Being) Used (1) Capacity Assessment • Administer capacity assessment tool • Documents and literature review M&E Tools Development • Data collection tools (Registration and Service Provision Forms) • Reporting tools (Monthly and Quarterly templates and reporting guidelines) Management Sciences for Health Training of CSO Staff • 30 individuals from 12 CSOs received formal training on importance of M&E, M&E tools, project indicators, data quality standards, data management, and reporting • Training was done together with Ministry of Social Development MSH Building Local Capacity Project 4
  • 5. Methodologies and Strategies (Being) Used (2) Accompaniment • Supporting CSOs to train secondary caregivers • Monitoring secondary caregivers as they provide services Coaching Sciences for Health Management • Monthly and quarterly data verification and support visits • Spot checks MSH Building Local Capacity Project 5
  • 6. Evidence of Success and Achievements (1) • Improved data quality - only Cumulative OVC and Caregivers Reached 60000 0,2% records in Dec 2012 53194 were discarded compared to 50000 12% in March 2012 OVC and Caregivers Reached • Overall, 53,194 OVC and 40000 38578 caregivers reached against a 30000 target of 51,700 • By December 2012, 23,5%Management Sciences for Health 20000 16647 (42,739) of OVC in Lesotho reached against a target of 10000 6826 25,5% by September 2013 0 186 Oct-12 Apr-12 Jun-12 Dec- Dec- Aug- Feb- 12 12 12 11 MSH Building Local Capacity Project 6
  • 7. Evidence of Success and Achievements (2) • CSOs applying Some quotes from CSOs „‟Well I believe it has brought about the importance of M&E within the acquired M&E skills organisation. Initial projects did not put much emphasis on it hence why there wasn't an M&E person . The emerging need and constant and knowledge emphasis of M&E also contributed to quality service provision.” • Improved quality of “Through the BLC project, my organization now has improved capacity to carry out quality monitoring and evaluation activities, not only within the BLC project, but now also within other in-house projects.” services • Improved data flow • Reduced duplication Management Sciences for Health of services MSH Building Local Capacity Project 7
  • 8. Challenges and Solutions • National CSOs and CBOs have few full-time staff; the majority are volunteers  As a solution, BLC together with partner CSOs developed simple data collection tools in local language  BLC provided long-term coaching support to CSO staff responsible for M&E activities Management Sciences for Health MSH Building Local Capacity Project 8
  • 9. Lessons Learned • Prioritize institutional capacity building before service provision • With adequate M&E capacity CSOs can reach more OVC with quality services • Coaching and accompaniment are effective capacity Management Sciences for Health building approaches • Equal partnership with CSOs promotes ownership and mutual trust MSH Building Local Capacity Project 9
  • 10. Conclusions Strengthening of monitoring and evaluation systems significantly contributes to increased quality of services and number of beneficiaries reached Management Sciences for Health MSH Building Local Capacity Project 10
  • 11. Questions & Comments Management Sciences for Health MSH Building Local Capacity Project 11