PEPFAR OVC Survey Toolkit

Janet Shriberg, EdD

Senior Evaluation Advisor

Office of HIV/AIDS

USAID

**please note that slides were created with work done by MEASURE Evaluation

PEPFAR Mission & Goal (OVC)

Mission: To mitigate the social, emotional and economic impacts of HIV/AIDS on children and to reduce their risk and vulnerability while increasing their resilience

A goal: To care for 5 million orphans and vulnerable children

10% funding earmark for OVC

The problem

High investment in OVC programs BUT impact is unclear & questions regarding “what works” in improving household well-being

Part of the challenge: lack of standardized measures and tools for child and household outcomes (well-being)

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A proposed solution

Standardized questionnaires for use in a survey of children ages 0-17 years and their adult caregivers

Who are these tools for?

Local and international research institutions and other implementing organizations with evaluation agenda

USAID Forward – supporting local researchers

The purpose

Standardize population-level child and caregiver well-being data beyond what is available from routine surveys

Produce actionable data to inform programs and enable mid-course corrections

Enable comparative assessments of child and caregiver well-being and household economic status across a diverse set of interventions and regions

Focus on PEPFAR OVC programs

Indicators need to reflect & be amenable to change by PEPFAR program intervention HH interventions led by

home visitors Community interventions Low direct funding per

target, focus on linkages Often inadequate

services in vicinity

How did we start…

Two step, participatory process:

Build consensus around core impact indicators for PEPFAR-funded OVC programs

Develop OVC program evaluation (survey) tools

Distilling the core indicators

Our starting point: 6+1 domains of PEPFAR OVC programming

Step 1: Extensive literature search

Step 2: Gaps (HES, PSS) filled through targeted research

Result: >600 child/HH wellbeing questions/indicators

Step 3: Analysis against 8 criteria

Result: shorter list of questions for discussion

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Finalizing the core indicators

External working group: solicited review from 49 stakeholders

Finalized core set of 12 child and 3 household measures

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Developing the tools

Tools drafted with strong stakeholder input

Draft tools piloted in Zambia and Nigeria Cognitive interviews to

test key concepts (e.g. social support)

Household pre-test of full tools, procedures

Structure and content

1. Caregiver questionnaire (including questions on household)

2. Child questionnaire (ages 0-9 years), administered to caregiver

3. Child questionnaire (ages 10-17), administered to child with parental consent & child assent

Sections Core questions Optional modulesSection 1: Household schedule

Household schedule* (10) Changes in household

composition (4)

 

Section 2: Background Information on Caregiver and Household

Demographic information* (7) Work* (3) Access to money (3) Shelter (1)

Household Economic Status (forthcoming)

Progress out of Poverty Index or similar (country specific)

Section 3: Food Security Household food security (6) Dietary Diversity (1)

Section 4: Caregiver Well-being and Attitudes

General health (2) Caregiver support (4) Parental self-efficacy (1)

Perceptions and experience of child discipline, violent discipline (forthcoming)

Gender roles and decisionmaking power* (9)

Section 5: HIV/AIDS Testing, Knowledge, Attitudes

Basic HIV/AIDS knowledge* (7) HIV testing* (3) Attitudes to condom educ (1)

HIV/AIDS attitudes* (4)

Section 6: Access to HIV Prevention, Care & Support

Household access to services (1)

 

*DHS, bold=core indicator

Caregiver questionnaire

Sections Core questions Optional modulesSection 1: Child Health and Welfare

Confirm demographics (5) General health & disability (4) Birth certificate (2) Vaccinations (11) Fever (<5 years)* (1) Diarrhea (<5 years)* (1) Experience of neglect (2) Slept under mosquito net* (1) HIV testing experience* (2)

Fever: extended* (4) Diarrhea: extended* (3) Health for children

living with HIV/AIDS (forthcoming)

Section 2: Education and Work

School attendance*, progression/repeats, drop-outs, missed school days (5+ years) (9)

Work for wages (2) Early childhood stimulation (2)

 

Section 3: Food Consumption

Food consumption (2+ years) (8) • Dietary diversity (1)

Section 4: Access to HIV Prevention, Care & Support

Child access to services (1)  

Section 5: Anthropometric Measures (of Children)

Weight*, Height*, MUAC  

Child questionnaire (ages 0-9)

*DHS, bold=core indicator

Child questionnaire (ages 10-17)Sections Core questions Optional modulesSection 1: Background Information on Child

Confirm demographics* (5) Identity of caregiver (1)

 

Section 2: Diary Daily log (6)  Section 3: Education School attendance*,

progression/repeats, drop-outs (9)

 

Section 4: Chores & Work Chores (3) Work (7)

 

Section 5: Food & Alcohol Consumption

Food consumption (8) Alcohol consumption (3)

Dietary diversity (1)

Section 6: Health, Support & Protection

Birth certificate (2) General health & disability (3) General support (4)

Health for children living with HIV/AIDS (forthcoming)

Perceptions/experience of violence (forthcoming)

Section 7: HIV Testing, Knowledge, and Attitudes

Basic HIV/AIDS knowledge* (7) HIV testing * (3)

Child development knowledge (6) HIV/AIDS attitudes and beliefs (4)

Section 8: Sexual Experience • Sexual behavior (13-17 yrs) (5)

Section 9: Access to HIV Prevention, Care & Support

Child access to services (1)  

Section 10: Anthropometric Measures: Weight and Height

Weight, Height, MUAC  

Using the Tools

There is no single data collection tool that can meet all OVC program M&E requirements.

Yes No

Situation analysis x

Targeting X

Case management X

Program monitoring X

Evaluation x

What’s in the toolkit?

Tools & Manual Template protocol with

consent/assent forms Methodological guidance

Data analysis guide Data collector training

manual and materials French translations

Global Monitoring, Evaluation and Reporting (“ the MER”) PEPFAR shift towards outcomes and impact

All technical areas participating (CARE, PREVENTION, TREATMENT)

Specific Changes for OVC Programs 2 indicators at Level 1 (required, reported to HQ)

Outcomes Package at Level 2 (required, reported at country level; indicators elevated from survey toolkit)

2 Education indicators: attendance and progression

Systems Strengthening and Social Protection at Level 3

(recommended)

Where can I find out more?

Go to MEASURE Evaluation website:http://www.cpc.unc.edu/measure/our-work/ovc

Email: Janet Shribergjshriberg@usaid.gov

Special Thanks to…

Dr. Jenifer Chapman, MEASURE Evaluation* (*Technical Lead for Toolkit, slideset creator)

Dr. Lisa Parker, MEASURE Evalution

OVC TWG Working Group, HQ and Missions

Stakeholders globally working on OVC programming

IATT Education for Guidance on education questions