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									 SECRETARIAT OF THE                                   SECRÉTARIAT GÉNÉRAL DE LA
 PACIFIC COMMUNITY                                     COMMUNAUTÉ DU PACIFIQUE
          BPD5                                                   BPD5
  98848, Noumea Cedex                                     98848 Nouméa Cedex
     New Caledonia                                         Nouvelle-Calédonie

TELEPHONE: +687 26.20.00                                 TÉLÉPHONE: +687 26.20.00
   FAX: +687 26.38.18                                   TÉLÉCOPIEUR: +687 26.38.18
   E-mail:                                       Mél :

             Draft Monitoring & Evaluation Plan
                    Tuberculosis Component

                     Grant Agreement MWP-202-G01-T-00
           The Global Fund to Fight AIDS, Tuberculosis and Malaria
       The Secretariat of the Pacific Community, Noumea, New Caledonia
 On 27th June 2003, the Global Fund to Fight AIDS, Tuberculosis and Malaria
(hereinafter “the Fund”) and the Secretariat of the Pacific Community in Noumea
(hereinafter “the SPC”) signed Grant Agreement MWP-202-G01-T-00 for the fight
against tuberculosis. The Grant totals USD 1,699,100 for the initial two - year
implementation of the five-year plan.

Within the framework of this agreement, SPC has been designated at the Principal
Recipient (PR).

This Plan is developed to meet or exceed the Global Fund stipulations regarding
Monitoring and Evaluation (M & E), while ensuring that the Plan itself is a workable
management tool, taking into account the capacity and existing systems of both the PR,
sub-recipients and other stakeholders spread across the 10 Pacific Island Small Island
States who are the beneficiaries of this project.

This document;

      Describes how the PR and other key stakeholders will use the M & E plan to
       ensure that the project is progressing as intended, or to highlight areas in need of
       adjustment to achieve the desired results;
      Identifies the source of the data that will need to be submitted to the PR for M &
       E purposes, together with the frequency of reporting;
      Assigns responsibilities for overseeing various aspects of M & E, including the
       budget for M & E activities;
      Describes what M & E activities are already in place; and
      Defines the key indicators within the M & E framework that will be used to
       measure and report progress against each objective.

Selection of Key Indicators
The PR in close consultation with the Tuberculosis Technical Working Group (TWG) has
selected the key indicators that are to be used for M & E purposes based on the
following criteria;

      During the first twelve months of implementation, the M & E plan will primarily
       focus on process indicators (the monitoring of activities, actions, systems etc;
       that need to be completed in order to achieve coverage);
      From year two onwards, we will progressively shift towards the use of coverage
       indicators (changes in key variables that indicate the successful implementation
       of the project). Because of the need to undertake surveillance as a means of
       establishing reliable base data, impact indicators will generally not be used
       during the first two years of implementation; and
      Wherever possible, indicators have been selected that will remain valid for the
       duration of the project.
Only a limited number of planned activities have been selected as key indicators for M &
E purposes. The indicators that have been chosen provide a balanced, objective and
independently verifiable measure of the projects achievements against its stated goal
and objectives without creating an overbearing M & E plan.

The implementation of other activities that are not included as key indicators will
generally be monitored through financial reports and country level CCM process

Using the M & E Plan to Measure Progress
The Project Coordinator, on behalf of the PR will collate individual country /
implementing agency data into a summary report of progress against key indicators in
the M & E framework. This will be circulated to PIRCCM executive 1 and TWG not less
than six monthly, or earlier if considered necessary. The PR and TWG will each provide
an assessment of the projects progress and achievements against its stated goal and
objectives, and will identify issues that need addressing, together with recommended
actions to be taken. These assessments will be submitted to the PIRCCM Executive
either for consideration during their next scheduled meeting, or to the full PIRCCM if an
annual meeting is shortly to be convened.

Following consideration, the PIRMCCM Executive (or full membership) and the PR will
agree on actions or specific interventions where necessary that are to be implemented
as part of the next six months workplan.

At the PIRCCM level, the focus will be on monitoring and evaluating the overall strategic
aspects of project delivery and progress at the objective level. Accordingly, it is not
envisaged that they would become involved in general implementation issues (individual
activity level).

The PR, in conjunction with CCMs (and together with members of the TWG as
appropriate) will monitor activity indicators at the individual country level, and any issues
will be addressed as part of the daily management of the project.

Financial monitoring of the project will be the responsibility of the PR. Financial issues of
significance that could impact on the achievement of objectives will be brought to the
attention of the PIRCCM Executive.

Data Collection and Frequency
The data source and frequency of collection is identified in Annex 1 M & E Framework,
which is appended to this plan.

Emphasis is placed on the collation of data that provides specific, quantifiable and time
bound reporting of progress towards the achievement of results that can, as necessary,
be independently verified.

    On behalf of the full PIRCCM
In most cases, data collection at the national level will be on-going, and will draw on
existing monitoring systems where appropriate (i.e. national health statistical databases)
to provide data that will be used for coverage and impact measurement. Reports will be
submitted six – monthly to the PR, unless determined otherwise.

Standard reporting templates are being developed for sub-recipients that will enable the
PR to summarise data into a „whole of project‟ report, while tying results and activities to
expenditure. In country members of the TWG will assist the sub-recipient / CCM compile
reports prior to submission to the PR. Written reports will be supplemented where
appropriate with other „physical‟ evidence of achievements against reported results, such
as copies of IEC materials.

The financial monitoring of the project will be part of the normal functions of the PR, with
continuous inputting of financial data on a daily basis. Internal monitoring will comply
with the standard existing, well defined procedures within the PR. Sub-recipients will
initially submit financial reports to the PR on a monthly basis, although this frequency will
be extended once they have demonstrated sound financial management practices are
being adhered to.

Reports of a technical nature will generally be subject to a „peer review‟ process by the
TWG prior to using the data within the M & E framework.

The PR in accordance with the Grant Agreement will forward reports to the Global Fund
of both the programmatic and financial aspects of the project through the Local Fund

Responsibilities for M & E
The table below details the various aspects of M & E, together with the assigned

Monitoring and Evaluation Component                    Responsible
Overall M & E of the project at the strategic level    PIRMCCM / PR (Public
                                                       Health Manager)
Overall M & E of the project at the individual country PR (Project Coordinator) /
activity level (process indicators)                    CCM
Financial monitoring of the project                    PR (Project Coordinator) / XB
                                                       Finance Manager. Annual
                                                       audit by approved auditors.
Monitoring the Impact of the project on the disease    MOH        national     health
                                                       statistics. WHO / SPC
                                                       Tuberculosis Specialists
Monitoring the coverage of the project                 MOH / TWG
Monitoring the implementation of individual activities PR (project coordinator) /
                                                       CCM and country TWG

At the strategic level, the PIRMCCM will periodically monitor the progress within the
project on a six monthly basis, at the time the report is submitted to the LFA. The
information contained in the report will include specific reporting against the key
indicators outlined in the M & E framework, plus an attached narrative produced by the
project coordinator, using a standard reporting format that exists within SPC.
The Manager, SPC Public Health Programme will monitor the overall progress of the
project from the perspective of the PR.

The Project Coordinator on behalf of the PR, will consolidate individual monitoring
reports into the M & E framework and will undertake an analysis of progress made
against the plan. The Project Coordinator will also periodically monitor the
implementation of activities, in particular those delivered by Regional Organisations. The
Project Coordinator will also independently monitor activities at the country level in
collaboration with the CCM.

The SPC Tuberculosis Specialist will in collaboration with WHO provide a monitoring
and evaluation role to review tuberculosis control on a regular basis, both for countries
directly impacted by this project, as well as others throughout the Pacific. She will also
monitor certain aspects of implementation at the country level to a schedule agreed
together with WHO. Jointly, they will monitor the implementation of regular supervision
plans at the national level.

The Project Financial Reporting Officer under the supervision of the SPC Finance
Manager – XB will monitor the financial performance of the project and the use of
financial resources, both at the PR level and, as required, at individual country level.
Annual independent audits will validate the financial reports.

The WHO will monitor changes in tuberculosis disease prevalence and characteristics
through surveys in 3 - 4 representative countries. Yearly cohort results (both for
detection and treatment results) will be sent to WHO for regular monitoring at Regional
and Global TB control levels. WHO will monitor the quality of individual MOH data

The Technical Working Group will provide technical assessments of specialised inputs
(such as surveys etc;), and will provide monitoring assistance at the country level to the
CCM on technical aspects of project delivery.

The CCM in each country will monitor the implementation of all activities at the country
level, both those undertaken by the Sub-Recipient, as well as those delivered by other
agencies. They will be guided by national M & E plans which are to be developed for
each country.

The Ministries of Health in each country will monitor tuberculosis case reporting on a
continuous basis through their health information systems (TB registers) and will make
this data available for the six monthly reports to the PR, together with the results of any
periodic national health surveys.

Local NGOs will monitor the impact of the project on local populations and vulnerable
groups through small-scale participatory surveys, which will complement national

Existing Monitoring and Evaluation Practices
In general, existing monitoring and evaluation practices are limited in the Small Island
States as a result of poor human resource capacity, a high staff turnover, inadequate
infrastructures and systems. In addition, TB prevalence and incidence in the Pacific
Islands are not known with certainty because of a lack of scientific data.

At the regional level, WHO monitor the status of DOTS implementation and expansion
on an annual basis.

The TB programme currently uses the WHO-recommended monitoring system based on
quarterly cohorts differentiating the new smear positive pulmonary cases.

Health Information Management Systems, where they exist, report a monthly number of
TB patients under treatment, but do not provide cohort-based indicators, such as case
notification and treatment success for the new smear positive pulmonary cases of TB.

All TB patients are registered in the TB registers in each national DOTS hospital.
National TB Programme coordinators at the central level are responsible for collecting
the data every quarter and sending them to the National Health Statistics office and
DOTS center.
Annex 1: Monitoring and Evaluation Framework – Tuberculosis Component

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