6 Programme Management and Organizational Capacity-building
Box 6.2
Case example: Using routine monitoring data and qualitative interviews to improve services in India
Distribution of free condoms to sex workers through routine outreach was an essential component of the Avahan AIDS Initiative in India. An examination of routine monitoring data from condom distribution in early 2005, about one year after the programme had started, revealed that across about 120 NGOs, as many as 50 % of the approximately 700,000 free condoms being distributed monthly were being given out by outreach workers who were not sex workers.
This raised questions about whether those most in need were receiving condoms and why community outreach workers, who were in more frequent contact with community members, were not charged with the primary responsibility for distributing the condoms. Discussions with the implementing NGOs, nonsex worker outreach workers, and community outreach workers revealed that some NGO staff lacked confidence that the community outreach workers knew how to adjust supplies to the individual needs of sex workers, when to reorder, and that they would actually distribute the condoms.
In response, the implementing NGOs at the state and local levels launched skills-building sessions to increase community outreach workers’ capacity to carry out these tasks. They also developed tools to record and monitor condom outreach, and trained non-sex worker outreach workers to coach and mentor community outreach workers rather than manage them closely. After these changes, sex worker participation in service delivery, including condom distribution, increased markedly: one year later, 2.5 million free condoms were being distributed each month.
For sex worker programmes, there are eight main data sources necessary to design, monitor and manage the programme( labelled A – H in Table 6.2). These are discussed on the following three pages. Table 6.3, which follows this section, is an example of a programme indicator table that may be used at higher levels in management to monitor progress towards the goal of scale-up.
Table 6.2 Main data sources for design, monitoring and management of HIV / STI programmes with sex workers
A B
C D E F G H
Special data-collection exercises
Programme data not routinely collected during direct contact between sex workers and programme services
Programme data from routine direct contact between sex workers and programme services Administrative data related to services including drugs, consumables and referrals Qualitative assessments
Quality monitoring Expenditure data Other outside data
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