Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Seite 172

6 Programme Management and Organizational Capacity-building

›› Probability evaluations involve randomization and are not necessary or feasible for most
programme evaluations.
Most sex worker evaluations fall somewhere between adequacy and plausibility. It should be noted
that good monitoring data are essential, first to demonstrate that the programme was implemented
as planned, and second as a signal to managers and funders that the programme is on track.
• Data triangulation: True baseline surveys (i.e. before interventions are started) in sex work
communities are difficult. Programmes need to build trust with the community before one asks
intimate questions or takes biologic specimens. Building trust usually entails providing services,
and baseline behaviour related to condom use may change quickly. It is therefore important to try
and collect additional information on “baseline” condom use through enrolment questionnaires,
or use condom distribution data to triangulate with survey data (see Section 6.2.2).
• Validation of programme data: Surveys used for evaluation should also be used to validate the
other programme data, where possible. In particular, surveys may be used to:
›› estimate programme coverage and validate the monitoring estimates
›› do size estimates using more mathematically based approaches
›› assess the level of reported violence
›› assess the level of individual and community agency.
• Dissemination plan: Dissemination plans should involve activities at all levels—from central to
local levels—including to the sex workers themselves. Dissemination creates ownership of the
results to help improve programmes.

Organizing a scaled programme for sex workers
6.2.4 Define the management structure
A clear structure for implementation and well-defined roles and responsibilities are essential for
smooth programme management. These include the roles and responsibilities at each level of
implementation, both in the programme and outside (government, media, medical services, etc.).
At the national/central level, the government or central management agency:
• sets programming standards
• monitors dashboard indicators from all implementing organizations in the country
• ensures that programmes are implemented in prioritized areas and sub-populations of sex workers
• has a centralized view of the monitoring data
• ensures a country-wide evaluation plan.
If government or a designated central management agency is not setting standards or requiring
centralized indicator reporting, implementing organizations should work together to standardize a
minimum package and centralize indicator collection in consultation with the government.
Figure 6.3 illustrates a management structure of a national programme, showing the oversight and
reporting relationships with the programme as well as the external relationships managed at the
various levels. Key management roles are:

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