Blog
Exclusive interview with Dr. Francis Agbo, Acting Director of Surveillance, Research and Monitoring and Evaluation Department at the National Agency for the Control of AIDS (NACA)
By: Henry Umaru
How
does NACA Collaborate with Governmental and non-governmental partners to ensure
effective Data collection, monitoring, and E valuation of HIV/AIDS Programmes?
In this department, our approach
is rooted in inclusivity, ensuring that everyone who should be a part of it is
included. We also place a strong emphasis on participation, ensuring that those
who are included actively engage in the process. We identify all relevant
stakeholders, whether they are international donor agencies, implementing partners,
Ministries, Departments, and Agencies (MDA), members of the community, and
People Living with HIV (PLHIV). We actively involve and engage with
representatives of these stakeholder groups in all our engagements.
Moreover, we maintain an open
feedback loop to ensure that everyone remains engaged and informed. Typically,
our Monitoring and Evaluation (M&E) activities involve data collection,
analysis, and the generation of meaningful insights from the data. Stakeholders
retain a keen interest in this valuable information generated from our
monitoring and evaluation system and so we actively disseminated at a and
information generated by the system.
Can
you share some recent findings or insights from NACA’ s monitoring and
evaluation efforts that have informed policy and programme decisions?
One of the pivotal initiatives in
our monitoring and evaluation efforts is the National AIDS Indicator and Impact
Survey (NAIIS) that was conducted in 2018, which, at the time of its
implementation, stood out as the largest general population HIV survey ever
conducted globally. The NAIIS helped Nigeria rebase her epidemic and it contributed
to establishing a true baseline for HIV in the country thus contributing to
improved decision-making, target setting, and resource allocation.
Prior to the NAIIS in 2018, there
existed uncertainty regarding the precise prevalence of HIV in Nigeria. Pre-NAIIS
It was unclear whether the reported figures were underestimated or
overestimated. However, the 2018 NAIIS provided a much-needed sense of the
actual HIV prevalence in the country.
In addition, Spectrum estimates
are done annually, help generate HIV estimates for all 36 states, and help assess
our progress towards the goals and priorities for the HIV response, make
readjustments, course corrections in the direction the national response is
going, and even help in the allocation of funds
How
does NACA ensure the accuracy and reliability of data collected for monitoring
and 52 evaluation purposes, especially in a dynamic and evolving field like
HIV/AIDS?
We employ a series of steps to
ensure data accuracy and reliability. The initial step involves the
harmonization and standardization of data collection and reporting tools. This
process unifies the tools used for data col lection, ensuring that every
stakeholder employs the same instruments in collecting data. This
standardization prevents variations in data collection methods and ensures that
data are comparable across population groups and geographical locations.
In addition, we prioritize
capacity building for the users of the tools. This entails training individuals
on the utilization of these standardized data collection tools. By providing
the relevant training, we ensure that people are able to use the standardized
tools, as neglecting this aspect could lead to inconsistent reporting even with
standardized tools available.
Furthermore, we implement data
quality assurance and assessment procedures. Upon receiving data, we conduct
periodic data spot checks, sending personnel to the reporting facilities to
verify reported data. This involves verifying reported data to ensure that the
numbers reported align with the actual figures on the ground while we also
assess the underlying system that generates the data for gaps so that we
implement corrective measures.
In addition, we have also largely
transitioned from paper-based data collection and reporting systems to
electronic methods. This shift is driven by the desire to reduce errors, as
electronic systems are typically automated, resulting in fewer inaccuracies
compared to paper-based methods.
What
are some of the key challenges and opportunities in monitoring and evaluating
HIV/AIDS programmes in the country, and how is NACA addressing them?
One of the primary challenges
faced by the HIV response in Nigeria is securing adequate funding. As a
standard, it is expected that resources allocated for M&E should be between
5-10% of programme budgets but this is not of-ten the case in the HIV response.
As such, financial resources are often insufficient to cover the full scope of
required activities. This funding challenge is particularly acute at the
sub-national level, encompassing states and local governments.
Another pressing challenge is
that of M&E technical capacity gaps. These gaps call for sustained and
continuous capacity building for enhanced skills and expertise among the
M&E workforce to effectively carry out programme monitoring and evaluation.
Furthermore, ensuring proper or
adequate coordination among the various stakeholders involved in HIV/AIDS
programmes remains a major challenge. The HIV response in Nigeria is
multisectoral involving many players . The presence of numerous individuals and
organizations engaged in this field makes effective coordination essential but
complex.
Additionally, data quality is a
concern we still grapple with. Timely, accurate, and reliable data are
essential for sound programme assessment, but they can sometimes fall short of
the desired level of precision.
NACA is actively working to
overcome these challenges, aiming to mobilize funding, build technical
institutional and technical capacity for M&E, improve coordination, and
enhance the quality of data to ensure the successful monitoring and evaluation
of HIV/AIDS programmes in the country.
How
does NACA engage with communities and affected individuals to gather their
input and experiences in the monitoring and evaluation process?
The future of the HIV response
lies in our ability to achieve HIV epidemic control and transition the HIV
programme to the subnational level (states, LGAs, and communities. As such NACA
recognizes the critical role of communities if we are to achieve our goal for a
sustainable HIV response that is also locally owned and driven. NACA employs a
comprehensive approach to engaging with communities and individuals affected by
HIV/AIDS in the monitoring and evaluation space. This commitment to inclusivity
is fundamental `to our work.
When we refer to
“communities,” we are addressing individuals at the grassroots level,
as well as PLHIV. It’s important to note that the estimated two million people
living with HIV in Nigeria may not all be directly engaged, but their voices
are represented through specific organizational 53 entities known as the
Network of People Living with HIV/AIDS in Nigeria (NEPHWAN).
NEPHWAN serves as an umbrella
organization that advocates for the interests of PLHIV. Their role is pivotal
in ensuring that the experiences, concerns, and perspectives of affected
individuals are incorporated into NACA’s activities. This partnership is
essential because we acknowledge that we cannot effectively implement
programmes or make informed decisions without the active involvement of PLHIV.
Their engagement in the process is not just a formality; it is a cornerstone of
our approach.
This principle extends to our
M&E efforts as well. In the context of M&E, we firmly believe that
community participation is indispensable. We actively collaborate with people
at the grassroots level to gather their input and experiences. Their
contributions are invaluable in assessing the impact of our programmes and making
necessary adjustments to improve outcomes.
In essence, NACA’ s engagement
with communities and affected individuals is rooted in the recognition that
their involvement is not just a checkbox on a checklist that we tick, but also
a fundamental aspect of our work. It ensures that our initiatives are more effective,
responsive, and reflective of the real experiences and needs of those living
with HIV in Nigeria.
Could
you share some success stories or examples of how NACA’s research and
evaluation work has led to positive outcomes in the fight against HIV/AIDS?
NACA’s research and evaluation
work has played a pivotal role in achieving positive outcomes in the battle
against HIV/AIDS. This effort primarily involves two key functions: data
collection through monitoring and evaluation and in-depth research analysis.
M&E is instrumental in
routine tracking the coverage of HIV services, ensuring that data on
individuals receiving such services at healthcare facilities are collected and
reported in a timely manner. Additionally, NACA’s M & E includes a research
component that delves deep into assessing the effectiveness of the
interventions and activities in the HIV response.
One concrete example of how
research and evaluation have led to positive outcomes is our approach to age
specific outreach. Through rigorous research, we identified a gap in reaching
the youth demographic with HIV prevention and treatment services. This evidence
prompted us to intensify our efforts in targeting and engaging with young
people, recognizing that they were underserved in the past.
Another notable area of impact is
related to key population groups. Our research revealed that specific key
populations were not adequately covered by our services. In response, we have
focused on enhancing programming to reach these underserved groups, ensuring
that they receive the necessary care and support to prevent and manage HIV.
Furthermore, the data driven
approach has been instrumental in identifying areas where pregnant HIV positive
women were not accessing essential services. This insight has led to the
development of tailored solutions to ensure that this vulnerable demographic
receives the care they require.