Annual Report: Compiling an Evidence Base for Orphans and Vulnerable Children Programming (OVC)

The project's primary objectives were to provide research-informed guidance and improved capacity for process and outcome monitoring. Tulane University designed and implemented major refinements to a standardized monitoring system for use by OVC programme implementing partners. New forms and tools, including automated reports and standard procedures, were created and disseminated to implementing partners for use in integrated case management and adolescent outcome monitoring. Tulane also conducted baseline data collection for a cohort study of adolescents living with HIV and led pre- and post-test monitoring for structured HIV prevention interventions. The project provided technical assistance to OVC programme implementing partners, responding to eight ad hoc requests for technical reviews of materials, including externally-generated research reports, structured curriculum training materials, and technical presentations. Additionally, Tulane delivered two presentations to local and international stakeholders, produced one research brief, and developed two peer-reviewed articles during the reporting year. Tulane is tasked with developing programme monitoring systems for use by USG-supported OVC implementing partners. The main objectives of this work are to design a standardized case management monitoring package that supports standardized, high-quality case management practices and related data collection, and to provide evidence for achievement of key programme objectives such as HIV case finding among OVC, prompt linkages to ART and other care and treatment services, and increases in precursors to HIV prevention. To meet the first objective, Tulane refined tools, procedures, and reports for core OVC case management process monitoring, including adaptations to CBIMS designed to facilitate capturing and reporting on data from a basic minimum set of standardized monitoring forms. Tulane also conducted initial trainings and strategic reviews of partners' experiences with the system to identify usage challenges, examine data quality, and provide needed support to direct improvements in data collection and processing procedures. Tulane provided materials designed to support implementation of the standardized case management monitoring package, including implementation guidelines, trainings, and assessment tools. The Case Management Monitoring Implementation Guidelines (October 2018) and related tools were officially released to partners in October 2018, and Tulane hosted a series of webinars to provide an overview of the database, tools, and procedures, and to answer relevant questions. Tulane also designed the USAID Site Visit Tool (June 2019) to guide assessments of OVC partners' performance during site visits. The tool supports intermittent assessment of service and data quality at community sites implementing OVC services. Assessment involves guided appraisal of case files, CBIMS reports, and a review of structured intervention offerings. Findings can be used by site and organization managers for quality improvement. For the inaugural SAPR Snapshot Report (June 2019), Tulane conducted a secondary analysis of CBIMS data from OVC implementing partners and all applicable sub-partners for the SAPR period October 2018 to March 2019. Results covered eight PEPFAR MER and custom indicators designed to understand general service reach and coverage, HIV case finding, including reasons for unknown status, and treatment linkages. Tulane provided adaptive solutions for partners and the USAID mission in response to evolving priorities and needs, including interpretation and implementation of designated PEPFAR MER indicators, as well as new indicators to track contributions along the HIV service cascade. A simple CBIMS report ("Progress report") was generated to calculate progress to date towards SAPR & APR targets for the OVC_SERV and OVC_HIVSTAT indicators. Indicator-specific reports in CBIMS and accompanying guidance were developed for the following PEPFAR MER indicators, including GEND_GBV.