HEALTH RESPONSE TO SURVIVORS of GBV/SV

Federal Democratic Republic of ETHIOPIA

MINISTRY of HEALTH

2016

PA RTI CI PAN T MA NUA L | MO D ULE FI VE

MONITORING and
EVALUATION

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 Module V: Monitoring and Evaluation

TABLE OF CONTENTS

Acronyms .......................................................................................................................................... 1
Introduction ...................................................................................................................................... 2
5.1 Learning Objectives ........................................................................................................................... 2
5.2 Definitions ......................................................................................................................................... 2
5.3. The Purpose of Monitoring and Evaluation ..................................................................................... 3
5.3.1. What should be Monitored and Evaluated in Post-Violence Care? ......................................... 3
Summary of Module V ...................................................................................................................... 4
Participant Self-Evaluation ............................................................................................................... 4
REFERENCES FOR FURTHER READING ............................................................................................... 5

Acronyms

GBV Gender-based Violence

M&E Monitoring and Evaluation

STI Sexually Transmitted Infection

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Introduction

In order to understand and see how health system interventions in relation to the (clinical)
management of cases of GBV/SV, it is important to monitor and evaluate these cases. Moreover,
monitoring and evaluating these interventions will also contribute to maintaining or even improving
the quality of the clinical management of survivors of such violence and better assess their needs
and identify and bridge capacity or knowledge gabs.

5.1 Learning Objectives

By the end of this section participants will be able to: Core Competencies:
o Describe the objectives of monitoring and evaluation Cognitive
of post-sexual violence care - Describe the purpose and value
of M&E in post-sexual violence
o Explain the difference between monitoring and
care
evaluation Skill
o List indicators that can be used for monitoring of - Producing reports using the
post-sexual violence care indicators
o Use register and produce reports on post sexual - Use and complete of register for
violence care post-sexual violence care

5.2 Definitions

Monitoring and evaluation is essential to maintain or improve the quality of health system
interventions against GBV and to understand whether these interventions have achieved the
planned targets or goals.

Monitoring is the continuous assessment of achievements during the implementation process.

Evaluation is a periodic, comprehensive and systematic review of an intervention, including its

design, implementation and results.

Indicators are numerical measures, which provide information about a complex situation or
event. They are specific, observable and measurable characteristics that can be used to show the
progress a program is making towards achieving its outcome.

Baseline refers to the prevalence of a disease, behavior or the quality of care before an
intervention or program is initiated. It provides a comparison against which progress or change
can be measured.

Standards express the minimum acceptable level of performance. Often informed by national or
international policies or legislation or benchmarked with performances in other areas with
accepted best practices.

Targets express the specific level of change or performance the institution hopes to achieve in a
certain period of time.

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Types of Indicators

Inputs: The total sum of resources and energies that contribute to the production and delivery
of outputs. These also include the basic resources required in terms of manpower, money,
materials and time. Inputs are what are used to do the work.
Processes/Activities: The processes or actions that use or are linked to the human and financial
resources that are required to achieve the program results. Activities are what we do.
Outputs: The immediate results of professional or institutional health care activities, usually
expressed as units of service, such as patient hospital days, outpatient visits, lab tests performed
etc. Outputs are what we produce or deliver.
Outcomes: The medium term results for specific beneficiaries that are the consequences of
achieving specific outputs. Outcomes should relate to institutions’ strategic goals and objectives
set out in its plans. Outcomes are what we wish to achieve.
Impact: The results of achieving specific outcomes, such as changes in health status or disease
burden in the community/population. Impacts are what we aim to change.

5.3. The Purpose of Monitoring and Evaluation

The objective and purpose of monitoring and evaluation is:

• To provide information on the progress of a program, service or intervention. This
information might also necessitate making changes to the program.
• To clarify objectives and to improve accountability for stakeholders, such as donors, the
community or government authorities.

5.3.1. What should be Monitored and Evaluated in Post-Violence Care?

Provision of a post-violence care service is a step towards reducing the possible physical, mental and
social consequences of sexual violence. Therefore, there are certain objectives or aims that need to
be achieved, including:

Service utilized by all cases of sexual violence in the coverage area:

• All survivors offered voluntary HIV testing and counseling
• All eligible survivors receive PEP and complete the course
• Chronic HIV care for all HIV positive survivors
• All eligible survivors receive EC to prevent unwanted pregnancies
• All survivors receive follow-up care
• All survivors must be provided with STI treatment
• All health care providers must be able to complete the sexual assault survivors’
documentation form
• All health care providers must be competent in conducting a complete evaluation of
survivors of sexual assault
• Health workers providing care to sexual assault survivors must be able to give evidence in
court
• Survivors must be satisfied with the services received
In order to determine if these objectives are achieved over a period of time, they need to be
measured in some way and must therefore be converted to indicators.

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Draft indicators (disaggregated by sex and ages) and their data sources

Definition of Indicator Data Source

Number of facilities offering GBV/SV survivors services Woreda/facility profile
Number of trained staff providing post-GBV/SV care Facility profile
Total number of survivors seen during a certain time period (further Post-GBV/SV care Register
segregated by age and sex)
Number of survivors tested for HIV during the initial visit Post-GBV/SV care Register
Number of survivors who tested positive for HIV Post-GBV/SV care Register
Number of survivors who received PEP Post-GBV/SV care Register
Number of survivors who completed PEP course Post-GBV/SV care Register
Number of survivors who initially tested HIV negative but HIV positive Post-GBV/SV care Register
at 12 weeks follow-up
Number of female survivors receiving Emergency Contraceptive Pill Post-GBV/SV care Register
(ECP)
Number of survivors who become pregnant despite ECP Post-GBV/SV care Register
Number of survivors who return for the first follow-up visit Post-GBV/SV care Register
Number of survivors who receive STI treatment Post-GBV/SV care Register
Number of survivors referred to a psychiatric clinic for Post-GBV/SV care Register
psychological/emotional counseling and support
Number of survivors referred to police for legal support Post-GBV/SV care Register
Number of survivors referred to CSO for social support Post-GBV/SV care Register

Summary of Module V

This Module emphasized the importance of monitoring and evaluation cases of GBV/SV in
order to maintain or improve the quality of health system interventions for survivors of
such violence. Moreover, M&E contributes significantly to a better understanding of how
these interventions have achieved the planned target or goals.

Participant Self-Evaluation

What did you learn?

What knowledge and skills were you able to improve?

What knowledge and skills still need improvement?

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 REFERENCES OF TRAINING MANUAL FOR FURTHER READING

Legal Documents

I. United Nations General Assembly, Convention on the Elimination of All Forms of

Discrimination Against Women, 18 December 1979, United Nations, Treaty Series, vol. 1249,
p. 13 (http://www.refworld.org/docid/3ae6b3970.html).
II. United Nations General Assembly, Declaration on the Elimination of Violence Against
Women, 1993.
III. The United Nations Fourth World Conference on Women (Beijing, China - September 1995),
Platform for Action, (http://www.un.org/womenwatch/daw/beijing/platform/health.htm.
IV. Constitution of the Federal Democratic Republic of Ethiopia (1995).
V. The revised Criminal Code of the Federal Democratic Republic of Ethiopia (2005).
VI. The revised Family Code of the Federal Democratic Republic of Ethiopia (2000).

National Governmental Documents

1. Federal Ministry of Health of Ethiopia. Standard Operating Procedure for the Response and
Prevention of Sexual Violence in Ethiopia, March 2016.
2. Federal Ministry of Health of Ethiopia. National Guidelines for Comprehensive HIV
Prevention, Care and Treatment, 2014.
3. Federal Ministry of Health of Ethiopia. Health Sector Gender Mainstreaming Manual,
September 2013.

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