the importance of impact evaluation of hiv/tb workplace programmes nathea nicolay
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The importance of Impact Evaluation of HIV/TB workplace programmes Nathea Nicolay AIDS Risk Consulting 2 April 2009. What is Monitoring and Evaluation? Performance measurement of HIV/TB workplace programmes Step 1: Goals and objectives Step 2: Select Indicators - PowerPoint PPT PresentationTRANSCRIPT
The importance of Impact Evaluation of HIV/TB workplace
programmes
Nathea Nicolay
AIDS Risk Consulting
2 April 2009
Agenda
• What is Monitoring and Evaluation?
• Performance measurement of HIV/TB workplace programmes
• Step 1: Goals and objectives
• Step 2: Select Indicators
• Step 3: Identify sources and methods of data collection
• Step 4: Data collection
• Step 5: Interpreting and sharing the results
• Workshop: case studies
• Workshop: reporting back
• Impact indicators to determine return on investment and impact on financial bottom line
What is Monitoring and Evaluation?
• Business world uses: Performance measurements and results
• Public health sector uses: Monitoring and Evaluation
• Monitoring is the routine, daily assessment of ongoing activities and progress.
• Evaluation is the episodic assessment of overall achievements.
• Both M&E are necessary for a co-ordinated national response to the epidemic.
• Monitoring and Evaluation
HIV and AIDSRisk Management
Measure
Manage
Monitor
Monitoring and Evaluation
INPUT
Resources:PoliciesPeopleMoneyEquipment
PROCESS
TrainingManagementActivities
OUTPUT
Short term output
OUTCOME
Results:BehavioursPractices
IMPACT
Long term effect:IncidencePrevalenceMortalityMorbidity
Monitoring of Process Measuring of Outcomes and Impact
HIV/TB WORKPLACE PROGRAMME: Goals and objectives
• Step 1: What is the goal of the programme?– Broad statement:– “Reduce HIV and TB related workplace costs”
• What are the objectives?– Specific– Measurable– Appropriate– Realistic– Time-bound– “Reduce HIV and TB related workplace costs by 10%
in one year.”
World-wide recession
HIV/TB WORKPLACE PROGRAMME: Examples
• Reduce new infections:– peer education– condom distribution– awareness campaigns
• Increase take-up on treatment:– wellness days– VCT
• Increase adherence to treatment– HIV disease management– Education
HIV/TB WORKPLACE PROGRAMME: Treatment
Increase take-up on treatment of HIV and TB through wellness days– Fewer deaths, disability claims– Reduced HR costs – absenteeism, training
and recruitment– Reduced medical expenses– Reduced HIV and TB related workplace costs
HIV/TB WORKPLACE PROGRAMME: Treatment
• Step 2: What are your indicators?– Process and Input indicators for wellness
days– No of people reached– No of people tested– No tested positive– Cost of wellness days– Time taken to roll-out
HIV/TB WORKPLACE PROGRAMME: Treatment
– Outputs• No enrolled out of those positive
– Outcomes• Cumulative number on treatment increased from 300 to 400
– Impact– Take-up on treatment increased to 40%
– Mortality reduced
– Morbidity reduced
– Absenteeism reduced
– Medical costs reduced
– Linked to finances: HIV and AIDS related costs – reduced by 15%
HIV/TB WORKPLACE PROGRAMME: Treatment
• Step 3: Identify sources and methods of data collection– Specify data needed to wellness day service
provider– Or HR train staff to collect data themselves
during wellness days
• Step 4: Collecting the data
• Step 5: Interpreting and sharing the results
Example of Impact Indicators
• HIV and AIDS actuarial Impact Assessment• Quick and cheap• Illustrates:
– Fewer deaths, disabilities– Reduced EB costs: Group Life Assurance, Permanent
Health Insurance– Reduced HR costs – absenteeism, training and
recruitment– Reduced medical expenses– Reduced HIV and TB related workplace costs
-
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Year
No Treatment Current Treatment Effective Treatment
Demographic Impact Assessment: AIDS deaths per mille
Total HIV/TB related workplace costs
-
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
No Treatment Current Treatment Effective Treatment
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Current Treatment Savings Potential Treatment Savings
Total savings due to 60% treatment take-up
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
10,000,000
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
12
20
13
20
14
20
15
20
16
Total EB costs Total HR costs Total medical costs
Total HIV/AIDS related costs broken down for 2008 with current 60% take-up
on ART
Cost Estimated cost (R million)
% payroll
Death benefits costs 1.8 0.6
Disability benefits costs 1.6 0.5
Sick leave costs 0.5 0.2
Productivity costs 1.5 0.5
Training costs 0.2 0.1
Medical costs 2 0.6
Total 7.6 2.5
Summary of HIV/AIDS related costs in 2006
Cost Estimated cost (R million)
% payroll
Death benefits costs 1.62 0.5
Disability benefits costs 1.44 0.5
Sick leave costs 0.45 0.1
Productivity costs 1.35 0.4
Training costs 0.18 0.1
Medical costs 1.8 0.6
Total 6.84 2.0
Summary of HIV/AIDS related costs in 2007
Conclusion
• Year on year HIV/TB related workplace costs have reduced by 10%
• Compared to a baseline of No treatment of TB/HIV – savings of R3.5 million were made
Conclusion
• Monitoring and evaluation is needed to assess the outcomes and impact of HIV/TB workplace interventions
• Several layers of M&E needed for valuable assessment
• Importance of data and training
• Importance of communication to the stakeholders