PEPFAR OVC Survey Toolkit
Janet Shriberg, EdD
Senior Evaluation Advisor
Office of HIV/AIDS
USAID
**please note that slides were created with work done by MEASURE Evaluation
PEPFAR Mission & Goal (OVC)
Mission: To mitigate the social, emotional and economic impacts of HIV/AIDS on children and to reduce their risk and vulnerability while increasing their resilience
A goal: To care for 5 million orphans and vulnerable children
10% funding earmark for OVC
The problem
High investment in OVC programs BUT impact is unclear & questions regarding “what works” in improving household well-being
Part of the challenge: lack of standardized measures and tools for child and household outcomes (well-being)
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A proposed solution
Standardized questionnaires for use in a survey of children ages 0-17 years and their adult caregivers
Who are these tools for?
Local and international research institutions and other implementing organizations with evaluation agenda
USAID Forward – supporting local researchers
The purpose
Standardize population-level child and caregiver well-being data beyond what is available from routine surveys
Produce actionable data to inform programs and enable mid-course corrections
Enable comparative assessments of child and caregiver well-being and household economic status across a diverse set of interventions and regions
Focus on PEPFAR OVC programs
Indicators need to reflect & be amenable to change by PEPFAR program intervention HH interventions led by
home visitors Community interventions Low direct funding per
target, focus on linkages Often inadequate
services in vicinity
How did we start…
Two step, participatory process:
Build consensus around core impact indicators for PEPFAR-funded OVC programs
Develop OVC program evaluation (survey) tools
Distilling the core indicators
Our starting point: 6+1 domains of PEPFAR OVC programming
Step 1: Extensive literature search
Step 2: Gaps (HES, PSS) filled through targeted research
Result: >600 child/HH wellbeing questions/indicators
Step 3: Analysis against 8 criteria
Result: shorter list of questions for discussion
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Finalizing the core indicators
External working group: solicited review from 49 stakeholders
Finalized core set of 12 child and 3 household measures
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Developing the tools
Tools drafted with strong stakeholder input
Draft tools piloted in Zambia and Nigeria Cognitive interviews to
test key concepts (e.g. social support)
Household pre-test of full tools, procedures
Structure and content
1. Caregiver questionnaire (including questions on household)
2. Child questionnaire (ages 0-9 years), administered to caregiver
3. Child questionnaire (ages 10-17), administered to child with parental consent & child assent
Sections Core questions Optional modulesSection 1: Household schedule
Household schedule* (10) Changes in household
composition (4)
Section 2: Background Information on Caregiver and Household
Demographic information* (7) Work* (3) Access to money (3) Shelter (1)
Household Economic Status (forthcoming)
Progress out of Poverty Index or similar (country specific)
Section 3: Food Security Household food security (6) Dietary Diversity (1)
Section 4: Caregiver Well-being and Attitudes
General health (2) Caregiver support (4) Parental self-efficacy (1)
Perceptions and experience of child discipline, violent discipline (forthcoming)
Gender roles and decisionmaking power* (9)
Section 5: HIV/AIDS Testing, Knowledge, Attitudes
Basic HIV/AIDS knowledge* (7) HIV testing* (3) Attitudes to condom educ (1)
HIV/AIDS attitudes* (4)
Section 6: Access to HIV Prevention, Care & Support
Household access to services (1)
*DHS, bold=core indicator
Caregiver questionnaire
Sections Core questions Optional modulesSection 1: Child Health and Welfare
Confirm demographics (5) General health & disability (4) Birth certificate (2) Vaccinations (11) Fever (<5 years)* (1) Diarrhea (<5 years)* (1) Experience of neglect (2) Slept under mosquito net* (1) HIV testing experience* (2)
Fever: extended* (4) Diarrhea: extended* (3) Health for children
living with HIV/AIDS (forthcoming)
Section 2: Education and Work
School attendance*, progression/repeats, drop-outs, missed school days (5+ years) (9)
Work for wages (2) Early childhood stimulation (2)
Section 3: Food Consumption
Food consumption (2+ years) (8) • Dietary diversity (1)
Section 4: Access to HIV Prevention, Care & Support
Child access to services (1)
Section 5: Anthropometric Measures (of Children)
Weight*, Height*, MUAC
Child questionnaire (ages 0-9)
*DHS, bold=core indicator
Child questionnaire (ages 10-17)Sections Core questions Optional modulesSection 1: Background Information on Child
Confirm demographics* (5) Identity of caregiver (1)
Section 2: Diary Daily log (6) Section 3: Education School attendance*,
progression/repeats, drop-outs (9)
Section 4: Chores & Work Chores (3) Work (7)
Section 5: Food & Alcohol Consumption
Food consumption (8) Alcohol consumption (3)
Dietary diversity (1)
Section 6: Health, Support & Protection
Birth certificate (2) General health & disability (3) General support (4)
Health for children living with HIV/AIDS (forthcoming)
Perceptions/experience of violence (forthcoming)
Section 7: HIV Testing, Knowledge, and Attitudes
Basic HIV/AIDS knowledge* (7) HIV testing * (3)
Child development knowledge (6) HIV/AIDS attitudes and beliefs (4)
Section 8: Sexual Experience • Sexual behavior (13-17 yrs) (5)
Section 9: Access to HIV Prevention, Care & Support
Child access to services (1)
Section 10: Anthropometric Measures: Weight and Height
Weight, Height, MUAC
Using the Tools
There is no single data collection tool that can meet all OVC program M&E requirements.
Yes No
Situation analysis x
Targeting X
Case management X
Program monitoring X
Evaluation x
What’s in the toolkit?
Tools & Manual Template protocol with
consent/assent forms Methodological guidance
Data analysis guide Data collector training
manual and materials French translations
Global Monitoring, Evaluation and Reporting (“ the MER”) PEPFAR shift towards outcomes and impact
All technical areas participating (CARE, PREVENTION, TREATMENT)
Specific Changes for OVC Programs 2 indicators at Level 1 (required, reported to HQ)
Outcomes Package at Level 2 (required, reported at country level; indicators elevated from survey toolkit)
2 Education indicators: attendance and progression
Systems Strengthening and Social Protection at Level 3
(recommended)
Where can I find out more?
Go to MEASURE Evaluation website:http://www.cpc.unc.edu/measure/our-work/ovc
Email: Janet [email protected]
Special Thanks to…
Dr. Jenifer Chapman, MEASURE Evaluation* (*Technical Lead for Toolkit, slideset creator)
Dr. Lisa Parker, MEASURE Evalution
OVC TWG Working Group, HQ and Missions
Stakeholders globally working on OVC programming
IATT Education for Guidance on education questions