Politics of monitoring and evaluation: Lessons from the AIDS epidemic

Evolution of Monitoring and Evaluation of AIDS Response in Ukraine: Laying the Groundwork for Evidence-Based Health Care

Once facing the most severe HIV epidemic in Eastern Europe, Ukraine has built an elaborate Monitoring and Evaluation (M&E) system to track the response to AIDS. This system was developed using recommendations and input from multiple international expert organizations and donors and, at the current stage, serves as a best practice model in many areas. The present paper aims to provide a comprehensive overview of the evolution of the M&E system in Ukraine since its inception. Notable achievements and challenges are described and illustrated by epidemiological data and the recommendations for future development are discussed. Unique experiences and advances in M&E in Ukraine may be useful to other countries facing similar epidemiological, structural or methodological issues.

Social and behavioral science in HIV vaccine trials: a gap assessment of the literature

Social and behavioral science research is integral to the conduct of HIV vaccine trials, especially because the vaccine targets an infection laden with sensitive human issues. Although social and behavioral sciences have played a larger role in HIV vaccine clinical trials than other vaccine clinical trials to date, this role should be expanded. Fortunately, related publications, conference coverage and research proposals are on the rise; community engagement is receiving more attention during the earlier stages of product development; and collaboration between HIV vaccine scientists and social and behavioral scientists is being fostered. Greater attention to social and behavioral science issues could not only facilitate accrual, but also improve research efficiency and relevance. In this review, gaps in the literature on social and behavioral science issues in HIV vaccine clinical research, including barriers and facilitators to trial participation, enhancing feasibility of trial success, health systems, policy and monitoring social and behavioral issues, are identified and directions are suggested for filling those gaps. Development of a safe, efficacious and acceptable HIV vaccine will be nurtured by addressing the gaps through interdisciplinary collaborations.

Burden of Proof: Documentation of an HIV Prevention Program in Ghana

Globally, HIV programs face pressure to document their accountability and achievements using “evidence-based” criteria or “monitoring and evaluation” (“M&E”), yet little is known about how M&E occurs on the ground or its social and political effects. This paper explores how NGO actors in Ghana experienced routine documentation of a USAID-funded HIV program. Drawing upon 20 months of ethnographic fieldwork, I illustrate how M&E documentation reproduces hierarchical aid relations by engaging NGO actors to self-govern through unexpected strict adherence to documentation requirements. I explore institutional supervisors' frustration with their deference to documentation to further show how inequality is indirectly reproduced.