HIV/AIDS Monitoring and Evaluation Systems Strengthening for the National AIDS Program in Albania

The Institute of Public Health (IPH) is the Principal Recipient (PR) of the Global Fund for AIDS, TB and Malaria Round 5 HIV/AIDS and TB grants. The GF HIV Grant is highly targeted, aimed at filling key gaps in the national response to HIV/AIDS. Albania is considered a low HIV prevalence country based on the number of reported cases. The work presented in this paper is carried out as part of the Monitoring and evaluation framework development in respect to the National AIDS strategy and Global Fund agreement. The performance framework consists of a range of indicators agreed by the PR (IPH in Albania), and specific targets to be met on an annual base. The PR must, therefore, be able to measure its performance against this framework in order to demonstrate that it is meeting its targets. To assist this process, the GFATM requires PRs to undertake an assessment of their capacity to monitor and evaluate the program, and put in place measures to strengthen any identified weaknesses. The Global Fund’s M&E Systems Strengthening Tool, MESST, was used. The MESST is conducted via a participatory workshop involving the PR, SRs,(Subrecipients) some representatives of the Country Coordinating Mechanism (CCM), the donor community and other stakeholders or implementing partners relevant to the exercise. The proposed output for this exercise is an M&E Action Plan for the PR. A 2-day MESST workshop was held in Tirana, Albania. Participants at the workshop assessed the M&E capacity of the national HIV program, and its implementers, the IPH and the sub recipients (SRs), by looking at three elements of the M&E system. These are: The Monitoring and Evaluation Plan, The ability of collate and analyze data at the IPH, The reporting systems in the health facilities, the community and the laboratories, The result was identification of a range of strengths and weaknesses, and from these, the development of a list of key actions to address the weaknesses identified.

An analysis of respondent driven sampling with Injection Drug Users (IDU) in Albania and the Russian Federation

Injection drug users in Tirana, Albania and St. Petersburg, Russia were recruited into a study assessing HIV-related behaviors and HIV serostatus using Respondent Driven Sampling (RDS), a peer-driven recruitment sampling strategy that results in a probability sample. (Salganik M, Heckathorn DD. Sampling and estimation in hidden populations using respondent-driven sampling. Sociol Method. 2004;34:193-239). This paper presents a comparison of RDS implementation, findings on network and recruitment characteristics, and lessons learned. Initiated with 13 to 15 seeds, approximately 200 IDUs were recruited within 8 weeks. Information resulting from RDS indicates that social network patterns from the two studies differ greatly. Female IDUs in Tirana had smaller network sizes than male IDUs, unlike in St. Petersburg where female IDUs had larger network sizes than male IDUs. Recruitment patterns in each country also differed by demographic categories. Recruitment analyses indicate that IDUs form socially distinct groups by sex in Tirana, whereas there was a greater degree of gender mixing patterns in St. Petersburg. RDS proved to be an effective means of surveying these hard-to-reach populations.