USAID Family Focused HIV Prevention, Care and Treatment

Activity

In Kirkos and Nefas silk lafto sub-City

Fayyaa Integrated Development Organization

(FIDO)

Activity Monitoring and Evaluation Plan

[October 2024 to September 2025]

[This is a living document that can be updated/amended as necessary]

October 2024
Contents
List of Acronyms 3
Background 6
I. Intended populations 6
II. Geographic Coverage and Performance Standards 6
Introduction or Overview 7
Audience Identification and data need 7
Theory of Change and logic model 8
Theory of Change: 8
Results Framework 9
Activity TOC 19
Conceptual Framework 20
FFHPCT’s M&E system intends to Monitoring Plan 22
Participatory Feedback 23
Performance Data Reviews 23
Evaluation Plan 24
Internal Evaluation 25
External Evaluation 25
Learning Plan 26
Collaboration, Learning and Adaptation (CLA) 26
Learning Agenda 27
Management data including Data Quality 29
Data Collection: 31
Data Quality & Safeguard Plan 31
Data Storage & Security: 32
Data Privacy and Informed Consent: 33
Data Analysis, Use, and Feedback Loops: 33
Data Coordination and Harmonization 34
Annex I: Indicator Summary Table 36
Annex II Indicator Reference Sheet 39
1 Standard/MER Indicators 39
2 OVC Custom indicators 54
3 Care and Treatment Custom Indicators 74

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Annex III Result Framework 94

List of Acronyms
ACRONYMS Description of ACRONYMS
AIDS Acquired Immunodeficiency Syndrome
AMELP Activity Monitoring, Evaluation and Learning Plan
ANC Anti-natal Care
ART Antiretroviral Therapy
ARVs Antiretroviral
ASM Appointment Spacing Model
BoWCYA Bureau of Women, Children and Youth Affairs
C&T Care and Treatment
C/ALHIV Children and Adolescents Living With HIV
CAGs Community ART Refill Groups
CARDs Community ART refill and distribution
CCCs Community Care Coalitions
CEFs Community Engagement Facilitators
CLA Collaboration, Learning and Adaptation
COP20 Country Operational Plan for the year 2020
CQMP Continuous quality management plan
CVC Caring for Vulnerable Children
DATIM Data for Accountability, Transparency and Impact
DQA Data Quality Assessment/Audit
DSD Direct Program Support
DSDM Differentiated Service Delivery Model
DV Data Verification
EAC Enhanced adherence counseling
EID Early Infant HIV Diagnosis
EPHIA Ethiopian Population Based HIV Impact Assessment
ER Expenditure Report
ES Economic Strengthening
FFHPCT Family Focused HIV Protection, Care and Treatment
FGD Focus Group Discussion
FSWs Female Sex Workers
FY Fiscal Year
GBV Gender Based Violence
GoE Government of Ethiopia
HF Health Facilities

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ACRONYMS Description of ACRONYMS
HFR High Frequency Reporting
HIV Human Immunodeficiency Virus
HIV_STAT Targets know their HIV status
HIVST HIV Self Testing
HPCT HIV Protection, Care and Treatment
HRF High Frequency Reporting
HRH_CURR. Health Workers who are working on HIV Related Activities
HRH_STAFF_NAT No of Health Workers Working on Any HIV Related Activities
HTS HIV testing Services
ICT Index Case Testing
IPT Isoniazid Preventive Therapy
FIDO Integrated Service for Health and Development
KII Key Informant Interview
KP Key Population
LA Learning Agenda
LIP Local Implementing Partners
LOP Life of the Program
LTFU Lost- To- Follow- Ups
M&E Monitoring and Evaluation
MEL Monitoring, Evaluation and Learning
MER Monitoring, Evaluation and Reporting
MoH's Ministry of Health in Ethiopia
MoUs Memorandum of Understanding
MoWCYA Ministry of Women, Children and Youth Affairs
OVC Orphan and Vulnerable Children
OVC_SERV Orphan and Vulnerable Children supported
OVC_TST-REFER Orphan and Vulnerable Children Testing and Referral
PBFW Pregnant and Breast Feeding Women
PEPFAR Presidents Emergency Plan for AIDS Relief
PHDP Positive Health Dignity and Prevention
PIRS Performance Indicator Reference Sheet
PLHIV People Living with HIV
PMP Performance management Plan
PMTCT Prevention of Mother-to Child Transmission
PNS Partner Notification service
PoA Plan of Action
PrEP Pre exposure prophylaxis
QI Quality Improvement
QM Quality management
RCAs Root Cause Analyses
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ACRONYMS Description of ACRONYMS
RDQA Routine Data Quality Assessments
RHBs Regional Health Bureaus
SBCC Social and Behavioral Change Communications
SNUs Sub National Units
SOP Standard Operating procedures
SOW Scope of work
TA Technical Assistance
TB Tuberculosis
TOC Theory of Change
ToT Training of Trainers
TWG Technical Working Groups
TX_CURR Treatment Current
UDS United Data Systems
UHEP Urban Health Extension Professionals
USAID United States Agency for International Development
USG United States Government
VL Viral Load
VLS Viral Load Suppression
VSLA Village Savings and Loans Associations
WHO World Health Organization
YALHIV Youth and Adolescents living with HIV
YLHIV Youth Living With HIV

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Introduction
Organization Background

Fayyaa Integrated Development Organization (FIDO) is an Ethiopian indigenous charity

organization that is executing different humanitarian and developmental programs including relief,
education, social, health, and development endeavours. FIDO is implementing USAID/FFHPCT
activity in collaboration with its Prime Partner (Donor); Mekdim Ethiopia National Association
(MENA). The aim of the project is significantly to accelerate and sustain HIV epidemic control in
Ethiopia through the delivery of high-impact community-based HIV services. The activities have
been implemented in collaboration with Mekidem Ethiopia National Association, local
stakeholders, and government structures through strong partnership and communications.

Background
The current working UNAIDS Spectrum estimate for PLHIV is 604,971 in Ethiopia. Of these, it is
estimated that in Ethiopia, 84% of HIV positive adults (ages 15-64 years) know their HIV status
and among adults living with HIV who know their HIV status, 90% were receiving ART and
among adults living with HIV who reported ARV use or had detectable ARVs, 96% had suppressed
viral loads. Collectively, the data suggest that Ethiopia is close to reaching HIV epidemic control,
but still has pockets which need to be appropriately addressed.

As Ethiopia gets closer to attaining the 95-95-95 targets for treatment coverage and reaching
epidemic control major programmatic challenges appear to be retaining the clients already
enrolled on ART and making progress towards growing the treatment cohort.

To Address these challenges Ethiopia will continue to implement and scale client centered services
including targeted interventions for orphans and vulnerable children and their caregivers, friendly
services for adolescents and young women and men, scheduling for clients with high viral load,
facility-community collaboration for case identification, adherence support and tracing of lost
clients, strengthening and expanding the implementation of the 6 months multi-month dispensing
(MMD) and the health worker managed community ART refill groups (CAG). Based on identified
gaps in retention or volume of reported lost clients due to different reasons, return to treatment
initiatives will be undertaken to selected geographic areas and sites to identify, track, and support
HIV-positive clients to re-enroll in ART. This will be done in close collaboration and
coordination between facility and community stakeholders.
I. Intended populations
 Children, adolescents and adults living with HIV who are undiagnosed; newly initiated on
ART; or receiving antiretroviral therapy but not achieving viral load suppression.
 Vulnerable children and adolescents who are less than 18 years of age with emphasis on
ages 10 to 14 years for primary HIV and violence prevention.
II. Geographic Coverage and Performance Standards

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The USAID Family Focused HIV Prevention, Care and Treatment Services will be implemented in
120 woredas or HIV high burden sub national units located in eleven sub cities of Addis Ababa
City.

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Introduction or Overview
The purpose of the award is to strengthen local HIV epidemic control to achieve 95% of individuals
living with HIV know their status, 95% of persons living with HIV to initiate ART and 95% of
ART clients achieve viral load suppression by 2025. HIV mitigation services for vulnerable
children will focus on case discovery and linkage to HIV treatment among undiagnosed children
living with HIV, on achieving better health outcomes through HIV viral load suppression and
establishing interpersonal, family and community norms to achieve HIV and violence prevention
(10 to 14 year old children).
Result 1: Increased access and demand to family-focused HIV services that reduce HIV
incidence in the community.
IR 1.1. Improved HIV testing and counselling in the community
IR 1.2. Improved HIV Prevention and Adherence Service
IR 1.3. Improved mitigation services for vulnerable children
Result 2: Strengthened utilization of data to monitor service delivery and conduct quality
improvement of program services
IR 2.1. Unified Data System
IR 2.2. Quality Improvement/Quality Management

Audience Identification and data need

Table 1: M&E Audiences of the Activity and the Information need.
Audience The data they need Why do they need Communication tool When is the data
the data? selected for reporting needed?
(Schedule)
PEPFAR/ ● Annual Work ⮚ For follow-up, Narrative & Tabular Work Annually
USAID plan & AMELP ⮚ Progress plan and revised AMELP
● Monthly activity monitoring USAID Unified Data System/ Monthly
Progress report ⮚ To track results CommCare
● Program report and decision HFR (High Frequency Monthly
● Financial report making Reporting)
⮚ For compliance
Quarter Progress report in Jan , and July
DATIM, Word Narrative &
Excel
Semi-annual Progress report April
in DATIM, Word Narrative
& Excel
Annual Progress report in Oct 2025
DATIM, Word Narrative &
Excel
Annual ER (Expenditure Oct 2025
Report) in DATIM
Final report, summary Oct 2025
narrative and images of
achievements during life of
grant disaggregated by
indicator & FY
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Audience The data they need Why do they need Communication tool When is the data
the data? selected for reporting needed?
(Schedule)
Addis ● Financial report ⮚ For follow-up, Quarter Progress report Jan , and July
Ababa City ● Program report ⮚ For
Administrati ● Annual plan Compliance Semi-annual Progress report April
on Bureau ● Program issue
of Health agreement Annual Progress report Oct 2025
Addis ● Financial report ⮚ For follow-up, Quarter Progress report Jan , and July
Ababa City ● Program report ⮚ For Progress
Administrati ● Annual plan monitoring
Semi-annual Progress report April
on Bureau ● Program ⮚ For
of Finance agreement Compliance
Annual Progress report Oct 2025
and issue
Economic
Cooperation
Addis ● Financial report ⮚ For follow-up, Quarter Progress report Jan , and July
Ababa City ● Program report ⮚ For Progress
Administrati Semi-annual Progress report April
● Annual plan Monitoring
on Bureau ● Program ⮚ For
of Women, agreement Compliance Annual Progress report Oct 2025
Children issue
and Youth
Affair

Theory of Change and logic model

Theory of Change:
To improve HIV epidemic control to the attainment of 95-95-95 goal that increases access and
demand to family-focused HIV services and strengthens utilization of data and enhance quality
improvement of program services within Kirkos and Nefas silk lafto subcity of Ethiopia, FFHPCTS
has developed the following Theory of Change:

IF underlying epidemic control/ management/ systems are driven by facilities and community,
enabled by technology, and supported by the government and community based, and faith based
organizations; and IF utilization of data to monitor service delivery and conduct quality
improvement of program services are strengthened, gender and age inclusive, and integrated with
larger unified database management systems and utilization of quality service deliver, and IF family
focused HIV prevention, Care and Treatment specific knowledge, attitudes, skills, and social
norms can promote positive community and individual changes, and technology leveraged to
support the same, THEN targeted communities, households and HFs will be better able to
sustainably contribute to reduce HIV incidence and mortality in the community.

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 Results Framework
FFHPCT’s results framework will be used for planning, monitoring, management and communication of the activity’s inputs and
results. The framework below explains the cause-effect linkages between the lower level results and higher level results.

Table 2: FFHPCT Results Framework

Input/Process Output Outcome Impact
 Receive ICT line list from facility and community, ensure case closer/provide feedback Improved HIV testing Increased access and demand Strengthened local
 Coordinate community volunteers with HF to get line lists from the HF per the SOP and counselling in the to family-focused HIV HIV epidemic control
developed by RHBs in collaboration with community partners (similar type of SOP community services that reduce HIV to achieve 95% of
developed by the AACHAB) incidence in the community. individuals living with
 Support health facilities to audit and clean ICT services and avail available eligible A HIV know their status
adult and OVC ICT line list, biological children, exposed infant. (PLHIV), 95% of
 Track families (Spouses, children and sexual partners) of index cases scripts, registers persons living with
and job aids. HIV initiate
 Conduct safe and ethical community conventional ICT antiretroviral therapy
 Conduct case identification nd 95% of
 Ensure all new cases detected are escorted and linked to treatment and C&S antiretroviral thereapy
 Ensure yield maximization through innovative activities (maximizing the number of clients achieve viral
contacts and on spot elicitation) load suppression by
 Conduct community-based recency testing for newly identified HIV+ case 2026
 Conduct HIV ST demand creation at community
 Scale up HIV testing using HIV self-test kit at home or community level
 Maximize pediatrics ICT case finding, same day linkage and enrollment to OVC program
 Initiate mental health screening and referral for each ICT/PNS
 Conduct intimate partner violence assessment for each ICT/PNS and refer at risk people
or survivors for IPV/GBV services
 Monitor to minimize repeat testing among known HIV positives using screening tool and
other methods
 Refer highly risk people to HIV and discordant couples/partners to PrEP services
 Work closely with regional health bureau and ensure the participation on RoTA
/OTA/initiative to maximize case identification biweekly base
 Ensure community SDPs/Test corners standards
 Ensure availability and utilization of IPPS materials at all HIV testing service delivery
points (COVID19, TB)
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Input/Process Output Outcome Impact
 Monitor weekly case identification performance
 Monitor distributed test kits(RTK, HIVST KIT, ..) to LIPS
 Distribute HIV ST brochure/ST demonstration job aid
 Distribute Male condom
 Provide gap filling basic ICT/PNS and IPV training to enhance the capacity of CEF and
specialists and other relevant program staff on comprehensive FFHPCTA for 5 days
 Providerefreshment orientation on ICT/PNS, HIVST/mental health screening for CRP/
facility CM/AS for 1 day
 provide recency testing training for CEF & specialists for 2 days
 Stakeholders’ integration meeting (PLHIV associations, CC/CC, Idir, different sectors
(W&CA, L&SA, HPCO, RHB)
 Undertake consultative workshop with 33 high burden ART facilities with the
consultation of sub cities HO/HAPCO
 Provide three days refresher training for community health care worker and technical
experts (emphasising infants, children, AY)
 Conduct experience sharing visit at best performing HIV testing services SDP
 Conduct quarterly New HIV positive proxy linkage and retention assessment
 Conduct proficiency testing for CEF at 25 SDP in collaboration with EPHI biannually
 Use a case management framework consistent with PEPFAR guidance and integrating Improved HIV
critical elements of MOH's community-based HIV guidelines Prevention and
 Ensure the availability and utilization of case management kits such us weight scale, tap Adherence Service
meter, and other necessary material to provide case management services at community
level
 Recruit and enroll beneficiaries for individual and group support which include ac
comprehensive package of counseling, education, screening and referrals of enrolled
PLHIV based on need on monthly basis. These packages of services include but not
limited to routine and enhanced adherence counseling, screening and referral for TB
including IPT, depression, malnutrition, GBV and provision of other PHDP interventions.
 Monitor viral load test is done for all clients enrolled in the case management services as
per the national guideline
 Provide VL literacy, testing demand creation for clients enrolled in case management
service
 Provide U=U education that individuals who are virally suppressed cannot pass HIV to
their sexual partners.
 Ensure all PLHIV in C&S screened for TB and those eligible supported to take for TB
preventive therapy
 Identify # of clients enrolled in adult case management program screened for TB and
referred for further support
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Input/Process Output Outcome Impact
 Map USAID and government safety net and TB program for referral service
 Conduct graduation assessment and graduate eligible clients
 Support the existing and new VSLA groups established and link with microfinance
institutes to get access to loan
 Conduct quality and beneficiaries’ satisfaction assessment regarding community-based
case management services
 Provide refreshment training on comprehensive community-based case management for
CEF & specialist and facility HCP for 3 days
 Provide orientation training on comprehensive community-based case management for
HF HCP for 3 days
 Provide orientation on comprehensive community based case management for CRPs,
Facility CM/As for 2 day
 Provide routine adherence counseling and support for all PLHIV in C&S and new clients
monthly bases
 Provide interventional adherence for clients with poor drug adherence
 Receive list of HVL clients
 Provide enhanced adherence counseling and barrier identification for HVL clients (Adult
and Pediatrics )
 Follow the re-suppression rate of each HVL after enhanced adherence counseling (HVL
cascade monitoring)
 Provide basic two days basic training on viral load monitoring, literacy and community
HVL management and community enhanced adherence support for CEF, Linkage
coordinators HIV and OVC technical experts
 Receive IIT line list from HFs on weekly basis
 Conduct tracing and counseling of IIT clients
 Re-engage IIT clients after tracing from communities
 Update the HF on the different outcomes of the IIT tracing effort /conduct line list case
closure on monthly bases
 Truck reason for IIT , period and IIT clients assessment and VL monitoring
 Work closely with Inter Religious Counsel Ethiopia (IRCE) to minimize IIT and maximize
tracing of clients experienced IIT as per the signed MOU
 Conduct active tracking of CALHIV who miss their facility appointment date within a
reasonable timeframe after the missed appointment(HEI, Childrens, AYLHIV)
 Strengthening bi-directional referral system for clients to increase access to community,
facility and social services to increase linkage to ART including same-day initiation,
adherence, retention, and viral load suppression through.
 Ensure the availability of updated service directory with complete information to
support the bidirectional referral system
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Input/Process Output Outcome Impact
 Conduct education & demand creation for cervical cancer screening for the beneficiaries,
PLHIV association, CBOs and FBOs
 Facilitate referral to facility for cervical cancer screening
 Conduct cervical ca screening and service providing facilities mapping treatment at
established referral sites
 Ensure systems in place to track and re-screen WLHIV with negative /postive cervical
cancer screening results every two years and every one yr respectively in order to
closely monitor outcomes in the context of HIV-related immunosuppression.
 Ensure the cervical cancer demand creation and screening performance is integrated
with other services
 Support the govt structure during campaign over CX ca activities
 Conduct CX ca Specific RM with RHB , subcities, HF (stakeholders
 CxCa Experience sharing and learning events
 Use the community platforms to promote, screening and linkage to mental health
treatment and psychosocial support.
 Conduct mental health screening and referral for PLHV in care
 Conduct MIPT_G
 Closely work with health facilities and community stakeholders, design services and
interventions that remove barriers to mental health, psychosocial support and substance
abuse services, including stigma and discrimination, and maximize convenience and
responsiveness to client needs and preferences
 Service mapping and updating service directory for Mental health
 prioritize mental health disorders screening for IIT, HVL, Poor adherence, New, decline
to start clients
 Strengthen all GBV survivors received post GBV care & support including safety planning
and referral for psychosocial support and mental health services.
 Provide training for CHW on (IPTG) for 5 days
 Monitor IPT_G session roll out, quality
 MIPT_G clinical mentoring using consultant mental health professionals
 Review IPT-G service RM with key stake holders
 Strengthen case management- update OVC case management SOPs and tools, job Aids for Improved mitigation
case workers to use during home visits. services for
 SOPs, tools/job aid for LIPs’ caseworkers to monitor CALHIVs’ ART adherence and vulnerable children
provide adherence counseling during home visits (age-appropriate).
 Distribute IEC for case workers and social service workers to provide age-appropriate
care and treatment/ART literacy education to CALHIV and their caregivers during home
visits (including VL testing literacy).
 Deliver training on the motivational counseling guidelines/scripts for SSWs.
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Input/Process Output Outcome Impact
 Deliver training on the motivational counseling guidelines/scripts for Case workers.
 Conduct regular site level mentoring, activity monitoring and coaching to ensure the
quality of services for OVC and their caregivers.
 Provide capacity building training to strengthen coordination of care for Subcity level
CCC and potential stakeholders for two days
 Conduct CCCs capacity assessment using community capacity assessment tool.
 Provide technical support to CC/CCCs to address their capacity gaps identified using the
capacity assessment.
 Organize consultative and recognition workshop with CC/CCCs, TWGs and LIPs staff on
Asset based community development/mobilizing local resources and reach for children
and their caregivers
 Support CCCs to mobilize local resource and provide services for OVC and their CGs
 Provide ongoing technical support to gender and social affairs offices to strengthen in
leadership for coordination care and child Protection
 Undertake quarterly bases case conferencing session with HFs and CCC members to
review and handle cases
 Provide a 2-day refresher training on Comprehensive OVC basic integrated skill for LIP
Key staff, SSW/ CEF to improve quality service
 Provide continuous technical assistance for Key staff, SSW/ CEF, Case Workers to
implement ongoing Case Management to OVC and caregivers
 Undertake on the spot discussion about the statues of case management by using
CommCare app utilization status
 Conduct Bi-weekly review meetings at SNU with CWs, SSWs and health providers to
review performance results of case management
 Conduct household strength and need assessment to gather information on each
household enrolled in the OVC Comprehensive Case Management Program and update
their case plan
 Provide food and other nutrition services for eligible children and caregivers directly or
through referral
 Ensure the provision of shelter and care for eligible children and caregiver
 Roll out 2-day orientation on Biological Children and Adolescents of PLHIV Staff on
PEPFAR Index case Testing for SSC, Linkage coordinators
 Provide educational support for target OVC sub population during regular home to home
visit and referral linkage
 Conduct HIV risk assessment to OVC
 Conduct home visits to screen nutritional status of OVC and refer for supplementary food
 Facilitate HIV testing to children with unknown HIV status and children at risk
 Facilitate referral linkage to ART to children newly diagnosed to HIV
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Input/Process Output Outcome Impact
 Enroll 100% of C/ALHIV from health facilities which are not covered in FY23 and newly
transferred in cases
 Organize training on the updated case management- SOPs and tools, job Aids for three
days
 Support those on ART remain adherent to treatment using regular home visits
 Enhance the capacity of CWs and SSWs to identify and address risk factors for poor
adherence and poor retention in care through SS
 Support those on ART access viral load testing using regular home visits
 Facilitate quality adherence counselling support in the community or refer for enhanced
adherence counseling (EAC)
 Facilitate HIV referral to Caregivers with unknown HIV status
 Facilitate referral linkage to ART to caregivers newly diagnosed to HIV
 Ensure caregivers on ART to remain adherent to treatment using regular home visits
 Ensure caregivers on ART access viral load testing using regular home visits
 Assessed HIV+ women on ART to identify biological children for index testing and
pending results, possible enrollment into OVC Comprehensive program, in collaboration
with HFs
 Provide transport stipends to high-risk households with pediatric and adult ART clients
who have an unsuppressed viral load
 Enhance the capacity of community volunteers, social service workers to identify and
address risk factors for poor adherence and poor retention in care through continuous SS
 Conduct home visits to screen nutritional status of OVC and refer for supplementary food
Unified Data System Strengthened utilization of
●Work with USAID and cooperating agencies to initiate and transition of all program data data to monitor service
management to an electoronic community case management system delivery and conduct quality
● Conduct sensitization workshop with all stakeholders on the initiation and transition improvement of program
of UDS activities services

● Develop/cutomize integrated SOP for bidirectional and UDS/CommCare, updated

MoU
● Conduct regular UDS forum with with relevant stakeholders, UDS task force, TA
partners, etc (every other month)

●Support and strengthen local implementing partners in importing routine client level inofrmaiton to
the system at all points of services
● Develop simple user’s mannual for use of UDS/CommCare
● Provide capacity building training on UDS/CommCare for frontline workers and Sub
awardee key staff members and HF data clerks
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Input/Process Output Outcome Impact
● Provide need based, onsite technical support/orientation and mentorship to frontline
workers
● Regular supportive supoervision and TA visit to sites/HF

●Collaborate with USAID to further refine and trenghten the unified data system/case management
system
● Follow up and update the UDS based on MER guidance changes, indicator definition,
age/sex disaggregation changes, new initiatives, incorporate new indicators in
CommCare/module,..
● In consultation with USAID and UDS task force, we set validation rules in the UDS

●Ensure the availability and functionality of electronic case management devices, air time/internet and
trainined techinical expertise/staffs
● Periodic review of case managment devices for availabilty and functionality
● Monitor use of airtime/internet for the purpose of data entry
● Follow up and update locationa hyerarchy based on any changes and requests

●Collaborate in the Data System taskforce to identify system improvements and operational
performance of the system alongside USAID and a lead technical partner
● Regular system review and update system version
● Identify system gaps regulary and work with UDS taskforce

●Equip selected community health workers and volunteers in the program with necessary equipment
such as smartphones or tablets to conduct data capture during their day-to-day encounters with
clients.
● Work on the provision of smartphones or tablest to manage the day to day client-
provider encounters
● Follow up and support in the maintenance of broken devices or in the replacement of
stolen devices

●Train community health workers and volunteers in the program to understand and operationalize the
Unified Data System including data capture, analysis and reporting. Optimally utilize the CommCare
system to conduct case management of clients.
● Provide basic or refresher training on Unified Data System including data capture,
analysis and reporting. Optimally utilize the CommCare system to conduct case
management of clients
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Input/Process Output Outcome Impact
● Periodic site visit and onsite coaching

●Follow up the optimum utilzation of CommCare for case management of clients by equipping
frontline workers with the necessary items like tablets/smart phones, airtime, internet, and the
expertise.
● Regular supply of airtime/internet and supportive supervison visits
●Utilize the UDS/CommCare for data analysis, visualization in reporting, quality improvement and
program improvement
● Follow up the utilization of UDS CommCare for reporting, data visualization for data
management activities
Quality
●In collaboration with USAID, define and implement quality management/quality improvement Improvement/Quality
(QM/QI) activities that define, monitor and analyze HIV prevention, C&T and OVC interventions. Management
This includes beneficiary engagement.
●Grantee will conduct service delivery reported to USAID based on defined quality standards and
practices. Standards are available from USAID Activity Manager.
●Grantee is expected to designate a staff person responsible for QM/QI, have a functional QM/QI
team that convenes regular QI team meetings, follows a QM/QI plan, and routinely reviews
performance and service delivery standards and develops written QM/QI plan that should be
implemented with defined staff roles and responsibilities.
●Grantees are also expected to follow routine data quality assurance procedures to verify the accuracy
and completeness of reported data on a regular basis.
●Have a system for review and use of performance data to inform implementation of quality
improvement activities.
●The grantee will host SIMS/Site Improvement through Monitoring System/ assessments conducted
by USAID. SIMS is a QA tool used to monitor and improve program quality at PEPFAR-supported
sites that guide and support service and non-service delivery functions. An important follow up
action after each SIMS visit will be development of a Performance Improvement Plan (PIP) to
address any challenges at the site level.
Cross-Cutting Areas
●HIV and gender equitable HIV prevention, care, treatment & support to promote positive gender HIV and Gender
norms.
●Gender-based violence prevention and care services for beneficiaries identified by the program
including post-GBV care.
●Increase gender equitable access to income and productive resources, including education and health
care.
●Organizational capacity building assistance will also provide technical support to address gender

17
Input/Process Output Outcome Impact
equity within organizational policies and practices.
●Monitoring and evaluation activities will collect sex and age disaggregated data per PEPFAR MER
standards.
HIV and COVID19
Grantee should be mindful of programming in the context of COVID-19 and guiding principles for the
provision of services in PEPFAR-supported countries during COVID-19 Pandemic
●Protect the gains in the HIV response:
●Leverage PEPFAR-supported systems and infrastructure:
●Reduce transmission of COVID-19 to frontline health workers and reduce non-essential exposure of
staff & clients to health care settings which may be both overburdened and potential sources of risk.
●Ensure the workers providing services to the targeted population access the necessary personal
protective equipment and adhere to the prevention practices.
●Whenever feasible integrate relevant COVID-19 messages into the ongoing awareness and
communication activities directed to the target communities.
●HIV and youth activities are expected to be aligned to USAID’s Youth in Development policy HIV and Youth
(2012) with the intent to strengthen youth programming, participation and partnership in support of
the Agency’s HIV epidemic control objectives and integrate youth issues and engage young people
across initiatives and operations.
●Monitoring and evaluation activities will collect sex and age disaggregated data per PEPFAR MER
standards.

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Activity TOC
FIDO’s Activity Monitoring, Evaluation, and Learning (MEL) Plan serves as the primary reference
guide for monitoring, measuring, and evaluating outcomes and impact for the project. In
addition, the plan supports the comprehensive systems level sustainability approaches built
into this project, incorporating sustainability readiness monitoring at all stages of the
program life cycle, regularly tracking progress of sustainability readiness, using feedback
loops to regularly course correct, and building local accountability and ownership from the
project design phase through the end of the project and beyond the life of the program
(LOP).

A clearly defined Logical Framework (Annex III: Logic Model) outlines FFHPCT’s goals and
results and includes a well-defined Performance Management Plan (PMP) with detail on indicator
definitions, collection frequency, disaggregation (including gender), and annual and LOP targets
will also be worked to make still better in consultation with our TAs and implementing partners. A
full complement of Performance Indicator Reference Sheets (PIRS) is also attached (See Annex II.
Performance Indicator Reference Sheets) providing further detail on all of FFHPCT’s custom
indicator definitions, units of measure, calculations, data collection roles and responsibilities, and
how and when data will be used. At all stages in the project lifecycle, FFHPCT’s comprehensive
monitoring and evaluation (M&E) system will:
● Ensure timely, high-quality data through systematic monitoring and capacity building, Routine
Data Quality Assessments (RDQAs) adapted from the US Agency for International
Development (USAID)-funded MEASURE Evaluation Project’s standardized RDQA tool, and a
robust electronic management information system;
● Measure the achievement of key project outputs and outcomes (project M&E);
● Identify strengths, challenges, and constraints on progress and use these data to inform timely
adjustments of interventions that maximize efficient use of resources and achievement of results
(project M&E);
● Meet all internal and external project reporting requirements (project monitoring);
● Disaggregate data and include gender in the overall analysis of project results;
● Use Agile approach to ensure robust Collaboration, Learning and Adaptation is embedded in all
aspects of the project, including M&E; and
● Measure progress towards sustainability of project activities and outcomes (project M&E).

FIDO has utilized lessons learned from FIDO’s other USAID funded HIV and OVC projects, along
with the M&E experiences of FIDO’s partners, to design and implement and more functional the
M&E system. This approach informs strategic decisions and provides continuous review and
improvement of program performance. The M&E system involves continuous (monthly, quarterly,
and semiannually) tracking of data inputs, reports and analysis, along with a robust USAID-led
independent baseline, midterm and final evaluations, will lead to improved program
implementation, organizational learning, and enhanced ability for evidence-based decision-making.

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Conceptual Framework

USAID FFHPCT’s MEL System Conceptual Framework

Strengthening data use (capacity building and create

clear understanding on the UUDS, program quality standards,
data management, enhancing utilization of UUDS)
Organize QM/QI teams at all leve
prepared and Program quali
improvement and data quality man
plan preparation conducted (Map
Program quality management, standards of USAID with relevant p
assurance and quality improvement Sharing and learning from past and current quality indicators)
experiences and adopt to the implementation of
continuous QM/QI that enable high-impact and
evidence-based interventions to achieve better
results.

Refine and implement as per SOPs, Conduct

RDQA and Program Quality Review (PQR) to
ensure quality standards of USAID

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Purpose of the MEL Plan: FIDO’s FFHPCT AMEL Plan allows the project to accurately assess
progress towards its goal and purposes, determine the constraints to progress, and promptly adjust
interventions as needed. This plan fosters a culture of learning and self-reflection, emphasizes data
quality through capacity building for local implementing partners and periodic data quality audits,
and encourages the use of data for decision-making at all project levels and by all stakeholders. It
serves as a project management tool and a platform for strengthening the M&E capacity and data
systems of FIDO and LIP and will guide project staff in meeting project requirements.
The objectives of this MEL Plan are as follows:
● To allow FIDO to work more effectively and efficiently towards achieving project goals and
purposes.
● To serve as a communication tool that outlines various M&E roles and responsibilities for the
project.
● To organize plans for data collection, analysis, use, and data quality.
● To serve as the foundation for our Collaboration, Learning and Adaptability (CLA) approach
● To outline specific strategies and tools to encourage evidence-based decision making.
● To organize the M&E activities that must take place for M&E to be successful in the unique
context of FFHPCT project areas
● To provide guidance on how the FFHPCT project will measure its achievements and therefore
provide accountability.
● To provide consensus and transparency on the collection of data and reporting.
● To preserve the institutional memory on how the FFHPCT project was monitored and
evaluated.
The MEL Plan was developed through taking views of local implementing partners and technical
staff from all organizations on the occasion of planning workshop periods. Key internal and
external stakeholders will continue to be involved in the revisions to the Plan throughout the
duration of the project in order to increase ownership and commitment to rigorous M&E at all
levels.
As a living document, the MEL Plan is never truly final. The initial Plan has been developed in
collaboration with FIDO’s implementing partners and is shared with USAID for feedback and
approval. Following approval and baseline, the Plan shall also be shared with local stakeholders for
their input and general agreement. FIDO will work closely with partners, project staff, intended
beneficiaries, USAID, the Sectors of Kirkos and Nefas silk lafto regional state, and other key
stakeholders in the final designing, developing, and continuous updating of the MEL Plan, when
changes to the Activity MEL Plan become necessary, we will discuss proposed modifications with
stakeholders, including USAID, before submitting the revision for approval.

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FFHPCT’s M&E system intends to Monitoring Plan
The FFHPCT Activity MEL Plan identifies all project specific (custom) and required standard
indicators to be tracked quarterly and annually by the project to inform project implementation and
reporting requirements. The plan ensures that information is generated, reported and analyzed in a
timely manner in order to enable evidence-based decision making for the project. In addition, the
plan describes the methodologies used to collect data on indicators, data collection frequency, and
responsible collection agents.
The project specific custom and standard indicators are clearly defined in the performance indicator
reference sheets (PIRS) (see Annex II). All mandatory PEPFAR MER indicators, Care and
Treatment custom indicators including OVC Custom Indicators, have been identified as requiring
special technical backstopping and robust data collection methodologies. Additionally, if there are
any indicators that require beneficiary-based surveys, FIDO will be discussed, identified and are
clearly defined as survey indicators and will be prepared PIRS.
Results chains, informed through periodic reports, will be used to demonstrate the ToC for both
results. Therefore, in addition to individual and household surveys ( if any), the FFHPCT
monitoring plan also includes indicators to monitor for changes at the systems level, to give
management information about what is working - and just as important what is not working - and
make informed programmatic decisions. These indicators are collected and reported quarterly to
ensure timely course corrections.
A number of qualitative data are collected through focus group discussions (FGDs) and key
informant interviews (KIIs) conducted periodically in target project intervention communities to
help us to enrich episodic reports. These FGDs, and qualitative data will also be collected for a
number of learning questions (Please See Section Learning Agenda).

The activities of FFHPCT will contribute to the PEPFAR expected outcome of HIV epidemic
control in Ethiopia through the interventions mentioned in our work plan; and the below mandatory
PEPFAR MER indicators and additional Custom Indicators will be used to gauge performance
against standards.
OVC Custom Indicators are sub-divided as “Suggested” and “Required” Custom Indicators. The
ones listed as annex are Required Custom Indicators. We will work with our AORs and agree on
which Suggested Custom Indicators to include going forward. The “USAID OVC Custom Indicator
Reference Sheets” draft document is annexed for both Suggested and Required OVC Custom
Indicators.

Implementation will be conducted during the period of Aug 12, 2020 to Aug 11, 2023. We will
collaborate with USAID to implement a harmonized data collection system at community and site
level for primary data collection. FIDO will collaborate with USAID to aggregate, analyze and
report through an electronic system.

In some instances, the implementing partner will be asked to implement USAID High Frequency
Reporting (HFR) standards on a sub-set of standard PEPFAR indicators. PEPFAR quarterly, semi-

22
annual and annual standard reporting requirements, including Expenditure Reporting will be
implemented using DATIM (Data for Accountability, Transparency and Impact Monitoring).

PEPFAR MER Indicators

collect project data through routine monitoring including quarterly, semi-Annually and annually.
There are 6 PEPFAR MER indicators that the project will be responsible for collecting as part of
quarter and semi-annual activities. All of the PIRS for PEPFAR MER indicators are drafted
following the guidance of Monitoring, Evaluation, and Reporting Indicator Reference Guide and
needs FIDO partners for further contextualization to the implementation woredas/areas ( See Annex
II.1: Standard PEPFAR MER Indicators).

Care and Treatment Custom Indicators

The Care and Treatment Custom indicators of FFHPCT project are 11and all of them are intended
to report on quarterly and annual basis.
The PIRS for Care and Treatment custom indicators are prepared and expected to be enriched upon
the responses of Project Hope as these indicators’ PIRS need further technical assistance (See
Annex II.2: Care and Support Custom Indicators).

OVC Custom Indicators

The OVC Custom indicators of FFHPCT project are 9 and all of them are intended to report on
Semi-Annually and annual basis.
The PIRS for OVC custom indicators are prepared and expected to be more contextualized to the
situation of Kirkos and Nefas silk lafto region (See Annex II.3: OVC Custom Indicators).

Participatory Feedback
The active role targeted communities and HFs play in monitoring and evaluation is recognized,
their rights to get accurate information and health education respected and therefore, targeted
communities and HFs will be involved in generating data and reviewing the project performance.
Information generated through the monitoring system will be shared with them in a timely manner
and in the appropriate format and context. Some of the participatory M&E methods to be used
include participant feedback surveys and use of community-based feedback sessions for the
communities to assess their contribution to the achievement of project goals.

Performance Data Reviews

Quarterly and Annual KPI reviews by project team with implementing partners.
FFHPCT will organize various facilitated Quarterly and Annual reviews for project teams and
implementing stakeholders. These reflection sessions for staff and local implementing partners,
including GoE and community members/leaders, allow FFHPCT to regularly complete learning
feedback loops: share existing progress, gather information on context changes and/or any shifting
priorities, and plan for and make necessary adaptations to its program cycle management (See
Section Data Analysis, Use, and Feedback Loops).

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 Evaluation Plan
FFHPCT program approach to evaluation aims to generate evidence related to project relevance,
effectiveness, efficiency, impact and sustainability; establish why results are or are not being
achieved as well as determine what unintended consequences may emerge. Evaluation addresses the
validity of the causal hypotheses that underlie the ToC and results framework.

FFHPCT will be evaluated at various phases during the project cycle in order to gain an overall
picture of the project as no single data collection approach can supply all the information necessary to
understand project performance. Multiple complementary evaluation approaches and methodologies
will be applied to address different evaluation needs.
According to FFHPCT’s evaluation experiences, the major purposes for FFHPCT to conduct project
evaluations include:
1) Accountability, to both donor agencies and to the organizations and communities it serves
2) Learning, for improving project design and implementation both within FIDO and among
implementing partners

USAID’s new evaluation policy also states two primary purposes of evaluation: accountability to
stakeholders and learning to improve effectiveness. The policy requires, at a minimum, evaluation
of large projects and all pilot projects of any size.

USAID Evaluation Concepts and Consistent Terminologies

Evaluation is the systematic collection and analysis of information about the characteristics and
outcomes of strategies, projects and activities as a basis for judgments, to improve effectiveness, and
timed to inform decisions about current and future programming. Evaluation is distinct from
assessment, which may be designed to examine country or sector context to inform project design, or
an informal review of projects.
Impact evaluations measure the change in a development outcome that is attributable to a defined
intervention; impact evaluations are based on models of cause and effect and require a credible and
rigorously defined counterfactual to control for factors other than the intervention that might account
for the observed change. Impact evaluations in which comparisons are made between beneficiaries that
are randomly assigned to either a treatment or a control group provide the strongest evidence of a
relationship between the intervention under study and the outcome measured.
Performance evaluations encompass a broad range of evaluation methods. They often incorporate
before-after comparisons, but generally lack a rigorously defined counterfactual. Performance
evaluations may address descriptive, normative, and/or cause-and-effect questions: what a particular
project or program has achieved (at any point during or after implementation); how it is being
implemented; how it is perceived and valued; whether expected results are occurring; and other
questions that are pertinent to design, management, and operational decision-making.

Evaluation of the FFHPCT project will include a baseline survey at the beginning of the project,
mid-term evaluation towards the middle and final evaluation at the end of the project.

24
Evaluations will be conducted as per the new evaluation policy of USAID with emphasis on
independence of evaluators and transparency of the process. FIDO will work with USAID to
determine the best approach for the various evaluations as well as in the solicitation of external
evaluators.

Internal Evaluation
Testing the Theory of Change
FFHPCT plans to conduct an internal annual evaluation of the project’s Theory of Change (TOC)
through internal review of results from our performance monitoring indicator data and results from
the USAID-led evaluation reports. Following the externally-led midline evaluation at the end of the
demonstration phase, FFHPCT will revise the existing AMEL Plan to account for 1) data collection
of new information required for evidence-based decision making, and 2) integration of new
learnings and course-adjustments. The internal review process of testing the theory of change will
include comparisons of our implementation and demonstration areas where those data are available.
● How the internal eval efforts will support learning (program effectiveness;
● Also an internal eval effort to determine how the flexible approach helped)
The FFHPCT M&E team will follow USAID’s COVID-19 M&E guidance as well as the GoE’s
restrictions for domestic travel and any other calamities if any. First and foremost, the FFHPCT
M&E team will limit any additional risks to project communities and beneficiaries. Given the
dynamic nature of the COVID-19 pandemic, we will consider dynamic approaches to M&E that
leverage information systems, remote data collection and/or non-personal data collection methods
to ensure that the FFHPCT project does no harm during the internal testing of ToC

External Evaluation
External evaluators will be contracted by USAID to develop (in collaboration with the
implementing partners), a comprehensive evaluation plan for the project that will be able to assess
both impact and performance of the project over the next three year time frame. The main purpose
of the evaluation plan is to build the evidence base on HIV programming in Kirkos and Nefas silk
lafto region and develop a rigorous evaluation plan that can assess the impact of the project as well
as provide valuable information on project implementation at key points in time for strategic
decision making.

As per the contractual agreement with USAID, the FFHPCT project is committed to do an
independent evaluation of the project. Among other things, the evaluation will focus on the
effectiveness of its objectives and targets and what lessons can be drawn from the project of the
various interventions. The findings of the planned evaluation will inform the design of future
interventions.

As per the USAID Evaluation Policy (updated in 2016), Evaluation is defined as the systematic
collection and analysis of information about the characteristics and outcomes of projects and
projects as a basis for judgments, to improve effectiveness, and/or inform decisions about current
and future programming. Accordingly, There will be SOW that intends to conduct Performance and
Impact evaluation that focuses on descriptive and normative questions: what FFHPCT project has
achieved (either at an intermediate point in execution including at the conclusion of an
25
implementation period i.e. in the end of Year 3); how it is being implemented; how it is perceived
and valued; whether expected results are occurring; and other questions that are as much as
pertinent to the FFHPCT project design, management and operational decision making 1.

If USAID wants to conduct a review of the “Family Focused HIV Prevention, Testing, Care
Services and Interventions for Vulnerable Children” any time before the end of the Activity, FIDO
will assist USAID.
Learning Plan
Collaboration, Learning and Adaptation (CLA)
CLA is central to FFHPCT`s organizational management approach. Strategic collaboration,
continuous learning, and adaptive management are integrated in all of the integrated the results and
intermediate results and throughout the FFHPCT project Cycle. FFHPCT will follow a holistic
approach to strategic collaboration, continuous learning, and adaptive management. These are
integrated in all phases of the project cycle management to ensure that activities are based on sound
and available evidence, generate knowledge and data for adaptive management, and inform
potential pathways to scale.
Strategic Collaboration: Internally, there will be continuous collaboration among the FFHPCT
results and intermediate results and the implementing partners through joint-facilitated monthly
review and planning sessions, joint monthly retrospective session and joint field monitoring, and
other internal collaboration strategies planned in FFHPCT project (See also: Section Data
Collaboration and Harmonization).
FFHPCT will also actively work to ensure strong collaboration with strategic implementing
partners by collaborating with and share information during organized joint work planning sessions
and FFHPCT events (e.g. review meetings), where government stakeholders at zonal and district
level will have opportunity to reflect on and provide their continuous feedback. Similarly, the key
stakeholders will participate in FFHPCT quarterly review meetings, annual planning meetings, and
various organized learning events throughout the duration of the project lifecycle.
FFHPCT program will also hold strategic meetings for cross-learning and collaboration with
USAID backbone support activity for similar programs like PSI, ADA, FIDO, MarryJoy and other
key development partners.
Management Structure: To ensure CLA is systematic and intentional throughout the project cycle,
FFHPCT uses a management structure of members of directors of the project (CLA teams) and led
by the COP. The MEL Plan development and evolution will also employ this structure. This means
members of directors will drive development and/or refinement of indicators, targets, and
monitoring tools and activities. The process will be grounded in user feedback and informed by
evidence generated by analyses of static and dynamic data for continuous program monitoring.
Detail works, newly emerged outstanding tasks and some backlogs will be planned annually and
reviewed quarterly. This process will produce deliverables to be completed in IPs by small,
integrated work teams. The MEL and CLA teams will employ a continuous work cycle with clear
sub-deliverables and approved resource allocations based on the overall milestones.
At the end of each discussion, CLA leads with all implementing partners will facilitate a discussion
retrospective to analyze, learn, and make necessary adjustments to deliverables for the next
discussion. Retrospective discussions are frequent and continuous opportunities to reflect, identify
1
USAID EVALUATION POLICY JANUARY 2011 UPDATED OCTOBER 2016 P.2

26
 learnings and adapt. All retrospectives and proposed adaptations for the following session will be
compiled and submitted in a retrospective report and sent up to the COP for review, guidance and
support.

Learning Agenda
Learning is an integral part of the FFHPCT project management cycle. FFHPCT has developed a
robust project-level Learning Agenda (LA) around critical knowledge gaps and learning needs. The
LA includes a robust knowledge management and share-out plan, documenting how the key
learnings from each reports/assessment undertaken by the program will be used for evidence-based
learning, either by the project staff themselves to improve the FFHPCT project implementation and
effectiveness of the program, or for others including value for designing and implementing future
programs.
As a living document, the LA will be reviewed and updated quarterly as new evidence is gained and
new learning questions evolve.

Table 3: Learning Agenda

Key Learning Questions Methods/Data Learning Value
What are the major factors that facilitate case Monitoring Data,
detection through partner notification Family based
services/index partner HIV testing? FGDs
To what extent is the project compliant to Evaluative/
national standards of care for OVC, HIV Monitoring Data
prevention and care?
How effective is VSLA-plus in contributing to Monitoring Data,
the three 95’s? VSLA based
FGDs
What are the available resource opportunities and Formative/ FGDs Helps to scale up
challenges for Layering VSLA intervention with and KIIs VSLA layering
HIV care and treatment services?
How do adolescent girls themselves define Evaluative/ FFHPCT relies on
empowerment, and how does the combination of Target clients adolescents’
interventions improve those outcomes for FGDs participation across
adolescent girls? multiple intervention
areas.
Does the use of technology improve the quality Evaluative/ Evidence base for
of data utilization for evidence based Monitoring Data value add of
programing, in terms of data management, data technologies such as
quality issue reduction and data security using UDS and
condition? consistent tools.
How effective are the school clubs (SCs) Formative & Informs program and
approach to improve the protection of GBV Evaluative/ adaptations needed for
incidences among adolescent girls in targeted Monitoring Data, replication stage
areas? School survey,
KIIs
Does Socio-economic services delivered to Formative & Helps to understand
HIV+ OVC contribute to ART adherence and Evaluative/ and scale up service
VLS? Monitoring Data, delivery approach
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Key Learning Questions Methods/Data Learning Value
KAP surveys,
Significance of OVC core services to HIV+ Formative & Helps to understand
OVC to meet graduation benchmarks. Evaluative/ level of contribution
Monitoring Data, of OVC core services
KAP surveys, to achieve child
wellbeing
How do adolescent girls themselves define Evaluative/ FFHPCT relies on
empowerment, and how does the combination of Target clients adolescents’
interventions improve those outcomes for FGDs participation across
adolescent girls? multiple intervention
areas.
How effective IMpower Intervention improves Evaluative/ Adolescent 9-14 years
the knowledge, attitude and practice (defense) of Target clients old girls participated
adolescent 9-14 years old girls against sexual FGDs in IMpower
violence and risk to HIV. intervention and
completed all the 12-
hour sessions
How effective Parenting for Life-Long Health Evaluative/ Adolescent 9-14 years
(Sinovuyo) Intervention improve the knowledge, Target clients old boys and girls
attitude and practice of 9-14 years old FGDs participated in
adolescent boys and girls against sexual violence Sinovuyo intervention
and risk to HIV. and completed all the
14-hour sessions
How effective are the school clubs (SCs) Formative & Informs program and
approach to improve the protection of GBV Evaluative/ adaptations needed for
incidences among adolescent girls in targeted Monitoring Data, replication stage
areas? School survey,
KIIs
Does the use of technology improve the quality Evaluative/ Evidence base for
of data utilization for evidence-based Monitoring Data value add of
programing, in terms of data management, data technologies such as
quality issue reduction and data security using UDS and
conditions? consistent tools.

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Coordination with USAID Backbone Support Activity

FFHPCT will work closely with backbone support team to ensure collaboration between USAID
partnership, Ministry of Health (MoH), Ministry of Women, Children and Youth Affairs
(MoWCYA), and respective government line offices in operational areas in a way system wide
improvement are achieved on HIV epidemic related shocks at family and community levels.
FFHPCT seeks to align activities for improved results of USAID funded initiatives and to influence
other outside actors critical for meaningful progress towards the common goal.
Some of the areas of cooperation include:
- Strengthening HFs’ capacity in in operational areas,
- Harmonizing approaches to different data management systems,
- Efforts around reducing conflict and gender mainstreaming.
Collaboration and coordination include regular and active participation by FFHPCT staff in USAID
partnership meetings, Health Areas Multi-Actors Platform, and coordination with regional
government and other development partners in FFHPCT operational areas. FFHPCT staff will also
regularly and actively participate on various meetings organized by the partnership and backbone
support activity such as:

- Monthly meetings of HAPCO, GBV clusters, Gender Mainstreaming and Other technical areas
as determined by the different clusters/forums and USAID IP Partnership.
- Quarterly national level coordination meetings, Quarterly High-Level Regional coordination
meetings and Regional Sub-Working Group coordination meetings to pursue common defined
development outcomes with all partners working in the Family Focused HPCT program.
Management data including Data Quality
FIDO Planning, Monitoring, Evaluation, Reporting and Learning (MERL) Unit is going to lead and
manage the entire MERL activities of the project. Under this unit, there will be a separate and
independent monitoring, evaluation, reporting and learning team which is fully responsible to the
overall MER deliverables of the activity at FIDO level. To this end, under the MERL unit, Quality
Assurance/Improvement and CLA teams will be established both at FIDO level in order to improve
project data quality which helps to inform strategic decision making and programing. FIDO will
employ a capable and experienced MERL staff with clear roles and responsibilities to undertake all
related activities as per the required quality and standard and detailed MERL plan.
In addition, FIDO will utilize CommCare to capture near real time client’s data, analysis, reporting
and use. Routine field monitoring, periodic performance evaluation, review meetings and reporting
will be conducted as per the agreed quality standards and timelines. To do these all, a detailed
MERL plan will be developed both at FIDO level which precisely shows how the MERL system is
working at each project stage by taking the following key issues into account.
● Clearly assign M&E focal persons and roles and responsibilities: Competent MERL Personnel
will be deployed with precisely outlined duty and responsibilities both at FIDO level who are
fully responsible to lead, manage and coordinate the MERL tasks of the project.
● Develop M&E plan at Prime as well as sub-partners level: Comprehensive MERL Plan will be
developed by all LIPs with the support of FIDO.

29
● In collaboration with USAID and GOE, implement M&E system that enables data collection,
aggregation, analysis, reporting and use at all levels. FIDO and Key government stakeholders
have already established a platform which enables data collection, aggregation, analysis,
reporting and use at all levels. In this regard, FIDO in collaboration with USAID will work on
strengthening and capacity building. M&E system strengthening, and capacity building
activities will be properly incorporated in the MERL plan.
● Carry out Data Flow Mapping, Data Verification and Data Quality Assessment (DQA) at Prime
as well as at sub-partners level, as needed. All these key elements of the MERL plan will be
conducted properly in a regular manner both by FIDO at each SNU.
● Produce comprehensive reports on a monthly basis and bi-weekly summary reports based on
USAID requirements. This includes, but not limited to, DATIM reporting, Excel-based and
narrative reports. As it is clearly indicated in the MERL plan, FIDO will take the responsibility
to collect quality reports from each LIP & consolidate and submit to USAID and relevant
government agencies keeping the agreed quality standards and timetables.
● Conduct routine review meetings with sub-partners, GOE and local stakeholders. To create
common understanding and enhance sense of ownership, quarter, bi-annual and annual review
meetings will be conducted with LIPs, key government stakeholders regarding the overall
performance and challenges encountered.
● Conduct supportive supervision to sub-partners and project sites routinely. FIDO will conduct
routine supportive supervision and field monitoring visits to provide on-the-spot technical
support and on-time innovative solutions to different bottlenecks which might emerge during
the actual project implementation.
Accordingly, FIDO’s FFHPCT MEL plan system has been carefully re-designed to provide a
consolidated data management platform to accommodate routine data collection and dissemination
from all areas of the project as a cohesive whole. MEL specialists are available in all of the LIP
offices, and M&E activities will not be stagnated between FIDO and implementing partners. A
unified project-level MEL plan will use standardized methodologies, approaches and tools to ensure
data quality and report generation, including demonstrated synergy between all implementing
partners.
At all phases of the project life cycle, FIDO will work closely with implementing partners, project
staffs, intended beneficiaries/clients, USAID, the Government of Ethiopia (GoE), and other key
stakeholders in the final designing, developing, and updating of the M&E Plan that will:

● Ensure timely, high-quality data through systematic monitoring and capacity building, Routine
Data Quality Assessments (RDQAs) adapted from the USAID-funded MEASURE Evaluation
Project’s standardized RDQA tool, and a robust monitoring system
● Measure the achievement of key project outputs and results;
● Identify strengths, challenges, and constraints on progress and use these data to inform timely
adjustments of interventions that maximize efficient use of resources and achievement of
results; and
● Meet all internal and external project reporting requirements using both dynamic and static
analysis and reporting mechanisms;
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Data Collection:

Data collection will utilize various methodologies which will include data collection forms, simple
household questionnaires, activity reports, quarterly reports, GIS mapping and mobile data
gathering using CommCare. The data collection tools will be developed for new indicators and
utilized previous programs tools for the existing indicators.

Mobile Technology: FFHPCT embraces mobile electronic data collection and will utilize digital
and mobile technologies in a variety of ways, building on existing approaches and incorporating
innovative solutions that support CLA. Evidence will be generated by analyses of primary data
collected as part of program monitoring, activity reports, secondary data sources, and from learning
activities conducted as part of the program’s learning agenda. The M&E teams will work closely
with PH teams together to apply dynamic analyses and visualizations of near real-time data for
decision-making. Deeper static analyses will involve using statistical tools and methods for
operational research and in-depth study. These analyses, along with learnings from the monthly
joint program reviews, will be shared at multiple points throughout the process to ensure that work
is prioritized and adjusted using evidence and stakeholder inputs.
CommCare Data: With regular intervals, FFHPCT will measure progress towards improved data
quality issues. FFHPCT will utilize PH’s CommCare (data collection, collation, analysis, reporting
and utilization) approach into the project M&E system. CommCare is a compelling measurement
and visualization method with Power BI for utilizing health related data that has been applied in
Ethiopia during last periods. CommCare uses a mobile and tab based application connected to a
mobile data collection platform that functions offline. Upon completion of data collection, results
are automatically uploaded to the server when in service coverage. From there it be exported for
analysis and/or visualized on dashboards, allowing monitoring in almost real-time as data are
collected and submitted from the field. This will be done at least once in a week. These simple and
informative visuals can be readily understood and shared with key stakeholders involved in the
program.

Data Quality & Safeguard Plan

Excellent data management, starting from development of the data collection tools to actual data
collection, analysis, and reporting has paramount importance. To ensure that data generated through
the project is reliable and of the highest quality, FFHPCT will institutionalize a data quality
assurance and data safeguard plan. The plan will verify the quality of reported data, with special
focus on validity, reliability, timeliness, precision and integrity. FFHPCT understands the
importance of quality data as necessary to provide an accurate representation of what is truly
happening on the ground. Furthermore, high quality data will:
- Promote responsive/client-based programming
- Reduce wastage of resources
- Promote efficiency by ensuring data is available when needed
- Inform management decision-making
Capacity strengthening for Quality Data Collection: FFHPCT will create a strong foundational
and common understanding among all project staff to collect, maintain and report on quality and
robust data. All program staff will receive training on use of mobile devices, the definition of each
31
indicator, how data is expected to be collected for each indicator, method of data collection,
frequency of data collection, level of analysis and disaggregation, the data collection tools, and
reporting tools and responsibilities. Training will be followed by regular technical backstopping by
the FFHPCT MEL team. The MEL team will also provide refreshers throughout the project
lifecycle to ensure the entire staff understand data flow, how to collect quality data from the field,
and to report challenges to the MEL specialists and MEL Managers in a timely manner.

Data cleaning and validation: FFHPCT will have in place data quality checks at all levels in the
respective intermediate results and activities. The M&E team will routine quarterly DQAs to audit
the validity and quality of the submitted data from implementing partners and staff. The Routine
Data Quality Assessments (RDQAs) will be adapted from the USAID-funded MEASURE
Evaluation Project’s standardized RDQA tool. The DQA will create an interface between the
project and MEL staff to assess the quality of data generated and build the capacity of project staff
on identified M&E gaps During DQAs, collective action plans will be developed with relevant
staffs to ensure that different staff are assigned to address observed quality issues.

Other routine data quality checks that the project will routinize to ensure data quality include:
● Proactive Checks: Review process, checklists, and discussions at key levels in the data
collection chain for all managers/coordinator/facilitators. Emphasis will be placed on data
correction and systems improvement before submission to the next level.
● Retrospective Checks: The retrospective component will have two processes:
● Field Visits. During the manager’s/coordinator field visit, DQ checks will be
conducted as part of all standard site visits and integrated into programming
quality assurance tools. Select data points will be verified against simple
standards to provide an indicative level of quality. Options include back check
and spot checks.
● M&E system check. The M&E system check will assure the integrity of the DQ
by supporting programming staff through training, on-the-job support, job-aids,
and system follow-up. System follow-up will focus on conducting a sample of
DV at various levels, including verification of the line manager’s field visit DV
paper trail. The M & E team will also conduct back checks and spot check both of
raw/aggregate data but also on the field visit DQ processes.
The M&E team will organize quarterly MEL review meetings including all partner MEL team
members. The review meeting will be used to share key MEL success and challenges experienced
in the project and draw action plans on how to address the observed challenges (See Section Data
Analysis, Use and Feedback Loops).

Data Storage & Security:

All project data shall be kept secured and protected. To ensure secure storage of all program
monitoring data, both human and technology-based approaches will be employed to prevent
unlawful or unauthorized processing and protect against accidental loss, destruction, or damage,
using appropriate technical and/or organizational measures. The use of mobile-data collection
reduces risks associated with paper-based systems (loss, damage), but additional physical and
environmental security measures shall be in place to ensure all data are stored on a secure server, in
a secure location, and with restricted access to unauthorized personnel. With the support of PH,
Mobile-collected data will be stored on a secure cloud-based server housed in Addis in a locked

32
location safe from environmental hazards such as water (flooding) or dust. This procedure is
applicable for both hard copy and electronic (soft copy) data collection and management.

Data Privacy and Informed Consent:

FIDO will get appropriate support from PH to have rigorous organizational standards for the
protection and security of collected data. Project staff will be trained by PH and ensure compliance
with all relevant local data protection laws and regulations that need to be followed. This may
include, inter alia, National eHealth Policies, Data Privacy Laws and Regulations, and other policies
laws or regulations.

To ensure that all participants are informed of and fully understand their data privacy rights and any
risk related to sharing their data, beneficiary related data will be conducted only after obtaining
informed consent. For individuals under 18 years of age, assent will be obtained in addition to
parental consent. Consents will be obtained verbally since signed consent will identify individuals.

Data Analysis, Use, and Feedback Loops:

Efforts will be made to regularly/routinely engage key stakeholders at sub-national and national
levels in the review and interpretation of both monitoring and evaluation data, to ensure quality
improvement in the project activities. Weekly data reviews at the site / district level will focus on
key program indicators
Beyond tracking whether performance targets are met, data should be reviewed and discussed to
identify opportunities for adapting interventions. Performance data will be analyzed and presented
to support data use at the following intervals throughout the project lifecycle:

Annual Reviews and Share-outs:

● Annual Data Progress Reviews are formalized reviews that include annual outcome
indicator data and review of progress towards targets. These events are attended by, at
minimum, all sector leads, CLA and MEL leads, and external local stakeholders, including
GoE and community members/leaders. During the annual reviews, any TOC gaps and
challenges will be identified, areas of success acknowledged, and targets confirmed or
refined. FFHPCT team will collaborate with local stakeholders (including community
members and GoE) to refine project implementation plans based on discussion of the
evidence (See Section Data Coordination and Harmonization)
● Annual USAID reporting
Quarterly Reviews and Share-outs:

● Quarterly Data Progress Reviews to review progress on activities and outputs along with
review of DQA assessments and discussion of M&E success and challenges during the
quarter. The project will also review learnings from LA assessments and other learning
activities in the learning agenda. Includes all project staff.
● Quarterly After-action Reviews to pivot activities to make use of new learnings. Various
platforms will be used, but the aim of these meetings is to regularly adapt and adjust
FFHPCT major tasks towards achieving the targets.
● Quarterly USAID reporting.

33
Monthly Reviews:
● Monthly reviews: share and review progress on output and process indicators. Check in on
schedule and if on track. Identify what is going well, and what to focus on improving over
the next session. Identify data gaps or new/changing data collection needs.
● Monthly retrospective meetings. Discussion team members discuss what went well during
the discussion and suggest ways how to improve the next one.

Data Coordination and Harmonization

The FFHPCT team is organized based on the principles of flexible management. The M&E system
will be managed at both Addis ababa field offices. General leadership for M&E will be provided by
the project office to all field offices and project reporting to USAID will be led by the COP. At the
district level, implementing partner teams will manage the zonal, HF and woreda based M&E data
management and reporting.
In addition, in order to ensure the integration of sustainability throughout the project cycle,
FFHPCT will collaborate with relevant government sector M&E focal point persons from relevant
government sectors including health, and women, children and youth affairs offices.
FFHPCT’s implementing partners will be given user rights to be able to retrieve reports and
aggregated data for further sector/district specific analysis. The rights granted will enable the
project team to access automatically generated reports, dashboard tables, graphs and maps
highlighting the progress made together as a synergized team. The M&E team will also share
results from qualitative data analysis with all implementing partners through review meetings and
other mediums for planning and decision making.
Data Sharing with External Institutions: When sharing datasets with outside institutions, for
purposes of analysis or research, FIDO uses a data sharing agreement as per the guidance and
direction of AOR. Key elements of this data sharing agreement include dataset-specific provisions
around protection of confidentiality of data as well as data ownership and use.

34
Roles and responsibilities
Table 4: Roles and responsibilities of project team members

MLE and CLA Type Role/ Responsibility CoP M&E Specialist

Design and test all data collection tools
Build and test mobile data collection tools
Collect routine activity and participant data X
Collect participant feedback X
Conduct Data Quality Assessments and Verifications X
Develop Collective Action Plans (from DQAs) X
Conduct data cleaning X
Reporting (CoP)
Reporting (donor) X
Reporting (internal) X
Facilitate share-outs/close feedback loops
Document and coordinate on course corrections X
Update MEL Plan and targets X
Identify (new) dashboard needs X
Ensure/coordinate translation of tools
Prioritize dashboard additions/changes
Maintain geocoded datasets for mapping
Build and maintain online accessible maps and dashboards
Develop data security and protection plan X
Implement data security and protection plan
Ensure database integrates data from mobile sources X
Develop plan & training for mobile device use and server uploads X
Upload data to server adhering to mobile data collection plan X X
Maintain updated learning agenda
Ensure quality, right-sized resourcing of learning agenda activities
Organize sharing and reflection of assessment results
Facilitate share-outs (incl. ToC reviews)
Document and coordinate course corrections

35
 Annex I: Indicator Summary Table
Indicator Code Indicator Description Required or Reporting level Indicator changes MER
suggested and Frequency 2.7
reporting to USG
Standard PEPFAR MER Indicators
HTS_INDEX Number of individuals who were identified and tested using Index testing Required Facility & Added a “Documented
services and received their results Community and Negative” disaggregate
Quarterly for pediatric age/sex
bands only

HTS_RECENT Number of newly diagnosed HIV-positive persons who received testing Required Facility &
for recent infection with a documented result during the reporting period Community and
Quarterly
HTS_SELF Number of individual HIV self-test kits distributed Required Facility &
Community and
Quarterly
OVC_HIVSTAT Percentage of orphans and vulnerable children (<18 years old) enrolled in Required Facility &
the OVC Comprehensive program with HIV status reported to Community and
implementing partner. Quarterly
OVC_SERV Number of beneficiaries served by PEPFAR OVC programs for children Required Facility &
and families affected by HIV Community and
Semi-Annually
OVC Custom Indicators:
OVC_OFFER Percentage of children and adolescents on ART in PEPFAR clinical Required Implementing New
settings offered enrollment into the OVC program partner and
Semi-Annually
OVC_ENROLL Percentage of HIV positive children and adolescents on ART at a Required Implementing New
PEPFAR clinical setting who are enrolled in the OVC comprehensive partner and
program after having been offered enrollment Semi-Annually
OVC_TST_ASSESS Number of children and adolescents <18 years (active and graduated) Required Implementing New
served by an OVC comprehensive program who were assessed for HIV partner and
risk of those whose HIV status was unknown or they were previously Semi-Annually
reported to be HIV negative or HIV test not required due to risk
assessment, but have had a change in risk profile since the last HIV risk
36
Indicator Code Indicator Description Required or Reporting level Indicator changes MER
suggested and Frequency 2.7
reporting to USG
assessment.
OVC_TST_RISK Number of children and adolescents <18 years (active and graduated) Required Implementing OVC_HIVSTAT subset
served by an OVC comprehensive program determined to need an HIV partner and
test after conducting the most recent HIV risk assessment Semi-Annually
OVC_TST_REFER Number of children and adolescents <18 years (active and graduated) Required Implementing OVC_HIVSTAT subset
served by an OVC comprehensive program referred for HIV testing and partner and
counseling services. Semi-Annually
OVC_TST_REPORT Number of children and adolescents <18 years (active and graduated) Required Implementing OVC_HIVSTAT subset
served by an OVC comprehensive program who reported an HIV test partner and
result to the implementing partner after being referred for HIV testing Semi-Annually
and counseling
OVC_VL_ELIGIBLE Percentage of HIV positive children and caregivers (active or graduated) Required Community and ?
who are served by an OVC comprehensive program on ART, who are Semi-Annually
eligible for viral load testing (eligible means consistently on ART for a
minimum of 3 months or whatever the standard is established in the
Country.)
OVC_VLR Percentage of HIV positive OVC and caregivers (active and graduated) Required Implementing New
who are served by an OVC comprehensive program who are on ART partner and
with a known documented viral load test result within the previous 12 Semi-Annually
months
OVC_VLS Percentage of HIV positive OVC and caregivers (active and graduated) Required Implementing New
who are served by an OVC comprehensive program who are on ART and partner and
are virally suppressed (<1000 copies/ml) Semi-Annually
Care and Treatment Custom Indicators:
C&T No 1 Total number of clients in CAGs/ CARGs (Community ART Suggested Community and New
Refill Groups/Peer-led Community ART Quarterly
Distributions/PCARDs).
C&T No 2 Number of clients received Comprehensive Case management services Suggested Community and New
Quarterly
C&T No 3 Number of patients that receive routine adherence support (clients with Suggested Community and New
no significant risk of poor adherence) Quarterly
C&T No 4 Number of clients received Interventional Adherence Support (patients Suggested Community and New
with poor adherence) Quarterly
C&T No 5 Number and % of completed referrals from community to facility Suggested Community and Existed

37
Indicator Code Indicator Description Required or Reporting level Indicator changes MER
suggested and Frequency 2.7
reporting to USG
(Number and % of clients received bi-directional referral services) Quarterly
C&T No 6 Number and % of clients received GBV screening and referral services Suggested Community and New
Quarterly
C&T No 7 Number of LTFU line lists of Clients received from Health Facilities Suggested Community and New
(HFs) Quarterly
C&T No 8 Number and % of LTFUs that are traced and located Suggested Community and New
Quarterly
C&T No 9 Number and % of clients re-engaged to care after tracing of LFTU Suggested Community and Existed
Quarterly
C&T No 10 Number of clients reached by cervical cancer screening messages or Suggested Community and New
other Quarterly
C&T No 11 Number and % of clients referred to HFs for Cervical cancer screening Suggested Community and New
with VIA (Visual Inspection of cervix with Acetic acid wash) Quarterly
Care and Treatment Custom Indicators:
GEND_NORM Number of people completing an intervention pertaining to gender Suggested Quarterly
norms, that meets minimum criteria
HTS_INDEX_GBV Percentage of individuals identified and tested using index testing Suggested Quarterly
services and received their results, who were screened for violence and
referred or provided GBV response services.
GBV_REPORT_COM Percentage of individuals who were provided with or referred to post- Suggested Quarterly
M violence services among those who disclosed experience of violence
within community settings. This is a community level indicator–we
would not expect to see HFs reporting this indicator
GEND_LINK_COMM Percentage of individuals who were provided with or referred to post- Suggested Quarterly
violence services among those who disclosed experience of violence
within community settings. This is a community level indicator–we
would not expect to see HFs reporting this indicator
GEND_GBV_OTHER Number of individuals who disclosed experience of violence and Suggested Quarterly
received clinical care at a site that does not provide the full minimum
package of GEND_GBV services

38
Annex II Indicator Reference Sheet
1 Standard/MER Indicators
1. HTS_INDEX
Description: Number of individuals who were identified and tested using Index testing services and received their results

Numerator: Number of individuals who were identified and

This indicator aims to monitor the scale and fidelity of implementation of
tested using Index testing services and received
HIV index testing-related services
their results
Denominator: N/A There is no official denominator. However, this indicator represents a
cascade and the collected disaggregating serve as both numerators and
denominators when analyzing the index testing cascade.
Indicator changes Added a disaggregate for “Documented Negative” for paediatric index testing, along with relevant guidance. “Documented
(MER 2.0 v2.5 to v2.6): Negative” is defined as a final negative HIV test at 18 months of age or 3 months after breastfeeding ended, whichever occurred
later, with no other known HIV exposure risk.
Reporting level: Facility & Community
Reporting
Quarterly
frequency:
How to collect: The suggested data source is a designated HIV Index Testing Services register or logbook. This will allow easier collection of
the data for each step in the index testing cascade. Alternatively, existing HTS registers, log books, and reporting forms already
in use to capture HTS can be revised to include the steps mentioned above and the updated disaggregation categories. Examples
of data collection forms include client intake forms, activity report forms, or health registers such as HTS registers, health
information systems, and non-governmental organization records.
Other important considerations for reporting on high-fidelity index testing services:
• For a contact to be counted under Step 4, he/she must be tested for HIV and receive their result or be a known positive. That
contact could either self-report a known exposure to someone with HIV as their reason for testing, have an index testing
referral letter/card/coupon given to them from their HIV-positive partner/family member (client-referral approach), or have been
identified during the elicitation process and contacted by a provider. For example, if someone comes to a facility or mobile unit
and requests an HIV test and reports a known exposure to someone with HIV as their reason for testing, that person should be
counted under HTS_INDEX. Further, that individual’s HI diagnosis must be confirmed using a nationally validated testing
algorithm. For example, an HIV-positive rapid HIV test performed at the community- or facility- level must be confirmed with a
second and third (in some contexts) test, which may be performed at the same site or at a different facility. If the confirmatory
test is performed at a different facility, then this may require follow-up by implementing partners to confirm the diagnosis before
reporting on the Step 4.

39
1. HTS_INDEX
• The partner elicitation process of index testing is a continuous process.
Providers/counselors should follow local SOPs to determine when PLHIV are asked again about any new partners or previous
partners that may not have been disclosed by the index client previously. That is, for Step 3 on ‘Contacts Elicited’, contacts may
not be elicited all in one session with the HTS counselor. Elicitation may even continue
into the next reporting quarter.
• Retesting for verification of HIV positive status before or at antiretroviral (ART) initiation should not be counted under
HTS_INDEX. Retesting for verification is primarily conducted as a quality assurance activity to avoid misdiagnosis and to
ensure those initiated on ART are indeed HIV positive. Therefore, retesting for verification should
only be conducted for persons who have received an HIV diagnosis, but have not yet been initiated on ART.
How to review Data should be reviewed regularly for the purposes of program management, to monitor progress towards achieving targets, and
for data to identify implementation and data quality issues.
In addition, data reported under each step can be compared to the previous step where it makes programmatic sense. Potential
quality:
scenarios include: (1) Generally speaking, the number of contacts who were tested for HIV (Step 4) should not be greater than
the number of contacts provided (Step 3). Note: testing of a contact of an index client, who was not part of a formal index
testing elicitation strategy, may be counted under Step 4 if that contact discloses that his/her sexual or needle-sharing partner is
a known positive. (2) Additionally, it is possible for the number of contacts provided by the index client (Step 3) to be greater
than the number of index clients who accepted index testing services (Step 2). However, if the number of contacts provided
(step 3) is lower than the number of index clients accepting services (step 2), then most index clients are naming zero contacts,
which may suggest an issue with the elicitation process.
How to
calculate Sum results across quarters.
annual totals:
Disaggregation: Numerator Disaggregations
Disaggregate groups Disaggregates
Number of index cases offered index testing services ● <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-
by age/sex 29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M,
[Required] Unknown Age F/M
Number of index cases that accepted index testing ● <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-
services by age/sex 29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M,
[Required] Unknown Age F/M
Number of contacts elicited and age/sex • <15 F/M, 15+ F/M, Unknown Age F/M
[Required]
Number of contacts tested by test result and ● New positives by: <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19
40
1. HTS_INDEX
age/sex F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M,
[Required] 45-49 F/M, 50+ F/M, Unknown Age F/M
● New negatives by: <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19
Underlined portions auto-populate into the INDEX F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M,
HTS_TST modality. 45-49 F/M, 50+ F/M, Unknown Age F/M
● Known positives: <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19
F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M,
45-49 F/M, 50+ F/M, Unknown Age F/M
● Documented negatives by: 1-4 F/M, 5-9 F/M, 10-14 F/M
Denominator Disaggregation:
Disaggregate groups Disaggregates
N/A N/A

Other Notes
Notes on baselines/targets (rationale for selecting the
baseline and setting target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept 2025) 1252
This sheet last updated on: October 2024

41
2 OVC_HIVSTAT
Description: Percentage of orphans and vulnerable children (<18 years old) enrolled in the OVC Comprehensive program with HIV status reported
to implementing partner.
Numerator: Data sources for this indicator include HIV test results that are self-reported by
OVC (or their caregivers), results of HIV Risk Assessments conducted by
Number of orphans and vulnerable children (<18
implementing partners, registers, referral forms, client
years old) enrolled in the OVC Comprehensive
records, or other confidential case
program with HIV status reported, disaggregated
management and program monitoring tools that track those in treatment and care.
by HIV status
Partners are encouraged to confirm HIV and ART status through clinical record
confirmation wherever possible.
Denominator: Number of orphans and vulnerable children Denominator is not collected again as part of this indicator, but is collected under
reported under the OVC_SERV “OVC the “OVC Comprehensive” disaggregate of OVC_SERV.
Comprehensive” disaggregate (<18 years old,
active and graduated)
Indicator changes Added paediatric age/sex disaggregates to allow for more precise monitoring of OVC Comprehensive program results and
(MER 2.0 v2.5 to v2.6): program coverage of C/ALHIV.
Added language to encourage clinical confirmation of OVC’s HIV and/or ART status wherever possible.
Reporting level: Facility & Community
Reporting
Semi-Annually
frequency:
How to use: Given the elevated risk of HIV infection among children affected by and vulnerable to HIV, it is imperative for PEPFAR
implementing partners to monitor HIV status among OVC Comprehensive beneficiaries, to assess their risk of HIV infection, and to
facilitate access and continuity of treatment for those who are HIV positive. When the implementing partner determines that the child
is at risk of HIV infection, the program should refer children for testing and counseling services. When the implementing partner
knows the HIV status, the program should ensure that the children are linked to appropriate care and treatment services as an essential
element of quality case management. OVC programs should also play an important role in family-centered disclosure, for those who
are HIV positive.
The goal of monitoring OVC_HIVSTAT is to increase the proportion of children in the OVC Comprehensive program with a known
HIV status or for whom an HIV test is not required based on a risk assessment.
• This indicator is NOT intended to be an indicator of HIV tests performed or receipt of testing results, as these are measured
elsewhere, and confirmed test results are frequently unavailable to community organizations due to health facility concerns about
patient confidentiality.
• This indicator is NOT intended to imply that all OVC beneficiaries require an HIV test. OVC with known positive or negative status
do not need to be tested. OVC with unknown HIV status should be assessed for risk, and if determined to be at risk, should be referred

42
2 OVC_HIVSTAT
or otherwise supported, to access HTS. For younger children who are determined not to be at risk (“test not required based on risk
assessment”) reassessment of risk will only be needed in cases where their risk situation changes (i.e., in cases of child sexual abuse).
Older children whom the IP thinks may be sexually active should be assessed every reporting period. An HIV risk assessment should
always occur prior to HIV testing to determine if a test is required.
• Status disclosure to the implementing partner is NOT a prerequisite for enrollment or continuation in an OVC program. OVC
programs serve persons of positive, negative, and unknown HIV status appropriate to their needs and vulnerability to HIV. This
indicator ensures that IPs are regularly providing outreach to caregivers to identify children’s HIV status, encouraging family
disclosure, and linking to care and treatment services as needed.

• This indicator captures if implementing partners are tracking the self-reported HIV status of the OVC that they serve and enrollment
in ART for those who are positive. Testing results for OVC who are referred for testing should be reported under HTS_TST based on
the service delivery point where they are tested.
• This indicator also captures if implementing partners are tracking if the OVC that they serve who report to be HIV positive are
successfully linked to and have continuity of treatment and care. ART treatment status should be recorded both at the time of
enrollment as well as at regular intervals at least once during the reporting period.
• Since this is not a testing indicator, HIV positivity yield should NOT be calculated based on this indicator. Yield calculations should
only be made by testing partners.
• A helpful way to assess OVC_HIVSTAT performance is to create a “known status proxy” category of known status/risk (by
combining those reported positive, negative, and those who have been risk assessed and found to not require a test) and compare this
with the OVC_SERV <18 “OVC Comprehensive” disaggregate. This analysis encourages programs to actively follow-up on all
instances of “HIV status unknown” by targeting instances of missing data, nondisclosure, and issues with reporting timing.
• This indicator is a subset of the OVC_SERV Comprehensive program. Only OVC who were reported under the OVC_SERV <18
“OVC Comprehensive” disaggregate should be reported in the numerator for this indicator.
How to collect: Data sources for this indicator include HIV test results that are self-reported by OVC (or their caregivers), results of HIV Risk
Assessments conducted by implementing partners, registers, referral forms, client records, or other confidential case management and
program monitoring tools that track those in treatment and care.
Implementation of the HIV risk assessment should be integrated into case management and on-going case monitoring, and should not
be conducted separately, if possible. This will vary by partner and project. The partners should work out a timeline based on their
experience of how long referral completion and status disclosure usually takes and factor that into their case management processes.
Implementing partners will record the OVC beneficiary’s self-reported HIV status semi-annually.
How to review The OVC_HIVSTAT total numerator should equal the OVC_SERV <18 “OVC Comprehensive” disaggregate, including active and
for data graduated. Review any site with the following reporting issues: 1) numerator greater than 100% of OVC_SERV <18 “OVC
Comprehensive” disaggregate, and 2) very low coverage of OVC_HIVSTAT (defined as OVC_HIVSTAT numerator divided by
quality:
OVC_SERV <18 “OVC Comprehensive” disaggregate) which provides data on reporting of status.
Missing data should be documented under “HIV status unknown” or “Reported HIV positive-Not currently receiving ART or ART
43
2 OVC_HIVSTAT
status unknown.” Potential reasons for missing data may include: 1) IP was not able to collect information from all caregivers of
OVC_SERV<18 Comprehensive beneficiaries within the reporting period, 2) IP was not able to locate all the caregivers of
OVC_SERV<18 Comprehensive beneficiaries (e.g., relocated, migrant work).

How to
calculate This is a snapshot indicator. Results are cumulative at each reporting period.
annual totals:
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
Status Type [Required] • Reported HIV positive to implementing partner
o Currently receiving ART
o Not currently receiving ART or ART status unknown
• Reported HIV negative to implementing partner
• Test not required based on risk assessment
• No HIV status reported to the implementing partner (HIV status unknown)
Denominator Disaggregation:
Disaggregate groups Disaggregates
See OVC_SERV “OVC Comprehensive” See OVC_SERV “OVC Comprehensive” disaggregate.
disaggregate”.
Disaggregate Status Type Disaggregate Definitions:
descriptions & • “Reported HIV positive to IP” includes all beneficiaries <age 18 enrolled in the OVC Comprehensive program who report to the
definitions: IP that they are HIV positive based on an HIV test conducted during or prior to the reporting period (regardless of where the test
occurred). All beneficiaries in this category should be reported as “currently receiving ART” or “not currently receiving ART or
ART Status Unknown.” This also includes beneficiaries <age 18 who report that they are HIV positive based on an HIV test
conducted during previous project reporting periods. OVC entered in either category as “Reported HIV positive– currently receiving
ART” or “Reported HIV positive– not currently receiving ART or ART Status Unknown” in the previous reporting period should be

44
2 OVC_HIVSTAT
followed in the current reporting period and their current ART treatment status noted. In order to be counted as “currently receiving
ART” the IP should confirm at the last visit preceding the reporting month whether the response to the following questions is “yes” to
ensure that this captures more than just initial linkage to care: Do you have enough ART pills to take until the date of your next
appointment?
“Reported HIV negative to IP” includes beneficiaries <age 18 enrolled in the OVC Comprehensive program who report that they
are HIV negative to the IP based on an HIV test conducted during the reporting period (regardless of where the test occurred). For a
child who reports multiple tests within the current period, use the most recent test. For beneficiaries entered as “Reported HIV
negative to IP” in a previous reporting period—if the IP believes the child’s risk has not changed in the last six months, they should
continue to report the child as negative during the current reporting period. However, if the IP believes that the child has recently been
exposed to risk of HIV infection (e.g., sexual violence) or if an adolescent has become sexually active, then the IP should conduct an
HIV risk assessment. Potential outcomes reported after the HIV risk assessment include 1) the child is tested and reported as HIV
positive and either currently receiving ART or not receiving ART or ART status unknown, or 2) the child is tested and reported as
HIV negative, 3) the child is reported as “No HIV Status reported to the IP”, or 4) the child is reported as “Test not required based on
risk assessment.”
• “Test not required based on risk assessment” includes beneficiaries < age 18 enrolled in the OVC Comprehensive program who
based on a risk assessment made by the implementing partner do not require a test during the reporting period (formerly known as test
not indicated).
• “No HIV status reported to the IP” (HIV status unknown) includes all beneficiaries <age 18 enrolled in the OVC Comprehensive
program who do not fit in the above categories and who report to the IP that they do not know their HIV status or for whom HIV
status is missing. Potential scenarios for reporting a child in this category include: o Not yet assessed: Child enrolled in program, but
not yet assessed for HIV risk.
o Refuse HIV assessment: Caregiver has been approached, but did not agree to let the IP conduct a risk assessment on the child in the
reporting period.
o At risk for HIV: Child has been assessed and is at risk for HIV, but caregiver has not yet taken child to be tested (including if they
have refused testing referral or if they have accepted the referral but not yet completed the test).
o HIV referral completed: OVC has completed HIV test, but result is not available OR caregiver doesn’t report results to IP in the
reporting period.
o Refuse report: Caregiver has been approached by IP but have not yet agreed to disclose whether the child has been tested and his/her
current HIV status in the reporting period
o Missing: No available data, including because an IP did not attempt to find out about a child’s status.
IPs should aim to move a newly enrolled OVC with HIV Status Unknown through the assessment cascade within the reporting period.
A newly enrolled child would initially be considered “HIV Status Unknown” until he/she is risk assessed. If the OVC is found to not
be at risk at present, he/she will be noted as “Test not required based on risk assessment.” If the OVC is found to be at risk, he/she will
be referred for HIV testing and then the program will work with the guardian to disclose the results until he/she can be reported as
“Reported HIV Negative”, “Reported HIV Positive – currently on ART” or “Reported HIV Positive – not currently on ART or ART
45
2 OVC_HIVSTAT
status unknown”.
For children reported as “HIV Status Unknown” in the previous reporting period, the IP should ensure that the child is risk assessed,
referred for testing if needed, and supported to disclose new test results. Children reported as “Test not required based on risk
assessment” with no changes in their risk situation for the past six months, don’t need to be reassessed. If the IP believes the child’s
risk situation has changed in the last six months, then the child should be reassessed by the implementing partner to determine whether
testing is indicated and the results entered as outlined above, and the child should receive appropriate follow-up.
Modifications to standard definition of DSD and TA-SDI related to eligible goods and services:
Provision of key staff or eligible goods/services for OVC beneficiaries receiving care and support services in the community include:
PEPFAR-support For beneficiaries of OVC services, this can include funding of salaries (partial or full) for staff of the organization delivering the
definition: individual, small group or community level activity (e.g., psychosocial support, child protection services, education, etc.). Partial
salary support may include stipends or incentives for volunteers/para-social workers or paying for transportation of those staff to the
point of service delivery. For goods or services to be eligible, goods or services (e.g., bursaries, cash transfers, uniforms) can either be
paid for out of the implementing partner’s budget or be provided as a result of the IP’s efforts to leverage and mobilize non-project
resources. For example, an IP may help beneficiaries fill out and file forms necessary for the receipt of government provided cash
transfers, social grants, or bursaries for which they are eligible. Given the focus on long-term local ownership, IP’s are encouraged to
mobilize goods and services whenever possible.
For care and support services, ongoing support for OVC service delivery for improvement includes: the development of activity-
related curricula, education materials, etc., supportive supervision of volunteers, support for setting quality standards and/or ethical
guidelines, and monitoring visits to assess the quality of the activity, including a home visit, a visit to a school to verify a child’s
attendance and progress in school or observation of a child’s participation in kids clubs.
1. If the sum of reported HIV negative + reported HIV positive + Test not required based on risk assessment is less than 90% of
OVC_SERV <18 “OVC Comprehensive” disaggregate, please explain why such a high proportion are being reported in the category
of “HIV Status Unknown” (i.e., the performance metric described in the “how to use” section). Are there certain partners that are
struggling with reporting or understanding the disaggregates? How is the Mission responding?
Guiding narrative
2. Please explain the breakdown of those reported under “HIV Status Unknown.” What percentage of caregivers refused to disclose a
questions:
child’s HIV status? What percentage represents those who have been referred for testing but do not yet have results? What percentage
represents missing data where an implementing partner failed to document the child’s HIV status? What are other reasons?
3. For children reported as “Reported HIV Positive - not currently on ART or ART Status Unknown”, what efforts are being
undertaken in response? Are there certain partners with low ART coverage, why? Is this an issue related to community case
management? Or are partners having a hard time collecting timely confirmation of treatment status (i.e., missing)?

46
Other Notes
Notes on baselines/targets (rationale for selecting the
baseline and setting target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept 2025) 2646
This sheet last updated on: October 2024
3. OVC_SERV
Description: Number of beneficiaries served by PEPFAR OVC programs for children and families affected by HIV

Numerator: The numerator is the sum of the following Program Participation Status
Number of beneficiaries served by PEPFAR disaggregates:
OVC programs for children and families 1. OVC Comprehensive Active and Graduated beneficiaries (children and
affected by HIV caregivers)
2. OVC Preventive beneficiaries
Denominator: N/A
Indicator changes Added new disaggregates to distinguish between beneficiaries in the three OVC_SERV program models: OVC Comprehensive,
(MER 2.0 v2.4 to v2.6): OVC Preventive.
• Added a new disaggregate to distinguish between OVC child beneficiaries aged 18-20 years who are completing secondary
education or an approved economic strengthening intervention and caregivers aged 18+.
• Revised guiding narrative questions.
• Updated language and figures to reflect COP20 guidance and new disaggregates.
Reporting level: Facility & Community
Reporting
Semi-Annually
frequency:

47
How to collect: Data sources include PEPFAR OVC program registers and other records of program data generated by implementing partners
(IPs). Implementing partners’ registers need to record sex and ages of children and caregivers who meet the criteria for the
disaggregates included in this indicator (e.g. participation status, program model). Use of a unique ID system is recommended. All
agencies and IPs receiving HKID funding are required to report on this indicator. Additionally, agencies and IPs implementing
approved primary prevention of HIV and sexual violence interventions (e.g. OVC Preventive) are required to report on this
indicator regardless of funding source.
Each individual should be counted only once under OVC_SERV in the reporting period. Please follow the hierarchy detailed in
Figures 2 & 3 to ensure that each individual is reported under only one program model (i.e. OVC Comprehensive, or OVC
Preventive). Efforts will need to be made to de-duplicate OVC_SERV data in SNUs with multiple IPs implementing the various
program models.
For those reported under OVC Comprehensive, IPs must record the participation status of children and caregivers (i.e. active or
graduated) or if they are transferred out to a PEPFAR-supported partner, transferred out to a non-PEPFAR supported partner, or
exited without graduation. The program participation status and transfer/exit disaggregate categories are mutually exclusive.

How to review Review PEPFAR OVC implementing partners’ results to ensure that there is no double counting between program models (e.g.
for data OVC Comprehensive, OVC Preventive) and between program participation status and transfer/exit disaggregate categories within
OVC Comprehensive.
quality:
Review IP and site results for deviations from one period to the next which may indicate rapid exit and entry of beneficiaries or
high sudden graduation rate in one, versus another period.
How to This is a snapshot indicator. Individuals should only be counted once by each partner at Q4 reporting. Individuals should only be
calculate counted under one OVC program model at Q4 reporting (see Figures 2 & 3).
annual totals:
Q4 OVC_SERV = (OVC Comprehensive Active Q4 + Graduated Q4) + (OVC Preventive Q4)
All disaggregates except for “active” under OVC Comprehensive are a snapshot for the entire fiscal year at the time of reporting.
This includes graduated, exited, and transferred disaggregates under OVC Comprehensive; and OVC Preventive.
Under OVC Comprehensive, program participation status at the end of Q4 should take precedence for where to count an individual
(i.e., if a beneficiary was counted as exited without graduation at Q2 but had met the criteria to be counted as active at Q4, then they
should be reported at Q4 only under the active category and not in the total reported for exited without graduation).
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
OVC Comprehensive Program Participation Status
[Required] o Active
OVC, by: Unknown age F/M, <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M,
15-17 F/M, 18-20 F/M
48
 Caregiver, by: 18+ F/M
o Graduated
OVC, by: Unknown age F/M, <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M,
15-17 F/M, 18-20 F/M
Caregiver, by: 18+ F/M
OVC Exited or Transferred ● Transferred out to a PEPFAR-supported partner
[Required] ● Transferred out to a non-PEPFAR supported partner
● Exited without graduation
OVC Preventive ● Age/Sex: Unknown age F/M, 5-9 F/M, 10-14 F/M
[Required]
Denominator Disaggregation:
Disaggregate groups Disaggregates
N/A N/A

Disaggregate Please see Figures 2 & 3 to help determine which disaggregate category to report individual beneficiaries under. Remember that for
descriptions & the purposes of OVC_SERV reporting these categories are mutually exclusive.
definitions: OVC COMPREHENSIVE
Active: A child or caregiver who has received at least one eligible PEPFAR OVC program service in each of the preceding two
quarters. New beneficiaries enrolled during the reporting period can be counted as active only if they have received at least one
service in the preceding quarter.
• Child beneficiaries (“OVC”) are defined as children and adolescents aged 0-17 years. Individuals aged 18-20 years are also
included as “OVC” if they are completing secondary education or an approved economic strengthening intervention.
o OVC aged 18-20 should be counted in the OVC 18-20 age/sex disaggregate, rather than the Caregiver 18+ age/sex disaggregate,
even if they are caregivers themselves (see Figure 3).
• Caregivers fulfill the role of parent or guardian to a child beneficiary. For OVC_SERV, there should be no more than two
primary caregivers per household. In most cases, given the vulnerability status of the households PEPFAR serves, there is likely to
be only one primary caregiver. While adults or household members who are not caregivers fulfilling the role of parent or guardian
may indirectly benefit from program support or access a one-time service, they should not be counted, as that does not meet the
intention of increasing primary caregivers’ access to critical services and support.
• All active OVC Comprehensive beneficiaries (both children and caregivers) must:
o Have a case plan that has been developed or updated in the last 12 months that monitors their progress towards the graduation
benchmarks (see details on the benchmarks below).
Have received directly from the project, was facilitated to obtain, or has a completed referral for at least one intervention in each of
the preceding two quarters (see Appendix E for illustrative eligible interventions; if a service is not included on this list, the partner
must seek and receive approval from local USG funding agency and note this in the OVC_SERV narrative).

49
Intake assessment, enrollment, subsequent assessments including HIV risk assessment, case plan development, and case plan
monitoring are considered critical administrative processes rather than services, but remain critical to ensuring provision of needs-
based services in a timely manner.
• In addition, child beneficiaries (“OVC”) aged 0-17 years and OVC aged 18-20 years completing secondary education or an
approved economic strengthening intervention must: o Be monitored at least quarterly, but as often as is necessary according to
the child’s safety, schooling, stability, and health status. Monitoring includes establishing contact in person, or virtually where
needed, to ensure that the case plan is progressing, and documentation of this contact is recorded in the case plan.
Graduated: The point at which a household enrolled in a PEPFAR OVC Comprehensive Program is deemed to have become more
resilient and is no longer in need of PEPFAR OVC project-provided services. For caregivers and child beneficiaries to be counted
as an individual graduated in DATIM, all child and all caregiver beneficiaries in a household must meet all applicable (age and HIV
status specific) graduation benchmarks established by PEPFAR for improving resiliency in the household.
• At Q2: Report the number of children and caregivers that graduated from the OVC program in the previous two quarters. At Q4:
Report the number of children and caregivers that graduated from the OVC program in the past four quarters.
• For the purposes of graduation, a household is defined as all children in the household/family unit less than age 18 years who
based on risk assessment are enrolled in the OVC project and their caregiver(s) (not to exceed two people fulfilling the role of
parent or guardian per household/family unit).
• PEPFAR guidance for graduation from an OVC project includes the following eight benchmarks (Figure 4) which align with the
illustrative services in Appendix E. Please see Appendix F for additional details, definitions, and data sources for each minimum
required benchmark. Countries may include additional benchmarks based on local criteria for achieving stability, but the eight
global benchmarks are a minimum requirement.

Exited or Transferred:
50
• Data reported into the Exited or Transferred disaggregate should only include beneficiaries exiting or transferring from the OVC
Comprehensive program. However, the Exited or Transferred disaggregate will not be included in the OVC Comprehensive total.
The OVC Comprehensive total includes only active and graduated beneficiaries.
• At Q2: Report the number of children and caregivers that exited or transferred from the OVC program in previous two quarters.
At Q4: Report the number of children and caregivers that exited or transferred from the OVC program in the past four quarters.
• “Transferred out to a non-PEPFAR-supported partner” is defined as when a child or caregiver beneficiary has transitioned to
programs that are not PEPFAR funded. These could include country-led services or other donor-funded programs.
• “Transferred out to a PEPFAR-supported partner” is defined as when a child or caregiver beneficiary has transitioned from
the support of one PEPFAR partner to another PEPFAR partner.
• “Exited without graduation” is defined as when a child or caregiver has not received program services in each of the past two
preceding quarters or is lost-to-follow up, re-located, died, or the child has aged-out of the program without the household meeting
graduation benchmarks from the PEPFAR OVC program.
OVC PREVENTIVE
Prevention of HIV and sexual violence are important services that fit under the core components of the OVC program. Delivery of
these services may differ from the OVC Comprehensive model. Individuals counted in this disaggregate are:
• Children aged 9-14 who have completed only a primary prevention of HIV & sexual violence intervention
o These individuals are not otherwise actively receiving services in the OVC Comprehensive program . Therefore, they are not
required to have an OVC case plan or to be monitored using the OVC graduation benchmarks.
o At Q2: Report the number of children that have completed an approved primary prevention intervention in the past two quarters.
At Q4: Report the number of children that have completed an approved primary prevention intervention in the past 4 quarters.
o Approved primary prevention of sexual violence and HIV interventions are as follows: Families Matter Program, Parenting for
Lifelong Health (also known as Sinovuyo), Coaching Boys into Men, IMpower (also known as No Means No Worldwide), and
Stepping Stones (editions or adaptations which are developmentally appropriate and include adequate citations). Countries are
strongly encouraged to implement one of these five pre-approved curricula. All other curricula used for 9-14 primary prevention
must be approved by S/GAC and the relevant agency HQ and must include the three S/GAC evidence-informed modules on healthy
and unhealthy relationships, healthy choices about sex, and understanding consent.

51
PEPFAR-support Modifications to standard definition of DSD and TA-SDI related to eligible goods and services:
definition: Provision of key staff or eligible goods/services for OVC beneficiaries receiving care and support services in the community
includes: For beneficiaries of OVC services, this can include funding of salaries (partial or full) for staff of the organization
delivering the individual, small group, or community level activity (e.g., psychosocial support, child protection services, education,
etc.). Partial salary support may include stipends or incentives for volunteers/para-social workers or paying for transportation of
those staff to the point of service delivery. For goods or services to be eligible, goods or services (e.g., bursaries, cash transfers,
uniforms) can either be paid for out of the implementing partner’s budget or be provided as a result of the IPs efforts to leverage
and mobilize non-project resources. For example, an IP may help beneficiaries fill out and file forms necessary for the receipt of
government provided cash transfers, social grants, or bursaries for which they are eligible. Given the focus on long-term local
ownership, IPs are encouraged to mobilize goods and services whenever possible.
For care and support services, ongoing support for OVC service delivery for improvement includes: the development of activity-
related curricula, education materials, etc., supportive supervision of volunteers, support for setting quality standards and/or ethical
guidelines, and monitoring visits to assess the quality of the activity, including a home visit, a visit to a school to verify a child’s

52
 attendance and progress in school or observation of a child’s participation in kids’ clubs.
1. Please explain reasons and context for highest/lowest performing partners’ performance (i.e., results/target) for OVC_SERV total
numerator and OVC_SERV <18, including any programmatic shifts or monitoring updates.
2. For OVC Comprehensive, please explain results by Program Participation Status:
a. For active beneficiaries, were there any interventions that were provided and approved by local USG funding agency that were
not included in the illustrative examples (Appendix E)?
b. For graduation, were any of the benchmarks especially challenging to achieve or monitor? If so, which ones and why?
Guiding narrative 3. For OVC Comprehensive, please explain results by exited/transferred:
questions: a. How many beneficiaries exited without graduation? Please explain the reasons for exiting without graduation and try to quantify
with percentages if possible. Are there certain partners with higher rates of exiting without graduation? How are you managing this
with the partner(s)?
b. How many beneficiaries were transferred? To whom (e.g., other NGOs, government support, etc.) were they transferred? Where
were beneficiaries transferred? Please provide disaggregates for beneficiaries transferred to specific sources of support.
4. For the OVC Preventive disaggregate, which approved primary prevention of HIV and sexual violence intervention(s) were
implemented during the reporting period? Were there any implementation challenges that affected results?

Other Notes
Notes on baselines/targets (rationale for selecting the
baseline and setting target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept 2025) 4278
This sheet last updated on: October 2024

53
2 OVC Custom indicators
4. OVC_OFFER
Description:
Percentage of children and adolescents on ART in PEPFAR clinical settings offered enrollment into the OVC program
Numerator: Number of children and adolescents on ART in PEPFAR clinical settings offered enrollment into the OVC program
Denominator: (TX_CURR <20) - (OVC_HIVSTAT_POS_ART)
Reporting level: Implementing partner
Reporting
Semi-Annually
frequency:
How to collect: The data for the numerator should be collected by PEPFAR OVC implementing partners. Data sources for this
indicator include facility patient records, referral forms or other facility monitoring tools that track those in treatment
and care. OVC implementing partners who do not have a memorandum of understanding (or equivalent) with
PEPFAR-supported facilities that allows the OVC partner to monitor patients on ART will not be able to report under
this indicator. In other words, OVC implementing partners should only report under this indicator if they are engaged
in the identification and screening of prospective OVC beneficiaries at the facility.
How to review f
or data Through routine data quality audits or assessments, conducted by the program or externally.
quality:
How to This is a cumulative indicator that calculates all prospective beneficiaries who were offered enrollment during the fiscal
calculate year. For example, during both Q2 and Q4 reporting, calculate all beneficiaries offered enrollment at any point during
annual totals: that fiscal year. All beneficiaries offered enrollment should be counted only once, regardless of the number of times
they were offered enrollment during a reporting period.
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
Age and Sex (required) ● By <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-17 F/M
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

54
Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting target,
other notes…):
Other notes:

Performance Indicator Values

Target
Time Period s Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 628
This sheet last updated on: October 2025

5. OVC_ENROLL
Description: Percentage of HIV positive children and adolescents on ART at a PEPFAR clinical setting who are enrolled in the OVC
comprehensive program after having been offered enrollment
Numerator: Number of HIV positive children and adolescents on ART at a PEPFAR clinical setting who are enrolled in the OVC
comprehensive program after having been offered enrollment
Denominator Number of children and adolescents on ART in PEPFAR clinical settings offered enrollment into the OVC program
: (OVC_OFFER)
Reporting lev
Implementing partner
el:
Reporting
Semi-Annually
frequency:
How to collec This data should be collected by PEPFAR OVC implementing partners. Data sources for this indicator include facility
t: patient records, OVC referral forms or other monitoring tools that track those in treatment and care. OVC implementing
partners who do not have a memorandum of understanding (or equivalent) with PEPFAR-supported facilities that allows
the OVC partner to monitor patients on ART will not be able to report under this indicator. In other words, OVC
implementing partners should only report under this indicator if they are engaged in the identification and screening of
prospective OVC beneficiaries at the facility (e.g. through an OVC staff member enrolling new beneficiaries at the facility,

55
 or equivalent). If, on the other hand, the facility staff is identifying, screening and referring to OVC beneficiaries, these
referrals should not be counted under this indicator.
How to revie
w for data Through routine data quality audits or assessments, conducted by the program or externally.
quality:
How to This is a cumulative indicator that calculates all prospective beneficiaries who were offered enrollment during the fiscal
calculate year. For example, during both Q2 and Q4 reporting, calculate all prospective beneficiaries offered enrollment and then
annual enrolled at any point during that fiscal year. This includes caregivers and the children of the caregiver. All prospective
totals: beneficiaries offered enrollment should be counted only once, regardless of the number of times they were offered
enrollment during a reporting period.
Disaggregatio Numerator Disaggregation
n: Disaggregate groups Disaggregates
Age and Sex (required) ● By <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-17 F/M
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A
Performance Indicator Values
Target Actu
Time Period s al Comments
Annual FY25 (Oct 2024 to Sept
2025) 628
This sheet last updated on: October 2025

6. OVC_TST_ASSESS
Description: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive
program who were assessed for HIV risk of those whose HIV status was unknown or they were previously
reported to be HIV negative or HIV test not required due to risk assessment, but have had a change in risk
profile since the last HIV risk assessment.
Numerator: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive
program who were assessed for HIV risk of those whose HIV status was unknown or they were previously
reported to be HIV negative or HIV test not required due to risk assessment, but have had a change in risk
56
6. OVC_TST_ASSESS
profile since the last HIV risk assessment.
Denominator: None
Reporting level: Implementing partner
Reporting
Semi-Annually
frequency:
How to use:
Given the elevated risk of HIV infection among children affected by and vulnerable to HIV, it is imperative
for PEPFAR implementing partners to monitor HIV status among OVC beneficiaries, to assess their risk of
HIV infection, and to facilitate access, initiation, and retention in ART treatment for those who are HIV
positive.

PEPFAR OVC programs should encourage caregivers of children to disclose to the program the HIV status
of the child/adolescent beneficiaries. When appropriate (i.e. the child or adolescent has never been tested or
their circumstances are such that warrant a risk assessment), the program should conduct an assessment of
HIV risk. This assessment will determine which beneficiaries the program should refer to HIV testing and
which are deemed “test not required”.

When the implementing partner determines that the beneficiary is at risk of HIV infection, the program
should refer them for HIV testing and counseling services. After the implementing partner refers “at risk”
beneficiaries for testing, the partner should follow up to make sure the test was conducted and to counsel the
caregiver to disclose the results of the test.

This indicator counts the number of beneficiaries <18 years old (active and graduated in an OVC
comprehensive program) for which their most recent HIV risk assessment has been conducted during the
reporting period, regardless of the results of the risk assessment. This indicator counts only the most recent
HIV risk assessment administered per beneficiary and does not include any HIV risk assessments
administered in previous reporting periods.

Only HIV risk assessments of active and graduated beneficiaries in an OVC Comprehensive program may be
reported in OVC_TST_ASSESS. Administering an HIV risk assessment alone is not a qualifying service
57
6. OVC_TST_ASSESS
under OVC_SERV. Refer to MER 2.6 guidance to determine how to calculate OVC_SERV.

The reporting periods are defined as follows for this indicator:

SAPR: count the most recent HIV risk assessment per beneficiary from Q1 and Q2
APR: count the most recent HIV risk assessment per beneficiary from Q1, Q2, Q3, and Q4
How to collect: Data sources for this indicator include client records, or other confidential case management and program
monitoring tools that track HIV risk assessments and assessment results.
Implementation of the HIV risk assessment should be integrated into case management and on-going case
monitoring, and should not be conducted separately, if possible. Children reported as “Test not required based
on risk assessment” with no changes in their risk situation for the past six months, don’t need to be
reassessed. If the implementing partner believes the child’s HIV risk profile has changed in the last six
months, then the child should be reassessed by the implementing partner to determine whether testing is
required. The appropriate follow-up should be provided to the child based on their HIV assessment and HIV
test results, where testing is required.
How to review fo Through routine data quality audits or assessments, conducted by the program or externally.
r data quality: OVC_TST_ASSESS is less than or equal to (OVC_SERV <18 years served by an OVC comprehensive
program)
How to calculate Annual totals include the most recent HIV risk assessment conducted during the previous 4 quarters (Q1, Q2,
annual totals: Q3 and Q4).
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A
Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting target, other
notes…):
58
6. OVC_TST_ASSESS
Other notes:
Performance Indicator Values
Targe Actu
Time Period ts al Comments
Annual FY25 (Oct 2024 to Sept 2025) 1985
This sheet last updated on: October 2024

59
7. OVC_TST_RISK
Description: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive program
determined to need an HIV test after conducting the most recent HIV risk assessment
Numerator: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive program
determined to need an HIV test after conducting the most recent HIV risk assessment
Denominator: None
Reporting level: Implementing partner
Reporting
Semi-Annually
frequency:
How to use: Given the elevated risk of HIV infection among children affected by and vulnerable to HIV, it is imperative for PEPFAR
implementing partners to monitor HIV status among OVC beneficiaries, to assess their risk of HIV infection, and to
facilitate access, initiation, and retention in ART treatment for those who are HIV positive.

PEPFAR OVC programs should encourage caregivers of children to disclose to the program the HIV status of the
child/adolescent beneficiaries. When appropriate (i.e. the child or adolescent has never been tested or their circumstances
are such that warrant a risk assessment), the program should conduct an assessment of HIV risk. This assessment will
determine which beneficiaries the program should refer to HIV testing and which are deemed “test not required”.

When the implementing partner determines that the beneficiary is at risk of HIV infection, the program should refer them
for HIV testing and counseling services. After the implementing partner refers “at risk” beneficiaries for testing, the
partner should follow up to make sure the test was conducted and to counsel the caregiver to disclose the results of the
test.

This indicator tracks the number of beneficiaries <18 years old (active or graduated) in an OVC comprehensive program
for which their most recent HIV risk assessment has been conducted during the reporting period, and they were
determined to be “at risk” for HIV infection. This indicator counts only those found to be at risk from the most recent
HIV risk assessment administered and does not include any “at risk” findings from HIV risk assessments administered in
previous reporting periods. All beneficiaries assessed for risk should be counted only once, regardless of if they were
assessed multiple times during a reporting period.

If a beneficiary < 18 years old is assessed for risk of HIV infection, but they are not counted as active or graduated in
60
7. OVC_TST_RISK
OVC_SERV, then the “at risk” finding of their most recent risk assessment cannot count towards this indicator. Only
active and graduated beneficiaries found to be at risk may be reported in OVC_TST_RISK. Administering an HIV risk
assessment alone is not a qualifying service under OVC_SERV.

The reporting periods are defined as follows for this indicator:

SAPR: count the most recent HIV risk assessment per beneficiary from Q1 and Q2
APR: count the most recent HIV risk assessment per beneficiary from Q1, Q2, Q3, and Q4
How to collect: Data sources for this indicator include client records, or other confidential case management and program monitoring
tools that track HIV risk assessments and assessment results.
Implementation of the HIV risk assessment should be integrated into case management and on-going case monitoring, and
should not be conducted separately, if possible. Children reported as “Test not required based on risk assessment” with no
changes in their risk situation for the past six months, don’t need to be reassessed. If the implementing partner believes the
child’s HIV risk profile has changed in the last six months, then the child should be reassessed by the implementing
partner to determine whether testing is required. The appropriate follow-up should be provided to the child based on their
HIV assessment and HIV test results, where testing is required.
How to review for Through routine data quality audits or assessments, conducted by the program or externally.
data quality: OVC_TST_RISK is less than or equal to OVC_TST_ASSESS
How to calculate Annual totals include those found to be at risk based on the most recent HIV risk assessment conducted in the former 4 quarters (Q1, Q2, Q3 and
annual totals: Q4).
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates

N/A N/A
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes

61
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 1852
This sheet last updated on: October 2023

62
8. OVC_TST_REFER
Description: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive program
referred for HIV testing and counseling services.
Numerator: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive program
referred for HIV testing and counseling services
Denominator: None
Reporting level
Implementing partner
:
Reporting
Semi-Annually
frequency:
How to use: Given the elevated risk of HIV infection among children affected by and vulnerable to HIV, it is imperative for
PEPFAR implementing partners to monitor HIV status among OVC beneficiaries, to assess their risk of HIV infection,
and to facilitate access, initiation, and retention in ART treatment for those who are HIV positive.
PEPFAR OVC programs should encourage caregivers of children to disclose to the program the HIV status of the
child/adolescent beneficiaries. When appropriate (i.e. the child or adolescent has never been tested or their
circumstances are such that warrant a risk assessment), the program should conduct an assessment of HIV risk. This
assessment will determine which beneficiaries the program should refer to HIV testing and which are deemed “test not
required”.
When the implementing partner determines that the beneficiary is at risk of HIV infection, the program should refer
them for HIV testing and counseling services. After the implementing partner refers “at risk” beneficiaries for testing,
the partner should follow up to make sure the test was conducted and to counsel the caregiver to disclose the results of
the test.
This indicator tracks the number of unique beneficiaries < 18 years (active and graduated served by an OVC
comprehensive program) referred for HIV testing and counseling during the reporting period, regardless of when that
beneficiary was determined to be at risk. If the caregiver refuses the referral of the child or adolescent for any reason,
the referral is not counted under this indicator since that referral could not officially be made. All beneficiaries referred
for testing should be counted only once, regardless of the number of times they were referred during a reporting period.
This indicator is not a direct subset of OVC_TST_RISK because it is possible that beneficiaries who are “at risk” from a
previous reporting period could be referred to in the current reporting period.
The reporting periods are defined as follows for this indicator:
SAPR: count the most recent HIV testing and counseling referral per beneficiary from Q1 and Q2
63
8. OVC_TST_REFER
APR: count the most recent HIV testing and counseling referral per beneficiary from Q1, Q2, Q3, and Q4
How to collect: Data sources for this indicator include client records, or other confidential case management and program monitoring
tools that track HIV testing and counseling referrals made.
How to review
for data Through routine data quality audits or assessments, conducted by the program or externally.
quality: OVC_TST_REFER is less than or equal to (OVC_SERV < 18 years served by an OVC comprehensive program)
OVC_TST_REFER < (OVC_HIVSTAT < 18 years who are not positive)

How to
calculate Annual totals include referred to HIV testing and counseling in the former four quarters (Q1, Q2, Q3 and Q4).
annual totals:
Disaggregation Numerator Disaggregation
: Disaggregate groups Disaggregates
N/A N/A
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 1852

64
This sheet last updated on: October 2024

9. OVC_TST_REPORT
Description: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive program
who reported an HIV test result to the implementing partner after being referred for HIV testing and counseling
Numerator: Number of children and adolescents <18 years (active and graduated) served by an OVC comprehensive
program who reported an HIV test result to the implementing partner after being referred for HIV testing and
counseling
Denominator: None
Reporting level: Implementing partner
Reporting
Semi-Annually
frequency:
How to use: Given the elevated risk of HIV infection among children affected by and vulnerable to HIV, it is imperative for
PEPFAR implementing partners to monitor HIV status among OVC beneficiaries, to assess their risk of HIV
infection, and to facilitate access, initiation, and retention in ART treatment for those who are HIV positive.

PEPFAR OVC programs should encourage caregivers of children to disclose to the program the HIV status of
the child/adolescent beneficiaries. When appropriate (i.e. the child or adolescent has never been tested or their
circumstances are such that warrant a risk assessment), the program should conduct an assessment of HIV risk.
This assessment will determine which beneficiaries the program should refer to HIV testing and which are
deemed “test not required”.

When the implementing partner determines that the beneficiary is at risk of HIV infection, the program should
refer them for HIV testing and counseling services. After the implementing partner refers “at risk” beneficiaries
65
9. OVC_TST_REPORT
for testing, the partner should follow up to make sure the test was conducted and to counsel the caregiver to
disclose the results of the test.

This indicator measures if beneficiaries that are referred for testing are being tested and reporting the results of
the test to the PEPFAR OVC implementing partner.

This indicator tracks the number of beneficiaries <18 years (active and graduated served by an OVC
comprehensive program) who reported an HIV test result to the implementing partner during the reporting
period, regardless of when the beneficiary was assessed for risk or referred for testing. This means that a
beneficiary could have been referred for testing during a prior reporting period, but disclosed the test result to
the implementing partner in the current reporting period. All beneficiaries should be counted only once,
regardless of the number of times they were tested and self-reported during a reporting period.

As a result, this indicator is not necessarily a subset of OVC_TST_REFER because it is possible that
beneficiaries who are referred in a previous reporting period could report their status under the current reporting
period.

The reporting periods are defined as follows for this indicator:

SAPR: count the most recent HIV test result reported to the implementing partner per beneficiary from Q1 and
Q2
APR: count the most recent HIV test result reported to the implementing partner per beneficiary from Q1, Q2,
Q3, and Q4
How to collect: Data sources for this indicator include client records, or other confidential case management and program
monitoring tools that track HIV risk assessments and assessment results and referrals.
Results of HIV tests are self-reported by the beneficiary to the PEPFAR OVC implementing partner. This self-
reported information should be tracked by the program. The aim is for 100% of beneficiaries who are referred
for testing, receive a test result and self-report that result to the implementing partner. Programs showing less
than 100% should explore the reasons why testing is not occurring and/or the results are not being reported to the
implementing partner.
How to review f Through routine data quality audits or assessments, conducted by the program or externally.

66
9. OVC_TST_REPORT
or data OVC_TST_RESULT < (OVC_SERV < 18 years served by an OVC comprehensive program)
quality: OVC_TST_RESULT < (OVC_HIVSTAT < 18 years who are not positive)
How to
calculate Annual totals include those who reported their HIV testing result in the former four quarters (Q1, Q2, Q3 and
annual totals: Q4).

Disaggregation: Numerator Disaggregation

Disaggregate groups Disaggregates
N/A N/A
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 1852
This sheet last updated on: October 2024

10. OVC_VL_ELIGIBLE
Description: Percentage of HIV positive children and caregivers (active or graduated) who are served by an OVC
comprehensive program on ART, who are eligible for viral load testing (eligible means consistently on ART
for a minimum of 3 months or whatever the standard is established in the Country.)
67
10. OVC_VL_ELIGIBLE
Numerator: Number of HIV positive children and caregivers (active or graduated) who are served by an OVC
comprehensive program on ART who are eligible to have a VL test
Denominator: Number of HIV positive children and caregivers (active or graduated) who are served by an OVC
comprehensive program on ART
Reporting level: Community
Reporting
Semi-Annually
frequency:
How to use: CD4+ T-cell counts are used, together with the Viral Load test, to get a complete picture about how the
immune system is fighting the virus. As HIV reproduces within the body, the viral load increases and HIV
destroys the CD4+ T-cells and thus lowers the amount of cells present. Generally, the higher the HIV viral
load, the more CD4+ T-cells are being destroyed. The goals are to keep CD4+ T-cell count high and viral load
low.2
OVC implementing partners should refer beneficiaries who are on ART and eligible for viral load testing.
Eligibility for viral load testing should be based off of in-country criteria and guidance.
This indicator continues along the HIV continuum of care from OVC_HIVSTAT to ensure HIV positive
beneficiaries are receiving appropriate treatment to reach viral suppression. As such, partners should refer to
definitions of “on ART” provided under OVC_HIVSTAT in the MER 2.6 Guidance.

68
10. OVC_VL_ELIGIBLE
How to collect: Viral load testing is conducted by clinical providers, not directly by OVC programs. Viral load testing
eligibility should be monitored primarily by clinical partners, however OVC implementing partners should
confirm beneficiary-reported viral load test eligibility with facility-based partners. This requires a data sharing
agreement that should be articulated in a memorandum of understanding (or equivalent) between the facility
partner and OVC partner.
As such, data sources for this indicator include client records, or other confidential case management and
program monitoring tools that track those in treatment and care.
OVC_VL_ELIGIBLE is applicable to all HIV-positive OVC_SERV beneficiaries (active or graduated who are
served by an OVC comprehensive program) who are on ART.

How to review fo Disaggregates should add up to 100% of the numerator.

r data quality:
How to calculate Calculate by counting all OVC_SERV who are on ART at any point during the former four quarters (Q1, Q2,
annual totals: Q3, Q4), then calculate the number of those who are eligible for viral load testing.
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
Age and Sex (required) ● By <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-17 F/M, 18-20 F/M youth

Age and Sex (optional) ● 18+ F/M caregivers

Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes

69
Notes on baselines/targets (rationale for
selecting the baseline and setting target,
other notes…):
Other notes:

Performance Indicator Values

Time Period Targets Actual Comments

Annual FY25 (Oct 2024 to Sept
2025) 628
This sheet last updated on: October 2024

11. OVC_VLR
Description: Percentage of HIV positive OVC and caregivers (active and graduated) who are served by an OVC comprehensive
program who are on ART with a known documented viral load test result within the previous 12 months
Numerator: Number of HIV positive OVC and caregivers (active and graduated) who are served by an OVC comprehensive
program who are on ART with a known documented viral load test result within the previous 12 months
Denominator: Number of HIV positive OVC and caregivers (active and graduated) who are served by an OVC comprehensive
program on ART who are eligible to have a viral load test
Reporting level: Implementing partner
Reporting
Semi-Annually
frequency:
How to collect: Viral load testing is conducted by clinical providers, not directly by OVC programs. Viral load testing should be
monitored primarily by clinical partners, however OVC implementing partners should confirm beneficiary-reported
viral load test results with facility-based partners. This requires a data sharing agreement that should be articulated in a
memorandum of understanding (MOU or equivalent) between the facility partner and OVC partner.

As such, data sources for this indicator include client records, or other confidential case management and program
monitoring tools that track those in treatment and care. In the absence of an MOU, OVC partners may collect self-
reported viral load test results from beneficiaries. This should be a temporary method of reporting on this indicator,
while MOUs are being established. Viral load results that are self-reported should be counted as “self-report” under the
disaggregates provided.
70
 OVC_VLR is applicable to all OVC_SERV who are served by a comprehensive OVC program.
How to review f
or data Disaggregates should add up to 100% of the numerator.
quality:
How to Calculate by counting all OVC_SERV who are on ART at any point during the former four quarters (Q1, Q2, Q3, Q4),
calculate then calculate the number of those who are eligible for a viral load test, then calculate the number of those who have a
annual totals: documented viral load test result in the last 12 months.
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates
Confirmed with ● Confirmed <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-17 F/M, 18-20 F/M youth
facility (as ● Confirmed 18+ F/M caregivers (suggested)
applicable), by age
and sex
Self-reported (as ● Self-reported <1 F/M, 5-6 F/M, 10-14 F/M, 15-17 F/M, 18-20 F/M youth
applicable), by age ● Self-reported 18+ F/M caregivers (suggested)
and sex

Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 628
71
This sheet last updated on: October 2024

72
12. OVC_VLS
Description: Percentage of HIV positive OVC and caregivers (active and graduated) who are served
by an OVC comprehensive program who are on ART and are virally suppressed (<1000
copies/ml)
Numerator:
Number of HIV positive OVC and (active and graduated) who are served by an OVC
comprehensive program who are on ART and are virally suppressed (<1000 copies/ml).
Denominator: Number of HIV positive OVC and (active and graduated) who are served by an OVC
comprehensive program who are on ART with a known documented viral load test result
within the previous 12 months (OVC_VLR numerator)
Reporting level: Implementing partner
Reporting frequency: Semi-Annually
How to collect: Viral load testing is conducted by clinical providers, not directly by OVC programs.
Viral load suppression should be monitored primarily by clinical partners, however
OVC implementing partners should confirm beneficiary-reported viral load test results
with facility-based partners. This requires a data sharing agreement that should be
articulated in a memorandum of understanding (MOU or equivalent) between the
facility partner and OVC partner.

As such, data sources for this indicator include client records, or other confidential case
management and program monitoring tools that track those in treatment and care. In the
absence of an MOU, OVC partners may collect self-reported viral suppression from
beneficiaries. This should be a temporary method of reporting on this indicator, while
MOUs are being established. Viral suppression instances that are self-reported should
be counted as “self-report” under the disaggregates provided.
OVC_VLR is applicable to all OVC_SERV who are served by a comprehensive OVC
program.
How to review for data quality: Disaggregates should add up to 100% of the numerator.
How to calculate annual totals: Calculate by counting all OVC_SERV who are on ART at any point during the former
four quarters (Q1, Q2, Q3, Q4), then calculate the number of those who have a
documented viral load test result in the last 12 months., then calculate the number who

73
12. OVC_VLS
are virally suppressed.
Disaggregation: Numerator Disaggregation
Disaggregate groups Disaggregates

Confirmed with ● Confirmed <1 F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-17
facility (as applicable) F/M, 18-20 F/M youth
by age and sex ● Confirmed 18+ F/M caregivers (suggested)
Self-reported (as ● Self-reported <1 F/M, 5-6 F/M, 10-14 F/M, 15-17 F/M, 18-
applicable), by age 20 F/M youth
and sex ● Self-reported 18+ F/M caregivers (suggested)
Denominator Disaggregation
Disaggregate groups Disaggregates
N/A N/A

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 628
This sheet last updated on: October 2024

74
3 Care and Treatment Custom Indicators
Indicator No 13
Name of Indicator: Total number of clients in CAGs (Community ART Refill Groups/Peer-led Community ART
Distributions/PCARDs)
Description: This is total/overall number of PLHIVs who are enrolled in differentiated care service delivery models which are
Community ART Refill Groups and Peer-led Community ART distributions.
Numerator: Total number of Clients in CAGs/ PCADs (Community ART Refill Groups/Peer-led Community ART distributions).
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator is key to ensuring that ART services are being provided in a client-centered manner. It will also ensure that
PLHIVs stay on treatment, which will lead to viral suppression, the third 95 of epidemic control.
How to collect: CAG Client Tracking Registers at HF and Community; CAG ART Pharmacy Register; CommCare app (when data
digitization is complete).
How to review for data quality:
How to calculate annual total: Sum of PLHIVs enrolled in CAGs/PCADs
Disaggregation: By number of CAGs/PCADs formed (having 4 to 8 members), age group (15-19, 20-24, 25-49, 50+), Sex (Male,
Female), Health systems level (woreda and community).
The CAG/PCAD membership may be reduced to 4, especially in the context of COVID-19 to keep the group < 4 and COVID-19 risk
free group. The membership of up to 8 could be for consideration after the COVID-19 pandemic.
Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
75
 Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 825
This sheet last updated on: October 2024

Indicator No 14
Name of Indicator: Number of clients received Comprehensive Case management services
Description: The number of people living with HIV who are receiving differentiated community-based case management services
defined as receiving at least one of the services from the minimum packages. Clients will receive scheduled assessments of their needs
and services will vary in intensity and frequency based on client need. These services may include referrals to facility services as well as
other services provided at the community level.
Numerator: Number of clients received Comprehensive Case management services.
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator counts the number of people living with HIV served at the community level, which supports treatment
adherence and therefore epidemic control.

How to collect: Care and Support data capturing tools/ CommCare app
How to review for data quality: Need to make sure that a client is counted only once.
How to calculate annual total: De-duplicated number of PLHIVs who received at least one of the services from the minimum
packages.
Disaggregation: By type of service (assessment, screening, counseling and education), type of client (New, Repeat), Age (<18, >18),
Sex (Male, Female), Health system level (woreda ).

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:

76
 Performance Indicator Values
Time Period Targets Actual Comments
Annual FY24 (Oct 2024 to Sept
2025) 1676
This sheet last updated on: October 2024

Indicator No 15
Name of Indicator: Number of patients that receive routine adherence support (clients with no significant risk of poor
adherence)
Description: This is the number of people living with HIV who are enrolled in care/case management and receiving routine adherence
support services. This adherence support is provided for clients with no significant risk of poor adherence.
Numerator: Number of patients that receive routine adherence support (clients with no significant risk of poor adherence)
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator counts the number of people living with HIV served at the community level, which proactively supports
treatment adherence and therefore epidemic control.
How to collect: Care and Support data capturing tools/ CommCare app
How to review for data quality: Need to make sure that a client is counted only once.
How to calculate annual total: De-duplicated number of PLHIVs who received at least one of the services from the minimum
packages.
Disaggregation: By type of service (assessment, screening, counseling and education), type of client (New, Repeat), Age (<18, >18),
Sex (Male, Female), Health system level (woreda ).

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025)
77
 This sheet last updated on: October 2024

Indicator No 16
Name of Indicator: Number of clients received Interventional Adherence Support (patients with poor adherence)
Description: This is the number of people living with HIV who are enrolled in routine adherence care and receiving interventional
adherence support services. This adherence support is provided for clients who are identified by CRPs/CEFS for not adhering well to
ART.
Numerator: Number of clients received Interventional Adherence Support (patients with poor adherence)
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator is key to ensuring PLHIV stay on treatment, which will lead to viral suppression, the third 95 of epidemic
control.
How to collect: CommCare app/Care & Support Register
How to review for data quality:
How to calculate annual total: Sum of PLHIV enrolled in the differentiated service delivery model
Disaggregation: By Age (<18, >18), Sex (Male, Female), and Health systems level (woreda)

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 560
This sheet last updated on: October 2024

Indicator No 17
Name of Indicator: Number and % of completed referrals from community to facility (Number and % of clients received bi-
directional referral services)
78
Description: This is community to facility referral service for which referral feedback is obtained.
Numerator: Number of completed referrals from community to facility
Denominator: Number of referrals issued at the community level (to health facilities)
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator measures the effectiveness of the referral system in linking PLHIV at the community level to facility
services they need in order to get on or stay on treatment.
How to collect: CEFs will enter the referral made from the community on the mobile and the CommCare app will display the referral
made to HCW at the health facility.
How to review for data quality:
How to calculate annual total: Divide sum of numerator by sum of denominator
Disaggregation: By Health system level (woreda & community), Type of referral (Ex: HIV testing, TB, FP, STI, Depression,
Adherence, Clinical GBV Services, others), Age <18 and >18), Sex (Male, Female).

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 521
This sheet last updated on: October 2024

Indicator No 18
Name of Indicator: Number and % of clients received GBV screening and referral services
Description: This is total/overall number of men and women PLHIVs who are enrolled in care who are screened for GBV and referred
to receive appropriate and relevant services for victims of GBV (services include psychosocial, health, legal, socioeconomic, etc. )
Numerator: Total/overall number of men and women PLHIVs who are enrolled in care and are screened for GBV.
Denominator: Total/overall number of men and women PLHIVs who are enrolled in care, screened for GBV and are referred to receive
the appropriate and relevant services for victims of GBV.
79
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator is key to ensuring that all men and women PLHIV who are enrolled in care are screened for GBV, and
referred to receive appropriate and relevant services (services include psychosocial, health, legal, socioeconomic, etc.) when found to be
victims of GBV.
How to collect: Care and Support data capturing tools/ CommCare app
How to review for data quality:
How to calculate annual total: Sum of men and women PLHIVs registered in the GBV screening and referral register
Disaggregation: By number of men and women PLHIV with age group (5-9; 10-14; 15-19, 20-24, 25-49, 50+), Sex (Male, Female),
Health systems level (woreda and community)
Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 787
This sheet last updated on: October 2024

80
 Indicator No 19
Name of Indicator: Number of LTFU line lists of Clients received from Health Facilities (HFs)
Description: This is the total number of line lists of LTFU PLHIV that are given from each health facility to the community partners for
tracing and returning into care and treatment.
Numerator: The total number of line lists of LTFU PLHIV who are given from each health facility to the community partners for
tracing.
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator measures the number of line list of LTFU PLHIVs provided from each Health Facility to the community
partners for tracing and re-engaging them back to treatment .The quality of the addresses of the line lists (proper telephone number,
identification (age/sex), physical address including sub-city, Woreda name, house number, etc.) provided from the facility is critical to
properly locating the lost clients, providing the required counseling and convincing the lost clients to return to treatment.
How to collect: Care and Support data capturing tools/ CommCare app
How to review for data quality:
How to calculate annual total: Sum of the total number of line lists of PLHIV who are LTFU received from each health facility. CEFs
will enter the lists of LTFU received from the facility on the mobile and the CommCare app will display the lists.
Disaggregation: By Health Facility and Health system level (woreda & community), Age <18 and >18), Sex (Male, Female)

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025)
This sheet last updated on: October 2024

Indicator No 20
Name of Indicator: Number and % of LTFUs that are traced and located

81
Description: This is the total number of line lists of LTFU received from each health facility and are traced and located in the
community.
Numerator: The total number of LTFU clients that are traced and located in the community
Denominator: The total number of line lists of LTFU that are given from each health facility to the community partners for tracing
and returning into care and treatment.
Reporting level: Community
Reporting frequency: Quarterly
How to use: The quality and completeness of the addresses of the line lists (proper telephone number, identification (age/sex),
physical address including sub-city, Woreda name, house number, etc.) provided from the facility is critical to properly locating the lost
clients before providing the required counseling and convincing the lost client to return to treatment.
This indicator measures the quality and completeness of the line list of LTFU data provided from each health facility to the
community partners which contributes to the effectiveness of tracing and locating of the client’s where about. This is a critical point for
the community health care provider to be able to provide the required counseling and ensure returning the client to care and treatment.
Furthermore, the disaggregation of the traced and located by different outcomes (self TO, still on treatment, dead, not willing to return
to care for different reasons such as traditional medicine, faith related reasons, etc.) is done at this level.
The total number of re-engaged to care (the next level of indicator) and the different other outcomes mentioned above should sum up to
the number of the clients traced and located.
How to collect: Care and Support data capturing tools/ CommCare app.
How to review for data quality:
How to calculate annual total: Sum up the lists of the LTFU clients that are successfully traced and located in the community.
Disaggregation: By Health Facility and Health system level (woreda & community), Age <18 and >18), Sex (Male, Female)

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025)
This sheet last updated on: October 2024

82
83
Indicator No 21
Name of Indicator: Number and % of clients re-engaged to care after tracing of LFTU
Description: This is the total number of line lists of LTFU clients who are re-engaged to care and treatment after tracing and locating
them in the community.
Numerator: The total number of LTFU clients that are re-engaged to care and treatment
Denominator: The total number of line list of LTFU clients that are traced and located in the community
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator measures the effectiveness of counseling skills the service provides to convince and return clients to
care/treatment after locating the LTFU clients in the community. Furthermore, the disaggregation level by different outcomes (self TO,
still on treatment, dead, not willing to return to care for different reasons such as traditional medicine, faith related reasons, etc.) is done
at this level. The total of re-engaged to care and these different outcomes mentioned above should sum up to the number of the clients
traced and located. Re-engagement to care is a key activity to ensuring lost PLHIV return and stay on treatment, contribute to increasing
the TX_CURR, lead to viral suppression and thereby reach the second and the third 95% of epidemic control.
How to collect: Care and Support data capturing tools/ CommCare app
How to review for data quality:
How to calculate annual total: Sum up the lists of the LTFU clients that are successfully re-engaged to care and treatment
Disaggregation: By Health Facility and Health system level (woreda & community), Age <18 and >18), Sex (Male, Female)

Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 389
This sheet last updated on: October 2024

Indicator No 22
Name of Indicator: Number of clients reached by cervical cancer screening messages or other

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Demand creation activities
Description: This is the total/overall number of Women Living with HIV (WLHIV) who are enrolled in care reached with demand
creation (through awareness creation and Literacy messaging) for Cervical Cancer Screening and Treatment.
Numerator: Total/overall number of WLHIV who are enrolled in care reached with demand creation (through awareness creation
and Literacy messaging) for Cervical Cancer Screening and Treatment
Denominator: NA
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator is key to ensuring that all eligible WLHIV are reached for demand creation by receiving awareness creation
and literacy about cervical cancer.
How to collect: Tracking register for clients with “Demand creation for cervical cancer screening and treatment” at Community;
CommCare app (when data digitization is complete)
How to review for data quality:
How to calculate annual total: Sum of WLHIV enrolled in the “demand creation” referral register
Disaggregation: By number of WLHIV received the demand creation, age group women (24-29; 30-39; 40-49; 50+), Sex (all Females),
Health systems level (woreda and community)

Other Notes
Notes on baselines/targets (rationale for selecting the
baseline and setting target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 5909
This sheet last updated on: October 2024

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Indicator No 23
Name of Indicator: Number and % of clients referred to HFs for Cervical cancer screening with VIA (Visual Inspection of
cervix with Acetic acid wash)
Description: This is the total/overall number of WLHIV who are reached with demand creation (through awareness creation and
Literacy messaging) for Cervical Cancer Screening and Treatment and are referred to HFs for screening and treatment.
Numerator: Total/overall number of WLHIV who are referred to HFs for cervical cancer screening and treatment with VIA after
getting the appropriate demand creation (through awareness creation and Literacy messaging).
Denominator: Total/overall number of WLHIV who are enrolled in care and are reached with demand creation (through
awareness creation and Literacy messaging) for Cervical Cancer Screening and Treatment
Reporting level: Community
Reporting frequency: Quarterly
How to use: This indicator is key to ensuring that all eligible WLHIV are reached with demand creation by receiving awareness
creation and literacy about cervical cancer and have an informed decision of undertaking early screening and treatment and lead a
better quality of life.
How to collect: Tracking register for clients with Demand creation for cervical cancer screening and treatment at Community;
CommCare app (when data digitization is complete)
How to review for data quality:
How to calculate annual total: Sum of WLHIV enrolled in the “demand creation and referral” register
Disaggregation: By number of WLHIV are referred to the HF for cervical screening; age group women (24-29; 30-39; 40-49; 50+),
Sex (all Females), Health Systems level (woreda and community).

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 886
This sheet last updated on: October 2024

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Indicator No 24
Name of Indicator: GEND_NORM
Description: This is total/overall number of people completing an intervention pertaining to gender norms, that meets the minimum
criteria
Numerator: Number of people completing an intervention pertaining to gender norms that meets the minimum criteria
Denominator: NA
Reporting level: Community and Facility
Reporting frequency: Quarterly
How to use:
At the country level, this indicator will enable PEPFAR country teams, governments, implementing partners, and other in-country
counterparts to:
● Help assess whether gender-related activities are being implemented within the country, based on the epidemiologic data, the
national strategy, and social, political, economic, and cultural context.
● When possible, support efforts to assess the impact of gender-related activities and services by correlating the scale-up of these
activities over time and by geographic area with outcomes related to gender (and HIV/AIDS), as described through other data
collection efforts such as the Demographic and Health Survey (DHS).
● Identify programmatic gaps by analyzing the number and types of people (male/female, age group) being reached by gender-
related activities.
● Contribute to building an enabling environment to prevent gender-based violence and violence against children, under PEPFAR as
well as other United States Government (USG) programs.
● Advocate for greater resources and technical assistance for gender-related programming.

How to collect: Data should be collected continuously at the community level, including in a variety of venues such as schools,
workplace, and community organizations. Standard program monitoring tools, such as forms, logbooks, spreadsheets, and databases
that partners develop or already use.
The numerator can be generated by counting the number of adults and children who completed a PEPFAR-supported intervention
pertaining to gender norms that meets the minimum criteria during the reporting period.
Minimum Criteria
All three minimum criteria must be met for the individual to count
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under this indicator:
1. The intervention must include a component that supports participants to understand
and question existing gender norms and reflect on the impact of those norms on their
lives and communities using a participatory methodology.
2. The intervention must address gender norms that in one way or another are linked to
HIV outcomes within prevention, treatment, care or support.
3. The intervention must involve a minimum of ten hours of intervention time that the
the same person must participate in either an individual, small group, or community setting.
One-off interventions cannot be counted under this indicator.
Interventions considered to meet the minimum criteria as of April 2022:
-Stepping Stones
-Yaari Dosti
-Program H
-One Man Can
-Men As Partners
-SASA!
-Coaching Boys into Men
-IMPower
-Grassroot Soccer
These activities are crosscutting and contribute to results across a range of PEPFAR program areas. Individuals counted under this
indicator may also be captured under other relevant prevention indicators. In other words, an individual counted here might also
receive other kinds of PEPFAR services, such as HIV testing, voluntary medical male circumcision (VMMC), or prevention of
mother-to-child transmission (PMTCT) of HIV.
Individuals reached by mass media activities, e.g., radio and TV spots, or billboards for the general population, are not counted
under this indicator.
Gender is a culturally defined set of economic, social, and political roles, responsibilities, rights, entitlements, and obligations
associated with being female and male, as well as the power relations between and among women and men, boys and girls. The
definition of and expectations for what it means to be a woman or girl and a man or boy, and sanctions for not adhering to those
expectations, vary across cultures and over time, and often intersect with other factors such as race, class, age, and sexual
orientation. All individuals, independent of gender identity, are subject to the same set of expectations and sanctions (Interagency
Gender Working Group, IGWG). Gender is not interchangeable with women or sex.
Harmful gender norms related to HIV/AIDS include those that govern the following behaviors: cross generational and transactional
sex; multiple concurrent partnerships; alcohol/substance misuse/abuse; inequitable control of household resources; poor use of
88
health care services; lack of support for partner’s health care concerns; stigma, discrimination and violence related to sexual
orientation and gender identity; and limited involvement in HIV/AIDS caregiving.
Activities that address harmful gender norms related to HIV/AIDS seek to change traditional, cultural, and social gender norms that
contribute to behaviors that increase HIV/AIDS risk in both men and women, and that impede access to care and treatment services
for those who need them. These activities are crosscutting and contribute to results across a range of PEPFAR program areas,
including prevention, care, and treatment.

Direct Service Delivery (DSD)

The number of adults and children reached by an individual, small group, or community-level activity that addresses gender norms
can be counted as directly supported by PEPFAR when the service receives support that:
1. Is critical to the delivery of the gender norms within the context of HIV/AIDS intervention. Examples include the provision of:
● Partial or full salary support for those developing activity-related curricula, educational materials, etc.; and/or
● Partial or full salary support for those actively delivering the individual, small group, or community-level activity (e.g., providing
one-on-one counseling or information exchange; facilitating small group discussions, meetings, or debates; providing community
engagement activities; facilitating town hall meetings; leading community sensitization or awareness forums, etc.) AND
2. Requires established presence and/or frequent presence (at least one visit per quarter) at the facilities or sites (or within the
communities) by the PEPFAR IP, where the activities are being delivered.
Both conditions must be met to count individuals as directly supported by PEPFAR under this indicator.
Note: Mass media activities cannot be counted as “direct” under this indicator.

How to review for data quality:

When disaggregating by age, it is important to focus on the target audience for the activity and the expected normative change. If a
parent participates with his or her child, both can be counted if the activity specifically targets both. However, if the activity only
targets the parent/adult, the child should not be counted, even if a logical link can be made between normative change for the
parent/adult and future positive outcomes for the child.
Care should be taken to not count an individual more than once within the reporting quarter.

How to calculate annual total:

Sum results across reporting periods, de-duplicating unique individuals already reached and reported in Q1, Q2, and Q3 of the same
fiscal year in Q4 reporting (an individual should be counted only once for the year

Disaggregation: By Age/Sex: <10 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M,45-49
F/M, 50+ F/M, Unknown age F/M OR <18 F/M, 18-44 F/M, 45+ F/M, Unknown Age F/M
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Type of Activity: Individual, small group, community level
Individual
<10 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age
F/M
Small Group
<10 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age
F/M
Community-level
<10 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age
F/M

Disaggregate descriptions & definitions:

Individual: Individual level activities are provided to one individual at a time, e.g., individual counseling, mentoring, etc.
Small Group: Small group level activities are those delivered in small group settings (less than 25 people), e.g., workplace
programs, men’s support groups, etc.
Community-level: Community-level activities are those delivered in community-wide settings (25 or greater people), e.g., town
hall meetings, community-wide education campaigns, etc.
Other Notes

Notes on baselines/targets (rationale for

selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 185
This sheet last updated on: October 2025
Indicator No 25
Name of Indicator: GEND_REPORT_COMM:
Description: Percentage of individuals who were provided with or referred to post-violence services among those who disclosed
experience of violence within community settings.

90
Numerator: Number of individuals who disclosed to program staff or outreach workers outside of clinical facilities that they
experienced violence within the past three months from any type of perpetrator and were referred for or provided clinical or non-
clinical post-violence care
Denominator: Number of individuals who disclosed to program staff or outreach workers outside of clinical facilities that they
experienced violence within the past three months from any type of perpetrator.
Reporting level: Community and Facility
Reporting frequency: Semi-annual
How to use:
How to collect:
How to review for data quality:
How to calculate annual total:
Sum results across reporting periods, de-duplicating unique individuals already reached and reported in Q1, Q2, and Q3 of the same
fiscal year in Q4 reporting (an individual should be counted only once for the year
Disaggregation:
Numerator / Denominator Disaggregation
By Violence Type: sexual violence, physical and/or emotional violence, if both–should be counted under sexual violence to avoid
duplication.
Perpetrator Type *: intimate partner, client of sex worker, relative/family member, police, Other,
non-disclosed/unknown
*Select only one type of perpetrator to avoid duplicating if multiple types are described
Age/Sex Type: <1 M/F, 1–4 M/F, 5–9 M/F, <10 M/F, 10–14 M/F, 15–19 M/F, 20–24 M/F, 25–29
M/F, 30–34 M/F, 35–39 M/F, 40–44 M/F, 45–49 M/F, 50+ M/F, unknown age M/F
Referral/Service Type: referral only, service provision only, referral and service provision

Other Notes
Notes on baselines/targets (rationale for
selecting the baseline and setting
target, other notes…):
Other notes:
Performance Indicator Values
Time Period Targets Actual Comments
Annual FY25 (Oct 2024 to Sept
2025) 787

91
This sheet last updated on: October 2024

92
Indicator No 26
Name of Indicator: HTS_INDEX_GBV:
Description: Percentage of individuals identified and tested using index testing services and received their results, who were screened for violence and referred or
provided GBV response services.
Numerator: Number of individuals identified and tested using index testing services and received their results, who were screened for violence and referred or
provided GBV response services
Denominator: Percentage of individuals identified and tested using index testing services and received their results, who were screened for violence and referred
or provided GBV response services.
Reporting level: Community and Facility
Reporting frequency: Quarterly
How to use:
How to collect:
How to review for data quality:
How to calculate annual total:
Sum results across reporting periods, de-duplicating unique individuals already reached and reported in Q1, Q2, and Q3 of the same fiscal year in Q4 reporting (an
individual should be counted only once for the year

Disaggregation:
Numerator / Denominator Disaggregation
Number of index cases offered index testing services by age/sex (required): <1 F/M, 1-4
F/M, 5-9 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age F/M
Number of index cases that accepted index testing services by age/sex (required): <1
F/M, 1-4 F/M, 5-9 F/M, 10-14 F/M, 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age F/M
Number of contacts elicited and age/sex (required): <15 F/M, 15+ F/M, Unknown Age F/M
Other Notes
Notes on baselines/targets (rationale
for selecting the baseline and
setting target, other notes…):
Other notes:
Performance Indicator Values
Targe
Time Period ts Actual Comments
Annual FY25 (Oct 2024 to Sept
2025)
This sheet last updated on: October 2024

93
Key Indicators of C-NCD-HIV integrated Service Delivery

Out Come Indicators

S.N
Indicator Data Source Frequency Contact person
o
1 # Of PLHIV assessed for NCDs risk Tally sheet Monthly Community engagement facilitators
2 # Of PLHIV screened for HPN Tally sheet Monthly Community engagement facilitators
Proportion of PLHIV screened for Tally sheet & C
3 Monthly Community engagement facilitators
HPN with raised BP NCD-HIV Logbook
Proportion of PLHIV with raised BP
4 Referral Register Monthly Community engagement facilitators
referred to HFs
Proportion of PLHIV with diagnosed
Referral Register &
5 HPN referred to CHW for follow up Monthly Community engagement facilitators
Feed back
at community level
Proportion of clients controlled for C-NCD-HIV
6 CEF Community engagement facilitators
HTN registration logbook
7 # Of PLHIV screened for DM Tally sheet Monthly Community engagement facilitators
Proportion of PLHIV screened for
8 Tally sheet Monthly Community engagement facilitators
DM with raised blood sugar
Proportion of PLHIV with raised
9 Referral Register Monthly Community engagement facilitators
blood sugar referred to HFs
Proportion of PLHIV with diagnosed Referral Register &
10 Monthly Community engagement facilitators
DM referred to CHW for follow up Feed back
Proportion of clients controlled for C-NCD-HIV
11 CEF Community engagement facilitators
DM registration logbook
Proportion of screened PLHIV with Tally sheet & C-NCD
12 Monthly Community engagement facilitators
both raised BP and blood sugar HIV Logbook
CVD risk assessment
13 # Of clients assessed for CVD risk Monthly Community engagement facilitators
tally sheet
14 Proportion of clients with high CVD C-NCD-HIV Logbook Monthly Community engagement facilitators
94
 risks profile
# Of eligible community members Tally sheet, Referral
15 screened for NCDs and risk positive Register & C-NCD Monthly Community engagement facilitators
for HIV test screening. HIV Logbook

# Of new HIV cases identified among

16 NCD clients and referred to HF for Referral Register Monthly Community engagement facilitators
testing
# Of clients with NCDs who received
C-NCD-HIV Follow up
17 healthy lifestyle counseling on NCD Monthly Community engagement facilitators
form & logbook
HIV
Proportion of PLHIV with C-NCD-HIV Follow up
18 Monthly Community engagement facilitators
complication and referred to HFs form & logbook

HIV-NCD LTFU line

# Of NCD client line list who lost/
19 list receiving form Monthly Community engagement facilitators
interrupt from care ART/NCD care
from HF
# Of NCD client returned back/ HIV-NCD LTFU &
20 Monthly Community engagement facilitators
reengaged to ART/NCD care referral register
# Of NCD client with another HIV-NCD LTFU &
21 Monthly Community engagement facilitators
outcome referral register
Proportion of NCD and HIV clients
who reported satisfaction and Baseline and endline
21 Bi-annual LIP & PH
empowerment with the integrated assessment
services provision
Proportion of HCWs and CHWs who
reported positive result/impact of Baseline and endline
22 Annual TF member
integration on their work assessment
p

95
Data Flow

96