High Level Regional Consultation for Policy Makers to Enhance Leadership in Planning the National HIV & AIDS Response S

P

Dominique Mathiot6 November 2007

Introduction to

Results Based Management (RBM)and

Results Based Planning (RBP)

Let’s talk about “results”!

S PSurveillance Data EPP

Census/UN Pop Division Estimates

UNAIDS model epidemic patterns

Spectrum

Costing and coverage data

Existing effectiveness data

Resource Needs Model

GOALS /MOT

Progression using Tools

What is the prevalence of HIV?

How will thedemography be

affected?

What resources are required?

How should we allocate resources?

How do we ensure sustainability?

NASA, Country strategic plans, etc

Financial Planning

SAT

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So far, you may have….

• Used the SAT to review your current national strategic framework

• Collected the data and evidence• Analyze the evidence – EPP, SPECTRUM, MOT• Estimated your resources needs• Taken into account data from NASA• Changed the behavior of your partners – CHAT and

aligned their support behind the “Three One Principles”

• Agreed nationally on your priorities and targets toward UA

To be continued…

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And you are…

• Probably exhausted, brain-dead, confused may be (I am)….

And know what, we haven’t yet even talked about making plans that work for us!!!!

So it is now time to talk about results-based planning and management….

S PThe Origins of RBM?

1950s – Peter Drucker's pioneering work/ 'Command and Control' of the workforce gives way to 'Management‘

1960s and 70s - Adoption of 'Management by Objectives' to motivate staff around ‘SMART’ objectives with established timelines

1980s – Adopted vigorously by UK and New Zealand in the 80s; USAID's Logical Framework Approach (LFA) and GTZ's ZOPP and the UN shift from line item budgets to budgeting around objectives

1990s – Wholesale adoption by development and humanitarian communities of Results-based management – is now being adopted to direct and justify increased development aid

2000 + – Results-based budgeting

S PWhy RBM?

Stated rationale/intended gains:

• Improved focus on results instead of activities• Improved transparency• Improved accountability• Enhanced performance orientation• Improved measurement of programme

achievements• Enhanced strategic focus• No choice, it is an industry standard• To get more funds!!

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Results Based Management …and Results Based Planning …What does it mean for you?

Please try to explain…Please try to explain…

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Results Based Programme Planning: Sum of interventions is sufficient to achieve the expected result

Results Based Programme Management: Resources focused on achieving expected results

Monitoring and evaluation of SMART indicators and targeted results used to-- adjust activities and interventions-- hold duty bearers accountable !

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Interventions must not only be necessary, but also sufficient to achieve the expected result

If a problem is caused

by conditionsthree

Principle of RBP

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All three conditions

Principle of RBP

must addressedbe

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So, since we are now talking about ‘results’, what is a ‘result’?

Want to try a definition…

Want to try a definition…

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A result is a measurable or describable change resulting from a cause and effect

relationship.

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Measurable transformation

• In an individual• In group• In an organization• In a society• In a country

Two major elements in ‘Results’

Cause and effect relationship between an action and the results achieved.

“If-then” logic.

Change Causality

S P“Results” in day to day life…

Inputs

WaterSalt, condimentsCooking oilVegetablesMeat, fishFirewoodWorking time,etc...

OutputThe sauce, the main dish, the meal

Output ResultImmediate (short-term),Satisfied (after having eaten this sauce, main dish or meal)

Impact ResultLong-term effect,‘quality of life’ (if I can ensure I have a balance diet for more than 5 years)

Outcome ResultMedium- term effect,improved physical well-being (if I can make sure I have a balance diet over time)

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Now it does get more complicated because there is a hierarchy of change in ‘results’…

Can you describe what are the three levels of results?

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The likely or achieved short-term andmedium-term effects of an intervention’soutputs.

Long-term effects produced by adevelopment intervention, directly or indirectly,intended or unintended.

Impact

Outcome

Output

Hierarchy of Change

The products and services which result from the completion of activities within a development intervention.

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Let’s talk now about the different ‘types’of change we could measureat each level of the ‘results’…

Any ideas?

S PTypes of Change

Impact

Outcomes

Output

Changes in the lives of people: realisation of their rights

Institutional Change: values, laws – associated with institutional performance, new institutions

Behavioural change: new attitudes, practices

Operational Change: products and services – knowledge, skills

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Outcome

Impact

Output

Activity

Level of Change

Strategic Result

Joint Programming

Result

Multiple or single

intervention result

Results Chain

Institutional/ Behavioural

Operational/ skills, abilities,

products & services

Human rights

Focus ofChange

Timeframe

<1 yr

<5 yrs

5 yrs

5-10 yrs

Collective Account-

ability

more

less Processes

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‘Results’ are supposed to beS. M. A. R. T.

Any idea of what S.M.A.R.T. stands for?

S PS Specific

M

A

R

T

Measurable

Achievable

Relevant

Time bound

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In summary….

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INPUTS ACTIVITIES

How? What do we want ? Why?

OUTPUTS

RESOURCES

OUTCOMES

IMPACT

RESULTS

Funds, HR, equipment,

etc.

Activity output

Operational change

Behavioral /

institutional change

Quality of life

MEASURABLE CHANGE

Effect

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A Typology for RBM: HIV & AIDS

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Outcome

Impact

Output

Activity

HIV incidence reduced

Leadership empowered

Skills of NAC strengthened

Train 250 district AIDS officers

Results Like… Focus Timeframe

<1 yr

<3 yrs

5 yrs

5-10 yrs

more

less

Collective

Accountability Institutions/

Behaviours

Knowledge, skills, abilities,

services

Human!

OutcomeResponse brought to

scale

Institutions/

Behaviours

5 yrs then if

if

if

if

then

then

then

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Result

ResultResult

ResultResultResult

Result Result Result Result

Strategic Result

Programme Result

Activity Result

Impact Level

Outcome Level

Ouput Level

The results chain usually takes the formof a more complex results framework,

preserving the levels…

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Result

ResultResult

ResultResultResult

Result Result Result Result

Program inputs (resources) and activities

lead to output level results

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Result

ResultResult

ResultResultResult

Result Result Result Result

Combined Program Results (outputs) lead to

Program Results at the outcome level

S PCombined Program Results lead to

Strategic Results at the impact level

Result

ResultResult

ResultResultResult

Result Result Result Result

S PWhen all results have been consolidated

into one matrix (logframe, NSP, NSF, UNDAF, AWP)go back and check the “if then” logic

Strategic Result

Program Result

ResultResult

Result Result

if

if

if

then

then

then

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Action Language expresses results

from the provider’s perspective

can be interpreted in many ways

focuses on completion of activities

Change Language describes changes in

the conditions of people

sets precise criteria for success

focuses on results, leaving options on how to achieve them

Results Language = Change Language

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Action Language1. To strengthen the capacity of teachers

to teach life skills through training on gender sensitive, child friendly, learner directed learning approaches

2. The capacity of teachers to teach life skills is strengthened

3. By 2007, the capacity of all life skills teachers in the 10 districts with the highest adolescent HIV incidence rates is strengthened

4. All life skills teachers in the 10 districts with the highest adolescent HIV incidence rates have increased capacity by 2007 to teach life skills to school children

Change Language1. Results language to

emphasise future condition

2. Take out information relating to strategy or activities

3. All teachers everywhere? By the year 4000? Be more specific

4. Bring the subject of change to the front and shift from passive to active language

Refining Results

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Action Language

Goal: to decrease the number of children dying of AIDS and AIDS related causes

Objective: to promote the use of long lasting insecticidal nets (LLINs)

Activity: train 1000 teachers in participatory learning techniques

Indicators: number of TV and radio jingles providing malaria education; number of LLINs distributed

Change Language

Impact Result: Child mortality from AIDS and related causes decreased from 100% to 40% by 2010 Outcome Result: at least 80% of people in endemic areas sleep under a long lasting Insecticidal net

Output Result: 2 teachers in 500 schools are trained in how to teach other teachers in participatory learning

Indicator: % of people who know that sleeping under an ITN reduces the risk of malaria; % of people who sleep under a long lasting insecticidal net

Examples

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Action Language

Expand the percentage of young people, successfully practicing strong life skills, including HIV/AIDS

Ensure that all pregnant women have access to PMTCT services

Improve the care and support environment for orphans and vulnerable children

Change Language

75% of people aged 12-24 are practicing abstinence, maintaining a monogamous relationship or consistently using condoms by 2010

The percentage of pregnant women using PMTCT services increased from 40% to 80% by 2010

90% of identified orphans and vulnerable children in model districts are accessing social safety net package by 2008

Suggested answers…

Examples

S PIn summary:

Principles of Results Based Planning

• Context specific causality analysis• Hierarchical logic• “If-then” causality between levels of results• Collective accountability increases as you move up the

hierarchy towards outcomes and impact• Uses change language to describe a specific,

measurable, achievable, relevant, time-bound result • AND… based on strategic choices that focus on

realization of human rights

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Applying ‘Results’ to UN programming – The Joint UN Program of Support on AIDS

Following GTT recommendations and the Secretary General’s letter of 12 December 2005,

enhanced accountability for ‘results’ in the UN

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SUPPORT TO NAC IN ACHIEVING THE "THREE ONES"

National Goal:

UNDAF Outcome 1:

UNDAF Country Programme Outcome 1.1:

Convernor: UN Agency XXX

UNDAF Country Programme Outputs

Milestones to 2011 Key Results for 2007 Main Activities for 2007Main

Implementing Partner

Funding

SourceBudget (in USD)

 

       

       

 

       

       

 

       

       

 

       

       

Joint UN Program – Results Matrix

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COUNTRY XXX NAC SUPPORT SERVICES

National Goal: Reduce the spread of HIV, improve the quality of life of those infected and affected and mitigate the socio-economic impact of the epidemic

UNDAF Outcome 3 Reduce the incidence and socio-economic impact of HIV/AIDS, malaria and TB

Joint Program of Support on AIDS Outcome 4:

One coordination body, action framework and M&E system strengthened to function as the core of all programming and resource allocation in support of the national HIV response

Convernor: UNAIDS Secretariat

Joint Programme Outputs Milestones to 2012 Key Results for 2008 Main Activities for 2008

Main Impleme-

ting Partner

Funding

SourceBudget (in USD)

4.1. Improved coordination capacity of the National AIDS Control Council in terms of planning, resource mobilization, strategic partnerships and leadership structures of the national HIV response

1) By mid-2008, a clear framework for civil society and private sector engagement in the national HIV response and collaboration with NAC is in place2) By end-2008, a High Level, multisectoral public sector HIV accountability structure is established and functioning3) By end-2009, all funding partners to the national HIV response have undergone minimum one peer review4) By end-2009, all major stakeholders in the national HIV response base their contribution on formal agreement with NAC (MoU/Code of Conduct)5) By end-2010, information on all resource allocation, programming and monitoring data is channelled through/available to NAC6) By end-2010, an effective mechanism is in place for sustainable long-term funding of the national HIV response

1) The NAC Partnership Forum is fully operational2) The High-level Public Sector Committee on HIV is established as part of the government accountability structure for HIV mainstreaming2) By mid-2008, the High-level committee on national HIV response oversight is meeting on a regular basis (at least bi-annually) and provides feedback reports3) By mid-2008, the consolidated resource mobilization plan for the national HIV response is in place4) By end-2008, six largest development partners (USG, DFID, WB, SIDA, etc.) and key public sectors (Health, Education, Transport, Agriculture, Law and Order and Security) in the HIV response have completed a peer review process

1. Facilitate participatory process for development of clear structure and documentation of NAC Partnership Forum

NAC

2. Source technical support to development of civil society and private sector engagement frameworks

NAC, ASOs

3. Provide financial and technical inputs to implementation of civil society engagement plan of action, capacity development and grant making processes

NAC, ASOs

4. Advocate for, and participate in negotiations of establishment of Public Sector HIV Committee

NAC, Xxxx

5. Advocate for institutionalization of periodic high-level national HIV response accountability reviews

NAC, Xxxx

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Universal Access Targets and Results-Based Planning

Are Universal Access Targets ‘results’? Yes? / No?

If Yes, what kind of ‘results’ are they?

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“Targets should focus on both achieving defined impact as well as overcoming

critical obstacles to scaling up. The impact targets would be set for 2010 with interim ‘process’ targets (milestones) for 2008”.

Scaling up towards Universal Access –Considerations for countries to set their own national targets

for HIV prevention, treatment and careUNAIDS, April 2006

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60% of women, men and children with advanced HIV infection are receiving ARV combination treatment by 2010

(Impact level result)

Interim process target or milestone by 2009(higher outcome level result)

Outcome level result

What if Universal Access Targets were used as the starting point for operational planning?

Interim process target or milestone by 2008(higher outcome level result)

Outcome level result Outcome level result

Output levelresult

Output levelresult

Output levelresult

Output levelresult

Output levelresult

Output levelresult

S PGeneral problems in applying RBM?

• Difficult to apply causal logic, especially in relation to complex, in-transparent or multi-faceted processes

• Difficult to learn: RBM is not intuitive, not easily 'taught', years of usage required to achieve common understanding and practice

• Difficult to integrate, e.g. integrating gender and HR concerns into the results chain and in indicators

• Difficult to revise, and therefore often becomes ‘fixed’• Difficult to measure: multitude of ‘indicator types’, difficulties

in choosing a reasonable number, reliance on un-measurable indicators, seeking visibility in indicators, weak indicator tracking

• Difficult to ‘attribute’, especially at Outcome level (e.g. institution xxx, partner yyy is accountable but not fully responsible)

S PMore specific problems

in applying RBM?

• Tautologies in the results chain• Results not logically linked• Results not sufficiently specific• Results are composites of several results• Results don’t express change (e.g. support provided to

strengthen….)• Results statements are too wordy• Confusion between levels of results• Indicators not logically linked horizontally, are un-

measurable or are results statements

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Some references…

• RBM in UNDP: Overview and General Principles• Results-Based Management in CIDA: An Introductory

Guide to the Concepts and Principles• Results-Based Management: An Overview, United

Nations System Staff College• Understanding Results-Based Programming Planning

and Management, UNICEF, May 2005• Results-Based Strategic Planning (RSP) – PowerPoint,

Work Bank Institute, ASAP Workshop, St Lucia• The use and abuse of the logical framework approach,

Sida, Nov 2005