Mbondo Mwende, Scherer Jennifer, Aluoch Gilbert Onyango, Sundsmo Aaron, Mwaura Njeri
PSI Kenya, Jumuia Place, Nairobi, Kenya.
Pan Afr Med J. 2013 Apr 3;14:129. doi: 10.11604/pamj.2013.14.129.2581. Print 2013.
Due to the commitment by the Government of Kenya (GoK) and international donors to address HIV/AIDS, Kenya has some of Africa's most developed health infrastructure for tackling the crisis. Despite this commitment, significant gaps exist in the national HIV/AIDS monitoring and evaluation (M&E) system. To identify these gaps and opportunities for improvement, the U.S. Centers for Disease Control and Prevention funded the Strengthening HIV Strategic Information in Kenya project, which conducted an organizational HIV M&E capacity rapid needs assessment (RNA).
The project included an in-depth desk review of national documents, policies, tools, and international best practices. National, regional, and district officials from government agencies, development partners, and implementing partners participated in key informant interviews and focus group discussions. Given the large number of regions and districts, purposive sampling was used to select 16 facilities in 8 districts across 2 regions based on the general quality of the reported HIV data and the number of partners supporting the regions.
RNA findings revealed tremendous improvements at the national level and in the various subsystems that contribute to the overall HIV strategic information. There also were significant gaps, including in a lack of M&E guidelines, parallel reporting systems, feedback given to subnational levels, and data use and general data management and use capacity at subnational levels.
An urgent need exists for the development of national M&E guidelines and a comprehensive training curriculum. To ensure success further, capacity building for subnational levels should be conducted and feedback channels to subnational staff should be established and maintained.
由于肯尼亚政府（GoK）和国际捐助方致力于应对艾滋病毒/艾滋病，肯尼亚拥有非洲一些最发达的应对该危机的卫生基础设施。尽管有这一承诺，但国家艾滋病毒/艾滋病监测与评估（M&E）系统仍存在重大差距。为了找出这些差距和改进机会，美国疾病控制与预防中心资助了肯尼亚加强艾滋病毒战略信息项目，该项目进行了一次组织艾滋病毒监测与评估能力快速需求评估（RNA）。
该项目包括对国家文件、政策、工具和国际最佳实践进行深入的案头审查。来自政府机构、发展伙伴和实施伙伴的国家、区域和地区官员参加了关键信息人士访谈和焦点小组讨论。鉴于地区和行政区数量众多，基于所报告的艾滋病毒数据的总体质量以及支持这些地区的伙伴数量，采用目的抽样法从2个地区的8个行政区中选取了16个机构。
RNA评估结果显示，在国家层面以及对整体艾滋病毒战略信息有贡献的各个子系统方面都有了巨大改进。但也存在重大差距，包括缺乏监测与评估指南、并行报告系统、向国家以下各级提供的反馈，以及国家以下各级的数据使用和一般数据管理及使用能力。
迫切需要制定国家监测与评估指南和全面的培训课程。为确保进一步取得成功，应开展国家以下各级的能力建设，并建立和维护与国家以下各级工作人员的反馈渠道。
