In 2004, national governments, civil society, and development partners agreed that in order to respond comprehensively and efficiently to the HIV epidemic, a country needs one national HIV strategic plan, one national HIV coordinating authority and one national HIV monitoring and evaluation (M&E) system. Establishing one national HIV M&E system is challenging since the system needs to function across different sectors (e.g., Ministry of Health, Ministry of Education and Youth, Ministry of Social Protection; as well as to comprise efforts of civil society, FBO & public institutions), different service delivery areas (e.g., prevention of mother-to-child transmission of HIV, antiretroviral treatment, palliative care), and different levels of implementation (e.g., national level, service-delivery level). Internationally, standards and guidelines have been developed for HIV and AIDS monitoring and evaluation systems leading to the multi-agency endorsement of the Organizing Framework for a Functional National HIV M&E system that establishes a unified approach in M&E by development partners and countries throughout the world.

The national M&E system in HIV/AIDS comprises 12 components, organized in 3 rings. Theouter ring represents the human resources, partnerships and planning to support data collection and data use. It includes individuals, organisations, functions/actions, and the organisational culture that are fundamental to improving and sustaining M&E system performance. The middle ring focuses on the mechanisms through which data are collected, verified, and transformed into useful information. The centre of the diagram represents the central purpose of the M&E system: using data for decision-making.

Outer ring – People, Partnerships and Planning

1. Organizational structures with HIV M&E functions – a variety of organizations need to work together at different levels for the national HIV M&E system to function effectively. Ideally, the system should be coordinated by one organization, such as the national AIDS coordinating authority or its equivalent;
2. Human capacity for HIV M&E – adequate skilled human resources should be ensured at all levels of the M&E system in order to complete all tasks defined in the annual costed national HIV M&E work plan;
3. Partnerships to plan, coordinate, and manage the HIV M&E system – establishment and maintenance of partnerships among in-country and international stakeholders who are involved in planning and managing the national HIV M&E system as it is important that all stakeholders in HIV M&E work together. The best practice among countries if establishment of a national M&E Technical Working Group that meets regularly and includes all relevant stakeholders;
4. National multi-sectoral HIV M&E plan – a national M&E plan including identified data needs, national standardized indicators, data collection procedures and tools, and roles and responsibilities should be developed and regularly updated;
5. Annual costed national HIV M&E work plan – an annual costed national M&E work plan, including the specific and costed HIV M&E activities of all relevant stakeholders and identified sources of funding should be developed and used for coordination and assessing progress of M&E implementation throughout the year;
6. Advocacy, communications, and culture for HIV M&E – it is important to demystify M&E, create a supportive M&E culture, and reduce any negative connotations of M&E as well as ensure knowledge of and commitment to HIV M&E system among policymakers, programme managers, programme staff, and other stakeholders;

Middle ring – Collecting, Verifying, and Analysing Data

7. Routine HIV programme monitoring- timely and high quality routine programme monitoring data are extremely important as they guide decision-making at all levels;
8. Surveys and surveillance – biological and behavioural surveillance and surveys are essential to determine the drivers and the spread of the HIV epidemic in each country. HIV surveillance and HIV surveys may focus on the general population, most-at-risk populations or both;
9. National and sub-national HIV databases – development and maintenance of national and sub-national HIV databases enable stakeholders to access relevant data for policy formulation and programme management and improvement;
10. Supportive supervision and data auditing – supportive supervision refers to overseeing and directing the performance of others and transferring the knowledge, attitudes, and skills that are essential for successful M&E of HIV activities;
11. HIV evaluation and research – appropriate use of evaluation/research data ensures that the planning of the HIV response is based on the best available evidence and guides ongoing programme improvement;

Centre – Using Data for Decision-Making

12. Data dissemination and use – the most important reason for conducting M&E is to provide the data needed for guiding policy formulation and programme operations.

In Republic of Moldova, within the framework of the mid-term review of the National AIDS Programme for 2006–2010, carried out in 2008 with the purpose to evaluate the NAP implementation, to identify gaps and to further develop the NAP to fulfil quality criteria for validation and to serve as a proper framework for the national response, the assessment of the M&E system was planned and carried out according to the Organisational Framework for 12 components of a functional M&E system. The evaluation represented a part of a piloting exercise of the assessment tool developed by Monitoring and Evaluation Reference Group (MERG). The findings of the M&E system assessment, with detailed descriptions of each component can be found in the Assessment Report: HIV/AIDS M&E System of the Republic of Moldova, November 2008.