BACKGROUND: Community Action for HIV Control - USAID/PEPFAR-funded project implemented by Pact Ukraine focuses on HIV prevention, testing, and linkage to care among key populations (KP) through implementation of innovative approaches and strengthening the capacity of local organizations. In the face of war, “putting people first” has become an innate motto for the project, with its M&E system being no exception.
DESCRIPTION: Due to the war, priorities in services for KPs have shifted, and to fulfill the project's objectives, it became necessary to develop differentiated service delivery (DSD) models, taking into account the provision of immediate needs for KPs. Adapting approaches to implement M&E for the development of effective DSD models has become an urgent task. To tailor approaches for engaging with KPs in dynamic circumstances, a range of adaptive measures to enhance M&E were introduced. These included studying the regional landscape concerning KPs needs, monitoring the availability of services, visualizing real-time data on rendered services, etc. These lead to project scope shifted from HIV only (disease-centric) to inclusion of emergency services (person-centric), making some objectives being irrelevant.
LESSONS LEARNED: While operating amidst conflict and chaos, CAHC and its local partners continue to tackle service delivery obstacles through highly collaborative, person-centered adaptations and innovations in data collection, reporting and quality assurance. The adaptation of M&E approaches created an opportunity to customize project activities and deliver HIV-related services to KPs whose priorities have shifted towards basic needs. Due to these strategies and despite the dynamic and complex operating environment, CAHC delivered emergency support services to 81,332 people (70.8% male, 29.2% female) between 1 April 2022 – 1 January 2024. Among them tested 65,589 individuals, of them 1,604 were confirmed newly positive; of them 1,499 (93.5%) were enrolled on ART.
CONCLUSIONS: For HIV programs operating in conflict, timely and accurate data is especially critical to enable programmatic decision making. As evidenced by the project, enhanced collaboration, innovation and collective feedback from KPs can enable successful M&E in even the most challenging contexts; and amidst war integrate innovative needs and methods into services provision. Complex adaptive M&E system can customize project activities and further implement them in challenging times.