Challenges

Focusing on performance - by linking funding to the achievement of clear and measurable results - requires investment in measurement systems. Monitoring and evaluation is therefore critical to performance-based funding and must be integrated throughout the life cycle of every Global Fund grant.

Three of the key challenges to performance-based funding at the Global Fund are ensuring that: (1) the indicators for grant performance measurement are appropriate and have baselines; (2) countries have adequate monitoring and evaluation systems to report on their achievements; and (3) data quality is assessed.

Global Fund monitoring and evaluation and data quality mechanisms

How does the Global Fund ensure the correct indicators are being measured?

• The Global Fund does not impose its own indicators and targets but uses those defined by countries themselves (generally in their National Disease Control Strategies and Monitoring and Evaluation Plans).
• The Global Fund has developed a Monitoring and Evaluation Toolkit to provide guidance to countries on developing robust monitoring and evaluation systems to gather a collection of standard indicators to manage results and monitor the impact of a program.

How does the Global Fund ensure that countries have adequate monitoring and evaluation systems?

• Before a grant is signed, the Global Fund:
• Recommends countries to conduct a multistakeholder workshop to assess their national monitoring and evaluation systems with the aim of developing a costed action plan to address identified gaps.
• Conducts a capacity assessment of the Principal Recipient responsible for implementing the Global Fund grant (through the Local Fund Agent).
• The Global Fund recommends that countries invest 5 to 10 percent of their grant budget in monitoring and evaluation.

 How does the Global Fund ensure the quality of data?

• For periodic disbursements (every 3, 6 or 12 months, depending on the grant), the Local Fund Agent verifies the authenticity and accuracy of all Principal Recipient and sub-recipient reports.
• At least once a year, the Local Fund Agent visits a sample of service delivery sites to verify that services are delivered to populations in need and that data are accurately reported from the sites through to the Principal Recipient’s office.
• Data quality audits are conducted by external service providers with expertise in public health on a small sample of grants each year (between 12 and 20 grants). The data quality audit methodology is based on internationally accepted standards on monitoring and evaluation, developed with major partners including the World Health Organization, Stop TB Partnership, Roll Back Malaria Partnership and UNAIDS, amongst others.