MEASURE Evaluation in the Dominican Republic

The island of Hispaniola, which comprises the Dominican Republic and Haiti, accounts for almost three-quarters of HIV infections in the entire Caribbean region. According to UNAIDS, 0.7% percent of adults in the Dominican Republic had the virus in 2011 . Rates vary greatly within the country, though, with the highest prevalence near the Haiti border, and the lowest rates in the central part of the country.  

Heterosexual transmission accounts for approximately three-fourths of new infections, according to the Center for Disease Control and Prevention. However, stigma toward homosexuality pervades the culture of the Dominican Republic, likely resulting in underreporting of new infections from men having sex with men. Women with very little formal education and residents of bayetes, sugar cane plantations, are disproportionately infected with HIV. Sex workers and injecting drug users also face a higher risk of infection than the general population. 

The Dominican Republic government’s bold response to the epidemic included creation of the President’s Council on AIDS (COPRESIDA) in 2000. This organization - now known as CONAVIHSIDA - coordinates the country’s HIV/AIDS strategy. The Ministry of Health implements delivery of HIV/AIDS care and treatment services and provides diagnostic services as well. 

MEASURE Evaluation has been active in the Dominican Republic since 2008. During Phase III, MEASURE Evaluation has worked with CONAVIHSIDA and USAID to improve the country’s HIV monitoring and evaluation (M&E) systems.

M&E Working Group

Prior to Phase III, MEASURE Evaluation began working with CONAVIHSIDA to come up with a national 5-year HIV strategy and M&E plan. An assessment of the country’s M&E systems revealed weaknesses in data collected by HIV/AIDS service delivery organizations that were not based in health facilities. In response, MEASURE Evaluation prepared a plan to develop and roll out data collection tools and an operations manual for these community-based organizations.  

During Phase III, MEASURE Evaluation helped CONAVIHSIDA re-launch a national level M&E working group to drive this process. The group, composed of agencies such as  USAID, UNAIDS, the Ministry of Health and CDC, has been very active in developing a new reporting system for organizations working outside of the health system.  SUME is the national reporting system for community-based HIV programs developed by CONAVIHSIDA.

M&E Training

MEASURE Evaluation has also worked with CONAVIHSIDA to conduct basic M&E trainings for non-governmental organizations (NGOs) in the Dominican Republic in order to improve the quality of data they report. The trainings cover basic M&E principles, key issues in ensuring data quality, reviewing trend data and promoting data use. 

In order to build local capacity to provide M&E expertise, MEASURE Evaluation has worked with the Center for Social and Demographic Studies (CESDEM), a Dominican Republic NGO. MEASURE Evaluation has provided CESDEM with up-to-date tools, resources and technical assistance to help carry out its M&E work.

Data Quality Assessment

To assure the reporting of high quality HIV/AIDS data to USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), MEASURE Evaluation has also been working with the USAID mission in the Dominican Republic to perform data quality audits. The audits have been completed in phases, with different organizations and indicators audited in each round until all PEPFAR indicators have been covered. Findings from the audits can provide feasible and concrete recommendations to help the organizations improve their M&E systems.