MEASURE Evaluation in Jamaica

Download MEASURE Evaluation in Jamaica fact sheet

MEASURE Evaluation initiated its activities in Jamaica with a PLACE study conducted in 1999/2000. PLACE refers to “Priorities for Local AIDS Control Efforts,” a rapid assessment tool used to monitor and improve HIV/AIDS prevention program coverage at venues where transmission is likely to occur, such as bars where people meet new sexual partners and places where intravenous drug users share needles. Sharon Weir and Ties Boerma developed the original PLACE protocol for MEASURE Evaluation in 1999. PLACE has since been revised, adapted, and implemented in more than 14 countries and contexts. The PLACE approach has been recommended by the World Health Organization, USAID, and the World Bank as a useful way to collect data on at-risk groups and document gaps in HIV prevention programs.

“Since that first PLACE study,” said Stephanie Watson-Grant, “our colleagues in Jamaica have been using the PLACE methodology to collect more rounds of data on the island’s most-at-risk populations, particularly men who have sex with men and sex workers.” Watson-Grant is a Country Portfolio Manager at MEASURE Evaluation and serves as the Country Focal Person for Jamaica. 

MARP Surveys

In 2010, MEASURE Evaluation began providing technical assistance to the latest round of Jamaica’s National HIV/STI Program survey of most at-risk populations (MARP). The National Monitoring and Evaluation Plan calls for these surveys to be conducted every two years. The purpose of the MARP surveys, which focus on men who have sex with men (MSM), sex workers and patrons of sex workers, is to provide data for the continued surveillance of the country’s HIV epidemic.

“These surveys target what are now the main drivers of the HIV epidemic in Jamaica,” Watson-Grant explained. “Even though the HIV prevalence rate in the general population is estimated at 1.6 percent, it is much higher in the most-at-risk subpopulations—approximately 32 percent among MSM and 9 percent among sex workers. Learning more about sub-groups where the infection rate is already so high will allow the national HIV program to better target its response.”

Pilot Test of UNAIDS MARP M&E Guidelines 

Years of PLACE data collection made Jamaica an ideal setting for pilot-testing the UNAIDS Guidelines for Monitoring and Evaluation of most at-risk populations. Piloting of the guidelines will include calculating and reporting the key indicators, using data from previous PLACE studies to estimate the size of MARPs, and facilitating the use of MARP survey data to inform policy and improve programs.

“In a lot of countries, it’s difficult to assess programs for most at-risk populations because we don’t know how big those populations are,” Watson-Grant said.

The MARP guidelines show program officials how to go about estimating these population sizes and associated modes of HIV transmission, and how to collect the data needed for a program impact evaluation. 

“If you know how HIV is being transmitted, you can design and target more effective prevention programs,” Watson-Grant explained. “And impact evaluation can tell people how an intervention ultimately affects health outcomes, which in turn helps them to design more effective programs.” Watson-Grant believes this process has great potential for improving Jamaica’s M&E system. “Jamaica is one of two countries selected to test these guidelines and reap the benefits of going through a number of the steps in the M&E process,” said Watson-Grant.

Capacity Building

In the context of Jamaica’s national response to the HIV epidemic, MEASURE Evaluation continues a focused effort to build M&E capacity among the country’s primary HIV stakeholder organizations. These include the national HIV program, government ministries, non-governmental organizations providing HIV services, and international development partners. A key objective of this effort is to build or update the skills needed in the various stakeholder groups to develop M&E systems capable of collecting complete and accurate data in a timely manner. A related objective is to increase stakeholder capacity to evaluate intervention activities and then use the evaluation data to inform HIV program decision making.

MEASURE Evaluation is also engaged in capacity-building activities relating specifically to the country’s HIV/AIDS Treatment Database. This database is intended to compile and make accessible critically important data on people receiving antiretroviral treatment and other related services. MEASURE Evaluation’s work focuses on identifying and resolving information gaps and weaknesses in the system that can lead to omissions in the database.

A significant effort toward building M&E capacity in Jamaica has been achieved through MEASURE Evaluation’s five-year collaboration with the national working group formed to collaborate with the M&E Unit of the NHP and assist with developing products such as the M&E Operations Manual that was rolled out in October 2010.

“Working with the national program on the M&E Operations Manual was a truly collaborative experience,” Watson-Grant said. “It pulled together a number of assessments that had been done over the past years. We expect it to significantly improve the quality of collection, reporting and analysis of HIV-related data in Jamaica.”