The Enhanced Strategic Information (ESI) project is a 5 year project funded by the USAID. The project's focus is the development of sustainable information systems in Lesotho. This, it seeks to achieve through the provision of technical assistance, training, mentoring and coaching of strategic partners in the practice of good quality M and E, HMIS, Decision support systems and the Geographic Information Systems (GIS). The projects relevance is highlighted by the strategic manner in which its goals and objectives are linked to the Government of Lesotho's (GOL) National Strategic Plan, The Health Management Information Systems Strategy (HMIS: 2008-2012) and the Partnership Framework Technical Assistance Strategy. The ESI project Lesotho, has aligned its activities to match and support activities that strengthen the coordination and management of the HMIS, improved Data Quality and management, support system harmonization and integration and enhance data analysis, dissemination and use. This project's goals are also aligned with the Partnership Frameworks Goal IV: Health systems are strengthened in 4 key areas (HMIS, Lab systems, organizational capacity, and supply chain) to support prevention, care treatment and support goals by 2014.

The partnership framework adapts a three pronged strategy that considers the following areas as important: i. Strengthening governance and leadership activities ii. Strengthening Health information systems iii. Strengthening data quality, data dissemination and use activities

JSI/ESI intends to pilot its interventions in 2 districts (Mohales hoek and Leribe) which will serve as a basis for roll out to all districts given further funding from the USG/PEPFAR. In this COP period, the project will extend its activities to three more districts. Specifically, the project will assist in

i. Building M & E and HMIS capacity at district and local level; and support the development of platform systems for the collection of all relevant data, including review and revision of current data collection forms. ii. Enhancing the capacity of the MOHSW (Lesotho) strengthen the community level information systems. iii. Provide TA to NAC in developing and enhancing Capacity to meet its SI objectives

The JSI/ESI team will adopt several strategies that will enhance capacities, strengthen systems and promote the usage of information for the purpose of program implementation. At National level, ESI will provide M and E technical support and conduct M and E training which shifts from the sharing of concepts but a focus on the practice of good M and E. The uniqueness of this strategy is highlighted by its focus on the utilization of M and E skills unlike popular approaches which train on concepts over a short period of time. The targeted population for ESI efforts would be members of the District Health Management Teams (DHMT), Data Clerks and Monitoring and Evaluation Officers working with and for PEPFAR Implementing partners, Government of Lesotho - Ministry of Health and Social Welfare, Ministry of Local Government and the National AIDS Commission. Organizations at community, district and national level will also be provided with TA if and when required. ESI Lesotho efforts are covered in the following task areas:

I. Task 1: Capacity Building for strategic Information II. Task 2: Improving Data quality III. Task 3 Enhancing Data Use IV. Task 5: Activities on Decision support systems at USG/PEPFAR level V. Task 6: GIS activities for the MOHSW and PEPFAR programs

At National Level, the ESI project team will provide technical support through its active participation in M & E and HMIS technical working groups. By participating in activities that shape the policy environment concerning HMIS and M and E, the team will participate in advocacy campaigns and the development of policy documents when required. The project is also able to leverage an extensive and comprehensive skill set from other ESI projects in South Africa and Swaziland. This indicates that there is going to be rich cross pollination of ideas and experiences in the provision of Technical Assistance (TA) during training, mentoring and coaching. Given the existing activities and partnerships within country, care will be taken to ensure that by participating in the mapping out of interventions, the joint effort and specifically JSI/ESI role in Lesotho will not consist of duplication of others efforts but it will be more strategic and effective in reaching our target beneficiaries.

For COP FY2011, ESI's focus will be on Capacity Building, Data Quality, and Data Use. LePMS development (Task 5) and GIS (Task 6) will be phasing out for Y4/COP FY2011 and should therefore be understood as requiring minimal technical and financial support in COP FY2011.

ESI will continue to address the following issues highlighted below:

Task 1: Capacity Building

* Conduct a comprehensive and relevant training for selected departments and institutions (e.g., NAC, MOHSW,) that will enhance the transfer of skills in basic M&E concepts, data quality, data analysis and information utilization and the strengthening of health information systems

* Strengthening synergies between training and the application of M&E skills in the workplace through the implementation targeted partner-specific capacity building TA at community and District level and tracking system for trained M & E personnel

As part of its remit, JSI/ESI Lesotho project will provide support to the LOMSHA at community, district and national level. Central to this support will be to enhance linkages between the national M and E systems to that of all the other partners, data analysis and use and management of HIV service data at community level.

Task 2: Improving Data Quality

To ensure quality, basic data quality criteria and monitoring of Quality assurance and improvement procedures, the team will conduct the RDQA as a diagnostic tool to identify and determine strategic interventions at community, District and IP level. In order to make critical, evidence-based decisions to strengthen the national response to HIV, the JSI/ESI project building on experiences garnered in implementing two of the three system strengthening tools developed under a joint global initiative, will focus on supporting, through training and TA, the TWG partners and government by:

* Support the development of SOP's at community and district level to ensure that there is clear understanding of the processes that are required to ensure quality

* In concert with the USG/PEPFAR Lesotho team support the development of a capacity building quality assessment scheme(Routine Data Quality Assessments)

* Organizing a joint workshop on how to utilize the RDQA to ensure a joint approach to enhancing quality of data being generated and utilized by IP's under the PEPFAR program and Health facilities at district level

* Support the institutionalization of the data quarterly review process

* Training targeted beneficiaries on all processes of the data management information cycle

* Advocacy for the harmonization and standardization of description/definiyions of variables/indicators being tracked nationally and at district level

* Development of a QA/QI approach amongst target beneficiaries (MOHSW, NAC and IP's)

Task 3: Enhancing Data Use

1) Leadership and Governance:

At District and community level, ESI project Lesotho intends to provide technical support in Data use and integration for the purpose of program development. From the 10 districts in Lesotho, we intend to train at least two members in each DHMT. This training will focus on the key components of fully functional and decentralized District Health systems. In this COP period, the project will focus on:

a) Assist the development and dissemination of Standards and Norms of Data collection, collation, analysis and procedures and that they available and accessible to end users

b) Analysis of Data, its interpretation and use

c) Develop capacity at district level to maintain data management systems (Electronic and paper based)

A process of back stopping for the District Quarterly review process will be put in place to ensure that there are skilled personnel who support the process with the aim of turning over the process to the existing structures of governance and management.

Task 5 Decision Support

During this COP period, JSI/Enhanced Strategic information will support the maintenance of the LePMS given that the finalized product will have been handed over to the USG/PEPFAR HMIS specialist. It is expected that this specialist will provided TA to partners on the use of this product. However, should there be any need for any back-end development required by PEPFAR; the JSI/ESI team will provide the required support.

Task 6 Geographical Information Systems

Barring the challenges in determining boundaries of the councils to ensure adequate scoping of the population catchment areas, the JSI/ESI team will provide the following for the PEPFAR team and the MOHSW:

Demographic profile for PEPFAR funding sites, HIV / AIDS prevalence Mapping, Time series analysis from 2004 to present, Develop a set of base maps for partners and other important stockholders to access and work with USAID / OGAC in continuing GIS work that has already been started in Lesotho