The Global Fund requires a functional routine reporting system with reasonable coverage to be in place to report programme performance accurately and in a timely manner. The monitoring and evaluation (M&E) system/Health Management and Information System (HMIS) for public-sector facilities shouldhave coverage of at least 50 percent, and there should be a costed plan to improve coverage to 80 percent.

The relevant HIV, TB and malaria indicators should have clear definitions, should be aligned with international definitions, and should be coded in the HMIS. The M&E system also needs to have a data-assurance mechanism in place to annually verify data.

M&E budget and funding request

If the national M&E system does not meet the necessary requirements, sufficient grant funds should be dedicated to strengthening M&E systems in the country. The Global Fund recommends that grants allocate 5–10 percent to M&E, which includes strengthening national data systems of reporting (analytical capacity and reviews, strengthening HMIS, population-based and risk group surveys, and birth and death statistics), with the following exceptions:

1. When the grant M&E budget is less than five percent, the Principal Recipient (PR) should demonstrate that sufficient funds are available from other sources to support implementation of the grant and the national M&E plan.
2. In cases of M&E system-strengthening proposals; when the proposal includes specific studies, surveys or reviews/evaluations to measure the outcome/impact of the disease control or health systems strengthening (HSS) investments; or when there is evidence of an extremely weak M&E system that requires funding for strengthening, the grant M&E budget may exceed the 10 percent indicative upper limit.

For more guidance on M&E budgeting, see the Global Fund Budgeting Guidelines. The M&E activities must be included in the funding request under the module ‘Health information system and M&E’. All M&E activities should be included under this module, whether disease-specific or cross-cutting. All M&E-related activities under this module will be considered as HSS, irrespective of the disease grant for which this module is included. Only those supervision-related activities that are specifically for data collection, reporting and/or data validation should be included under this module. Other costs related to programme supervision and site visits should be included under the module ‘Programme management’.

The health information systems and M&E module has five standard interventions and associated indicators, activities and budget lines, plus a sixth undetermined intervention allowing applicants to lay out their own M&E priorities.

1. Routine reporting – included in the scope of this intervention are activities related to the establishment, maintenance and/or strengthening of the national M&E system.
2. Analysis, review and transparency – activities related to programme evaluation including analysis, interpretation and use of data generated through integrated programme reviews, implementation research, and evaluations of the national strategic plans and/or health sector strategies.
3. Surveys – including surveys/studies related to morbidity, mortality and behavioural surveys in general population or identified risk groups.
4. Administrative and finance data sources – including establishing systems for periodic (annual) reporting on key health administrative and service availability statistics, setting up financial reporting/accounting systems, annual reviews of health sector and/or disease programme budget.
5. Vital registration systems – including establishing/strengthening and scaling up vital registration information system, including sample vital registration systems, strengthening reporting of hospital morbidity and mortality statistics, cause of death, establishment of SMS system of reporting; training of community health workers on reporting vital events, drug stock-outs etc.
6. Other – other interventions related to health information and M&E systems.