The MSM Health Scorecard is a tool developed by AMSHeR, with the technical support of AIDS Accountability International; the tool includes relevant country level indicators that help monitor accountability of governments, civil society organizations or funding partners in improving the health of MSM. The Scorecards form part of the MSM Health Advocacy Project at AMSHeR (see below).

Snapshot of African MSM Health Scorecards

Cote D'Ivoire MSM Health Scorecard

Kenya  MSM Health Scorecard

Nigeria MSM Health Scorecard

Scorecard Elements

The MSM Health Scorecard contains sixteen elements each of which evaluates a different aspect of the response to MSM by different stakeholders: government, civil society and funding partners.

PART I: Holding Government Accountable Element 1: HIV Prevalence Element 2: Sexually Transmitted Infections Element 3: HIV Prevention Element 4: HIV Testing Element 5: Condom Use Element 6: Reproductive Health Commodities Element 7: Policy Environment Element 8:Legal Environment Element 9: Sensitization and Training of Healthcare Workers Element 10: Budget and Financing Element 11: Service ProvisionBudget and Financing

PART II: Holding Civil Society Accountable Element 12: Civil Society Organizations Element 13: Civil Society Organizations Advocacy Element 14: Civil Society OrganizationsOutreach

PART III: Holding Funding Partners Accountable Element 15: Funding for MSM Organizations Element 16: Funders’ Policy on Gender and Sexual Orientation

Developing the MSM Health Scorecard

Methodology and data limitations

An Implementation Guide was developed by AMSHeR and AAI to help understand the rationale behind each indicator, as well as what each indicator measures and the data limitations. A questionnaire was concomitantly conceived to facilitate in-country quality data collection. Workshops on how to complete the questionnaire were run by AMSHeR and the data then submitted to AAI. AAI used the data collected to analyze and produce country Scorecards and Reports. This Guide will be made available after the launch of the MSM Health Scorecards in March 2015.

Lessons learnt

The main challenges in the development of MSM Scorecard Guidelines and Questionnaire were the lack of available official data on indicators for MSM health in Africa and the disparity of data sources for same indicators in different countries. AMSHeR mapping and baseline reporting projects will have to provide many indicators through primary data collection.

It is important for coordinating organisations working on MSM health to consolidate all the data available to inform programming. This data should be consolidated and made available to relevant people to inform programming. Ishtar has worked for years and kept all data it’s only recently that Ishtar has stated using the new NASCOP tools and data is shared in a national level.

It is also important for us have a national coordination body that will feed all the information gathered to the National policy level. Ishtar in its capacity and the representative MSM at the national steering committees needs to form a reporting mechanism to capture the information and move it forward.

Mainstream organisations should be held accountable when receiving funding for MSM programming. MSM led organisations capacity should be built to be able to run programs on their own. 

Using the MSM Health Scorecard

Objective

The Scorecards will be used by AMSHeR and member organizations for advocacy and tracking of progress on strategic indicators of MSM health. The reports will summarize the analysis of the data, detailing key assumptions, identifying challenges and successes to data analysis, and providing recommendations for improvements for future versions.

Next steps

Training will be provided at a later stage in health policy advocacy, combined with support to develop and execute a national health policy advocacy strategy targeted to engagement with Ministries of Health, national AIDS councils, Country Coordinating Mechanisms, PEPFAR and their programme implementers, and advocacy bodies on behalf of MSM. 

The MSM Health Advocacy Project

On a global level, men who have sex with men or MSM are 19 times more likely to be infected by HIV than people in the “general population”. Several key studies have shown that MSM in Africa are about 19% more susceptible to acquiring HIV than the general population. 

Although both of these 19s mean different things, both show alarming disregard for the health needs of MSM in Africa. Despite the grave need for urgent attention to their health needs, they remain at the margins of HIV interventions. This is evidenced by the lack of service provision to meet the specific health needs of MSM as well as the lack of comprehensive data analyzing the HIV epidemiology occurring amongst MSM, and this exclusion occurs in all regions of the continent. 

The MSM Health Advocacy Project (MHAP) is run by AMSHeR and aims at improving the policy and health environment for the delivery of HIV services to MSM at all levels. The objectives of the project are: establish a baseline of current MSM health services in Cote D’Ivoire, Kenya and Nigeria; increase capacity to collect data, analyze, and report on MSM health disparities by AMSHeR member organizations in those countries; develop an advocacy program for improvements in health outcomes; build a community network for health advocacy between the three countries. The MHAP is a three years project and will utilize an MSM Health Scorecard as the tool for establishing a baseline and building accountability for MSM health services.