TY - JOUR T1 - Addressing the Need for a Preexposure Prophylaxis Monitoring and Evaluation Implementation Guide: Experience From Zambia JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-22-00396 VL - 11 IS - 2 SP - e2200396 AU - Marie-Claude C. Lavoie AU - Natalie Blanco AU - Linah K. Mwango AU - Brooke E. Nichols AU - Anna Whittington AU - Brianna Lindsay AU - Olufunso Adebayo AU - Morley Mujansi AU - Kalima Tembo AU - Lottie Hachaambwa AU - Daliso Mumba AU - Bupe Musonda AU - Cassidy W. Claassen Y1 - 2023/04/28 UR - http://www.ghspjournal.org/content/11/2/e2200396.abstract N2 - Key FindingsUnder the leadership of the Zambia Ministry of Health, stakeholders developed a national monitoring and evaluation (M&E) implementation guide to measure the uptake, use, safety, and cost of preexposure prophylaxis (PrEP).The guide builds upon global indicators and incorporates specific indicators to meet the country’s needs and provide a comprehensive overview of the PrEP cascade. The development and use of indicators along the PrEP care continuum are still in the initial stages in most countries.Key ImplicationAs other countries scale up PrEP services and plan for a robust M&E program, they should consider the following: implementation of a patient-level health information system, use of a people-centered approach that allows flexibility for PrEP modalities and location of service delivery (both community and facility), and training of health care workers.Background:The HIV care continuum comprises well-defined steps and indicators. In contrast, indicators along the preexposure prophylaxis (PrEP) cascade are still in the early stages of implementation. Monitoring and evaluation (M&E) of PrEP services is critical to optimizing PrEP uptake and adherence during periods of HIV risk. We provide an overview of global indicators for PrEP, describe the development process and outcomes of Zambia’s 2022 National Pre-Exposure Prophylaxis (PrEP) Program Monitoring & Evaluation Implementation Guide, and discuss the guide’s implications for other countries in sub-Saharan Africa.National M&E Guide Development Process:During the scale-up of PrEP, the Zambia Ministry of Health (MOH) and the National HIV/AIDS/STI/TB Council recognized the need for a national unified monitoring system to guide the effective implementation of PrEP services. Stakeholders from the MOH, civil society, professional organizations, funding agencies, and implementing partners developed the National Pre-Exposure Prophylaxis (PrEP) Program Monitoring & Evaluation Implementation Guide. This guide is aligned with the existing global indicators from the World Health Organization and the U.S. President’s Emergency Plan for AIDS Relief and adapted to the country’s needs, context, and health information systems. Zambia’s experience in developing the guide has highlighted the importance of strengthening client-level monitoring systems for HIV prevention, ensuring flexibility of the PrEP monitoring system to accommodate PrEP delivery modalities and differentiated service delivery models, and training health workers to enhance PrEP services and deliver care PrEP services along the continuum to prevent HIV acquisition effectively.Conclusions:Using a collaborative and consensus-based approach, Zambia developed its first national PrEP M&E implementation guide to provide standardized guidelines for optimizing the delivery, monitoring, and evaluation of PrEP service delivery. Zambia’s experience can inform other countries in sub-Saharan Africa as they develop national M&E implementation approaches for PrEP. ER -