Participatory Monitoring and Evaluation Practices, Policy Beliefs, and Performance of Policy-Mandated HIV Prevention Projects for Key Populations in Kenya

Abstract

The disproportionate burden of HIV infections in key populations in Kenya, is an important public health concern, being responsible for almost 30% of new infections. This study examined the relationship between participatory practices in monitoring and evaluation (M&E) and policy beliefs and their relation to HIV prevention project performance among Female Sex Workers (FSWs), Men who have Sex with Men (MSM), People Who Inject Drugs (PWID) and Transgender Individuals. A cross-sectional research design using quantitative and qualitative methodology was employed. Data were gathered from 81 respondents including project directors, M&E specialists and policy managers from 36 HIV prevention projects through structured questionnaires and interviews. Reliability (Cronbach's alphas all >= 0.79) and diagnostic tests guaranteed strong statistical results. Regression analysis tested hypothesis, Findings show that the participatory M&E practices have a significant positive impact on project performance (β = 0.723, p < 0.001) which is moderated by policy beliefs (β_interaction = 0.145, p = 0.039). Results from the combined effects of M&E practices and policy beliefs was found to account for 52% of the variance in project outcomes (β_joint = 0.356, p = 0.002). While service coverage, quality and health impacts were good, stigma reduction and consistent inclusion of PWID and Transgender Individuals remain the challenges. The study provides empirical evidence that inclusive M&E practices, supported by positive stakeholder beliefs, are essential for improving HIV prevention outcomes, offering practical insights for policymakers and program implementers in Kenya and other high-prevalence contexts.