Who do the data serve? Critical reflections on program monitoring during the war in Ukraine.

Global health is driven by concerns for indicators, metrics, and standards, with measures of program 'success' intricately linked to counting people reached and services delivered towards improving the health of populations. Within the context of crises, program monitoring takes on a new salience. Based on a collaborative study between the Ukrainian Institute for Social Research after O. Yaremenko and the University of Manitoba, we draw on data exploring monitoring and evaluation during the war in Ukraine from key informants working in organizations responding to HIV and sexually transmitted and blood borne infections. We conducted 26 in-depth interviews with individuals from 24 organizations across the country between May and June 2023. Our findings point towards a burdensome system of reporting documents that do not reflect current program realities and obscure additional ways that programs respond to client needs. Our study highlights the critical need to listen to the perspectives and needs of those on the ground doing the daily work of global health interventions to ensure that monitoring systems are flexible and responsive to their evolving contexts, and gather data that is useful for program improvement, rather than simply accountable to external donors.