Monitoring and Evaluation

Monitoring and Evaluation Charles Katende PhD. Director of Monitoring, Evaluation and Research JHPIEGO (An affiliate of John Hopkins University)

Session Objective • To increase participants understanding of the concepts used in designing M&E Frameworks and Plans • To build participants competence in designing Program M&E Plans

Expected Results • At the end of the sessions participants will know about Program frameworks, M&E frameworks and the difference between the two frameworks • Participants will be able to identify and select appropriate indicators for a program. • Participants will be able to produce a program monitoring and evaluation framework.

Introduction… • Write the health problem addressed by a major public health program in your country • Write at up to three specific objectives of a public health program that addresses the above mentioned health problem. • Write down two indicators the program mentioned above uses to monitor it progress or performance towards its objectives.

Monitoringis the routine process of data collection and measurement of progress toward program objectives. Evaluationis the use of social research methods to systematically investigate a achievement of a program’s results What is Program Monitoring, Evaluation?

Key Questions • What is the purpose of carrying out M&E • Who needs, uses M&E Information • Who carries out M&E? • How is M&E carried out? • When should M&E be carried out?

What is the purpose….? • Improve program implementation • Data on program progress and implementation • Improve program management and decision making • Inform future programming • Inform stakeholders • Accountability (donors, beneficiaries) • Advocacy

To Improve program implementation… To Inform and improve future programs Inform stakeholders Managers Donors Governments Technocrats Donors Governments Communities Beneficiaries Who needs, uses M&E Information?

Who conducts M&E….? Program implementer Stakeholders Beneficiary Remember .. M&E Technical skills Participatory process

How to carry out M&E…? Key Features • Program Framework: Analyze and systematically lay out program elements • Identify key elements to monitor and evaluate. • Determine and describe the measures to be used for monitoring and evaluation • Develop M&E Framework and action plans, including data collection and analysis, reporting and dissemination of findings.

Program Framework What do you know about your program….?

Program Framework • Systematic lay out of the program elements and path showing what the program plans to: do ……………..achieve!

Program Framework • Based on a theoretical, empirical model, or general understanding Public health Problem Population, system level factors that cause the public health problem Action/interventions that can change the factors and ultimately alleviate/eliminate the problem

Results Framework Improved Health Status Impact: Improved (Sustained) Use of Key Health Services and Practices/Behaviors Strategic Objective: Increased quality of… Increased availability/ access to… Improved social / policy environment… Intermediate Result: Strategies: Strategies: Strategies: Strategies (Sub IR):

Example: Result Framework for a Family Planning Project GOAL: REDUCED FERTILITY SO: Increased FP use and improved FP/RH practices Increased knowledge of, improved attitudes toward, and acceptance of key services and behavior Increased quality of FP counseling and services for Increased availability/access to FP/RH Improved social and policy environment for FP Strategies: • Increase availability of educational materials at clinic and community level • Community mobilization (using PRA and PDI) including men • Implement mass media strategy • Mobilize opinion leaders at national and local level • Design/ implement supportive supervision System • Train service providers (in-service and preservice in FP counseling and management of side effects • Remodel clinic to allow for privacy • Design and implement quality improvement program • Strengthen logistics management • Mobilize private sector providers • Mobilize CHWs/CBDs • Encourage socially marketed pills Advocate for community based distribution of pills Promote addition of Depo injections to EPI outreach strategy Pilot social marketing of pills

Basic Logic Model

Case 1: To decrease maternal mortality, a 10-year program plan to improve to train midwifes to Delivery and ANC services at health facilities, and to train and deploy CHWs to increase the community’s awareness about, and use of the improved services at the health facilities. Case 2: To reduce high fertility, a 5-year program plans to work with the Government to change policies in order to allow and promote use of modern family planning methods, train family planning providers to provide better FP services, and to launch public campaigns that promote family planning methods. Case 3: To reduce HIV infection among adolescents, a five-year program plans to implement income generation activities for the youth, provide and promote universal secondary education, and build adolescent-friendly reproductive health service delivery points.

Exercise • Identify and state is the Public Health problem implied in the case study. • What are population level factors will the program target to change in order to alleviate the public health problem • Prepare a Program Framework for the scase study

Monitoring and Evaluations Framework

M&E Questions • Monitoring questions • What is being done? • By whom? • Target population? • When? • How much? • How often? • Additional outputs? • Resources used? (Staff, funds, materials, etc.)

M&E Questions • Evaluation Questions? • Is the content of the intervention or the activity being delivered as planned? • Does the content of the intervention or the activity reflect the requisite standards? • Have the intervention achieved the expected results?

What do we need to answer these questions…?INDICATORS …to take measurements.

Indicators: Definition • Markers that help to measure change by showing progress towards meeting objectives • Observable, measurable, and agreed upon as valid markers of a less well-defined concept or objective • Indicators differ from objectives in that they address specific criteria that will be used to judge the success of the project or program. See comment for examples

Type and Level of Each Indicator • Type • Input/Process (Monitoring) • Outcome / Impact (Evaluation) • Level • Global level • Country level • Program level

Exercise: Group work • Use your case study and identify at least two indicators for program monitoring and two indicators for program evaluation.

What Is a Good Indicator? • Valid: Measures the effect it is supposed to measure • Reliable: Gives same result if measured in the same way • Precise: Is operationally defined so people are clear about what they are measuring • Timely: Can be measured at an interval that is appropriate to the level of change expected • Comparable: Can be compared across different target groups or project approaches

Criteria for Indicator Selection • Consistent with project design—measure the desired result • Useful—contributes to project design, management, and evaluation • Available • Affordable

Standard Indicators Where possible, a project should select standard indicators. • They have been tested for validity and reliability. • They allow comparison between projects or sites. • They tend to be available for SOs and some IRs.

How Many Indicators? • Choose at least one or two indicators per intermediate result, as well as the SO for evaluation purposes. • Choose one or two indicators per result for program monitoring. • Choose indicators that may be able to “cover” more than one element. • For management, think about basic activities that you need to monitor to judge if you are implementing activities as planned; include indicators that help you make decisions.

Exercise: Group work Refer to the indicators you selected.. • Were the good indicators ? • Did you select a minimum number recommended given the type and size of your program?

M&E Framework

Sample M&E Framework Preventing Post Partum Hemorrhage : Increase Active Management of the Third Stage of Labor See comment for examples

M&E Plan • The plan is a managerial tool that specifies the schedule, resources, responsibilities, for your M&E activities (data collection, data quality control, reporting, dissemination and use of data) • Note: • The plan should specify the time points when evaluations will be carried out, for example: Midterm, and End term. • Outcome/Impact evaluation is reserved for large longer term programs that can make impact at public health status level. • Your plan should include activities to monitor and evaluate the implementation, as planned, of the M&E plan.

Source: CDC. Global AIDS program monitoring and evaluation (M&E) field guide

Question If funding for your case study program was cut off and the program closed in two years. What changes would you make to you M&E Plan?

Sources of Information • http://www.cpc.unc.edu/measure • http://www.unaids.org/DocOrder/OrderForm.aspx • http://www.fhi.org/en/Publications/index.htm

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Monitoring and Evaluation