Increasing district level evidence-based decision making

in Côte d’Ivoire

Tara NutleyMEASURE Evaluation / Futures Group

Mini University, Washington DC March 7, 2014

Improving Information Systems

Global commitment to M&E and information systems have generated more & improved data

Data Demand & Use Intervention

8 mutually reinforcing activity areas that are based on the literature & MEASURE Evaluation experience

Traditional M&E activities coupled with linkages to decision makers & decision making functions

Data Use Intervention

1. Assess the data use context

2. Engage data users & producers

3. Identify information needs

4. Improve data quality

5. Improve data availability (access, synthesis, communication)

6. Build capacity in data use core competencies

7. Strengthen organization’s data use infrastructure

8. Evaluate & communicate data use successes

Data-informed decision making in Côte d’Ivoire

1. Assess data use context

PRISM 2008 - found improved RHIS processes but weaknesses in data quality and use of information

2. Engage data users & producers

Regional data review meetings every 6 months Questions identified

Additional analysis

Recommendations for improved programs

Tool application

3. Identify information needs

4. Improve Data Quality

National data management procedures manual

Trained at central & regional levels in data quality procedures & use of RDQA

RDQA supervision by MOH

5. Improve data availability (access, synthesis, communication)

Created and disseminated data use modules for the OVC database & care and treatment database

6. Build data use core competencies

Data use concepts & tools incorporated into 4 in-service & pre- service training institutions Schools of: health professionals, public health,

statistics & economics, social training

Trained: students, PEPFAR IPs, MOH staff

Cascade training

7. Strengthen organization’s data use infrastructure

M&E staffing MOH mandated new regional positions - Head

of M&E

Six regions hired regional M&E specialists

1 region hired 6 district M&E officers

Regular regional data review meetings, data use tools, DQA procedures

8. Evaluate results

PRISM results 2008 & 2012

Data use 44% to 70% district level

38% - no change facility level

Data quality 43% to 60% at district level

40% to 81% at facility level

Data availability - facility level (information feed back) 7% to 29%

8. Assess data use results (cont.)

Observed results:

Engagement & ID information needs - Established 2 types of quarterly strategic data use meetings

Capacity building - data use curriculum in national universities

Institutionalization - National guidelines & protocols, regular data use fora, new positions to oversee data use activities

Data Use

Instructions• Divide into groups• First group selects a category and $ amount and

receives a question (groups can confer among themselves for the answer)

• The first group to raise their flag answers. If answered correctly they get the points. If incorrect they lose the points and the first group to raise their flag can answer.

Data Use

Building Blocks Theory Similar Experiences

200 200 200

400 400 400

600 600 600

Daily Double

MEASURE Evaluation is funded by the U.S. Agency for

International Development (USAID) and implemented by the

Carolina Population Center at the University of North Carolina

at Chapel Hill in partnership with Futures Group International,

ICF International, John Snow, Inc., Management Sciences for

Health, and Tulane University. Views expressed in this

presentation do not necessarily reflect the views of USAID or the

U.S. government.

MEASURE Evaluation is the USAID Global Health Bureau's

primary vehicle for supporting improvements in monitoring and

evaluation in population, health and nutrition worldwide

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