Monitoring of Results - WHO · Monitoring of Results: Implementing the recommendations of the Commission 5 | on Information and Accountability for Women's and Children's Health A

Monitoring of Results: Implementing the recommendations of the Commission on Information and Accountability for Women's and Children's Health 1 |

Monitoring of Results

Implementing the recommendations of the Commission

on Information and Accountability for Women's and

Children's Health


Monitoring of Results:

Session Outline

What is good system of monitoring results?

– What would success look like?

– What are the key features?

– RMNCH indicators and data sources

Country group :

– What is the current situation in your country?

– What are the main gaps/weaknesses ?

– What actions are required to move forward?



What is the goal?

Strengthen country monitoring and evaluation practices and systems to inform regular review

and accountability processes


Monitoring of Results

What are the key features of a

good monitoring system ?


A strong M&E plan

National Health Strategy is the basis for information and accountability

sound and comprehensive M&E component of National Health Strategy

Monitoring & evaluation technical framework

Coverage indicators, data sources, compilation, analysis, data quality, and communication and use

M&E coordination and Institutional capacity

– system with coordination, clear roles and responsibilities including all major country institutions

Country mechanisms for review and action


A technical M&E framework Monitoring & Evaluation of health systems reform /strengthening

Inputs & processes Outputs Outcomes Impact

Data collection

Indicatordomains

Analysis & synthesis

Communi-cation & use

Improved health outcomes

& equity

Social and financial risk protection

Responsiveness

Fin

an

cin

g

Infrastructure / ICT

Health workforce

Supply chain

Information

Interventionaccess & services

readiness

Interventionquality, safety and efficiency

Coverage of interventions

Prevalence risk behaviours &

factors

Go

vern

an

ce

Administrative sourcesFinancial tracking system; NHADatabases and records: HR, infrastructure, medicines etc.Policy data

Facility assessments Population-based surveysCoverage, health status, equity, risk protection, responsiveness

Facility reporting systemsService readiness, quality, coverage, health status

Vital registration

Data quality assessment; Estimates and projections; Use of research results; Assessment of progress and performance; Evaluation

Targeted and comprehensive reporting; Regular country review processes; Global reporting


Review of health progress and performance A stepwise approach

Monitoring of Results: Implementing the recommendations of the Commission on Information and Accountability for Women's and Children's Health 8 | 8

Three tracer indicators

– maternal mortality ratio

– under-5 child mortality (with the proportion of newborn deaths)

– children under 5 who are stunted

Eight coverage indicators

– met need for contraception

– antenatal care coverage

– antiretroviral prophylaxis among HIV positive pregnant women to prevent mother-to-child transmission of HIV

– skilled attendant at birth

– postnatal care (within 48 hours of childbirth) for mother and child

– breastfeeding exclusively for 6 months

– three doses of the combined diphtheria, pertussis and tetanus vaccine

– children with suspected pneumonia receiving antibiotics.

Are the 11 RMNCH indicators used for

monitoring


Are the 11 RMNCH indicators available and used for monitoring?


Are the key data sources for core indicators

in good shape?

SURVEYS:

Population health surveys are conducted more frequently nowadays; DHS and MICS mostly

Need to ensure regular and harmonised surveys with key indicators, every 2-3 years for MNCH intervention coverage

FACILITY DATA:

Routine data from health facility reports aggregated on a continuing basis → more timely results for annual monitoring

There are still major gaps – particularly on service availability, readiness, quality of care and issues of data quality

Need to ensure regular facility assessments of quality of care, readiness


Data quality

What confidence do we have in the numbers?

Problems of completeness, accuracy, timeliness, and denominators

Lack of data quality assessment and adjustment, and transparency

Requires annual data quality reports:

– Systematic examination: completeness, internal consistency and accuracy, external consistency

– Sharing of the results of the data quality assessment - accompanying performance review reports

– Transparency: sharing of the underlying data and methods


Is there adequate capacity for analysis

More countries producing annual reports of progress and performance reports to inform reviews

Integration of data from multiple sources and data quality – hardly ever done

Comparison of inputs and results / value for money – rarely done

Benchmarking of progress, comparison with peer countries – sometimes used

Qualitative data on policy and contextual changes – Not systematic

National institutional capacity – under used?


Is equity analysis a prominent element

of health reviews?

Increasingly there is a focus on disaggregated analysis to track and target disadvantaged populations

– Sex

– age

– income

– residence

– geographic location

This implies regular surveys and strengthening analytical capacity


Data sharing:

Are data and reports publicly accessible?

Analytical reports for reviews available and accessible

Facility data on core indicators on the web

Data quality assessment reports – accessible

Requires: Data and reports posted to publicly accessible website/country health observatory /portals


In sum: Key features of

a good system for monitoring of results

M&E PLAN : A strong M&E plan of the NHS, that also covers MNCH, including a framework for indicators, data sources, analysis etc

M&E COORDINATION: Well-functioning national committee in charge of coordination of M&E

HEALTH INDICATORS with well defined baselines and targets used to monitor progress

SURVEYS: Regular harmonized survey system

FACILITY DATA: Well functioning facility reporting system, with data quality reports and annual independent data verification and service readiness and quality of care assessments

EQUITY: Disaggregated health survey and facility data on core indicators (

CAPACITY: Analytical capacity for report of progress and performance & statistical summary to feed into reviews and Countdown processes.

DATA SHARING : Data transparency and access to information



What would success look like?

Documents

Monitoring of Results - WHO · Monitoring of Results: Implementing the recommendations of the Commission 5 | on Information and Accountability for Women's and Children's Health A