File Name: monitoring and evaluation in public health .zip
Open Access PDF. About Open Access. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations.
The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.
What we need to know [link]. Some pitfalls to avoid [link]. What we need to do [link]. How to choose what to monitor or evaluate [link]. Select the most appropriate indicators [link]. Collect the data [link]. Analyse the data [link]. Act on the result [link]. We will originally have set objectives, i. Monitoring refers to ongoing assessment of our progress.
It should be set up as part of our routine programme management and is ideally done by both programme and community members together. It uses the record systems we have built into the programme. Evaluation refers to a systematic review of the programme outcomes and impact often at the end of a funding cycle.
It often involves an outside evaluation team. If monitoring is carried out well, evaluation will be easier. We often start with good ideas and ambitious objectives. As time goes on, these may get lost in day-to-day activities or problems See Figure 9. Regular monitoring will also identify problems early so they can be corrected, and improvements can be suggested.
Figure 9. Reproduced courtesy of David Gifford. Reproduced courtesy of Eleanor Duncan. Community members will work with us in this process. Findings and results will need to be presented in such a way that the community sees the benefits and problems and is motivated to participate in improvements see Chapter 2. In practice, evaluations are often carried out because donors want confirmation that their money is being well spent.
But all stakeholders—programme, community, p. An evaluation showing good results can help our programme to become better known and a model for other programmes. We can use Twitter, Facebook and other forms of social media to make findings known to wider audiences. If it uses a rigorous methodology it can be published to share the learning and raise the profile of the programme. Governments may want to know what results the programme is achieving and whether it is reaching district and national targets.
If we are involved in specific programmes, e. Civil society organizations involved in community-based health care CBHC are often able to achieve more effective results at community level than government. Evaluation and the return of regular monitoring figures should enable us to demonstrate this and increase our credibility Figure 9. The definitions in Box 9. Box 9. The section on participatory appraisal PA in Chapter 6 should be read alongside this section.
The title of the book Nothing about us without us 2 provides a slogan to remind us that the community needs to be involved closely at every stage, rather than being marked by outsiders as though they were taking an examination.
This is especially important when vulnerable community members are monitored, as with the people living with disability and those with mental health issues.
Monitoring can be done by the health team and the community together, but it will need to be planned carefully using appropriately simple participatory techniques. The team would need to have, or be taught, necessary skills and good monitoring systems would need to be in place to feed into the evaluation. The term community-based participatory evaluation is sometimes used. In practice, final impact evaluations usually involve outside experts who come to work alongside the health team and community.
The success of using outsiders depends on several conditions. Firstly, the evaluation must be planned in advance. It may last one or two weeks, and will need to be done at a time of year when neither the health team nor community is overworked, nor the weather too extreme. Essential programme activities should continue, not least because evaluators will want to observe the programme at work.
Secondly, the evaluators must have clear terms of reference, i. They should be sensitive to the local culture, and have an affirming attitude. Terms of reference should be p. Evaluators should be carefully briefed both by donor and programme before starting work. There are several advantages of using outsiders these include involving experts with special skills who will be able to advise on effective methods of carrying out the evaluation. Because of their lack of bias, results from outsiders may be more accurate as the evaluators have no personal interest in the achievements of the programme.
Finally, outsiders may receive more accurate feedback from the community, and community members may be readier to tell outsiders how they really feel. Disadvantages of using outsiders include higher costs in terms of time and money, although a donor agency often funds the evaluation. Also, the visiting experts may not know the local customs, language, or situation. It is therefore helpful if evaluators are familiar with the country, region, and type of programme they are evaluating.
Finally, published material from evaluations or visits may be politically insensitive or unhelpful to the community. If the evaluation includes any research that may be written up, this must be clearly discussed beforehand. Annual reports are still written, with patient numbers, immunizations and procedures carried out. Such figures may accurately record the activity being carried out, but p. It is easy to become overwhelmed by challenges and needs; record systems and reports can turn into a nightmare.
Obviously, any lack of quality in reporting or recording information is serious and we need to act, including being honest with any agency that is helping to fund the programme. The list of questions in Box 9. What effect does the presence of the project have on the local community?
If the project did not exist, what would happen? A story may help to show the project impact. What do project staff consider the three most common diseases in the project area? What effect has the project had on the prevalence of these diseases during the last three years? Is there any statistical evidence? Is the local community involved in this project? If yes, how is their involvement facilitated e.
How often do project staff meet with community members? If there is no community involvement, why? Are there any plans to increase this? If not, why? Do volunteers from the community work in the project e. Approximately what number are there currently active and newly trained in the last year? What are the three most serious problems which have a negative effect on the running of the project?
How have these problems been addressed? How successful have these efforts been? What do project staff consider would be needed to solve them? What may stop them implementing these objectives? How do they plan to overcome these problems? Some programmes go to the opposite extreme, which can happen especially if they are very bureaucratic or run by managers interested in statistics. Collecting figures and producing good reports becomes more important than working for long-term improvements in the community.
Sometimes programmes are required to provide huge numbers of reports. We must therefore ask donors to request only vital information, and we should only agree to evaluations that are genuinely useful for the programme. Programmes should clearly negotiate with donors, and consider refusing funding if it is tied to a very heavy monitoring schedule or to many new indicators.
Thus, the role of a programme manager is to resist adding indicators. One suggestion is that indicators should be reviewed every year for usefulness and any ineffectual or burdensome ones discarded.
When we gather qualitative information, the articulate and well-off usually do most of the talking, while the poor may have less chance to express their views. Sometimes the overall health of a p. We can monitor this by keeping separate figures for different socio-economic groups. Similarly, we can keep separate figures for men and women, or for different language groups, or for those living with disability.
Follow CompassforSbc. Click here to access this Guide in Arabic. It is a living document that should be referred to and updated on a regular basis. This will ensure there is a system in place to monitor the program and evaluate success. This guide is designed primarily for program managers or personnel who are not trained researchers themselves but who need to understand the rationale and process of conducting research. This guide can help managers to support the need for research and ensure that research staff have adequate resources to conduct the research that is needed to be certain that the program is evidence based and that results can be tracked over time and measured at the end of the program.
Its goal is to improve current and future management of outputs, outcomes and impact. Monitoring is a continuous assessment of programmes based on early detailed information on the progress or delay of the ongoing assessed activities. The credibility and objectivity of monitoring and evaluation reports depend very much on the independence of the evaluators. Their expertise and independence is of major importance for the process to be successful. The developed countries are using this process to assess their own development and cooperation agencies. An evaluation is a systematic and objective examination concerning the relevance, effectiveness, efficiency and impact of activities in the light of specified objectives.
Our approach for curriculum development as well as the consensus building experience could also be adapted for use in other situations. It can identify what works, what does not work, and provide information about why. Evaluation is critical to public health programs locally and globally, as donors, governments, and others strive to improve program performance and validate their investments. In order to address this deficient capacity, there is a need to develop the supply of these skills to match demand as it grows among these countries 3. Public health trainings, especially among masters level programs, produce a large number of public health professionals across the world. With public health education undergoing major reforms, the advent of the twenty first century has seen academic education move away from the traditional knowledge-based approach and the use of competency-based models is increasingly gaining relevance, since competency-based education has the potential to align the public health education program with health systems priorities 4 , 5. As a response to national and global public health systems priorities, many public health institutes are developing and adopting new curricula to include contemporary solutions to public health issues.
Monitoring and evaluation of Primary Health Care attributes at the national level: new challenges. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care PHC. It builds on the correction of distributive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population.
Open Access PDF. About Open Access. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
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