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Monitoring and Evaluation of Health Services Dr. Rasha Salama PhD Public Health Faculty of Medicine Suez Canal University-Egypt
Presentation Outline
Monitoring and Evaluation (M&E) ,[object Object],[object Object],[object Object]
Where does M&E fit?
Monitoring versus Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Comparison between Monitoring and Evaluation
Evaluation
Evaluation can focus on: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Processes  Services  Projects  Conditions  Programs
Evaluation may focus on different aspects of a service or program: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Processes  Inputs  Impacts  Outputs  Efficiency  Effectiveness Outcomes
 
So what do you think? ,[object Object]
When Is Evaluation Desirable? ,[object Object],[object Object],[object Object]
Prospective versus Retrospective Evaluation ,[object Object],[object Object],[object Object]
Evaluation Matrix ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation Matrix
Components of Comprehensive Evaluation
Evaluation Designs  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Who conducts evaluation?
Who conducts evaluation? ,[object Object],[object Object]
Tradeoffs between External and Internal Evaluation
Tradeoffs between External and Internal Evaluation Source: Adapted from UNICEF Guide for Monitoring and Evaluation, 1991 .
Guidelines for Evaluation (FIVE phases)
Phase A: Planning the Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Phase B:Selecting Appropriate Evaluation Methods   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sample evaluation questions: What might  stakeholders  want to know? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Indicators..... What are they? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Characteristics of Indicators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Which Indicators? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation Area (Formative assessment ) Evaluation Question Examples of Specific Measurable Indicators Staff Supply  Is staff supply sufficient? Staff-to-client ratios Service Utilization What are the program’s usage levels? Percentage of utilization  Accessibility of Services How do members of the target population perceive service availability? ,[object Object],[object Object],[object Object],[object Object],Client Satisfaction How satisfied are clients? Percentage of clients who report being satisfied with the service received
Evaluation Area ( Summative Assessment) Evaluation question  Examples of specific measurable indicators  Changes in Behaviour Have risk factors for cardiac disease have changed? Compare proportion of respondents who reported increased physical activity Morbidity/Mortality ,[object Object],[object Object],[object Object],[object Object]
 
So what will we do ? Use Importance Feasibility Matrix
Face reality! Assess your strengths and weakness
Eventually......
Phase C: Collecting and Analysing Information ,[object Object],[object Object],[object Object],[object Object],[object Object]
Development of a frame logical model A program logic model provides a framework for an evaluation. It is a flow chart that shows the program’s components, the relationships between components and the sequencing of events.
Use of IF-THEN Logic Model Statements To support logic model development, a set of “IF-THEN” statements helps determine if the rationale linking program inputs, outputs and objectives/outcomes is plausible, filling in links in the chain of reasoning
CAT SOLO mnemonic  Next, the CAT Elements ( Components, Activities and Target Groups) of a logic model can be examined
Gathering of Qualitative and Quantitative Information: Instruments ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Quantitative tools: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pretesting or piloting......
Other monitoring and evaluation methods:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spider Web Method: This method is a visual index developed to identify the kind of indicators/criteria that can be used to monitor change over the program period. This would present a ‘before’ and ‘after’ program/project situation. It is commonly used in participatory evaluation.
Phase D: Reporting Findings ,[object Object],[object Object],[object Object],[object Object]
Example of suggested outline for an evaluation report
Phase E:Implementing Evaluation Recommendations   ,[object Object],[object Object],[object Object]
 
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References (cont.)  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Thank You

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Monitoring and Evaluation of Health Services