Framework for Linking Data with Action
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The 7 Steps to Improve HIV/AIDS Programs Guide presents concrete steps and illustrative examples that can be used to facilitate the use of information as a part of the decision-making processes guiding program design, management and service provision in the health sector. Download 7 Steps to Improve HIV/AIDS Programs Guide. Tool: http://www.cpc.unc.edu/measure/publications/ms-11-46-b Webinar Recording: http://universityofnc.adobeconnect.com/p5msoue5e67/
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Framework for Linking Data with Action
- 1. Data Demand & Use: Framework for Linking Data with Action Webinar Series #5 Tuesday, February 14, 2012 Presenters: Tara Nutley, Molly Cannon, Nicole Judice
- 2. Troubleshooting If you lose connectivity Re-enter the meeting room by clicking on the webinar link provided If you have trouble with audio Refer to the conference call instructions in the upper right hand corner Send an email to leah.gordon@unc.edu
- 3. Tips for Participating in the Discussion To comment, raise your hand by clicking on the icon. Speak into your microphone (be sure it is enabled by clicking on the icon at the top of the screen). Type questions in Q&A window located at the top of your screen. A recording of the webinar will be made available at www.measureevaluation.org/ddu
- 4. Agenda • Welcome - webinar tips • Brief overview of Data Demand and Use • Presentation of Tools • Field Application of Tools • Questions and Answers • Wrap up
- 5. Why improve data-informed decision making? Pressing need to develop health policies, strategies, and interventions
- 6. “… without information, things are done arbitrarily and one becomes unsure of whether a policy or program will fail or succeed. If we allow our policies to be guided by empirical facts and data, there will be a noticeable change in the impact of what we do.” National-level Policymaker, Nigeria
- 7. Definitions Data use – Using data in the decision making process monitor a program create or revise a program or strategic plan develop or revise a policy advocate for a policy or program allocate resources Data Demand - decision makers specify what kind of information they want & seek it out
- 8. Data-informed Decision Making Cycle
- 9. Improving Data-informed Decision Making Data Users & Data Producers Tool Application Capacity Building Organizational Support Monitoring & Evaluation System Improvements
- 10. Framework for Linking Data with Action
- 11. Framework for Linking Data with Action Creates a time-bound plan for data-informed decision making Encourages greater use of existing information Monitors the use of information in decision making Functions as a management tool
- 12. Build Data Use into Your Work Regular Coordination & Collaboration Engage in dialogue with stakeholders to fully understand the: decisions they make information they need data they have best way to share/feedback information
- 13. Framework for Linking Data with Action Two versions: Version 1 - Data Version 2 – Decisions and questions
- 14. Version 1: Data Research Findings Recommend- Decision Communic- Timeline Question ation / Maker / ation Decision Other Channel Stakeholders
- 15. Version 1: Data Research Findings Recommenda- Decision Communica- Timeline Question tion / Decision Maker / tion Channel Other Stake- holders What is the 26% of females Increase DM – Dr. Monthly July 30, level of exposed dissemination of Smith meetings, 2011 exposure to prevention messages CoM, Mrs. personal (girls) messages via through Yent GA communicatio to early media vs. 75% RLs & PEs OS – n marriage exposed via religious prevention non-media (RLs leaders, messages? & PEs) PEs Females Recruit 10 SDAs DM – Dr. DM—briefing Sept. 30, reported to train religious Smith, sheet - key 2011 hearing leaders about CoM recommendatio prevention early OS – ns messages most marriage religious OS—radio spot frequently prevention leaders on study key findings, fact
- 16. Version 2: Decisions & Questions Answer question that respond to immediate needs and priorities
- 17. What Are Decisions & Programmatic Questions? Decisions - choices that lead to action All decisions are informed by questions All questions should be based on data Which planning decisions do I need more information about before I can make a decision?
- 18. Decisions Allocation of resources across states / districts / facilities Revising OVC program approaches to emphasize fostering and adoption Develop and institute workplace policies on HIV/AIDS in all institutions in state X Hire and allocate staff to facilities
- 20. Programmatic Questions What percentage of HIV+ pregnant women in care actually are delivering in health facilities? What percentage of clients starting ART are lost to follow-up? Are the number of family planning clients decreasing?
- 21. Framework for Linking Data with Action (Version 2) Program Data Indicator Timeline Decision Communica- Decision/ Question Source for Maker tion Action Analysis Channel
- 22. Framework for Linking Data with Action Program Data Indicator Timeline Decision Communica- Decision/ Question Source for Maker, tion Action Analysis Other Channel Stake- holders Are high NHP (5) 4-12-12, Regional Quarterly TBD risk popula- Preven- number of Quarterly BCC regional tions tion condoms thereafter Coordinator meeting accessing Indicator distributed condoms Form to MSMs (BCC & CSWs Report)
- 23. Team Action Plan – Part A Part B: Answering Programmatic Questions Question Action Steps Responsible Date Output Person Completed Indicator Question 1: 1. 1. 1. 1. 2. 2 2. 2. 3. 3 3. 3.
- 24. Action Plan Framework for Linking Data with Action Version 2 – Action Plan Question: Are high risk populations accessing condoms? Action Steps Responsible Date Completed Output Person Indicator 1. Collate logs at district level and 1. Mr. Jones 1. 5-15-12 1. Regional collated submit to region 2. Dr. Smith condom distribution 2. 5-20-12 2. Analyze data from logs and prepare data by risk group, data for presentation and discussion 3. Mrs. White 3. 5-30-12 by district by, quarter 3. Discuss data during quarterly 4. Mrs. White 2. Documentation 4. 4-15-12 regional meeting 5. Mrs. White (meeting minutes) 4. Make recommendations (or not) for 5. TBD that data were 6. Dr. Smith changes in condom distribution 6. TBD reviewed, discussed program & recommendation 5. Implement recommendations 7. Quarterly made 6. Follow-up on recommendation to 3.Documentation that document if implemented recommendation was 7. Repeat steps 1-6 implemented
- 25. Building Data Use into Your Work Use & institutionalize DDU tools: Stakeholder Engagement Tool Assessment of Constraints to Data Use Information Use Map PRISM 7 Steps Approach to Data Use Framework for Linking Data with Action https://www.cpc.unc.edu/measure/our-work/data-demand-and- use
- 26. Field Applications Nigeria Jamaica
- 27. Nigeria Adapted tool Used at different levels Clinical and service delivery Program and organization State National
- 28. Nigeria – NGO Framework Example Stake- Decisions/ Questions When will Indicators Source How will When holders Actions decision and/or data of data data be are data be presented avail- made? ? able? LGA Leveraging What type of IGA May, 2010 # of clients Monthly Narratives, March/ Chairman resources for would work? referred for IGA reports Graphs April, income What are the (by types) and Tables 2010 generating characteristics of # of clients who activities clients? How many accessed IGA (IGA) clients are to be (by types) supported? LGA Planning and How many people Monthly # of clients Monthly Narratives Monthly Chairman resource access HCT tested, # that Report and allocation services? What % received result, univariate of clients tested # of reactive analysis were reactive and and referred for referred? Are the treatment, # number of staff trained in adequate? providing HCT
- 29. Jamaica – Regional Framework Examples Programmatic Data Source Indicator Timeline Decision Maker Communication Question for Channel Analysis What is the accurate - Self reporting # or % of Monthly - National M&E Monthly reports to level of adherence - Pharmacy pick PLHIV with Unit Officer pharmacy, Adherence among PLHIV in the ups 95% - Team that counselor, nurses Western Region? - Pill count adherence includes SW, clinicians, AC What is the cost of - Pharmacy - Usage April 2012 - Regional - Budget submission ARV drugs to the Database pattern for the Then Technical Director - HIV Budget Report region? - National Health individual every 6 - Budget Presentation Fund drugs months - Dissemination - Treatment and - # of persons meeting via MOH care component who need of the NHP ARVs - HIV Incidence in the region
- 31. MEASURE Evaluation DDU Resources www.measureevaluation.org/ddu Data Demand and Use Tool Kit Data Demand and Use Training Resources Next webinar will be on February 21, 2012 at 9:00 am Seven Steps to Use Routine Information to Improve HIV/AIDS Programs – A guide for program managers
- 32. Join Data Use Net Send an email to listserv@unc.edu. Leave the subject field blank and in the body of the message type ‘subscribe DataUseNet.’ For example: To: listserv@unc.edu From: youremail@youremail.com Subject: Subscribe Data Use Net
- 33. Presenter Contact Information Tara Nutley - tnutley@futuresgroup.com Nicole Judice – njudice@fuguresgroup.com Molly Cannon - mcannon@futuresgroup.com
- 34. 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
Editor's Notes
- We are all aware of the challenges involved in providing quality health services in the contexts where we work. In many countries health programs are facing a high disease burden, a growing population, inadequate numbers and poor distribution of qualified health workers, and inadequate health systems to support the distribution of services. It is in this situation that it becomes extremely important for to make the best use of their limited resources. The need to develop strategies, policies, and interventions that are based on quality data and information is urgent.
- The importance of data-informed decision making is expressed on this slide by a national-level policymaker in Nigeria who participated in a data use assessment conducted by MEASURE Evaluation. The assessment involved interviews with a range of professionals at the national, regional, and facility levels. The policymaker interviewed, stated… (READ SLIDE)“… without information, things are done arbitrarily and one becomes unsure of whether a policy or program will fail or succeed. If we allow our policies to be guided by empirical facts and data, there will be a noticeable change in the impact of what we do.” This statement nicely summarizes why we are here today to discuss the importance of improving data-informed decision making.
- Not reporting or disseminationREVIEWING & DISCUSSING
- When we talk about improving the use of and demand for data in decision making we talk about it as a cycle – not a one-time event. The idea of a cycle of evidence-based decision making is the framework on the slide. It starts with basic M&E systems and the collection of information – including ensuring that the information is available and in a format that is easily understood by relevant stakeholders so that the information can be interpreted and used to improve policies and programs. The cycle supports the assumption that the more positive experiences a decision maker has in using information to support a decision, the stronger the commitment will be to improving data collection systems and continuing to use the information they generate. This leads to repeated data use. You will note that this cycle is supported by coordination and collaboration. This coordination is among data users and data producers as well as between management systems and other organizational supports that facilitate and support data informed decision making. Lastly, the cycle is supported by improving capacity to ensure that individuals are equipped with the skills to collect and use data. All of these supports are critical to ensure that the cycle continues functioning to create a culture of data use. Yet, we all know that cycles that rely on multiple inputs, activities and systems to function effectively – often don’t. In the best designed M&E systems you often find lackluster data use. Data is not being used as often as it should be.
- How do we improve DDU?Firstly, build upon a commitment and ongoing efforts to improve M&E and information systems – this is the foundation of all data use improvement interventions.Identify and engaging data users and data producers is also critical. By data users we are referring to those whose primary function is to manage data systems and by data users we are referring to those whose primary function is to use data to monitor and improve health service delivery. These two groups don’t always work closely together. For data use to function as we saw on the previous slide, regular collaboration between these two groups is critical. It is also important to apply tools, build capacity and strengthen organizational systems to support data informed decision making. In this webinar series we will be discussing tool application (the pink box) and the types of tools MEASURE Evaluation has developed to facilitate DDU. The last webinar session of this series will address capacity building and at a later date we will offer a webinar on strengthening organizational supports to improve data demand and sue. The combination of tool application, capacity building and strengthening organizations are all complimentary and necessary elements of any strategy to improve the use of data in decision making.
- The Framework for Linking Data with Action can assists you to implement your leadership practice of ‘planning and aligning’ while meeting the other demands of you job. Everyone on your team already has a job with a full workload in their specific program area. It can be hard to the find time to come back together and work toward regular data use. The Framework for Linking Data with Action helps to keep everyone on the same page, especially while managing their other work priorities. It’s a management tool—a combination of template and process—that serves three key purposes:1) Creates a time-bound plan for data-informed decision making by setting dates by which data should be reviewed in relation to key programmatic questions and upcoming decisions. 2) Encourages greater use of existing information byidentifying existing data resources and linking that information with the programmatic questions that need answers to support evidence-based decision making.Last, it provides you with a data-informed decision-making ‘record’ so that you can— 3) Monitor the use of information in decision making—Providesa timeline for conducting analyses and making decisions.
- Now let’s discuss the practical aspect of data use. How can you manage to build data use into your work? How do you ensure that data use becomes part and parcel of your organization’s day-to-day duties? The answer is to PLAN for it and to LEAD. The first strategy is to make this a REGULAR team effort. As leaders in your organizations, it is important to inspire and align others to participate. The key here is to involve the data users and data producers so that you fully understand the:Decisions they makeThe various processes for decision making and how they can be alignedThe information different decision makers need to make decisions – remember the earlier slide – there is a lot of quality information collected in this country. It is challenging to know and keep up with what’s out there – we need to alert each other of our data resources. And lastly, the best way to share your data and information both among yourselves and back to those that collected it. The underlying element that facilitates smooth coordination and collaboration among stakeholders is to know your stakeholder’s needs and to strategically engage them in the data use process. MANAGEMENT PLAN
- Data: should be used when a new data collection or analysis activity has been completed. This version provides a framework for identifying and documenting key findings, recommendations linked to those findings, and specific actions that can be taken based on the recommendations. 2. Decisions and questions: should be used when there is a specific decision to be made, or stakeholders have specific questions around program or policy issues. It facilitates evidence-based decision making by providing a clear, systematic process for identifying and documenting: Actions and/or decisions Questions that decision makers need to answer in order to take action or make a decision Data required to answer the question and sources for these data
- Encourage better use of existing information—Identifies existing data and uses that information to answer questions that will support evidence-based decision making. For example, a research group mandated to evaluate the effectiveness of a national family planning program has completed the report and is now interested in ensuring that this information is used to improve programs and influence family planning policies.Version 1: Data—assists M&E specialists, researchers and program managers with identifying useful applications of existing data. The following steps would commonly be implemented when using this version:»» Identify main research questions from existing data source.»» Identify key findings from analysis.»» Interpret findings with appropriate stakeholders.»» Identify recommendations for action or decision that could be influenced by these findings.»» Determine the decision-makers and key stakeholders necessary to make the decisions or take action.»» Determine the appropriate communication channel to reach the decision-maker and key stakeholders.»» Develop timeline to implement the
- Encourage better use of existing information—Identifies existing data and uses that information to answer questions that will support evidence-based decision making. For example, a research group mandated to evaluate the effectiveness of a national family planning program has completed the report and is now interested in ensuring that this information is used to improve programs and influence family planning policies.Version 1: Data—assists M&E specialists, researchers and program managers with identifying useful applications of existing data. The following steps would commonly be implemented when using this version:»» Identify main research questions from existing data source.»» Identify key findings from analysis.»» Interpret findings with appropriate stakeholders.»» Identify recommendations for action or decision that could be influenced by these findings.»» Determine the decision-makers and key stakeholders necessary to make the decisions or take action.»» Determine the appropriate communication channel to reach the decision-maker and key stakeholders.»» Develop timeline to implement the
- The Framework is unique because it forces you to identify your priority programmatic questions. Why is it important to focus on your questions?Remember this slide? Vast amounts of HIV data are available to you. When working to improve DDU can be hard to know where to start. IMPORTANT to have a data use success. You can be more efficient by first identifying and then prioritizing key questions of interest. Available data can then be analyzed in a targeted way to answer these questions. This gives you a DDU success and generates motivation to continue the DDU process.
- Lets clarify what we mean by ‘decision’….For example: every day you need to make a decision about what to wear outside of the house. To make this decision, you may ask yourself some questions that will inform it:What is the temperature?Is it raining?What events do I have planned for the day?To answer these questions, you may consult the thermometer, the weather report, or your daily calendar.
- In some contexts, a decision cannot be identified before a key programmatic or policy question is answered. Or decision makers may have a question about their program for which they need an answer. It is the answer to this question that may provide the evidence that some kind of action needs to be taken to either improve or realign services. In these cases, we focus on identifying ‘programmatic questions,’ as opposed to decisions.
- Let’s look at the tool. What is unique about this tool is that it starts with identifying your programmatic questions. These are the questions you have about your program on a regular basis. Answers to these questions let you know if you are on track with your program activities. If you are meeting your programmatic objectives. If you have are meeting the needs of the populations you are serving.
- So what might be a relevant programmatic question to this group?We recommend that each regional team use the F4LDwA as a way to prioritize the questions that are important to managing a coordinated response to HIV in your regions. You can use this tool as a way to not only make sure those questions get answered, but also to track if recommendations that are made based on those analysis actually get implemented. It’s a way to monitor the data use process .
- Refer to Handout
- Refer to Handout
- You can also institutionalize the use of tools that can facilitate this process. MEASURE Evaluation has developed a set of tools that facilitate DDU. They include:In the next hour we will discuss and practice using one of these tools – the Framework - that you can regularly use to help institutionalize data use among your team.