The Stakeholder Engagement tool helps ensure that the appropriate stakeholders in decision processes have been identified and involved.
Webinar Recording: http://universityofnc.adobeconnect.com/p99y8bhnosx/
When welcoming folks, thank them for volunteering for the webinar. Introduce presenters and participants
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 dissemination REVIEWING & 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.
Now I would like to briefly introduce to you the Data Demand and Use Stakeholder Tools
What is a stakeholder? A stakeholder is anyone who has a “stake” or interest in your program. We often think of government agencies, policymakers, funding agencies, and even implementers or providers as stakeholders. However, we often do not think of the beneficiaries or health programs as stakeholders. The people that our programs and services strive to serve make decisions about seeking services and continuing to seek care. It is vital to consider these stakeholders when designing and implementing any program or service. As we begin to talk about stakeholders, it is important to note that they often fall into two groups: data users and data producers. We typically think only of data users as our stakeholders but, as you can see here, data producers play a key role in the data-informed decision-making process.
To make a decision, three elements are critical: Data Decisions The involvement of stakeholders Let’s discuss stakeholders’ roles in the context of decision making. Large amounts of money and effort are being developed to collecting data from health facilities, communities, and populations. As a result, we want to maximize the impact that data has for real-world benefit. This is where involvement of stakeholders becomes important. We want prospective users of data to value what has been collected and analyzed. When data are seen as useful and valuable, it is more likely to be ‘owned’ by those who need it to inform decision-making.
It is important to recognize that different stakeholders will affect the data-informed decision-making process in different ways. Different stakeholders …. Typically, stakeholder analysis is done informally, in an ad hoc way. The rationale behind choosing and engaging stakeholders is rarely consistent, systematic, or documented. A researcher may talk to people to identify stakeholders and their roles, but the process is intuitive rather than systematic, and it rarely happens the same way twice. As a result, the following scenarios are typical: Only data producers are included Only those stakeholders in agreement with the proposed plan are invited to participate. Stakeholders are selected only from the organization that is directly involved in the project. Stakeholders are invited to a preliminary briefing, but they are not included thereafter in project design. The process includes only the bare minimum number of stakeholders required to obtain formal approvals. Stakeholders included in the project may not be at the appropriate level in a community or organization to contribute to the project or make decisions. If these kinds of conditions exist, the work of the M&E project/system will, in all likelihood, suffer as a result. Here are a couple of examples of how things went awry when there was inadequate stakeholder involvement: The national government of an African country did not support the findings of a new demographic and health survey because they had not been very involved in the process. In addition, the results conflicted with other indicators and data sources they had that cited similar information. Since they were not involved in the process, they did not see the value of the new data and did not use/support its use. The clinic staff tasked with collecting data for a new M&E system did not see much purpose in what they had been tasked to do and, as a result, the data collected were of poor quality. They had not been engaged early on as stakeholders and thus had a difficult time appreciating their role in the larger context of the health information chain. As a result, staff memebers had little incentif to provide the energy and attention to detail that would have produced higher quality data.
Those are just a couple of examples that point to a similar conclusion – there is a strong relationship between ownership, data quality, data relevance, and data use. People are more likely to use data in their decision making if they have been involved from the beginning, they believe the data are of high quality, and they feel the specific data addresses their priorities. Engaging stakeholders early and systematically in the process enables the right questions to be asked in the right way, and in turn, to define data activities that will generate quality information that can be used.
As we have just discussed, stakeholder engagement is a very important aspect of your M&E work. MEASURE Evaluation’s stakeholder tools are designed to help you determine who are the important stakeholders to include for your project and develop a plan for how to engage stakeholders identified. while this tool encourages you to involve more people (which freaks folks out) it also helps you to be strategic for how to involve them. The tool isn’t recommending that you involve all these stakeholders all of the time in every step. Another point to emphasize – often folks think they already know who the stakeholders are. But they often think about those that are the usual suspects and need to be involved. What they don’t think about is if there are other stakeholders that you could add to improve your activity OR – as important – other stakeholders who could impede your activity
Let’s first look at the Stakeholder Analysis Matrix. This tool helps to identify individuals and groups that are stakeholders in an M&E or data-use activity, either as contributors, influencers, or beneficiaries. The tool provides a structured way to define the roles that stakeholders play in the activity and assess the resources they could bring to bear. It also provides a framework for assessing the interests, knowledge, positions, alliances, resources, power, and importance of various stakeholders. Who will resist the initiative? Who will support it? What are their reasons? The tool helps to assess which stakeholders to include in the process by determining the relative priority of stakeholders. Which stakeholders have the highest priority? • Who needs to use the data, and what questions are they seeking to answer? • Who has influence and resources that can be brought to bear to aid this project? • Who will be directly or indirectly affected by the outcome of this initiative? • Who will support our plan? Who will oppose it? Why? How do we deal with it? • What each of these individuals contribute to the process?
NOTE TO FACILITATOR: click on each column to show the red circle highlighting each column. Here is an example of the Matrix. Let’s look at the information required in each column. In the first column, you list your stakeholder and whether this stakeholder is a person, group, or organization. In the second column, you describe the stakeholder, including job title, organizational purpose, funding sources, etc. In the third column, you include a brief explanation of why this stakeholder is relevant to your activity – are they a program implementer? Can they help make decisions or authorize changes to a program/policy? Can they fund aspects of the project? Will they help communicate your findings to a wider audience or are they a credible stakeholder who support is needed for general buy-in and support for tool use. In the fourth column, you list the stakeholder’s level of knowledge about your issue. This is important because sometimes you will choose a stakeholder for his/her knowledge level, and sometimes you will choose one in spite of his/her knowledge level because of other resources he/she can bring to the activity. In the fifth column, you list each stakeholder’s level of commitment to the activity. Finally, in the last column, you list the resources that each stakeholder brings to the activity.
Here you see an example of a Stakeholder Analysis Matrix. As you can see, this matrix was created during the development of a plan to scale up PMTCT programs throughout the system. Let’s walk through each column. NOTE to facilitator : Read each column from the example and ask the participants if they have any clarifying questions.
Once you analyze each of the stakeholders, it is helpful to create a Stakeholder Engagement Plan to ensure that stakeholders are involved throughout the activity. The first column lists the stakeholder, while the second lists the potential role of that stakeholder. The third column shows how you plan to involve the stakeholder, and the final column lists who is responsible for ensuring involvement. NOTE to facilitator: Cick on each column to show the red circle highlighting each column.
Let’s look at an example. You will see that we took the first two columns (the stakeholder and its potential role in the activity) from the Stakeholder Analysis Matrix and inserted that information here. NOTE to facilitator : read through this example.
There are a variety of tools developed by MEASURE Evaluation used to improve the demand for and use of information in health decision making. Templates and explanations of each tool can be found on the MEASURE Evaluation website. The Stakeholder Engagement Tool can be used separately or with other tools depending on your needs. For example, an assessment to data use constraints tool might be conducted first and you may find that one constraint is that data are not used because stakeholders do not value data from the system. In this case, you could do the stakeholder analysis matrix and engagement plan to address that issue. Or, we discussed, it is important to include stakeholders in all aspects of the M&E process so including them as interviewees for the assessment to data use constraints would be important and including them when you do the Framework for Linking Data with Action…
Data Demand & Use: Stakeholder Analysis Matrix and Engagement Tools Webinar Series #3 Tuesday, January 31, 2012 Presenters: Tara Nutley, Molly Cannon, Drew Koleros
Troubleshooting <ul><li>If you lose connectivity </li></ul><ul><ul><li>Re-enter the meeting room by clicking on the webinar link provided </li></ul></ul><ul><li>If you have trouble with audio </li></ul><ul><ul><li>Refer to the conference call instructions in the upper right hand corner </li></ul></ul><ul><li>Send an email to [email_address] </li></ul>
Tips for Participating in the Discussion <ul><li>To comment, raise your hand by clicking on the icon. </li></ul><ul><ul><li>Speak into your microphone (be sure it is enabled by clicking on the icon at the top of the screen). </li></ul></ul><ul><ul><li>Type questions in Q&A window located at the top of your screen. </li></ul></ul><ul><ul><li>A recording of the webinar will be made available at www.measureevaluation.org/ddu </li></ul></ul>
Agenda <ul><li>Welcome - webinar tips </li></ul><ul><li>Brief overview of Data Demand and Use </li></ul><ul><li>Presentation of Tools </li></ul><ul><li>Field Application of Tools – Drew Koleros </li></ul><ul><li>Questions and Answers </li></ul><ul><li>Wrap up </li></ul>
Why improve data-informed decision making? Pressing need to develop health policies, strategies, and interventions
“… 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
Definitions <ul><li>Data use – Using data in the decision making process </li></ul><ul><ul><li>monitor a program </li></ul></ul><ul><ul><li>create or revise a program or strategic plan </li></ul></ul><ul><ul><li>develop or revise a policy </li></ul></ul><ul><ul><li>advocate for a policy or program </li></ul></ul><ul><ul><li>allocate resources </li></ul></ul><ul><li>Data Demand - decision makers specify what kind of information they want & seek it out </li></ul>
What Is a Stakeholder? <ul><li>Any person, group, or organization with a particular interest in a policy or program </li></ul><ul><ul><li>Government agencies </li></ul></ul><ul><ul><li>Beneficiaries </li></ul></ul><ul><ul><li>Policymakers </li></ul></ul><ul><ul><li>Funding agencies </li></ul></ul><ul><ul><li>Providers / implementers </li></ul></ul><ul><ul><li>Civil society </li></ul></ul><ul><ul><li>Researchers </li></ul></ul><ul><ul><li>M&E specialists </li></ul></ul>
Stake-holders Decisions Context of Decision Making Data
Importance of Knowing Your Stakeholders <ul><ul><li>View activities from different perspectives </li></ul></ul><ul><ul><li>Have different degrees of understanding </li></ul></ul><ul><ul><li>Need / want different information </li></ul></ul><ul><ul><li>Need information at different levels of complexity </li></ul></ul><ul><ul><li>Have different intensities of interest </li></ul></ul><ul><ul><li>Have different roles in the decision-making process </li></ul></ul>
Results of Involving Stakeholders in Data Use Process <ul><li>Relevance of data </li></ul><ul><li> Ownership of data </li></ul><ul><li> Appropriate dissemination of data </li></ul><ul><li> Use of data </li></ul>
Stakeholder Analysis Matrix and Engagement Plan <ul><li>Purpose: </li></ul><ul><ul><li>To ensure that data initiatives reflect the needs and values of relevant stakeholders to support data use in decision making. </li></ul></ul><ul><li>Description: </li></ul><ul><ul><li>Identify all relevant stakeholders involved in the process. </li></ul></ul><ul><ul><li>Determine appropriate strategies for engaging with stakeholders. </li></ul></ul>
Process <ul><li>Identify the need </li></ul><ul><li>Go through Stakeholder Analysis Matrix </li></ul><ul><li>Set the optimum stakeholder group </li></ul><ul><li>Create a Stakeholder Engagement Plan </li></ul><ul><li>Track stakeholder engagement throughout the project </li></ul>
Stakeholder Analysis Matrix <ul><li>The Stakeholder Analysis Matrix is a framework and process used at the start of a project for planning purposes by: </li></ul><ul><ul><li>Identifying stakeholders </li></ul></ul><ul><ul><li>Defining their roles and resources </li></ul></ul><ul><ul><li>Identifying dynamics among stakeholders </li></ul></ul><ul><ul><li>Setting the optimum stakeholder group </li></ul></ul>
Stakeholder Analysis Matrix Name of Stakeholder organization, group or individual Stakeholder description Primary purpose, affiliation, funding Potential role in the issue or activity Level of knowledge of the issue Level of commitment Support or oppose the activity, to what extent, and why? Available resources Staff, money, technology, information, influence Government - Political - Commercial - NGO - Other Civil Society - International Donors -
Stakeholder Analysis Matrix Program issue Develop plan (inc. M&E plan) to scale up PMTCT programs throughout system. Proposed activity Convene stakeholders to identify priorities based on available data and develop action plan. Date November 2006 Name of stakeholder organization, group, or individual Stakeholder description Primary purpose, affiliation, funding Potential role in the issue or activity Level of knowledge of the issue Level of commitment Support or oppose the activity, to what extent, and why? Available resources Staff, money, technology, information, influence Government - National AIDS Control Committee (NACC) Involved in planning, implementation, M&E of all HIV/AIDS programs in the country; approves donor and NGO-funded HIV/AIDS programs Facilitates the stakeholder meeting, prepares for meeting by identifying data sources and preparing an agenda High – receives reports on PMTCT activities from MCH division at MOH; Medium level of knowledge of int’l guidelines and studies Strongly supports activity but hesitant to use international data sources. NACC opposes use of the DHS and most recent international estimates, as it considers these sources to overestimate HIV prevalence Staff available to facilitate; room and computers available for meetings at NACC headquarters
Stakeholder Engagement Plan <ul><li>The Stakeholder Engagement Plan provides a platform for following up and tracking stakeholders. It is primarily used for project implementation and follow-up phases. </li></ul>
Stakeholder Engagement Plan Program issue Proposed activity Date Stakeholder organization, group, or individual Potential role in the activity Engagement strategy How will you engage this stakeholder in the activity? Follow-up strategy Plans for feedback or continued involvement Government - Political - Commercial - NGO - Other Civil Society - International NGOs -
Stakeholder Engagement Plan Program issue Develop plan (inc. M&E plan) to scale up PMTCT programs throughout system. Proposed activity Convene stakeholders to identify priorities based on available data and develop action plan. Date November 2006 Stakeholder organization, group, or individual Potential role in the activity Engagement strategy How will you engage this stakeholder in the activity? Follow-up strategy Plans for feedback or continued involvement National AIDS Control Committee (NACC) Facilitates the stakeholder meeting, prepares for meeting by identifying data sources and preparing an agenda that allows for the sources to be discussed The NACC is the lead in this activity. It will be important for the NACC to involve more specifically the PMTCT coordinator, clinical care coordinator, and National AIDS Program Coordinator The NACC is responsible for following up with the prioritized stakeholders
Guiding Principles <ul><li>Ownership fosters use </li></ul><ul><li>Stakeholder engagement improves relevance of data </li></ul><ul><li>Stakeholders should represent a diversity of perspectives </li></ul><ul><li>Recognize the differing roles of stakeholder groups and individuals </li></ul><ul><li>Engage stakeholders throughout the project process—from design to follow up </li></ul><ul><li>Acknowledge the unintended effects of stakeholder engagement </li></ul><ul><li>The more stakeholders, the greater the complexities of project design </li></ul><ul><li>A large stakeholder group might stimulate excessive expectations </li></ul><ul><li>Transparency can add unwanted accountability </li></ul>
FIELD APPLICATION <ul><li>Drew Koleros, Program Advisor </li></ul>
Stakeholder Engagement <ul><li>Key step in the planning process to ensure that expected results are meeting end-user needs </li></ul><ul><ul><li>Strategic planning </li></ul></ul><ul><ul><li>Research planning </li></ul></ul><ul><li>Essential to dissemination to ensure that actual results are used for intended purposes </li></ul><ul><ul><li>Data analysis and research findings </li></ul></ul><ul><ul><li>Communication materials </li></ul></ul>
Strategic Planning <ul><li>Example from midterm review of Rwanda’s National Strategic Plan on HIV and AIDS 2009-12 </li></ul><ul><ul><li>Terms of Reference </li></ul></ul><ul><ul><li>Purpose & Specific Objectives </li></ul></ul><ul><ul><li>Expected Results </li></ul></ul>
Research Planning <ul><li>Example from Côte d’Ivoire’s study to estimate the unit cost of reaching sex workers and MSM with HIV services </li></ul><ul><ul><li>Scope of research study </li></ul></ul><ul><ul><li>Perspective of study </li></ul></ul><ul><ul><li>Timing of study </li></ul></ul>
Data analysis & research findings <ul><li>Example from HIV data triangulation exercise in Rwanda </li></ul>Finding Stake-holders Recommend-ation Method for Data Dissemination Timeline Assessment HIV prevalence is 34% among young women under 25 in Gikondo Transit Camp Program Managers, HIV IPs Implement targeted HIV prevention programs at camp Triangulation National Dissemination workshop Feb 2010 Programs in place Directors of Planning, National Institutions <ul><li>Advocacy for: </li></ul><ul><li>scaling up services </li></ul><ul><li>Surveillance </li></ul><ul><li>condom provision </li></ul>One-on-one consultative meetings with key national staff Early 2010 Surveillance activities conducted; condoms available
Communication materials <ul><li>Example from Rwanda HIV Update Informational Brochures </li></ul>
2007 Rwanda HIV and AIDS Response Update compiled by the National Aids Control Commission (CNLS) of Rwanda www.cnls.gov.rw According to the above graph, 56% of the total number of HIV+ pregnant women requiring PMTCT (Rwanda 2008 EPP Projections) received any PMTCT services in 2007. The below graph displays data from the 2007 Rwanda Service Provision Assessment (SPA), in which a little over half of health facilities are offering any PMTCT services. PMTCT For more information on the National and District-level HIV data in Rwanda, please contact: Department of Planning, Coordination, Monitoring and Evaluation (PCM&E Unit) The National AIDS Control Commission of Rwanda (CNLS): BP 7162 Kigali, Rwanda Telephone: (250) 503980 E-mail: email@example.com www.cnls.gov.rw The 2007 Rwanda HIV and AIDS Response Update was developed by the CNLS M&E unit, in close collaboration, with MEASURE Evaluation’s Data Demand and Information Use (DDIU) team. Funding for this brochure was provided by USAID through the President’s Emergency Plan for AIDS Relief (PEPFAR).
2007 Rwanda HIV and AIDS Response Update The above graph displays the condom utilization rates among men aged 15-29 from the Rwanda DHS 2000 and 2005. Rates of condom use at their last high risk sexual encounter in the last 12 months have declined where “high risk” is defined as a non-marital or non-cohabitating partner. The graph above displays female data from DHS 2000 and 2005. In the age group 15-19, condom use has slightly dropped from 28% to 27.6%, whereas condom use increased for both the 20-24 and 25-29 age groups, though use remains low. The above graph displays the percentage of HIV+ adults and children who received treatment in 2007 out of the total requiring treatment, as estimated using HIV and AIDS estimations and projections. According to the graph, 30% of adults and 38% of children who require treatment are currently not receiving ART. The above graph displays the percentage of health facilities surveyed in the 2007 Rwanda Service Provision Assessment (SPA) offering any ART services. The above graph displays the percentage of OVC by district receiving any support services, as reported by implementing partners in a national survey conducted by the CNLS, MIGEPROF and UNICEF in 2007. Prevention Orphans and Vulnerable Children Treatment Treatment Percentage of HIV+ Adults and Children receiving treatment out of total need (n=61,545) (n=6,489)
Stakeholder Engagement and Other DDU Tools : http://www.measureevaluation.org/ddu <ul><li>Stakeholder Engagement Tool </li></ul><ul><li>Information Use Mapping Tool </li></ul><ul><li>Assessments to Data Use Constraints </li></ul><ul><li>Framework for Linking Data with Action </li></ul><ul><li>PRISM Tools </li></ul>
Stakeholder Engagement Resources <ul><li>Tool is available on the MEASURE Evaluation website: www.measureevaluation.org/ddu-toolkit </li></ul><ul><ul><li>Instructions for use </li></ul></ul><ul><ul><li>Stakeholder Analysis Matrix and Engagement Templates </li></ul></ul><ul><ul><li>Field application </li></ul></ul><ul><ul><li>Implementation checklist </li></ul></ul>
MEASURE Evaluation DDU Resources <ul><li>www.measureevaluation.org/ddu </li></ul><ul><ul><li>Data Demand and Use Tool Kit </li></ul></ul><ul><ul><li>Data Demand and Use Training Resources </li></ul></ul><ul><li>Next webinar will be on February 7, 2012 at 9:00 am PRISM. </li></ul>
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<ul><li>MEASURE Evaluation is a MEASURE project funded by the </li></ul><ul><li>U.S. Agency for International Development and implemented by </li></ul><ul><li>the Carolina Population Center at the University of North Carolina </li></ul><ul><li>at Chapel Hill in partnership with Futures Group International, </li></ul><ul><li>ICF Macro, John Snow, Inc., Management Sciences for Health, </li></ul><ul><li>and Tulane University. Views expressed in this presentation do not </li></ul><ul><li>necessarily reflect the views of USAID or the U.S. Government. </li></ul><ul><li>MEASURE Evaluation is the USAID Global Health Bureau's </li></ul><ul><li>primary vehicle for supporting improvements in monitoring and </li></ul><ul><li>evaluation in population, health and nutrition worldwide. </li></ul>