Primer on Monitoring and

Evaluation

The 3 Pillars of Monitoring and Evaluation

Identifying the Performance IndicatorsCollecting information using appropriate M&E tools and methods

Household surveysFacility SurveysHMISQuantifiable Supervisory Checklists

Using M & E results for program decisions

Coverage for Routine Immunization

Very Low Initial Reach : <20%

Coverage for Routine ImmunizationFailure to sustain coverage after

initial reach

Coverage for Maternal Health Very Low Initial Reach : <35%

for AN care

Inequities in Under-five Mortality Rates

DHS 2003

Under-five Mortality – Absolute Difference between low and highNigeria has highest difference in the Region

• All performance indicators should have Base-line and Targets – NHSDP has them

• Should provide data at the required frequency and with adequate disaggregation

• Should be able to identify sub groups that are missing out services (Equity)

Principles of M &E

•Should use 3rd party assessments for Evaluations

1.Independence2.Less distraction for the program

manager

•Clearly defined responsibilities for analysis and use of data• Availability of dedicated staff and • Systems/protocols for reviewing and

using data

•Robust enough to meet the data requirements of RBF /CCT/Contracting which require more precision in measuring results

Principles of M &E

Where does Nigeria Stand now?

Reduction in Under

5mortality Rates;

Maternal Mortality

Ratios and HIV

prevalence among 15-

24 Year population

Level IHealth Impact

Level 2Program

Outcomes

Level 3Service Delivery outputs

Level 4 Institutional Processes

Level 5Inputs

1. Wards meeting the Staffing requirements to deliver minimum package of services (%)

2. Health Personnel receiving competency based training (Number)

3. Health Facilities Renovated/ Rehabilitated (Number)

4. Health Centers receiving supplies of Essential Medicines for ward Minimum Health Package (%)

1. Increase in Federal and State Budgets allocated for health sector (%)

2. Improved retention of Human Resources for Health (%)

3. Public health facilities having active committees (at least 4 meetings per year) that include community representatives (%)

4. Increase in State HMIS reports meeting minimum quality standards (Number

1. Increase in Children 12-23 months fully immunized (%)

2. Increase in women receiving IPT for malaria during pregnancy (%)

3. Increase in births attended by Skilled providers (%)

4. Improved TB case detection rates (%)

5.Reduction in unmet need for FP services (%)

1. Increase in children under five sleeping under an ITN during the previous night (%)

2.Enhanced condom use at last high risk sex (%)

3. Improved TB Cure rates (%)

4. Increase in contraceptive prevalence rates (%)

The NSHDP Results Framework in Place

Collecting data on NSHDP performance indicators using appropriate M&E tools and methods

Household surveys:

DHS being done once in 5 years – Possibility of Mini DHS in between DHS rounds?MICs proposed once every 3 yearsLQAS being used for Malaria + Program – Scope for using in other programs, but requires capacity building at sub national levelUrgent need for more frequent surveys providing disaggregated data for States/LGAs

Collecting data on NHSDP performance indicators using appropriate M&E tools and methods

Facility Surveys: Being done under the Malaria Program Need to develop design, pilot and

implement

Quantifiable Supervision Checklists: Not being done Will be required with improved results

focus Need to design, pilot and implement

HMIS: In place Quality, coverage and timely reporting

remain a concern Requires systems for validation of data

Using M&E results for program decisions

Lot more work still needs to be done

Developing simple tools for annual State/LGA performance ranking

Capacity building at District and LGA levels on decentralized data analysis

Ensuring robust M&E for RBF/Performance Contracting initiatives

Proposed Organization of Session:

Day 3Quiz : What we know about M&E A brief primer on Monitoring and EvaluationPresentations on different M&E tools and approaches

Day 4 Introduction to New M&E tools : LQASCase StudyDiscussion on next Steps on Development of State Results chains and specific actions for putting in place M&E systems for disaggregated data generation and use

Distribution of States by Scores Achieved using Self Administered Questionnaire