New Challenges in M&E Lets go. Scaling Up Monitoring & Evaluation Strategic Information PROGRAM GUIDANCE RESULT NEEDS OPPORTUNITIES Resources New directions.

New Challenges in M&ELet’s go

Scaling Up

Monitoring & EvaluationStrategic Information

PROGRAM GUIDANCERESULT NEEDS

OPPORTUNITIESResources

New directions

INCREASING DEMAND FOR INFORMATION

STRATEGIC INFORMATION

INCREASING EMPHASIS ON DATA USE AND UTILITY

DATA DEMAND GENERATION

WHAT DO WE MEAN BY STRATEGIC INFORMATION?

DATA

KNOWLEDGE

ÎNFORMATION

ACTION

Analysis

Understanding

Application

Generating information andknowledge to influence policy making,

programme action, and research

Assessment

INCREASING EMPHASIS ON DATA USE AND UTILITY

DATA DEMAND GENERATION

WHAT KIND OF INFORMATION DO WE NEED?

Needs, resources, access, coverageWhat are and will be the needs for services?What resources are available and what will be needed?How many have access? Who has access?

Programme Monitoring & EvaluationIs the programme performing according to plans?

Is the programme able to contain drug resistance development?Does the programme make a difference? Is it achieving its goals?

How much does it cost and how cost effective is it?Patient monitoring

Operations ResearchHow can programme implementation be improved?What are the best models of implementation?What can be done to improve health systems?

ResearchCan we provide more efficacious and more effective interventions?

What impact do programmes have?

INCREASINGCOMPLEXITY

MONITORING AND EVALUATION

Input Process Output Outcome Impact

A FRAMEWORK for Monitoring and Evaluation for ARV Therapy Programmes

ResourcesStaffingPolicies

TrainingLogistics

ManagementEducation

etc.

Services available

(testing &counseling, ART, lab)

Qualityservices

Publicunderstands

ART

Peopleon

Treatment

Knowledge HIV status

Stigma lowerBehavioural

change

SurvivalQuality of

life

HIV/STI transmission

reduced

INCREASING M&EIMPORTANCE -

INCREASING VOLUME M&E

MONITORING AND EVALUATION

IndicatorsTools

Methods

No programmeNo data

COVERAGE

• Build national monitoring systems

• Global coverage survey of key informants 2003

• Global district access/coverage survey 2004 : health system focus

HowMany Now?

MEASUREMENTISSUES

• Second generation surveillance • Self-reported risk behaviour in household surveys

Frustration with measurement of risk behavioursthrough self-reports in generalpopulation

EVALUATION

Scaling UpImpactCareful planningMultiple data sources

Integration of surveillance and M&E necessary

M&E does notautomatically implygood evaluation: but we need more Evaluation

CoordinationMore efforts to coordinateand harmonize, focus oncountry and global levels

Allon board?

District focusMore decentralization of M&Ewill present a challenge tonational systems

Existing Information SystemsNational SurveillanceActivities•National Census•Demographic and HealthSurvey•Health ManagementInformation System•Labour Force Survey•Household Budget Survey•Agricultural Survey•National AIDS ControlProgram•TB/ Leprosy Program•Vital Registration•Integrated DiseaseSurveillance

District SurveillanceActivities1. DSS at TANESA -Mwanza2. AMMP-2 - Hai site3. NSS - Igunga site4. NSS - Kigoma site5. Village Register - Kilosasite6. AMMP-2 - Morogoro site7. Village Register - Kibahasite8. AMMP-2 - Dar es Salaamsite9. Village Register -Mbarale10. Ifakara DSS11. Rufiji DSS12. Village Register -Masasi site13. Village Register -Mtwara site

1

32

9 10

5 611

78

1213

4