Poster from the Innovations for MNCH Initiative team at the 2015 Evaluation Conference, summarizing research methods for evaluating the impact of an mHealth intervention with frontline health workers in five districts in Ghana. Learn more about the project at http://www.innovationsformnch.org

1. Introduction
 Increasing need for effective monitoring and evaluation in global health programs to improve
project management, track progress and scale-up successes.
 Program evaluations often take too long limiting use of data to support implementation
or make improvements
 The Care Community Hub (CCH) pilot in Ghana follows a 2 year mixed methods, theory-drive
(Figure 1) evaluation model to assess how the provision of the Community Health Nurse
(CHN) on the Go mobile health application influences the job satisfaction, motivation and
health knowledge of nurses.
Objective: To highlight the evaluation approach to understanding the pathways through
which the outcomes are reached in order to make programmatic changes throughout
the project.
Care Community Hub
 CHNs posted to rural areas as part of Ghana's government's Community-based Health Plan-
ning and Services system lack motivation due to professional isolation and lack of support
 CCH seeks to provide knowledge, learning, motivational and communication tools through
mobile technology (see details in Figure 3) to CHNs to improve their well-
being, connectedness and motivation.
The pilot is implemented by Grameen Foundation from June 2014 to May 2016 in 5 districts
in Ghana (Figure 2).
Data collection methods
 Mixed method approach with multiple time points of data collection and review: outcome
evaluation with baseline and endline assessments, routine monitoring and process documen-
tation throughout the project.
 Theory-driven approach that acts as a framework that guides program design as well as its
evaluation.
The Theory of change
 displays the pathways through which the various CCH application modules work to increase
the motivation and job satisfaction levels of the participating CHNs , improving their perfor-
mance and ultimately the quality of maternal, newborn and child health care.
 Evaluation in tandem with program development and implementation activities, utilizing data
from CHNs to feedback into the intervention design
Main purpose of ongoing monitoring and process documentation driven by the TOC is:
1.To assess how well the CCH activities adhered to the original design of the project during im-
plementation (fidelity) including the level of activities delivered and participation (dose deliv-
ered and received/reach), the level of satisfaction among participants, and quality of program
management;
2. To examine the proposed change pathways in the theory of change to document the emer-
gence of preconditions, intermediate and direct outcomes, explore the underlying drivers of
change, and assess the integrity of the project design;
3. o examine the role of contextual factors on the CCH intervention; and
4. To provide data during the course of implementation to facilitate real-time, or close to real-
time, feedback to program staff thus facilitating a continuous learning process and program
adaptation. The mixed-method approach utilizes different activities to collect data from key
populations of interest and stakeholders throughout the lifetime of the project outlined in
Figure 4.
Results
Results from 2 rounds of process documentation and ongoing monitoring are summarized in
Figure 4.
CONTRIBUTION OF MULTIPLE ASSESSMENT METHODOLOGIES IN A THEORY-DRIVEN
EVALUATION OF MOTIVATION AMONG COMMUNITY HEALTH NURSES IN GHANA
1. THEORY OF CHANGE
ASSUMPTION: CHNs feel unmotivated and frustrated with their jobs.
SOUMYA ALVA, PhD, JSI Research & Training Insitute Inc.
SOPHIA MAGALONA, MPH, JSI Research & Training Insitute Inc.
LINDA VESEL, PhD, Concern Worldwide US
Innovations for Maternal, Newborn & Child Health, an initiative of Concern
Worldwide U.S., accelerates the discovery and testing of creative solutions
to understand and overcome barriers that prevent essential health services
from reaching women and children. JSI Research & Training Institute, Inc.
collaborates with Innovations to provide technical oversight and support
for research, monitoring, and evaluation along with Ivy League Consult Af-
rica, the in-country research partner.
3. CHN ON THE GO MOBILE APP
Ada East, Ada West, & Ningo
Prampram
South Dayi & South Tongu
Health Centers & CHPS
Community Health Nurses
Supervisors
Pilot districts
50
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4. EVALUATION ACTIVITIES
2. PROJECT AREA
HOME SCREEN LEARNING CENTERPOINT OF CARE PLANNER
ACHIEVEMENT CENTER STAYING WELL SUPERVISOR APP