Global Health Council-Nyangara


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  • The quality monitoring process – starts with establishing quality standards – that guide program implementations Quality monitoring doesn’t need NEW SYSTEMS or new tools!
  • The purpose or the hypothesis behind Quality monitoring is to confirm that standards are adhered to and programs are improving child wellbeing. If not what can be done?
  • Do program staff, volunteers, caregivers etc find the information useful?
  • Markers of QL Improvement (Indicators)
  • Global Health Council-Nyangara

    1. 1. Methods for Monitoring Quality of OVC Programs Florence Nyangara, PhD. Futures Group/MEASURE Evaluation Global Health Conference May 29 th , 2009
    2. 2. The Questions? <ul><li>How can we measure and monitor the Quality of OVC programs? </li></ul><ul><li>Which indicators will provide the most useful information to monitor and improve quality? </li></ul>
    3. 3. Presentation objectives <ul><ul><li>Understand why monitor quality of services </li></ul></ul><ul><ul><li>Tools and approaches to systematically assess and monitor the quality of OVC services standards i.e. CSI </li></ul></ul><ul><ul><li>Indicators necessary to make informed decisions to improve, manage, and report on the quality of services provided to OVC? </li></ul></ul>
    4. 4. Quality Monitoring Process <ul><li>Well Defined Quality Standards - established for most Dimensions of Quality, such as technical competence, effectiveness, efficiency, safety, and coverage - for each service domain, i.e. Education </li></ul><ul><li>Plan a monitoring system and a set of tools to collect data (existing M&E tools - multipurpose) </li></ul>
    5. 5. Ultimate Goal of Improving Quality Comply with the set Standards Set a Quality Monitoring System Standards Set <ul><ul><li>Improved </li></ul></ul><ul><ul><li>Outcomes </li></ul></ul>Improving Quality of Services
    6. 6. Quality Monitoring System/Plan <ul><li>Define objectives and expected results </li></ul><ul><li>Define key activities or processes </li></ul><ul><li>Collect the data as usual (use existing tools) </li></ul><ul><li>Decide what information your program needs to make decisions, i.e. select key indicators </li></ul><ul><li>Analyze data and use the information to make changes that improve service quality & program </li></ul>Inputs Activities Outputs Outcomes
    7. 7. Monitoring QL Improvement <ul><li>M onitoring processes and the measurement of specific outcomes ensures that we are meeting acceptable standards </li></ul><ul><li>Example in Education: </li></ul><ul><ul><li>Essential Action (STD) : Engage schools/communities to ensure OVC attend school </li></ul></ul><ul><li>Process Indicator: # of schools/communities engaged </li></ul><ul><li>Example Outcome: % OVC attending school or advancing in class/grade level (performance) </li></ul>
    8. 8. Methods of collecting Data….. <ul><ul><li>Observations </li></ul></ul><ul><ul><li>Client satisfaction surveys </li></ul></ul><ul><ul><li>Focus group interviews </li></ul></ul><ul><ul><li>Checklist (supervision or home visits) </li></ul></ul><ul><ul><li>Spot-checks </li></ul></ul><ul><ul><li>Periodic assessments of outcomes for sample of OVC </li></ul></ul><ul><ul><li>Conduct program evaluation (baseline, mid-term and end-line surveys) </li></ul></ul>
    9. 9. Tools….. <ul><ul><li>Home visit forms </li></ul></ul><ul><ul><li>Supervision checklist </li></ul></ul><ul><ul><li>Survey questionnaires </li></ul></ul><ul><ul><li>Child Status Index (CSI) Assessment – OUTCOMES </li></ul></ul><ul><ul><li>which can also gives data on outputs: </li></ul></ul><ul><ul><ul><li>What services child received </li></ul></ul></ul><ul><ul><ul><li>Frequency and source of support </li></ul></ul></ul><ul><ul><ul><li>OVC needs and outcomes in each domain </li></ul></ul></ul>
    10. 10. Example – PC3 Program Ethiopia, used the CSI to monitor the effects of QL Improvement <ul><li>575 Tier III partners & 5 international partners (TI) </li></ul><ul><li>Developed service quality standards to achieve set Goals (see Child Status Index) </li></ul><ul><li>Conducted CSI assessments 3 times 6-months apart. </li></ul><ul><li>A sample of 3,000 OVC were assessed in the 3 waves </li></ul><ul><li>Results show improvement in all domains except Food & Nutrition which declined. </li></ul><ul><li>We can say – QL improvement is associated with better outcomes </li></ul>
    11. 11. Results – PC3 - CSI Assessment <ul><li>Mean scores 12 indicators during the three assessments Domains </li></ul><ul><li>Jan-08 Jun-08 Mar-09 Domain Average </li></ul><ul><li>1 Food security 2.73 2.7 2.71 2.71 </li></ul><ul><li>2 Nutrition& growth 2.88 2.89 2.89 2.89 </li></ul><ul><li>3 Shelter 2.8 2.78 2.83 2.80 </li></ul><ul><li>4 Care 2.89 2.95 3.02 2.95 </li></ul><ul><li>5 Abuse and exploitation 3.18 3.25 3.28 3.24 </li></ul><ul><li>6 Legal protection 3.16 3.23 3.28 3.22 </li></ul><ul><li>7 Wellness 3.09 3.1 3.2 3.13 </li></ul><ul><li>8 Health care services 2.92 3 3.1 3.01 </li></ul><ul><li>9 Social behavior 3.04 3.08 3.16 3.09 </li></ul><ul><li>10 Emotional health 3.16 3.23 3.27 3.22 </li></ul><ul><li>11 Performance 2.92 2.94 3.03 2.96 </li></ul><ul><li>12 Education & work 2.96 3.05 3.1 3.04 </li></ul>
    12. 12. Conclusion <ul><li>Define service quality standards </li></ul><ul><li>Monitoring Steps: </li></ul><ul><ul><li>Ensure all essential actions for each domain are taken (use checklist) </li></ul></ul><ul><ul><li>Progress in implementing the essential actions (# done) </li></ul></ul><ul><ul><li>Outputs: Number of children reached with improved services (# OVC) </li></ul></ul><ul><ul><li>Monitor outcome progress – periodic CSI assessments </li></ul></ul>
    13. 13. Thank You!!