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Monitoring Scale-up of Health Practices and Interventions

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MEASURE Evaluation PRH webinar presented by Bridgit Adamou in July 2013

Published in: Technology, Business

Monitoring Scale-up of Health Practices and Interventions

  1. 1. Monitoring Scale-up of Health Practices and Interventions Bridgit Adamou MEASURE Evaluation Population and Reproductive Health (PRH) Project
  2. 2. Objectives:  Provide background information on the monitoring scale-up initiative  Introduce the result (the guide)  Present what information is included in the guide  Highlight key components of the guide
  3. 3. Background
  4. 4. Background
  5. 5. Parameters  Succinct, but also including enough background narrative, examples, and explanations  Very user-friendly and applicable to a broad audience, yet technical enough to be helpful  FP-focused, but easily applicable to other health practices and interventions  Informed by ExpandNet’s work, but not necessarily dictated by it
  6. 6. This practical “how to” resource includes:  Rationale for monitoring scale-up  Readiness assessment  Ten considerations to monitoring scale-up  Appendices including: - Three monitoring scale-up case studies - “Defining the Innovation” piece - Selected frameworks and approaches for scaling-up - Using GIS to monitor scale-up expansion
  7. 7. Rationale Successful scale-up involves two key elements: institutionalizing the practice and expanding or replicating it.
  8. 8. And another way to look at scale up…
  9. 9. Readiness Assessment
  10. 10. 10 Considerations to Monitoring Scale-Up 1. Define objectives and scope of scale up plan 2. Create a framework 3. Identify necessary resources to implement monitoring plan 4. Select indicators 5. Establish data sources and reporting systems 6. Develop a data use and dissemination plan 7. Collect data 8. Analyze data and determine if scale up is progressing on track 9. Make program adjustments based on findings and recommendations 10. Continue the M&E process
  11. 11. 1: Define objectives and scope of the scale-up plan  What do you want or need to know in order to say your scale-up is working?  Is the scale-up fulfilling the objectives of the original program or pilot?  How will you know if there are problems or that your scale-up is not achieving its pre-determined objectives?
  12. 12. 2: Create a framework
  13. 13. 3: Identify necessary resources to implement monitoring plan  Human resources  Financial resources
  14. 14. 4: Select indicators Level Indicators (by health domain) Data Sources FINANCING process The practice is included in the current year annual operating plan Operational plan; budget process The budget is linked to the current year annual operational plan Budgets; chart of accounts; operational plan ACCESS TO PHYSICAL RESOURCES process Percent of facilities with available equipment to implement the practice Health facility audit; GIS data; specialized survey process Availability of job aids and service protocols for the given practice Health facility audit; specialized survey output Percent of facilities or community-based providers that experienced a stock out of a given commodity at any point during a specified time period Site visits, physical inventories, stock records; logistics management information system records; supervision records; GIS data LEADERSHIP/GOVERNANCE process Existence of a strategic plan for expanding coverage of the practice Review of strategic plan or strategy documents; interviews with key staff (e.g., managers) output Examples of practice being included and/or supported in national or subnational policy, strategy, guidelines, curricula, or related documents and communications Review of national or subnational policy, strategy, guidelines, curricula, or other related documents HEALTH MANAGEMENT INFORMATION SYSTEMS input HMIS adapted to capture and report on key information on the implementation of the practice Meeting notes; HMIS output Key information on the implementation of the practice routinely reported in the HMIS HMIS HEALTH WORKFORCE process Number of providers trained in the practice, by type of personnel Training records output Number or percent of providers competent to provide specific services upon completion of training Competency tests (such as a checklist administered by the trainers and/or external expert observer) SERVICE DELIVERY output Percent of trained providers performing the core components of the practice National guidelines/standards for service delivery; checklists and notes of an expert observer outcome Number of clients receiving the practice of interest in a given timeframe Facility records outcome Percent of sites implementing the practice with fidelity to the model, based on pre-determined criteria and definition of the practice/innovation Facility records; facility audits; program records (for community-based services); interviews with key staff COMMUNITY INVOLVEMENT output Community participation in and support for the practice Program records; focus groups; in-depth interviews output Percent of audience with a favorable attitude toward the practice Sample surveys with members of the intended audience; focus groups; in-depth interviews
  15. 15. 5: Establish data sources and reporting systems
  16. 16. 6: Develop a data use and dissemination plan  Who will be responsible for analyzing and interpreting the data?  How will the findings be presented and disseminated?  Who are the internal and external audiences for dissemination?  Who will be using the data?
  17. 17. 7: Collect Data
  18. 18. 8: Analyze Data and Determine if Scale-up Is Progressing On Track  How is scale up progressing at the various levels and within the different domains?  Do the service delivery points have the necessary commodities for the practice to be properly implemented?  Is the scale-up maintaining fidelity to the practice?
  19. 19. 9: Make program adjustments based on findings & recommendations  Discuss challenges and potential solutions to getting the scale-up back on track or change strategies  Develop an action plan for implementing each of these solutions.
  20. 20. 10: Continue the M&E process
  21. 21. Appendices  IRH’s Defining the Innovation, with accompanying worksheet  Selected frameworks and approaches for scale-up of health interventions
  22. 22. Appendices  Case Studies: - PROGRESS Project: Monitoring the scale-up of FP integration into comprehensive care centers in Kenya - FAM Project: Monitoring the scale-up of standard days method in five countries - NCP Project: Monitoring vitamin A promotion in Niger  Using GIS to monitor scale-up
  23. 23. "Measurement is the first step that leads to control and eventually to improvement. If you can't measure something, you can't understand it. If you can't understand it, you can't control it. If you can't control it, you can't improve it." - H. James Harrington
  24. 24. MEASURE Evaluation PRH is a MEASURE project funded by the United States Agency for International Development (USAID) through Cooperative Agreement GHA-A-00-08-00003- 00 and is implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill in partnership with Futures Group International, Management Sciences for Health, and Tulane University. Views expressed in this presentation do not necessarily reflect the views of USAID or the U.S. Government. MEASURE Evaluation PRH supports improvements in monitoring and evaluation in population, health and nutrition worldwide.

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