2. Monitoring and Control
When you have studied this session, you should be able to:
Define and use correctly all of the key words printed in bold.
Explain the importance of monitoring and control for your healthcare
practice.
Identify the main ways of gathering the information you need for
monitoring and performance control of your health work in the community
Describe how you would provide constructive feedback to someone
whose performance you are monitoring.
3. Monitoring in healthcare management
What is monitoring?
Monitoring is the regular observation and recording of activities that will
help you answer questions about your team’s performance.
• For example reporting the number of children vaccinated in the village
• Reporting enables gathered information to be used in making decisions to
improve service performance. For example, if monitoring identifies the
shortage of bed nets in the village you should report this to your supervisor.
4. The purpose of monitoring
The uses of monitoring information
Understanding the health situation in your community and how the
health services are performing.
Determining whether the resources in the health services are being well used.
Ensuring that all activities are carried out properly by the right people
and at the right time.
Ensuring that activities and tasks are performed in accordance with set standards.
Identifying health problems facing the community and starting to find solutions.
Ensuring community groups and local individuals participate appropriately in
health activities.
5. Successful monitoring
Build simple information collection methods.
Understand why you collect all those pieces of information.
Make sure that all your monitoring records are completed fully and
accurately.
Give people who are providing you with information feedback on the
monitoring results and explain to them how monitoring is being used to
make the service more effective.
Check that the service is not collecting the same piece of information
more than once.
6. Monitoring..
• Why do you think it is important to be accurate in your
collection of information about the services that you are
providing?
Inaccurate information may lead to the wrong action being
taken in the future.
If the correct data is not collected then it becomes impossible
to plan proper healthcare for the people in your community.
7. Methods of gathering information for
monitoring
Some of the sources of information available to you include:
Examining records: Example health service records, financial and
administrative records.
Documentation: Example letters, reports, plans, attendance lists, forms,
invoices, receipts, minutes of meetings and official reports.
Continually observing work progress, staff performance and service
achievements.
Discussing progress and any problems with staff and with the community.
8. Monitoring….
• Information obtained from monitoring can be used to identify
day to day problems, as well as for regular planning of the
health work in your community.
• It is essential to be aware of the significance of the information
you collect and to be confident of its correctness.
• Records must be reviewed at regular intervals and information
must be verified.
9. Using a checklist
• A checklist is a set of criteria that you can prepare to assist you in
monitoring your own activities.
• A checklist can also be a record or a reminder of what has been
happening so that you can follow the progress you are making.
• This will help you to trace the causes of any work problems.
• Problems may be caused by personal, administrative, technical or
organisational difficulties.
Example, receiving expired drugs is a technical fault.
10. Supervision
• Supervision is usually a meeting at which you are able to sit down with a senior
colleague and discuss issues that are important in your work.
• During that sort of supervision you can discuss, explain, justify, and obtain the
commitment of community workers to the objectives of the programme.
• Supervision makes sure that there are no divergences between the objectives
and the team’s standard of performance.
• It seeks solutions to any conflict that may have arisen between the health
practitioners and community workers or members of your community regarding
the programme objectives.
11. Supervision….
• Supervision is one way to discover how tasks entrusted to
different categories of worker are carried out, and under what
conditions.
• You should be able to analyse the factors that result in satisfactory
performance and uncover any obstacles to meeting your
objectives.
• It helps you to determine the causes of difficulties.
12. Steps of managerial control
• Control is a basic managerial function involving setting
standards, evaluating against standards and taking corrective
action.
• It is the process of regulating service activities so that your
performance conforms to expected standards and goals, and it
ensures that the necessary corrective action is taken whenever
deviations occur.
13. Controlling…
• As a HEP you will be involved in the four steps of controlling.
• 1st step, you should establish the necessary standards required
to ensure that achievements are in accordance with your overall plan.
• 2nd step, you measure performance.
• 3rd step, you compare that performance with the predetermined
standards.
• 4th step, If there is any deviation you will be able to take corrective
action.
14. Establishing standards of performance
• Standards must be established and expressed in
such a way that the people concerned can easily
understand them and the outcomes can be measured
without difficulty.
Example: Your standard might be to increase the
number of pregnant women attending
antenatal care by 20% in the village this year.
15. Measuring performance
• You should measure your actual performance and compare it with the
standards you have set.
• Quantitative measurements should be done in cases where standards have
been set in numerical terms;
Example 500 pregnant women should attend your antenatal care service
this year.
• In other cases, the performance can be measured in terms of qualitative
factors,
Example, how well the model household training went.
16. Comparing performance with standards
• You can base your comparison on the monitoring
information you collected for services that you
have provided or activities you
have organized.
• Then you summarize the outcomes as planned
versus actual results.
17. Taking corrective action
• When problems are identified corrective action is
obviously called for.
• This involves those in management roles taking
appropriate decisions, such as the replanning or
redrawing of goals or standards and perhaps
changing the way that things are done.
• This may also require further training of the
health workers in your team.
18. Constructive and effective feedback
• We all need feedback to help us improve.
• As a HEP you will have colleagues and team members working at your
Health Post and in your community.
• If a member of your team does something well you will want to praise and
reward them, but if they are performing poorly you should let them know
so they can improve.
• Try to be specific.
• People generally want to know about their performance but giving negative
feedback can be difficult, you don’t want to hurt feelings or cause offense.
19. Giving effective feedback
• Using your monitoring and control mechanisms you have
determined the
success or failure of your groups’ performance.
• Your feedback to individuals must be based on the evidence you
have gathered from the monitoring and controlling process.
• Feedback must also be timely – it is no good giving the feedback
after the opportunity for improvement has already passed.
20. Giving effective feedback
To be effective feedback should be:
based on previously established performance goals/standards
Timely
regularly given
Specific
Constructive
Motivating
a routine part of your management function.
21. Giving constructive criticism
Giving effective, constructive criticism usually involves three main steps:
Step 1 Provide feedback in a one-to-one meeting
Always try to give your feedback during a one-to-one, private session
Deliver the message in a single, focused conversation and go directly to the
point. For example; ‘I want to give you some feedback on your work. You
planned to conduct three community meetings last quarter, but have
only done two so far. I want to help you to perform better in the coming
quarter. If you need any help I would be happy to assist’.
22. Step2 Be specific
• Be specific about what’s wrong and how it can be
improved.
• Constructive criticism should focus on specific
actions or behaviors that the person can change or
do something about. Instead of general criticisms
say something more specific
23. Step 3 Reinforce the relationship
• In order to maintain a good relationship, your criticism needs
to focus on an action or level of performance, not on the
person.
• You want a change in behaviour.
• You should send the message that you value the person but not
the specific behaviour or performance in question.
• Effective feedback requires direct, truthful communication
