HMIS Monitoring and Evaluation, Lecture notes of Food science

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Maricho Barnachea -Moran RMT Our Lady of Fatima University-Valenzuela College of Medical Laboratory Science

TOPIC OUTLINE

1. Definition of Monitoring and **Evaluation (M&E)

2. M&E Plan
3. M&E Framework
4. Relationship between M&E with HMIS** **Indicators
5. Indicators**

DEFINITION

Monitoring is the systematic collection, analysis and use of information from programs for three basic purposes: (1) Learning from the experiences acquired ( learning function); (2) Accounting internally and externally for the resources used; and (3) the results obtained ( monitoring function) and taking decisions ( steering function). Meanwhile, Evaluation is assessing an ongoing or completed program or policy as systematically and as objectively as possible. The object is to be able to make statements about their relevance, effectiveness, efficiency, impact and sustainability.

M&E Purpose

The primary aim is to have a strong M&E and review system in place for the national health strategic plan that comprises all major disease programs and health systems. A robust monitoring and evaluation (M&E) system is required to assess the effect of integrated service delivery. Appropriate indicators, data collection systems and data analysis to support decision-making help guide successful implementation of integrated services and measures the effect on both service delivery and use of services (FP/Immunization Integration Working Group, n.d.).

Progress of any medical institution are monitored and evaluated through various activities such as monitoring reports, HMIS, surveys and evaluation studies. The state has undertaken various activities as a part of established monitoring and evaluation system. According to the National Health Mission (2014), strategies for operationalizing the framework should:  (^) be primarily country-focused but also offer the basis for global monitoring;  (^) address M&E needs for multiple users and purposes, including monitoring program inputs, processes and results, tracking health systems performance and evaluation;  (^) facilitate the identification of indicators and data sources, provide tools and guidance for data analysis, and show how the data can be communicated and used for decision-making  (^) bring together the monitoring and evaluation work in disease-specific programs with cross- cutting efforts such as tracking human resources, logistics and procurement, and health service delivery.

M&E Framework

Monitoring and evaluation (M&E) is a core component of current efforts to scale up for better health. Global partners and countries have developed a general framework for M&E of health system strengthening (HSS). The framework builds upon principles derived from the Paris declaration on aid harmonization and effectiveness and the IHP+, putting country health strategies, and the related M&E processes such as annual health sector reviews, at the center. The core is the strengthening of a common country platform for M&E of HSS, which should result in better alignment of country and global M&E systems and can be used both for monitoring:

**1. health systems funding platform

2. tracking the performance of specific programs.** The framework addresses indicator selection, related data sources, analysis and synthesis practices (including quality assessment), performance review, communication and use (World Health Organization, 2009).

Figure 7.2: Common framework for monitoring performance and evaluating progress in the scale-up for better health

Relationship between M&E with HMIS Indicators

An indicator can be defined as a

• (^) variable whose value changes.
• (^) measurement that measures the value of the change in meaningful units that can be compared to past and future units.
• (^) It focuses on a single aspect of a program or project – i.e., an input, output or the overarching objective. There are different HMIS indicators which can be used for monitoring of key aspects of the health system performance. **These are from among the five broad categories

1. Reproductive health,
2. Immunization,
3. Disease prevention and control,
4. Resources utilization and
5. Data Quality**

Indicators for monitoring FP/Immunization integration Table 7.2 below provides specific indicators, data sources, and purpose of tracking each indicator in Reproductive Health area, as listed by the FP/Immunization Integration Working Group. This table includes a variety of quantitative indicators, it is also important to complement collection of these data with the use of qualitative techniques in order to better understand nuances of the integration processes and solicit feedback on the approach. Table 7.2: Indicators in the Reproductive Health Area

Table 7.2: Indicators in the Reproductive Health Area

Relationship of HMIS Indicators with Health Program HMIS is a source of routine data that is necessary for monitoring different aspects of various health programs implemented in the country. The HMIS indicators have been carefully selected to meet the key information needs of monitoring the performance of various health programs and services and provide a snapshot of the available health resources. The disease data provide the status report on communicable and non-communicable diseases. The following sections illustrate the relationship of HMIS information and some of the health programs. The purpose of these illustrations is to provide an in-depth understanding of how HMIS can be used for monitoring program performance and how it encourages similar in-depth analysis for all health programs and services such as:

1. Maternal Survival Intervention
   2. Child Mortality and Child Survival Intervention
   3. STOP TB Program

The STOP TB Program With the vision to have a TB free world, the goal of the STOP TB Program (STP) is to dramatically reduce the global burden of TB by 2015, in line with the Millennium Development Goals and the Stop TB Partnership targets of the World Health Organization (2006). One of the main objectives of the program is to achieve universal access to high-quality care (i.e. universal access to high quality diagnosis and patient centered treatment) for all people with TB (including those co-infected with HIV and those with drug-resistant TB). TB case detection and successful completion of the treatment/cure of the TB remains at the core of the Stop TB Strategy. Hence one of the targets linked to the MDGs and endorsed by the Stop TB Partnership is by 2050 to reduce prevalence and deaths due to TB by 50% compared with a baseline of 1990.The following flowchart puts the HMIS indicators (in green shaded boxes) in the context of the STOP TB Program.

HMIS Indicators to Monitor STOP TB Program

1. TB patients on DOTS
2. Number of new smear pulmonary TB cases enrolled in the cohort
3. TB Case Detection
4. Number of New smear positive pulmonary TB cases detected
5. Number of new smear negative pulmonary TB cases detected
6. Number of new extra pulmonary TB cases detected
7. HIV – TB – Co-infection
8. Proportion of newly diagnosed TB cases tested to HIV
9. HIV+ new TB patients enrolled in DOTS
10. TB Treatment outcome
11. Treatment completed PTB+
12. Cured PTB+, Defaulted PTB+, Deaths PTB+

Mikhail A. Valdescona, RMT, MPH HMIS Monitoring and Evaluation By: