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This poster was made possible by the generous support of theAmerican people through the United States Agency for InternationalDevelopment (USAID), under the terms of the Leader with AssociatesCooperative Agreement GHS‐A‐00‐08‐00002‐00. The contents are theresponsibility of the Maternal and Child Health Integrated Program(MCHIP) and do not necessarily reflect the views of USAID or theUnited StatesGovernment.
Overview of Technical Areas and DonorsTechnical Area(s) Primary Donor/Mechanism Program InterventionsMALE CIRCUMCISION PEPFAR/CDC Expansion of Male Circumcision Services to Prevent HIV
in Botswana (MC Training and Service Delivery)
PRE‐SERVICE EDUCATION PEPFAR/CDC Strengthening PSE programs in Health Training Institutions
Monitoring, Evaluation and Research ActivitiesTitle of Program or Research/
Evaluation ActivityPrimary Monitoring or Study
Data Source(s)For Research and Evaluation Activities
Name of IRB(s) That Approved Activity Project Status
Male Circumcision Facility registers, training register, mentoring tool
n/a n/a
Pre Service Education Training registers, site visit assessment tool
n/a n/a
A Study of Adverse Events Related to Male Circumcision In Botswana
Client interviews, facility registers JHU SPH, CDC, MOH HRDC Awaiting approval from JHU, CDC and MOH HRDC Review Boards
Assessment of In‐service HIV and AIDS Training Methods and
Models in Botswana
Health care provider interviews, management interviews, Event Costing worksheet, focus group
discussions
JHU SPH, MOH HRDC CDC Non research determination obtained from MOH HRDC (Botswana) and JHU SPH Review Boards. Awaiting
approval from CDC
Male circumcision Facility registers, Facility quality assessment
JHU SPH for routine monitoring beingdeveloped
Multi‐country ethical clearance under way
Key Monitoring, Evaluation and Research Challenges
BotswanaMonitoring, Evaluation and
Research
Challenges How did you or how are you currently addressing these challenges?
1. Final National SMC M&E framework not yet in place so it is difficult to develop a final Jhpiego SMC M&E plan. MOH and CDC yet to give final guidance on Jhpiego focus area (Training /Service delivery).
Periodic review and reorientation of M&E plans, budgets and continuous consultation with MOH and CDC.
2. Changing targets and unclear reporting guidelines due to changes in Jhpiego SOW and MOH SMC scale up plans.
Maintaining close collaboration with MOH in planning processes.
3. Lack of current textbooks and journals for student use in Health Institutions E‐granary installed and increased wireless internet access
Office OverviewNumber of staff: 15
Number of dedicated M&E staff: 1
Workshop AttendeesNumber of staff: 1
Name: Rudo M. Mhonde
Title: M&E Advisor
M&E‐related success story or achievement of our program• Jhpiego has trained 72 Health
care providers on MC (includingSMC M&E & QA) sinceNovember 2010. SMC dataquality has improvedconsiderably in facilities wherethe health care providers weretrained.
A trainee recording data during SMC Training
Rudo Msipa MhondeM&E Advisor
• Jhpiego has set up proxy networks in IHSs after monitoring challenges with internet access and connectivity. All students now have individualinternet accounts.
• Two protocols for a study on Adverse Events Related to Male Circumcision In Botswana and an Assessment of In‐service HIV and AIDS TrainingMethods and Models in Botswana have been submitted and the latter has been approved.
Introduction to Computing Lesson Gaborone IHS, Computer Lab
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions
HIV CDC/JHU TSEHAI Male Circumcision, HIV Counseling and Testing
HIV DoD Male Circumcision
MNH USAID/MCHIP Multiple MNH Activities
MNH Pathfinder/IFHP BEmONC training and SBM-R
MNH UNICEF BEmONC training and SBM-R
Monitoring, Evaluation and Research Activities
Title of Program or
Research/
Evaluation Activity
Primary Monitoring or
Study Data Source(s)
For Research and Evaluation Activities
Name of IRB(s) That Approved
Activity
Project Status
Ethiopia
Monitoring, Evaluation & Research
Office Overview
Number of staff: 49
Number of dedicated M&E staff: 3
Workshop Attendees
Number of staff:2
Ephrem Daniel, M&E Advisor
Tsigereda Bekele, M&E Officer
Maternal Neonatal and
Child Health (MNCH)
Team
Country Director
Male
Circumcisio
n
(MC) Team
HCT Team
Finance & Admin
Director
Technical Director
Deputy Country
Director
Infection Prevention (IP)
Performance Improvement (PI)
Unit
Pre-service Education (PSE)
Monitoring and Evaluation
(M&E) Unit
Senior Program Officer
This poster was made possible by the generous support of the American people
through the United States Agency for International Development (USAID), under the
terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00.
The contents are the responsibility of the Maternal and Child Health Integrated
Program (MCHIP) and do not necessarily reflect the views of USAID or the United
States Government.
Male circumcision Facility registers JHU IRB for routine monitoring
being developed
Multi-country ethical clearance under way
Community Kangaroo Mother
Care
Client interviews, facility
registers
JHU SPH, EPHA (local) Protocol development is on the final stage
Cultural barriers affecting
women’s utilization of
optimal MNH practices
Literature review, focus group
discussion and key informant
interview
JHU SPH, EPHA (local) Literature review started to prepare the protocol
Preservice program
evaluation
Faculty interviews, student
interviews, document review,
JHU SPH, EPHA (local) Protocol development is underway
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges?
1. Delayed roll out of the new Ethiopian HMIS Use program funds to print and distribute the new HMIS tools to MCHIP
supported sites
2. Absence of baseline data in the SBM-R implementing facilities to
show improvement of service delivery
Key output/outcome indicators were selected to be included as part of SBM-R
standards to new programs
3. Absence of unique identifiers for individuals is a huge challenge for
data quality in TIMS
In addition to names, we use phone numbers to identify individuals
M&E-related success story or achievement• Use of TIMS to monitor all PEPFAR Ethiopia-supported training courses and to follow-up/track providers post
training
• Importance of M&E was given due attention and it is organized as a unit with three full-time staff
• M&E unit had been instrumental to improve program outcomes by providing evidence-based and timely feedback
- E.g. Data from the M&E unit was instrumental in showing the decline in MC clients and the need of demand
generation to increase MC uptake
- To shift to opt-out testing approach to improve the proportion of MC clients who are tested for HIV
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Areas Primary Donor/Mechanism Program Interventions
HIV USAID/MCHIP SBM-R, pre-service
MALARIA USAID/MCHIP SBM-R, pre-service
FAMILY PLANNING USAID/MCHIP SBM-R, pre-service
TUBERCULOSIS USAID/MCHIP SBM-R, pre-service
POST-PARTUM FAMILY PLANNING USAID/MCHIP SBM-R, pre-service
NEWBORN RESUSCITATION (HBB) USAID/MCHIP SBM-R, pre-service
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities
Name of IRB(s) That Approved Activity
Project Status
Assessing Quality of Education, Student Competency and
Postpartum Family Planning Uptake - A Comparison Study
1. SBMR Assessments (tutors, clinical preceptors, students) 2. Survey of women one year
post delivery in well baby clinic
JHU IRB application to be submitted
IRB application
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges?
1. Limited indicators for pre-service activities (e.g. PEPFAR indicators focus on in-service training)
Some indicators that we are using include: 1. % of schools participating; 2. % tutors trained; 3. # students who have received training from tutors trained; 4. competence of students trained; 5. Utilization of services
Monitoring, Evaluation and Research in Ghana: a shared commitment and responsibility
Country Office staff: 4; Dedicated M&E staff: 0
Workshop Attendee: Joyce Ablordeppey, Sr Technical Advisor
Country Director*
Sr Technical Advisor*
Sr Technical Advisor*
Finance & Admin Assistant
* M&E responsibilities
Ghana Team
Success Story: Using SBMR Data for Advocacy • This year MCHIP in Ghana is focusing on strengthening
HIV, TB, Malaria and FP in pre-service education for Midwives, Public and Community Health Nurses
• SBMR baseline assessment data was used to communicate with the National Programmes for HIV, TB and Malaria to secure their commitment and resources to strengthening pre-service education
• After a presentation and discussion on the results, each program committed trainers for a 2 week period to train tutors, provided resource materials and committed ongoing support to schools
Baseline Assessment: % Standards achieved in HIV, TB, Malaria and FP
Average performance of of 23 schools Teaching Materials; Knowledge & Skills
Elements Necessary for a Functional M&E System: Developing M&E Standards
To support organizational and country program growth we are developing M&E standards based on UNAIDS Organizing Framework for a Functional M&E System. Country programs need 1) a dedicated M&E unit with well-defined relationships between HQ and field staff, 2) sufficient numbers of trained, dedicated M&E staff representing a wide range of skills (including GIS, health informatics, data analysis, etc), 3) strong ties to program staff, facility staff, and government representatives, 4) an annually updated M&E plan, 5) a budget sufficient to strengthen and maintain a high-quality M&E system, 6) ongoing activities to enhance data use across the organization, including global MER meetings, 7) strong monitoring systems from facility to HQ, 8) ability to implement targeted surveys to support program development, 9) databases such as RISE and TIMS to communicate results across the organization, 10) routine (annual) data quality audits in all country programs, 11) expertise to carry out program evaluations to demonstrate technical program successes and research to fill gaps in knowledge, and 12) publishing and presenting Jhpiego’s program successes and technical innovations.
Intermediate Result 4: Improved Health Knowledge, Attitudes and
Capacity for Community Action
Intermediate Result 3: Availability of Quality Health Services Increased
Intermediate Result 2: Quality of Health Services Improved
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Key Monitoring, Evaluation and Research Challenges
Jhpiego Global M&E Vision Jhpiego measures program results in terms of improved health
and lives saved drawing on an organization-wide results framework that articulates pathways and milestones leading to impact.
Key Activities:
1. Support country programs to: develop M&E plans and frameworks, develop data collection tools, analyze qualitative and quantitative data, identify areas and methods for data quality improvement, displaying data including mapping, providing results information systems
2. Design and implement operations research in priority areas for the organization 3. Support the dissemination of Jhpiego’s program and technical results
Success Story: Tremendous Organizational and MER Growth
Jhpiego, Baltimore Monitoring, Evaluation and Research
Office Overview
Number of dedicated M&E staff: 12 Workshop Attendees
Number of staff: 10
Sr. M&E Advisors: Eva Bazant, Young Mi Kim
Health Informatics Advisor: Ed Bunker
RISE Project Director: Catherine Schenck-Yglesias
M&E Advisors: Mary Drake, Megan Harris, Mainza Lukobo-Durrell, Reena Sethi, Maya Tholandi
Director, MER: Linda Fogarty
Challenges How did you or how are you currently addressing these challenges? 1. Integrating more successfully into Global Program Operations
Attending regional, country and GPO general meetings; assisting with quarterly country review reporting; providing M&E-specific LOE guidance for program planning, budgeting
2. Helping to ensure data quality at the program level Involvement in quarterly country review reporting; providing routine data quality audit tools and support; requesting annual country visits
3. Supporting RISE in a way that meets users’ needs across the organization
Involving countries in RISE development process; providing in-person training at global meeting; developing training guides; planning RISE support into technical assistance visits
4. Balancing new program development with program technical assistance Developing a system that tags and searches past proposals, (e.g., by country, donor, technical area) to make future responses more efficient, richer, and more contextualized
GOAL: Health Status Improved and Lives Saved
Strategic Objective: Use of MCH/FP/HIV/AIDS Services Increased and Positive Health Behavior Adopted in
the Population
Intermediate Result 1: Health Systems Strengthened
Jhpiego Results Framework
Whe
re w
e w
ork Current MER Capacity and Organizational Commitment: • Fully staffed HQ MER unit with wide range of expertise across M&E
competencies • Quantitative and qualitative research capacity and commitment to
impact evaluation • Investment in information systems to assist country programs and
organization to track and publish results (RISE, TIMS, SBMR database) • Advocating for M&E components in new programs; commitment to
5-10% of all program funds for M&E
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
PPFANI Program/ ACCESS -FP
Overview of Technical Areas and Donors
Technical Areas Primary Donor/Mechanism
Program Interventions
- Institutional strengthening (friends of youth service improvement, strengthening technical capacity, staff training, increase range of services, availability of services, space for the provision of FP services) - Community activities (creation of adult and young Committee, clubs, development of awareness and education, radio equipment)
USAID FP for girls and young mothers aged 15-24
Monitoring, Evaluation and Research Activities Title of Program or Research/
Evaluation Activity Primary Monitoring or Study Data Source(s) For Research and Evaluation
Activities Name of IRB(s) That Approved Activity
Project Status
Operational research on low FP use determinants by girls and young mothers
(15 - 24 years)
Primary investigation: interviews, focus group, institutional records
consultation,
Minister of Health in Haiti
Completed
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges?
1. Inability for youth to negotiate their sexual relationship linked to their socio-economic situation (low income, unemployment)
Partnership established with professional / social institutions for preparing girls and young mothers to have a useful trade. Empowering women to
negotiate sexual relations (FP)
2. Young mothers lack of decision power.
Men's participation in the activities, training of parents, clubs, and Committee of surveillance of maternal mortality (the project champion)
Achievements •Fewer early pregnancies in the rural community, •Fewer dropout in the second year of implementation of the project (statement by the Director of the school of Azile : less than 4 pregnancies compare to 20 in previous years.) •FP is no longer a taboo, FP is part of the daily life of the inhabitants of the area the integration of young people with participatory research project
Haiti Monitoring, Evaluation and Research
Office Overview
Number of staff: 7
Number of dedicated M&E staff: 1 Workshop Attendees
Number of staff: 1 Honore Marie Patrice, Technical Coordinator
Family Planning Project Accessibility- Nippes
Results dissemination workshop
262
80
1193
160 70
200
400
600
800
1000
1200
Nom
bre
de o
lient
s P
F
Condom Lo-femenal DMPA Norplant IUD Othernaturalmethod
Types de methodesPF
Asile- Centre de Sante
15-24 yrs.
58
1558
0
500
1000
1500
2000
utilisatrices de depart utilisatrices à la fin
Evolution de l'utilisation du debut à la fin du projet
18 mois (Janv 08 – May 09)
Situ
atio
n de
bas
e Contraintes Manque des connaissance profondes en matière SSR et PF Initiation des rapports sexuels a l’âge de 12 à 14 ans Rumeurs sur la PF Manque de communication entre les parents/adultes et les jeunes Manque d’opportunités économiques Manques de satisfaction avec les service SSR/PF
Facilitateurs Politiques nationales
Dial
ogue
com
mun
auta
ire
Création des comites des adultes et jeunes Recherche de base participative Développement des stratégies/ interventions L’élaboration des matériaux Suivi du projet Evaluation
Résu
ltats
Structures sanitaires •Amélioration des services amis-des- jeunes
Individuel •Amélioration des connaissances: PF, source d’information et services •Utilisation des méthodes Social •Amélioration de la communication parents et jeunes •Amélioration des connaissances SSR dans la communauté •Augmentation de la discussion de SSR
L’Im
pact
Communautaire •Support communautaire pour SSR et PF pour les jeunes •Institionalisation des services amis-des-jeunes
Amélioration des SSR pour les jeunes mères jeunes filles
This poster was made possible by the generous support of the American peoplethrough the United States Agency for International Development (USAID), under theterms of the Leader with Associates Cooperative Agreement GHS‐A‐00‐08‐00002‐00.The contents are the responsibility of the Maternal and Child Health IntegratedProgram (MCHIP) and do not necessarily reflect the views of USAID or the UnitedStates Government.
Overview of Technical Areas and DonorsTechnical Area(s) Primary Donor/Mechanism Program Interventions
Pre‐Service Education MCHIP Strengthening Pre‐service education, SBM‐RFamily Planning USAID/MCHIP Strengthening FP services, SBM‐R, Capacity buildingFamily Planning Bill & Melinda Gates Foundation Repositioning of PPFP/PPIUCD, SBM‐R, In‐Service Training, IEC/BCCFamily Planning Norway‐India Partnership Initiative (NIPI) Strengthening PPFP/PPIUCD services, In‐Service Training, IEC/BCCVaccine Preventable Disease USAID/MCHIP Capacity building, demonstration of best practices, Supportive
Supervision, New Born Tracking, synergies between PEI & RINew Born Care USAID/MCHIP Supportive Supervision, In‐Service Trainings, Facility strengthening for
ENCWater, Sanitation & Hygiene USAID/MCHIP Double –blinded RCT, IEC/BCC;
Monitoring, Evaluation and Research ActivitiesTitle of Program or Research/
Evaluation ActivityPrimary Monitoring or Study Data
Source(s)For Research and Evaluation Activities
Name of IRB(s) That Approved Activity
Project Status
Assessment of Postpartum Intrauterine Contraceptive Device (PPIUCD) Services
Facility registers, Interviews, FGDs Protocol to be submitted for IRB
Postpartum Systematic Screening in Jharkhand, India PPSS tool, Observations Protocol to be submitted for IRB
MCHIP Immunization program in India WHO Thirty Cluster Survey, Supportive Supervision checklist
Protocol to be submitted for IRB
Assessment of Facility readiness for ENC/R in two selected districts of Jharkhand
Survey, Facility registers
Key Monitoring, Evaluation and Research ChallengesChallenges How did you or how are you currently
addressing these challenges? 1. Although, it is crucial to monitor the counseling of pregnant/post‐partum women, timing of counseling (during antenatal period/early labor or postpartum) and subsequent decision of acceptance/non‐acceptance of PPFP/PPIUCD and method opted; however, the counseling data is poorly recorded in the service records of the facility and is not captured in the current HMIS.
A column is being added in the clinic registers to record provision of family planning counseling services. The providers are also being sensitized about the need for this data and on how to capture this data.
2. Measuring the practice of ‘Active Management of Third stage of Labor’ which includes (i) administration of uterotonic (Inj. Oxytocin 10 I.U. intramuscular after delivery of baby, (ii) uterine massage, (iii) controlled cord traction. Although, use of uterotonic is recorded on the case sheets but other two steps are not mentioned in the case sheets.
The use of uterotonic in third stage of labor will only be measured.
3. Number of newborns receiving essential newborn care including essential preventive care and recognition of danger signs and referral through USG‐supported programs‐ prioritized facilities in focus districts only. At present the facilities do not record all the steps of essential newborn care in the case sheets or registers.
The health staff will be sensitized and supported for recording some of the steps of essential newborn care and resuscitation as proxy during the mentoring visits to the facilities.
INDIAMonitoring, Evaluation and Research
Office OverviewNumber of staff: 58 (MCHIP + Jhpiego)
Number of dedicated M&E staff: 02
Workshop AttendeesNumber of staff: 1
Siddhartha Saha, M&E Advisor
PPIUCD Facility Registers‐Circulated in all PPIUCD service delivery sites in 19 states of India in around 40 facilities across different projects (MCHIP/BMGF/NIPI)
PPIUCD Facility Reporting format‐Standardized monthly reporting system for all PPIUCD service delivery sites (this being new service yet to be integrated in electronic HMIS).
Project Reporting Tools currently in MS Excel, being developed in MS Access for data entry and collation by project field staff
PPIUCD Multi‐site database providing information on PPIUCD insertion, follow‐up etc. for program monitoring
‐
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Community formative research on health practices of the MCHIP key messages : FGD with Health Center Staffs
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions
MNH USAID/MCHIP, ExxonMobil, Chevron Community, facility, health office management
Cervical Cancer Screening Ford Foundation VIA
Infection Prevention GITEC Pre-service infection prevention curriculum
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities
Name of IRB(s) That Approved Activity
Project Status
Evaluation of Quality improvement interventions
Clinical observations, facility registers, provider interviews
JHU IRB Report writing
Assessment of referral processes
Interviews of postpartum women
JHU IRB Report writing
Handwashing practices amongst mothers with
newborns
Videotaping, in-depth interviews, focus group
discussions
London School of Hygiene and Tropical Medicine (collaboration
with Unilever
Report writing
Community formative research on health practices of the MCHIP key messages
Interview with community, health practices at health
center, midwives, and district health office
JHU IRB
Report writing
CECAP Appreciative Inquiry Client interviews JHU IRB Report writing
Ongoing SBM-R initiatives SBM-R tools On-going
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges?
1. Prioritizing the key indicators—balancing between the “nice to know” and “need to know”
Consultation with M&E team in Washington
2. Using the existing data collection at district level to answer the key indicators
Assessment on the existing data collection system at district level (starts from the village, subdistrict and district level)
3. Prioritizing SBM-R standards—how to balance wanting to measure compliance with key life-saving interventions and wanting to measure broader quality of care
At this time, we are measuring broader quality but also feeling a need to be able to measure the most important life-saving interventions amongst those
standards
SBMR Calculator • What? Develop a calculator to help midwives, health centers and
hospitals analyze their SBMR data • Why? Total number of standard performance in each SBMR tool is
a lot and limitation of midwives, health centers and hospitals staffs’ skills on Ms. Office (Excel) in order to generate the graphs. No special data operator at midwives, health centers and hospitals to entry and analyze SBMR data also become the reason of the calculator development.
INDONESIA Monitoring, Evaluation and Research
Office Overview
Number of staff: ~ 40
Number of dedicated M&E staff:
4 for MCHIP, including 2 Jhpiego staff
Workshop Attendees
Number of staff: 1
Mia Pesik, Senior Program Manager
Main Menu
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions EmONC, FP, Child Health, ASRH, HIV/AIDS,TB,
Malaria, Mental Health, Emergency USAID, sub on RBHS bilateral with JSI PSE, SBMR, training, policy/guidelines, clinical
site strengthening FP USAID/MCHIP Policy, in-service training, site renovation, BCC
Monitoring, Evaluation and Research Activities Title of Program or
Research/ Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities Name of IRB(s) That Approved
Activity Project Status
Task Analysis Provider interviews JHSPH Complete
BPHS monitoring Service statistics, TIMS forms, Reports from site TA visits
n/a Ongoing
EPI/FP Integration Facility registers JHSPH – Submission pending Planning
FP Facility registers, TIMS forms, Reports from site TA visits
n/a Ongoing
PPH prevention TBD TBD Design
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges? 1. Data quality
Initial visit conducted and site-level plans made. MCHIP to provide regular follow-up. Liaising with USAID bilateral where Jhpiego is sub to follow-up data quality concerns for facilities supported by RBHS, and negotiating with USAID to reorganize resources in order to provide regular sites visits that include data quality and clinical technical assistance for non-RBHS MCHIP sites. Considering development of job aid to standardize reporting.
2. Coordinated follow-up between MOH, MCHIP and RBHS
Conduct joint site visits with MOH, MCHIP and RBHS (where applicable).
3. Use of data by facility staff
Monthly mentoring monitoring visits with feedback to facility staff
• Task analysis provided evidence to strengthen MNH clinical practice requirements of PA and RN curricula
• Task analysis results presented at several conferences, including upcoming Global Health Council
• Increased availability of data on MNH services
Liberia Monitoring, Evaluation and Research
Office Overview
Number of staff:2 MCHIP, 2 RBHS
Number of dedicated M&E staff: 0 Workshop Attendees
Number of staff: 1
Comfort Gebeh, MCHIP FP/RH Advisor
Data Quality Exercise, FP Data Jan-March2011, 2 Hospitals
Indicator HIS Report
Facility Registers
Difference % Match
New FP clients 1741 1452
289 120%
Revisit FP clients
3102 3236
-134 96%
RBHS
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions HIV USAID/MCHIP SBM-R in PMTCT, Male Circumcision,
MNH BEmONC, Community MNH/Mobilization, KMC, SBM-R in RH
Child Health Water and Sanitation, Malaria IEC, LLIN distribution
Performance Based Incentives linked to SBM-R Helping Babies Breathe
PPFP, FP Social Marketing
List the primary technical areas (e.g., MNH, HIV, etc.) covered by your program and your major donors, for example:
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities Name of IRB(s) That Approved
Activity Project Status
SBM-R evaluation Client interviews, provider interviews, facility HMIS,
SBM-R assessments
WIRB and NHSRC/Malawi Manuscript submitted to Midwifery Journal
Male circumcision Facility registers, mobile clinic registers
JHU IRB for routine monitoring being developed
Multi-country ethical clearance under way
Malaria Tracking Results Continuously (TRaC) Study
Client interviews COMREC Malawi IRB protocol submitted, awaiting review
Family Planning TRaC Study Client interviews COMREC or NHSRC IRB being developed
Protocol under draft
Helping Babies Breathe Evaluation
Provider observations, client interviews, service statistics
Concept note developed and under finalization
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges? 1. The Malawi National Health Sciences Committee (NHSRC) charges a 10% fee based on the study budget for all approved studies. Because the fee is considered unethical, this will limit Jhpiego’s participation in any operational research to be conducted in the country.
USG and other donors in the country have taken up the issue with NHSRC to discuss an agreement. Operational research that may be considered as
“development assistance” are being submitted for IRB approval and a waiver of the fee is requested.
2. HMIS system does not collect the host of indicators required by the MCHIP program and there is tremendous resistance to introducing parallel systems for data collection, unless approved by the MOH
MCHIP is looking into partnering with the MOH to set up a sentinel site surveillance system for selected MNH, Malaria, and HIV related indicators. MCHIP will also explore the use of electronic systems to collect data at the
point of care. 3. Quality of data is generally poor, requiring active follow-up by program staff.
M&E personnel have been included in all supportive supervision visits to provide an opportunity for M&E mentoring and validation of data.
Description of up to three key M&E challenges for your unit
MALAWI Monitoring, Evaluation and Research
Office Overview
Number of staff: 28
Number of dedicated M&E staff: 3 Workshop Attendees
Number of staff: 1
Aleisha Rozario, M&E Advisor
List the primary monitoring, research and evaluation activities currently under way in your office, for example:
23.3 24.5
80.9 88.4 92.6
82.1
19.8 8.74
51.4 51.5
75.7 87.3
0102030405060708090
100
% ofpregn.women
attending> 4 ANC
visits
% preg.women
attendingANC in 1sttrimester
% preg.women
receiving>2 doses
IPTp
% preg.womennewly
tested forHIV
% HIVpositive
preg.women
receivingCPT
% HIVpositive
preg.women
receivingARVs
Intervention
Control39
63
88 3.2
2.9 2.7
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
0
10
20
30
40
50
60
70
80
90
100
2008 2009 2010
Perc
enta
ge (%
)
Perc
enta
ge (%
) PQI RHscores
DirectObstetricDeath Rate
22
63 65
59.2 61.2
79.8
0
10
20
30
40
50
60
70
80
90
0
10
20
30
40
50
60
70
2008 2009 2010
Perc
enta
ge
Perc
enta
ge
PQI score
% SBA
Deliveries by SBA rise at Mpasa Health Center as PQI scores increase Direct Obstetric Deaths decline as PQI scores increase, Machinga Disrtict Hospital
Increased coverage in MNH-PMTCT in MCHIP supported sites, Phalombe district
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions Maternal Health USAID/MCHIP
Organization of Islamic Conference
Active Management of Third Stage of Labor Postpartum Family Planning
Postabortion Care Oxytocin in Uniject Device
Newborn Health
USAID/MCHIP
Essential Newborn Care Kangaroo Mother Care
Child Health USAID/MCHIP
Community Case Management
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities Name of IRB(s) That Approved
Activity Project Status
Baseline Assessments Client interviews, provider interviews, facility need
assessment
Ministry of Health
Planning Phase
Use of matrons to provide LAM at community health
center
Client interviews, provider interviews, facility HMIS,
Ministry of Health Planning Phase
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges? 1. High expectations from the Mission in regards to measurable results within a short timeframe
We will work with the HMIS and existing data collection systems to build capacity and ensure effective and efficient data collection
MALI Monitoring, Evaluation and Research
MALI Office Overview
Number of staff: 9 technical
Number of dedicated M&E staff: 2 Workshop Attendees
Number of staff: 1
Dr Camara Tiguida
Monitoring and Evaluation Manager
MCHIP Chief of party Dr Diarra
Maternal health /FP Advisor
Mme Haidara
Regianal cordinator of Kayes Dr Yorotté
District Cordinator of Kita
Dr Lazare
District cordinator of Diéma Dr Lala
Newborn Health Advisor
Dr Kanté
Program Assistante Child health/CCM
Advisor Dr Ouattara
Monitoring and Evaluation Manager
Dr Tiguida
This poster was made possible by the generous support of the American peoplethrough the United States Agency for International Development (USAID), under theterms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00.The contents are the responsibility of the Maternal and Child Health IntegratedProgram (MCHIP) and do not necessarily reflect the views of USAID or the UnitedStates Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions
HIV CDC TB/HIV Infection Control Community Counseling TestingProvider Initiated Counseling and Testing
Infection Prevention and Control Minor Surgery/Male circumcision services
Human Capacity Development CDC In-service training information systemPre-service training information system
Nursing curricular revision SBM-R in pre-service educationModel inpatient wards Workplace safety/ post-exposure prophylaxis
In-service training ancillary workers
MNH USAID/MCHIP Strengthening of EMNC and BEmONC services, including PPFPSBMR (model maternities) CECAP
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities
Name of IRB(s) That Approved Activity
Project Status
Model maternities Facility registers n/a Protocol development
Male circumcision Facility registers JHU IRB for routine monitoring being developed
Multi-country ethical clearance under way
Impact of SBM-R in new graduates performance
Client interviews, provider interviews
n/a Protocol development
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges?
1. Creating awareness within the programs regarding the importance of timely and accurate M&E.
Require minimal mastery of tools by program staff [they should know what data exists and how to access it…].
2. Getting technical teams to identify indicators able to measure the outcome/impact of Jhpiego programs in Mozambique.
Clarify with technical teams how their programs contribute to Jhpiego local and global results.
3. Knowledge management not understood as part of institutional (program-level) mandate and individual duties at Jhpiego Mozambique.
Ensure, within each team, a continuous process of identification and communication of success stories, lessons learned, best practices, besides mere reporting of numbers.
Integrating CECAP forms in the national Health Information System: a success story
• The Ministry of Health of Mozambique launched CECAP in 2009, as part of family planning consultations (single visit approach). Interventions use low cost screening tools, with training being supported by Jhpiego, which also developed and tested temporary CECAP forms, in articulation with MOH.
• Jhpiego used excellent work relations with MOH to support the revision of all reproductive health data forms. In this process, Jhpiego advocated for the successful inclusion of CECAP data elements, which are now part of FP forms, as well as for the mainstreaming of CECAP client forms.
• Jhpiego also facilitated the country-wide training of health workers in the use of the new FP/CECAP forms.• Program managers at MOH are now able to access data required to appropriate planning and monitoring
of CECAP interventions.
Picture (right): Facility health workers discuss data in forms developed with Jhpiego support
Monitoring, Evaluation and Research
Office Overview
Number of staff: 10
Number of dedicated M&E staff: 6
Workshop Attendees
Number of staff: 3
Argentina Balate, M&E Advisor
Victor Muchanga, Senior M&E Advisor
Humberto Muquingue, M&E Manager
M&E/IST Manager
M&E of CDC-funded programs
M&E Advisors
DatabaseManagers
Database Assistant
M&E of USAID-funded programs(MCHIP)
M&E Advisor
InformationSystems and Technologies
IST Advisors
ICT Assistant
“For a M&E agile in supporting the management of Jhpiego’s programs, with recourse to compatible technologies”
Health worker developing a results framework, in a M&E training held in Southern Mozambique. Courtesy of FORTE Saúde.
Organizational chart of M&E and IST unit at Jhpiego Mozambique
This poster was made possible by the generous support of the American people
through the United States Agency for International Development (USAID), under the
terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00.
The contents are the responsibility of the Maternal and Child Health Integrated
Program (MCHIP) and do not necessarily reflect the views of USAID or the United
States Government.
Overview of Technical Areas and Donors
Monitoring, Evaluation and Research Activities
Title of Program or
Research/
Evaluation Activity
Primary Monitoring or
Study Data Source(s)
For Research and Evaluation Activities
Name of IRB(s) That Approved
Activity
Project Status
Field testing of AAC LRP Training sites N/A N/A
Acceptability and compliance of
calcium supplementation for
prevention of PE/E
•Program monitoring
•HMIS
•Surveys
local IRB Approved, waiting for getting calcium
Test the sensitivity and
specificity of the Point of Care
(POC) test compared to dipstick
urinalysis and the Esbach test in
a laboratory setting (Step 1
and 2)
Laboratory findings JHU IRB and local IRB Completed
Determine the acceptability
and ability to interpret the
results of POC among pregnant
women in clinic setting (Step 3)
• Program monitoring
• Interviews with pregnant
women, staff
•FGD with PW
JHU IRB and local IRB Planned
Determine the acceptability,
coverage and compliance of
community-based POC among
pregnant women (Step 4)
• Program monitoring
• Surveys (FCHVs, PW)
FGD (FCHVs, PW, MIL)
JHU IRB and local IRB Planned
Using Standards to Improve
MNH Services
• Program monitoring
• SBM-R assessments
N/A Planned
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges?
1. Lack of dedicated M&E staff or staff with M&E expertise to oversee
research
• Training, capacity-building
• Coordination and support from US
• Plan to increase staff (MNH Advisor, M&E Officer, Program Officer)
2. Working in collaboration with large projects that allows limited
control over development and implementation of M&E tools &
Indicators
• Program staff working consistently with the M&E staff from these large
projects
Nepal
Monitoring, Evaluation and Research
Office Overview
Number of staff: 9
Number of dedicated M&E staff: 0
Workshop Attendees
Number of staff: 1
Geeta Sharma, Program Officer
Technical Area(s) Primary Donor/Mechanism Program Interventions
MNH (Anesthesia) Nick Simons Foundation (NSF) • Training Course Development (AAC LRP) for
Anesthesia Assistants (AAs)
MNH USAID/MCHIP
USAID/Development Innovation Venture (DIV)
• Pre-eclampsia prevention detection and
management
• MNCH integration
• Evaluation, research and capacity-building
Training Systems NSF, Jhpiego • Revision of Clinical Training Skills (CTS) course
• Training
FP, MNCH USAID bilateral, Nepal Family Health Program II
(NFHP II): Sub to JSI
• Performance improvement
• Training systems
• Innovations
FP, MNCH, nutrition USAID bilateral, Integrated Nutrition Program
(INP): Sub to Save the Children (pending award)
•Performance improvement
• Training
Monitoring, Evaluation and Research Activities
Program OfficerFuncionaria del Pais
Carmen Crow
**TECHNICAL LEAD /
LĺDER TECNICOMaternal Health AdvisorEncargado de Programas
de Salud Materna
Vicente Bataglia
Newborn Health Advisor
Encargada de Programas de Salud
Neonatal
Mercedes Portillo
Community Interventions
Advisor Encargada de IntervencionComunitaria
Maria Peña
**ADMINISTRATIVE LEAD / LĺDER
ADMINISTRATIVAProgram Coordinator
Coordinadora de Programas
Jhalily Hermosilla
Admin/Finance Assistant
Asistente de Adm inistración y
Finanzas
Mirtha Ayala
Consult together for coordination
Se ponen de acuerdo paracoordinación
Technical advisors from headquarters provide supportAsesores técnicos de la sede proporcionan apoyo
Jeffrey Smith, Bertha Pooley , Joseph de Graft-Johnson, Jennifer Luna, Goldy Mazia
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors Technical
Area(s) Primary
Donor/Mechanism Program Interventions
Maternal Newborn Health
USAID/Paraguay (MCHIP)
•Quality Improvement of facility based care (SBM-R ) •Updating MOHSW MNH protocols, policies, norms •Improving use of SIP (National, computerized MNH information system) •Facility based quality, high-impact essential and basic emergency maternal and neonatal care and resuscitation training in targeted facilities •Improving communities and families’ MNH knowledge/ practices
•IEC for pregnant women waiting for ANC in health facility and new mothers staying in hospital group home •Training health care providers on MNH messages & IEC techniques • Community Health promotion activities
•Establishing KMC demonstration centers
Newborn Sepsis
USAID/LAC Regional (MCHIP)
• Prevention of facility based newborn sepsis
AMTSL USAID/LAC Regional (MCHIP)
•Integrate AMTSL into Paraguay midwifery curriculum (South-to-South technical assistance from Peru)
Monitoring, Evaluation and Research Activities Title of Program or Research/
Evaluation Activity Primary Monitoring or Study Data Source(s) For Research and Evaluation
Activities Project Status
SBM-R
Client interviews, provider interviews, facility HMIS, SBM-R assessments
First workshop to be implemented at the end of April
Improved MOHSW and health facility systems for better completion of SIP
As shown in quality control flow chart System designed, discussed and permission obtained from National MOHSW
Information on AMTSL and Essential Newborn Care that complements facility HIS
Stamp with format for additional information to be collected on back of Partogram
Information has been defined
M&E for community interventions •Exit interviews of women after ANC antenatal care visits •Pre-post tests of new mothers staying in hospital group home and receive education on newborn health •Pre-post tests of providers trained on MNH messages and IEC
Being developed
M&E for KMC at demonstration centers KMC registers Information determined
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges? Various clinical providers fill information on SIP clinical history form, so nobody feels responsible for the information
•Developing an organized information flow system for which the head of each clinical rotation is accountable for complete information and where health facility director and MOHSW at national level enforce the system; •Involves obtaining buy-in from MOHSW and health facility directors
HIS is based on SIP, ( computer based information system) which is a LAC regional maternal newborn health record system , from CLAP ( Latin American perinatal and human development center) Obtaining permission to customize the system to country context and newer interventions is difficult.
At suggestion of facility staff, adding a format to partogram to collect information on AMTSL and essential newborn care
Paraguay Monitoring, Evaluation and Research
Organizational Chart
Quality control Flow Chart
Office Overview
Number of staff: 5
Number of dedicated M&E staff:
Technical team leader responsible
for M&E with support from
community and newborn advisors Workshop Attendees
Number of staff: 1 / Maria S Peña
Community Interventions adviser
Left to right: Mercedes Portillo, Mirtha Ayala, Vicente Bataglia, Maria Peña, Jhalily Hermosilla, Carmen Crow.
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions Child Health USAID/MCHIP IMCI (Facility and Community) and Pediatric HIV
MNH USAID/MCHIP FP, EmONC, FANC, ENC, Nutrition, and KMC Community Health USAID/MCHIP FP/CBP, CB-MNH
Pre-services Training USAID/MCHIP Practical training and nursing council support BCC USAID/MCHIP MNCH BCC Sub-strategy
Immunization USAID/MCHIP Rota Virus Introduction Male circumcision DOD/Jhpiego HIV Prevention in RDF
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities Name of IRB(s) That Approved
Activity Project Status
Malaria surveillance Facility ANC registers JHU/ Rwanda national ethical committee
Protocol developed and ready for submission to USAID and MoH
Feasibility and effectiveness
of distributing Misoprostol at community level to prevent
PPH in Rwanda
Community based registers and self administered survey with
CHWs
JHU/ Rwanda national ethical committee
Protocol developed and still under review
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges? 1. Data quality
• Training of data managers at facility and CHWs supervisors in M&E • Orient data collectors on indicator definition and data collection tools
2. Many database in the health sector that are not linked
Advocacy to MoH
3.Data is not fully used for decision
Training of decision makers at national, district and community level on data driven decision making (DDDM)
Rwanda MCHIP-Ikiraro Project M&E success story: • District needs assessment and planning for the 13 MCHIP supported districts was done in the participatory way with districts
stakeholders to ensure their ownership and sustainability, where collecting baseline information and the process of disseminating the findings of the assessment to MoH, USAID and other implementing partners was seen as a mechanism to avoid duplication of efforts and to save resources. Also the involvement of the MoH in planning process for MCHIP interventions provides leadership and guidance based on country priorities
(Rwanda) Monitoring, Evaluation and Research
Office Overview
Number of staff: 34
Number of dedicated M&E staff: 2 Workshop Attendees
Number of staff: 2
Dr. Twahirwa William
Mr. Sinzahera Jovite
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions HIV/AIDS and TB CDC/bilateral • HIV/AIDS Counseling and Testing (HCT) ,Greater Involvement of
People Living with HIV/AIDS (GIPA) training, Counselor trainings Maternal Child , Nutrition and Child Health USAID/MCHIP-bilateral • PMTCT in-service training, Mentoring and supportive supervision,
M&E data collection. We currently support t 23 health facilities
• CECAP in-service training, mentoring and supportive supervision, logistical support-buying cryotherapy machines and related inputs. There are 30 health facilities across two Provinces that are supported by the M&E unit
• TIMS training and mentoring of PEPFAR partner organization M&E staff. This project runs in 18 sites spread over five Provinces
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s) For Research and Evaluation Activities Name of IRB (s) That
Approved Activity Project Status
CECAP close out programme review
CECAP facility registers, baseline assessment tools, exit interview tools, Demographic health survey (DHS), StatsSA data
n/a • Desktop Literature review underway • Routine data collection underway • Close-out reports being prepared
Male circumcision programme review
Draft situational analysis reports, Provincial reports, subject matter experts (Provincial)
n/a • Desktop Literature review underway
PMTCT programme review PMTCT facility registers, baseline assessment tools, exit interview tools ,Demographic health survey (DHS), StatsSA data, District Health Information System data (DHIS)
n/a • Desktop Literature review underway • Routine data collection underway • Close-out reports being prepared
Key Monitoring, Evaluation and Research Challenges Challenges How did we or how are we currently addressing these challenges?
1. Although a unit workplan exists, there is no dedicated budget for the M&E work plan to carry out routine activities as well as on-site M&E support
We are currently involved in the budgeting process through advocacy and ongoing engagement with programme managers
2. Staffing continues to be a challenge to support all organizational activities especially data quality, capacity building and research, which are key to improvement in programme service delivery
Jhpiego recently lost several key staff in the M&E unit which have not been replaced to date due to budgetary restraints within projects, however with new business development initiatives, key proposals are incorporating new personnel to support the programme areas in the long term
3.Long term sustainability of the unit activities through turnover of key human resources (all M&E staff to leave by end of May 2011)
Currently all projects and new business initiatives incorporates sustainability plans for future continuation. Development of best practices is underway as part of Knowledge Management
M&E Key developments • Jhpiego ME staff have engaged with the national district health information system (DHIS) and are critically positioned to provide and strengthen the national
DHIS at facility and district levels • The MCHIP project has recently undergone a facility audit commissioned by the USAID mission-awaiting the results • Successfully implemented the USG/USAID mission online reporting inventory dataware house system to merger financial and programme activity performance. • Participated in the key new business initiatives for new programmes • Finalized standard operating procedures for the key programmes to introduce a culture of data use in programme planning and reporting
(South Africa) Monitoring, Evaluation and Research
Office Overview
Number of staff: 15
Number of dedicated M&E staff: 2
Workshop Attendees Number of staff: 1
John Lubwama, M&E Officer
Jhpiego ME&R portfolio : A background profile (2007-2011) Prior to 2007 and throughout the year, there was a single M&E advisor working with M&E support from Baltimore who supported all the programmes in the organization. By then ACCESS and the Siyazi HIV/AIDS Counseling and testing (HCT) projects were the main programmes in-country. ACCESS had a focus on cervical cancer screening within the North West Province. In 2007, the Art2scale project, a key flagship project for the South Africa office was operationalized. With it came a requirement to form a local NGO through which USAID would finance the in-country activities. Under Art2scale were two main projects- NIMART (Nurse Initiated and Managed ART) and Accreditation projects responsible for the accreditation of health facilities for provision of ARVs in South Africa. NIMART’s main activities were to build capacity of the nurses, as part of the task shifting process, so that they initiate and manage ART within PHC facilities. In 2009, two key core staff portfolios were added to the M&E in country team and a temporary PEPFAR M&E fellow to support the functions within the unit. The core staff by end of the year, comprised of the Senior M&E Advisor, M&E Advisor (Art2scale) and the Health Information officer. At the beginning of 2010, funding mechanisms created by USAID saw close out of ACCESS programme and the new development of MCHIP as the in country programme. MCHIP funds included carry overs from the ACCESS programme. Within MCHIP, plans were underway to recruit two Provincial M&E officers for the two Provinces that the programme operated in. Currently (2011), there are now two projects, Siyazi and MCHIP which are operational, staffed by the M&E officer and Health Information officer as part of the core team with support from Baltimore M&E team. We support an estimated 54 facilities in two Provinces under MCHIP and 54 partner organizations with workplace HCT under the Siyazi HCT project.
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area Primary Donor
Program Interventions Primary Monitoring Data Source
Research / Evaluation Activity Project Status
HIV Counseling and Testing
USAID PITC, outreach HCT Nationally approved health facility registers ; stored in
web-based database
PHE STATUS (a multi-country study comparing three models of PITC in Outpatient Departments) (OGAC
approved; NIMR approved)
Orientation done to regions, data collection scheduled for June/ July
2011
Maternal and Newborn
Health
USAID / MCHIP
In-service training, SBM-R, research
Service statistics using sentinel sites; performance
standards assessments; observational assessment of deliveries and newborn care
(twice LOP)
MNH Quality of care study (JHSPH IRB and National Institute of Medical
Research)
Fieldwork completed, report written; identifying journal for
manuscript preparation
Malaria in Pregnancy (MIP)
CDC Study on placental parasitemia in Zanzibar; sub on program to
improve interpersonal communication skills of health
care providers on MIP
Facility-based data collection using study forms
ANC and OPD client exit
interview study
Placental Parasitemia among women who have not received IPTp in
Zanzibar (JHSPH IRB and Zanzibar Research Council approved)
Training of health care providers to take place end of May, data collection to start in June 2011
Exit interview study done, report
writing underway Cervical Cancer
Prevention USAID In-service training, service
delivery support, policy TA to MOHSW
Nationally approved health facility registers ; client level
data stored in web-based database
Secondary analysis of CECAP database data (JHSPH non-research
determination)
Poster under preparation for IAS 2011: PITC integration into CECAP
services
Male Circumcision
USAID / MCHIP
In-service training, service delivery support, qualitative
evaluation / assessment, TA to MOHSW on M&E tools for MC
Nationally approved health facility registers ; client level and routine data stored in
web-based database
Qualitative Assessment of MC Attitudes in Iringa Region (JHSPH IRB
approved)
Secondary analysis of MC database data (JHSPH non-research
determination)
Fieldwork completed, report written; identifying journal for
manuscript preparation
Manuscript submitted to PLoS Medicine
Integrated PMTCT/
postnatal care
USAID Community-based comprehensive MNH program using community volunteers,
facility-based program to improve postnatal care
CHW forms, nationally approved health facility
registers
-- --
Pre-Service Education
CDC Faculty and institutional support for medical and nursing /
midwifery schools
Performance standards assessments
Pre-service needs assessment for medical schools (program evaluation)
Tracking of nursing and midwifery graduates in Tanzania
Report written and disseminated
Application to PHIRST being prepared
Infection Prevention
CDC Establishing standards and guidelines at national level; in-
service training and service delivery support at facility level
Performance standards assessments
Study on hospital acquired infections Not yet in design stage
Accomplishment: Web-based databases in the Tanzania office Background Solution Databases Developed
Tanzania has programs in multiple technical areas, regional offices and a strong focus on monitoring service statistics. We also support MOHSW in the area of HMIS and wanted to come up with data management solutions which were in line with national HMIS approaches. Some departments of MOHSW have embraced DHIS as a national HMIS tool.
Adopt DHIS-compatible service delivery databases, installed on servers to be accessible to both Jhpiego Tanzania HQ and
regional offices
Work with Jhpiego HQ to develop performance standards database to monitor SBM-R program achievements (called QI in Tanzania); installed on servers to be accessible to both Jhpiego
Tanzania HQ and regional offices
DHIS-compatible: MC database (client level and aggregated)
CECAP database UHAI-CT database (measures aggregated PITC
data)
QI Database
Tanzania: Monitoring, Evaluation and Research Office Overview
Number of staff: 86
Number of dedicated M&E staff: 11
Workshop Attendees
Marya Plotkin, Senior M&E Officer
Michael Machaku, M&E Officer, MC
Lusekelo Njonge, M&E Officer, UHAI-CT
Victor Mponzi, M&E Officer, MAISHA
Flora Hezwa, Senior Data Manager
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions
Maternal Health USAID/MCHIP Support MoHCW to formulate national health policies
Newborn Health USAID/MCHIP Improve the quality of maternal and newborn health services provided by District Hospitals (DH) and Rural Health Centers (RHC)
Child Health USAID/MCHIP Improve the coverage and quality of high‐impact MNCH interventions provided by Primary Care Nurses in RHCs and by Village Health Workers in
communities
Immunization USAID/MCHIP Increase routine immunization
PMTCT USAID/MCHIP Integrate PMTCT with MNCH services
Postpartum Family Planning (PPFP) USAID/MCHIP Integrate PPFP with MNCH services
Monitoring, Evaluation and Research Activities
Title of Program or Research/ Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation ActivitiesName of IRB(s) That Approved
Activity
Project Status
Maternal and Newborn Health (MNH) Standards Based Management and Recognition (SBM‐R) evaluation
(baseline)
Client/provider interviews, case observation, SBM‐R assessments
N/A Data collection completed; report writing currently underway
Child Health Needs Assessment Client/provider interviews, case observation, SBM‐R assessments
N/A Data collection completed; report writing currently underway
Immunization Needs Assessment Provider interviews N/A Data collection completed; report writing currently underway
MNH National Quality of Care Study Case observation, provider interviews N/A Attached to National Health Facility Assessment; on hold pending discussions between MOHCW
and donors
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges? 1. Data availability issues – some MCHIP indicators will be very difficult to measure given the current state of data collection tools/forms/registers in HFs, and current challenges faced by the HMISsystem. In particular, it will be challenging to measure the indicator related to provision of essential newborn care services, as there is no routine data currently being collected on these services in HFs.
In order to measure this indicator (and others with similar datacollection/quality issues), MCHIP/Zimbabwe is currently working towards developing separate data collection tools for use at facilities, and orient/train Health Facility workers as to proper use of these tools.
2. “Poor functioning” of the HMIS due to a series of issues, such as need for improved HMIS coordination/management at all levels; lack of HMIS forms and registers in some facilities; poor provider capacity to collect consistent, quality data; poor computing/communications infrastructure availability; and an unidirectional data flow, i.e., data always moves upwards without any system of giving routine feedback back to reporting sites.
MCHIP/Zimbabwe is currently working towards getting involved in strengthening of the national HMIS through participating in the Health Information Task Force meetings, providing technical and financial assistance for training of existing staff, and exploring other ways of improving data collection tools and methods.
3. Community‐based MNCH data collected by community‐based health workers is not linked to the HMIS and its usage is localized to individual health facilities.
MCHIP/Zimbabwe will work with village health workers (VHWs) to add MNCH‐related indicators to their existing registers. In addition, MCHIP will explore ability to pilot linking VHW registers to the HMIS system.
ZimbabweMonitoring, Evaluation and Research
Office OverviewNumber of staff: 20
Number of dedicated M&E staff: 1
Workshop AttendeesNumber of staff: 1
Frank Chikhata, M&E Officer
May 2011
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS‐A‐00‐08‐00002‐00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
MCHIP MER Support to USAID’s Child Survival and Health grantees resulted in: 17 operations research study designs that test innovations in
community-oriented programs in 16 countries; first results due 2012 21 project population-based baseline surveys in 19 countries 41 final evaluation surveys in 30 countries, demonstrating increased
coverage of high impact MNCH interventions including insecticide treated net use, handwashing, maternal tetanus toxoid, postnatal visits, and exclusive breastfeeding (example results in graph, below)
This poster was made possible by the generous support of the American peoplethrough the United States Agency for International Development (USAID), under theterms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00.The contents are the responsibility of the Maternal and Child Health IntegratedProgram (MCHIP) and do not necessarily reflect the views of USAID or the UnitedStates Government.
Key Monitoring, Evaluation and Research Challenges
Challenges How did you or how are you currently addressing these challenges?
1. Data collection, aggregation, and analysis at the global level. This challenge will be addressed through the launch of the new Results Information System for Excellence (RISE)
2. Rapid growth of the Program in Years 2/3 without concomitant increases in human and financial resources dedicated to M&E
HQ will be hiring an additional full-time M&E Officer in the near future. New guidance to country programs will require either an M&E staff member
or program support person in-country
3. Outdated health information system registers and client charts and poor quality data (also affects our ability to link SBM-R to health outcomes)
MCHIP works to strengthen elements of the national HMIS in countries where appropriate and advocate for revised registers
4. PVOs must develop operations research (OR) designs that are practically suited to integrated programs with limited budgets
MCHIP provides individualized technical assistance, hosted an OR workshop, and disseminated an OR guidance document
Global MCHIPMonitoring, Evaluation and Research
MCHIP Global M&E VisionIncreased use of appropriate data to guide program decision-making and
policy formulation for delivery of high-impact maternal, newborn, and child health interventions and services at scale.
Key Priorities1. Developing M&E Indicators, Tools, & Resources2. Contributing to the Evidence Base on High Impact MNCH Interventions3. Strengthening Elements of Health Information Systems4. Building Capacity of MCHIP Staff and Collaborators in Monitoring, Evaluation, and Research
91 (0.51%)
80 (0.52%)
59 (0.33%)
80 (0.45%)
71 (0.40%)
49
(0.31%)
0
10
20
30
40
50
60
70
80
90
100
0
10
20
30
40
50
60
70
80
90
100
Jul-Sep09 Oct-Dec09 Jan-Mar10 Apr-Jun10 Jul-Sep10 Oct-Dec10
Nu
mb
er
of
Ma
tern
al D
ea
ths
Pe
rce
nt
Correlation between QI standards, intervention use, and
maternal deaths in Mozambique
% of SBMR related to SPE/E % of SBMR related to PPH % of AMTSL use # maternal deaths
Throughout the first six
quarters of the Model
Maternities Initiative, in
the 17 health facilities
that did follow-up
quality evaluations,
there was an upward
trend in the adherence
to quality standards
related to PPH and
eclampsia; an upward
trend in the use of
AMTSL; and a generally
downward trend in
number of maternal
deaths from all causes
(% in parentheses).
Cause-specific mortality
currently not available
in HIS.
MCHIP Results Achieved: Country Examples
Progress toward MCHIP LOP Goals: 16,200* lives saved among children under five 14 countries with improved coverage of high impact
MNCH interventions
Select global achievements to date: 25,094 people trained in MNCH/FP: 33 national policies or guidelines developed with MCHIP
support 6 international policies/standards/strategies
developed/revised with MCHIP support 82 MCHIP supported studies
Select country achievements to date: Improved facility-based and/or community
recordkeeping forms, including registers and client charts (e.g., Mozambique, Malawi, Nigeria, Bangladesh, Guyana) Increased capacity of health workers and supervisors to
accurately record, aggregate and display data (e.g. Mozambique, Nigeria, Guyana) Increased use of data for decision making by health
workers and/or supervisors and District Health Management Teams
(e.g., Mozambique, Nigeria, Bangladesh, Malawi) Increased capacity of partners to conduct research studies
*Lives saved is calculated using LiST by CSHGP grantees with baseline and midterm or final population-based coverage figures. Approx. 10 countries in Years 1 and 2.
GOAL: Reductions in under-five and maternal mortality and morbidity and accelerated progress toward reaching MDGs 4 & 5
Strategic Objective:Increased use/coverage of high impact MNCH interventions
Sub-Objective 1:Increased availability and use of appropriate high impact MNCH interventions, including supportive
family planning interventions
Sub-Objective 2:Global leadership in MNCH, including further
development and promotion of improved approaches
Sub-Objective 3:Innovative, effective & scalable community oriented strategies that
deliver integrated high impact interventions to vulnerable populations designed, implemented and evaluated by PVOs/NGOs.
MCHIP Results Framework
Development and revision of data collection tools and guides Community case management (CCM) toolkit Facility survey toolkit for assessing quality of care for prevention and
management of common maternal and newborn complications Knowledge, Practices, and Coverage Survey, Lives Saved Tool, and
Rapid Health Facility Assessment Application of mHealth tools in M&E activities
Innovating with mHealth Smart data capture on mobile phones Data transmission from remote field
locations to in-country web-servers Posting of preliminary data tables
onto the web.
Demonstrated global leadership in MER Leadership in various M&E technical working groups, including efforts to
identify global “benchmark” MNH indicators and (CCM) indicators Contributions to global MNCH evidence-base through special research
studies and program evaluations, ex. Healthy Fertility study in Bangladesh, calcium supplementation crossover trial, CCM case studies, Malaria in Pregnancy case studies, and Quality of Care for Maternal and Newborn Complications studies in five countries.
39
63
88
3.2
2.92.7
0
0.5
1
1.5
2
2.5
3
3.5
0
10
20
30
40
50
60
70
80
90
100
2008 2009 2010
Dir
ect O
bste
tric
De
ath
Ra
te (%
)
PQ
I RH
Sco
re (%
)
Direct obstetric death rate and PQI/RH scores for
Machinga District Hospital, Malawi (2008-2010)
PQI RH scores
Direct obstetric
death rate
The proportion of
direct obstetric
deaths has
declined from
3.2% in 2008 to
2.7% in 2010. In
the same period,
quality of RH
services increased
through MCHIP
programs. Based
on program data,
PQI IP and PQI RH
may have
contributed to the
decrease in
obstetric deaths.7685
22092
4679949006
1211292 1984
3675
283 (3.68%) 344 (1.56%) 338 (0.72%)163 (0.33%)
6287
21150
30467
45138
95.3%98.8%
86.5%
96.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
10000
20000
30000
40000
50000
60000
FY07 FY08 FY09 FY10
PPH and use of AMSTL compared with maternal deaths
and deliveries for 10 hospitals* in Nigeria (2007-2010)
# Total delivery by SBAs # of cases of PPH # of maternal death recorded # cases with AMTSL Proportion of AMTSL
In 10 hospitals* in
Nigeria, annual
deliveries have
increased from 2007 to
2010, as has the
number of cases of
post-partum
hemmorhage (PPH). The
proportion of women
wtih active
management of the
third stage of labor
(AMSTL) has also
increase, as maternal
deaths have declined
markedly from 283
(3.68% of all births
attended by a skilled
attendant) in 2007 to
163 (0.33% of all births
attended by a skills
attendant) in 2010.
*Facilities include Kaura Namoda GH, Kin Fahad WCH, Zurmi GH, MMSH, Gezawa GH, Rano GH, Dawakin Tofa GH, Daura GH, Funtua GH, and
DutseMa GH. 2007 data not available for Zurmi, Daura, Funtua, and DutseMa. 2008 data not available for Daura.
Success Story: Delivering on Promise of Immunization
“This will give mothers peace of mind.” “This will reduce my fear of my child dying of pneumonia.”
“This will reduce the number of trips mothers make to the health center.”
“This will save me money if my child doesn’t get sick.”
“This” is pneumococcal vaccine. Mothers in Rwanda shared their relief that they now have a vaccine to help protect against pneumonia, the most common cause of under-five mortality globally. With the recommendation
of WHO and support from MCHIP, Rwanda became Africa’s first sub-Saharan country to introduce
pneumococcal vaccine in its national Expanded Program on Immunization (EPI) in 2009.
0
20
40
60
80
100
Pe
rce
nt
Co
vera
ge fo
r EB
F (
%)
Baseline Endline
Exclusive breast feeding (EBF) is one of the Rapid CATCH indicators reported by all CSHGP grantees. There was a statistically significant increase in EBF coverage in the catchment areas for 8 of 13 projects ending in FY2010 with endline data available.
CSHGP Grantees Improve Coverage in High-Impact Interventions
Results from Projects Ending in FY10
Office Overview: MCHIP HQNumber of dedicated M&E staff: 14(2 full-time and 12 part-time staff)
Workshop Attendees
Number of staff: 13
Barbara Rawlins Heather RosenBecca Levine Mainza Lukobo-DurrellDavid Cantor Mary Drake Moussa LyEva Bazant Maya Tholandi Reena SethiFlorence Nyangara Megan Harris Young Mi Kim
This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-00. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.
Overview of Technical Areas and Donors
Technical Area(s) Primary Donor/Mechanism Program Interventions HIV CDC/bilateral ART, PMTCT, CT, TB/HIV, MC, SI HIV DOD ART, TB/HIV, PMTCT, System Strengthening, SBMR HIV CDC/Eastern bilateral PMTCT, CT, TB/HIV MC PSI/USAID MC training and site refurbishments MC PSI/BM Gates Foundation MC training and QA
Monitoring, Evaluation and Research Activities
Title of Program or Research/
Evaluation Activity
Primary Monitoring or Study Data Source(s)
For Research and Evaluation Activities Name of IRB(s) That Approved
Activity Project Status
Training activities TIMS n/a Ongoing program monitoring Monthly DOD site data Site registers n/a Ongoing program monitoring Monthly MC site data Site registers n/a Ongoing program monitoring ART CME evaluation Participant interviews JHU SON, UNZA, CDC Data collected, analysis in process MC counseling study Client interviews, facility
registers WIRB, UNZA , CDC
Data collection under way
SBM-R evaluation Client interviews, provider
interviews, facility HMIS, SBM-R assessments
JHU SPH, UNZA Data collection under way
Key Monitoring, Evaluation and Research Challenges Challenges How did you or how are you currently addressing these challenges? 1. Data Quality from sites from MC and DOD program
Site visits, group training/orientation, revised data collection tools, site level data collection guide
2.Site level data not easy to use, summarize due to using Excel Hired contractor to develop site level database
3.Budgets for evaluation not always correct nor enough Request more funds, be more involved in work planning process
4. Ensuring all staff more aware of M&E activities Adding M&E to monthly All Staff agenda
5. No dedicated M&E nor data staff at sites Train and orient ZDF and MOH staff, use Jhpiego technical staff to assist with M&E follow-up during site visits
Highlights and Achievements • ART CME evaluation – preliminary results presented at AIDS 2010 in Vienna and led to improvements in the program implementation • M&E Unit instrumental in new Quarterly Review process • Development of Access database for site level data, leading to improved use • Using online SBMR database to share MC QA results with Prime Partner (in process) • Using MC data to improve the program implementation • Adopted data Quality Assessment tools to conduct DQ visits which lead to training/orientation for site managers on data collection, reporting
and use
Zambia Monitoring, Evaluation and Research
Office Overview
Number of staff: 33
Number of dedicated M&E staff: 2 Workshop Attendees
Number of staff:3
Cyndi Hiner, Deputy Country Director
Webby Kanjipite, M&E Advisor
Shambulo Kabangu, M&E Officer
Country Director (Kwame Asiedu)
Technical Director (Joseph Nikisi)
DOD Program Manager
(Joseph Banda)
STI and CT Officer (Nchimunya Malambo)
ART Advisor (TBD) PMTCT Advisor (Maureen Chilila)
PMTCT Officer (Hilda Shasulwe)
TB/HIV and CT Officer
(Dominic Phiri)
Pre-service Advisor (Lastina Lwatula)
Administration and Human Resource Manager (TBD)
Office Manager (Susan Zeko)
Office Assistant (Martha Brango)
Office Assistant (Fannie Chipeta)
Receptionist (Edgar Wamundila)
Office Assistant /Gardener
(Kennedy Chiabi)
Travel Coordinator (Priscilla Miti)
Driver (Davies Matanda)
Driver (Moses Mvula)
Driver (Lameck Banda)
Driver (Michael Mtonga)
IT Officer (Gizmo’s consultants)
Finance Manager (Suki Mwale)
Finance Officer (Jonathan Mulenga)
Finance Officer (Sibeso Sefulo)
Procurement Officer (Doreen
Malambo)
Regional MC Advisor
(Jabbin Mulwanda)
MC Advisor (TBD)
MC Officer (Nashiol Nyirongo)
MC Advisor (Martha Ndhlovu)
MC Advisor (TBD)
Deputy Country Director
(Cyndi Hiner)
Program Officer (Michelle Wallon)
M&E Advisor (Webby Kanjipite)
M&E Officer (Shambulo Kabangu)
SmartCare Advisor (George Muyunda)
SmartCare Officer (Anthony Sikana)