Communicating Findings & Linking Data with Action

COMMUNICATING FINDINGS & LINKING DATA WITH ACTION

Module 5

PART I: PROVIDING FEEDBACK ON DATA COLLECTED / ANALYZED

Part 1: Session Objectives

Understand the importance of feedback in program improvement and management

Consider how to improve feedback mechanisms in own work

3

“We are always giving patient forms and data to our M&E Unit, who then gives data to donors and the government. I am the head doctor and I never have the chance to look through the data before they go up. We just keep giving data up and up, and we never hear back about it…”

Head of ART facility, Nigeria

Importance of Feedback Information needs to be shared

At timely and regular intervals Within, between, up, and down

Paves path between data collectors and users at all levels of the health system

Importance of Feedback Leads to greater appreciation of data:

Improved data quality Influencing collection of appropriate data

Important element of management and supervision Creates opportunity to monitor & improve

program services Incentive for staff

Examples of Feedback Sharing information within a facility or organization Sharing aggregated service provision data from

facilities within a district or between provinces Meetings between facility and supervising agency

to review and discuss information Meetings between donor and NGO to review

information and discuss challenges and opportunities

Working Toward a Culture of Information Use

Information becomes an integral part of decision-making processes, including planning, problem solving, choosing alternatives, feedback, etc.

Empowers people to ask questions, seek improvement, learn, and improve quality

Higher Levels: District, Province, National

Analysts, Evaluators

Service Delivery Point

Feedback Managers,

Government, Donors

Program

Compiled Data

Clinical Histories, Service

Statistics

Reports

Information Flow

Variety of Formats

Narratives Summaries, bulleted items, graphs, charts

In-person discussion One-on-one Staff meetings, district meetings

Speeches to staff Supervision visits

Community Distribution ProgramMonthly Performance Review

Distributor: _______________ Supervisor: _________________Region: __________________ Month: _______ Year: ________

Number of NEW clients: _____MARK WITH AN X ON THE BAR BELOW

0 5 22

Number of RETURNING clients: _____MARK WITH AN X ON THE BAR BELOW

0 12 73

Community Distribution ProgramMonthly Performance Review

Distributor: _______________ Supervisor: _________________Region: __________________ Month: _______ Year: ________

Number of NEW clients: _____MARK WITH AN X ON THE BAR BELOW

0 5 22

Number of RETURNING clients: _____MARK WITH AN X ON THE BAR BELOW

0 12 73

Quarterly Performance Indicators# Indicator Numerator Denominator Percentage

ART1 % of eligible clients

placed on ART # of new clients on ART Sum of # of new clients on

ART and clients on ART waiting list 100%

39 392 % of current ART

clients # of active clients on ART # of cumulative clients on

ART 92%1620 1765

3 % of ART clients in 6 month cohort undergoing repeat CD4 testing

# of clients for whom repeat CD4 testing was done at 6 months

Total # of active ART clients in 6 month cohort 94%

147 156Pediatric ART

1 % of children current on ART

# of active children on ART # of cumulative children on ART 78%

45 58ART Care Follow-up

1 % of non active ART patients who have stopped ART.

# of patients who stopped ART.

# of non active ART patients.0%

0 1452 % of non active ART

patients who transferred out.

# of patients who transferred out.


8 1453 % of non active ART

patients who died. # of patients who died. # of non active ART patients. 73%106 145

4 % of non active ART patients who have been lost to follow-up.

# of patients who have been lost to follow-up.


23 145

When developing feedback mechanism, consider…

The information being shared Who will benefit from feedback The format of the feedback mechanism The forum in which the feedback will be shared How often the feedback will be provided

How the feedback will move to the next level

Document the process

Potential barriers to providing feedback

Hierarchy Role clarification – data clerk & M&E officer Approval requirements to distribute data Lack of knowledge of what information

stakeholders need

Group Participation Discuss barriers to providing feedback that

you have experienced in your work Discuss the benefits of feedback that you

have experienced in your work Identify:

Two stakeholder groups that would benefit from receiving feedback

The ideal mechanism to provide feedback to them

PART 2: LINKING DECISIONS/QUESTIONS WITH POTENTIAL DATA SOURCES

Part 2: Session Objectives Identify priority decisions and programmatic

questions Link decisions/questions with potential data sources Create a time-bound plan for using data in decision

making (Framework for Linking Data with Action)

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Building Data Use into Your Work PLAN PLAN PLAN ! Regularly review your data – schedule time Use the Framework for Linking Data with Action Engage in dialogue with stakeholders to fully

understand the decisions they makeinformation they need best way to present that information

Elements of the Framework

Decision makers and stakeholders with potential interest in your data

Decisions / actions that the stakeholder makes (possible uses of data)

Questions to which the stakeholder requires answers

When the decision will be made

Elements of the Framework (cont’d)

Indicators and/or data of interest (to respond to stakeholder need)

Source of data How will data be presented (what types of

analyses, graphs, formats)?

FRAMEWORK FOR LINKING DATA WITH ACTION

Framework for Linking Data with Action

Decision/ Action

Program/Policy Question

Decision Maker(DM), Other Stakehold-ers (OS)

Indicator/Data

Data Source

Timeline(Analysis) (Decision)

Commu-nication Channel


Decision/ Action


Decision Maker(DM), Other Stakehold-ers (OS)

Indicator/Data

Data Source

Timeline(Analysis) (Decision)

Commu-nication Channel

What Are Decisions?

Choices that lead to action All decisions are informed by questions All questions should be based on data

Decisions Allocation of resources across IPs/ states /

districts/facilities Revising OVC program approaches to

emphasize fostering and adoption Develop and institute workplace policies on

HIV/AIDS in all institutions in state X Hire and allocate staff to facilities

Programmatic Questions What percentage of HIV+ pregnant women in

care actually are delivering in health facilities?

What percentage of clients starting ART are lost to follow-up?

Are the number of family planning clients decreasing?

What percentage of pregnant patients who are HIV+ actually are receiving ART?


Decision/ Action


Decision Maker (DM), Other Stakeholders (OS)

Indicator/Data

Data Source

Timeline(Analysis)(Decision)

Commu-nication ChannelDMOS

Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse: client ratio?


Decision/ Action



Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse: client ratio?

DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training


Decision/ Action



Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse:client?





Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse:client ratio?


711 form indicators K41, B73, B 91

Service statistics; Logistics manage-ment system


Decision/ Action



Indicator/Data

Data Source


Commu-nication ChannelDM OS






Decision/ Action



Indicator/Data

Data Source







Dec. 2010,March 2011,June 2011, September 2011,December 2011


Decision/ Action



Indicator/Data

Data Source


Commu-nication Channel DMOS





Dec. 2010


Decision/ Action



Indicator/Data

Data Source







Dec. 2010 Short summary presented to facility manager at weekly clinic meeting


Decision/ Action



Indicator/Data

Data Source



Hire more PMTCT counsel-ors





Dec. 2010 Short summary presented to facility manager at weekly clinic meeting


Creates a time-bound plan for information-informed decision making

Encourages greater use of existing information

Monitors the use of information in decision making

Small Group Activity 6 – Instructions

Select a note taker On flip chart paper, create the Framework table Brainstorm three decisions or questions in

columns 1 & 2 Complete the remaining columns Time: 1 hour

Small Group Activity – Report Back

Each group will have 10 minutes to present its completed Framework

Group discussion – are there other data sources that might have been used in this decision? Were there other stakeholders who should have been considered? (10 minutes)

Building Data Use into Your Work PLAN PLAN PLAN ! Regularly review your data – schedule time Use the Framework for Linking Data with Action Engage in dialogue with stakeholders Consider other tools or methods related to data

demand and use

Improving Data Demand & Use: Multifaceted Approach

Applying a combination of: Assessment of current data use, capacity building

needs, and barriers to data use Capacity building initiatives around data use concepts,

use of tools, data analysis… Tool application Organization development (e.g., leadership, systems

improvement) Collaborative efforts between data users and producers

Multifaceted Approach in Nigeria Large amount of data collected, feeding NNRIMS Data were not being used effectively at sites or

within project Pervasive mistrust of data Lack of understanding of how RHIS data could

be used Lack of understanding of how indicators were

calculated and used for program improvement

Capacity Building Assessment Organizational Support

Data Users & Data Producers

Data System Improvements

Multifaceted Approach in Nigeria













Multifaceted Approach in Nigeria: Results

86% of respondents implemented solutions to identified barriers to data use

76% reported assisting decision makers with data interpretation

THANK YOU!MEASURE Evaluation is a MEASURE project funded by the U.S. Agency for International Development and implemented by the

Carolina Population Center at the University of North Carolina at Chapel Hill in partnership with Futures Group International, ICF Macro, John Snow, Inc., Management Sciences for Health, and Tulane University. Views expressed in this presentation do not necessarily reflect the views of USAID or the U.S. Government.

MEASURE Evaluation is the USAID Global Health Bureau's primary vehicle for supporting improvements in monitoring and

evaluation in population, health and nutrition worldwide.

Visit us online at http://www.cpc.unc.edu/measure

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Communicating Findings & Linking Data with Action