MEASURE Evaluation

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MEASURE (Monitoring and Evaluation to Assess and Use Results) Evaluation aims to strengthen the capacity of developing countries to gather, interpret, and use data to improve health. MEASURE Evaluation creates tools and approaches for rigorous evaluations, providing evidence to address health challenges, and strengthening health information systems so countries can make better decisions and sustain good health outcomes over time. MEASURE Evaluation is a cooperative agreement awarded by the U.S. Agency for International Development (USAID) to the Carolina Population Center at the University of North Carolina at Chapel Hill and five partner organizations: ICF International, John Snow Inc., Management Sciences for Health, Palladium, and Tulane University. This MEASURE Evaluation partnership provides technical leadership through collaboration at local, national, and global levels to build the sustainable capacity of developing nations to identify data needs, collect and analyze technically sound data, and use that data for health decision-making. [1]

Contents

Purpose

MEASURE Evaluation works closely with USAID, its country missions, and counterparts to improve the collection, analysis, and presentation of data to promote better use of data in planning, policy-making, managing, monitoring, and evaluating population, health, and nutrition programs. The underlying premise is that improving the use of information in health sector decision-making will lead to better health services, systems, and outcomes. [2]

The last few years have seen a dramatic increase in demand for high-quality health information through large global health initiatives that emphasize quantitative measures of progress to ensure accountability. [3] These demands stretch weak and overburdened monitoring and evaluation (M&E) and health information systems (HIS). There is an urgent need to strengthen the performance of HIS and M&E systems at all levels, improve measurement in areas in which measurement methods are weak, increase evidence on the effectiveness of global health programs, and strengthen the use of information beyond meeting reporting requirements to inform program decision-making.

Monitoring and Evaluation

M&E is the process by which data are collected and analyzed to provide information to policy-makers and others for use in program planning and project management. Monitoring focuses on the implementation process and progress towards the achievement of program objectives. Evaluation measures how well the program activities have met expected objectives and/or the extent to which changes in outcomes can be attributed to the program. [4]

M&E is important because it helps program implementers make informed decisions regarding program operations and service delivery based on objective evidence. It also ensures the most effective and efficient use of resources, helps determine the success or failure of a program, and assists in meeting organizational requirements such as reporting. Most importantly, monitoring and evaluation often convince donors that their investments have been worthwhile.

MEASURE Evaluation supports the international development goal of maximizing program results, by systematically collecting and analyzing information about and evidence on health program performance and impact. Evaluation findings support organizational learning, strengthen health systems, and improve program effectiveness so that people live healthier lives.

Health Information System Strengthening

Strong health information systems are a crucial element in overall health systems and, therefore, a critical factor in achieving better health for people. Health information systems provide essential information to enable all decision makers—from policy-makers to health providers—to make evidence-informed choices for budgeting on health, health workforce needs, and services for citizens. [5]

MEASURE Evaluation has worked in this arena for over 20 years, assisting countries in the systematic collection and analysis of evidence about health program performance and impact. MEASURE Evaluation’s Health Information Systems Strengthening Resource Center serves as a central hub for the exploration of what works to strengthen HIS, a repository for evidence about how strengthened health information systems improve health outcomes, and a learning space for health professionals to share and exchange information on strengthening health information systems. [6]

The project also develops tools and builds capacity in developing countries to strengthen electronic medical records, routine health information systems, and community-based health information systems. This involves developing data quality procedures; establishing guidelines for health data confidentiality, security, and ethics; improving data system interoperability; helping countries integrate data from disease surveillance and response systems, commodities and logistics management information systems, and civil registration and population health surveys; and promoting data demand and use. Other focal areas include gender, health, and knowledge management.

MEASURE Evaluation's Work

Under optimum conditions, public health relies upon a network of facilities staffed with competent providers, a ready supply of essential medicines, and a governance structure supported by managers who understand the health issues of the population and are equipped to make good policy and program decisions based on evidence.

MEASURE Evaluation works in low- and middle-income countries (LMICs) to strengthen health information systems. Specific populations addressed by the project include orphans and vulnerable children, adolescents, and key populations at risk of HIV.

The project applies research expertise and provides technical assistance to developing countries in data ethics, data science, network analysis, data quality, geospatial analysis, health informatics, secondary data analysis, digital data collection, statistical sampling, and systems thinking. It conducts studies using a range of research methods: rigorous evaluation (outcome, impact, economic, and process evaluations), complexity-aware methods, mixed-methods studies, surveys, modeling, and most significant change.

MEASURE Evaluation researches health system performance; builds human capacity; and supports public health practitioners and policymakers to use data to perform these six essential functions of a health information system: [7]

1. Monitor trends in health outcomes and services.

2. Ensure that data are trustworthy.

3. Make decisions quickly and efficiently.

4. Identify what works.

5. Ensure the coordination and equity of health services.

6. Manage resources for the greatest benefit.

Where MEASURE Evaluation Works

MEASURE Evaluation works in sub-Saharan Africa, Latin America, the Caribbean, Southeast Asia, and Eurasia, implementing research and building capacity for rigorous evaluation and health information system strengthening in about 40 countries at any one time. [8]

Earlier Phases

MEASURE Evaluation is now in Phase IV. Phase I (1998–2003) focused on data analysis and the design of new tools. Phase II (2004–2009) included data demand and utilization (now Data Demand and Use), training and capacity building, collaboration and coordination, and research and development. [9] Phase III added knowledge management and organization development. Phase IV strengthened the project's dual focus on evaluation and health information system strengthening. [10]

Monitor

Monitor is a monthly update sent via email detailing all new developments at MEASURE Evaluation. Currently, this newsletter reaches about 13,000 people worldwide.

Related Research Articles

In common usage, evaluation is a systematic determination and assessment of a subject's merit, worth and significance, using criteria governed by a set of standards. It can assist an organization, program, design, project or any other intervention or initiative to assess any aim, realisable concept/proposal, or any alternative, to help in decision-making; or to generate the degree of achievement or value in regard to the aim and objectives and results of any such action that has been completed.

Program evaluation is a systematic method for collecting, analyzing, and using information to answer questions about projects, policies and programs, particularly about their effectiveness and efficiency.

Adaptive management, also known as adaptive resource management or adaptive environmental assessment and management, is a structured, iterative process of robust decision making in the face of uncertainty, with an aim to reducing uncertainty over time via system monitoring. In this way, decision making simultaneously meets one or more resource management objectives and, either passively or actively, accrues information needed to improve future management. Adaptive management is a tool which should be used not only to change a system, but also to learn about the system. Because adaptive management is based on a learning process, it improves long-run management outcomes. The challenge in using the adaptive management approach lies in finding the correct balance between gaining knowledge to improve management in the future and achieving the best short-term outcome based on current knowledge. This approach has more recently been employed in implementing international development programs.

<span class="mw-page-title-main">Health human resources</span> People acting to improve health outcomes

Health human resources (HHR) – also known as human resources for health (HRH) or health workforce – is defined as "all people engaged in actions whose primary intent is to enhance positive health outcomes", according to World Health Organization's World Health Report 2006. Human resources for health are identified as one of the six core building blocks of a health system. They include physicians, nursing professionals, pharmacists, midwives, dentists, allied health professions, community health workers, and other social service and health care providers.

Evidence-based policy is a concept in public policy that advocates for policy decisions to be grounded on, or influenced by, rigorously established objective evidence. This concept presents a stark contrast to policymaking predicated on ideology, 'common sense,' anecdotes, or personal intuitions. The methodology employed in evidence-based policy often includes comprehensive research methods such as randomized controlled trials (RCT). Good data, analytical skills, and political support to the use of scientific information are typically seen as the crucial elements of an evidence-based approach.

<span class="mw-page-title-main">Capacity building</span> Process by which individuals or organizations improve their capability to produce, perform or deploy

Capacity building is the improvement in an individual's or organization's facility "to produce, perform or deploy". The terms capacity building and capacity development have often been used interchangeably, although a publication by OECD-DAC stated in 2006 that capacity development was the preferable term. Since the 1950s, international organizations, governments, non-governmental organizations (NGOs) and communities use the concept of capacity building as part of "social and economic development" in national and subnational plans. The United Nations Development Programme defines itself by "capacity development" in the sense of "'how UNDP works" to fulfill its mission. The UN system applies it in almost every sector, including several of the Sustainable Development Goals to be achieved by 2030. For example, the Sustainable Development Goal 17 advocates for enhanced international support for capacity building in developing countries to support national plans to implement the 2030 Agenda. 

The Dominican Republic has achieved impressive increases in access to water supply and sanitation over the past two decades. However, the quality of water supply and sanitation services remains poor, despite the country's high economic growth during the 1990s.

<span class="mw-page-title-main">Malawi–United States relations</span> Bilateral relations

The United States established diplomatic relations with Malawi in 1964 after Malawi gained independence from the United Kingdom. Malawi's transition from a one-party state to a multi-party democracy significantly strengthened the already cordial U.S. relationship with Malawi. Significant numbers of Malawians study in the United States. The United States has an active Peace Corps program, Centers for Disease Control and Prevention, Department of Health and Human Services, and an Agency for International Development (USAID) mission in Malawi. Both countries have a common history and English language, as they were part of the British Empire.

The Demographic and Health Surveys (DHS) Program is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. The project is implemented by ICF International and is funded by the United States Agency for International Development (USAID) with contributions from other donors such as UNICEF, UNFPA, WHO, and UNAIDS.

Community-based monitoring (CBM) is a form of public oversight, ideally driven by local information needs and community values, to increase the accountability and quality of social services such as health, development aid, or to contribute to the management of natural resources. Within the CBM framework, members of a community affected by a social program or environmental change track this change and its local impacts, and generate demands, suggestions, critiques and data that they then act on, including by feeding back to the organization implementing the program or managing the environmental change. For a Toolkit on Community-Based Monitoring methodology with a focus on community oversight of infrastructure projects, see www.communitymonitoring.org. For a library of resources relating to community-based monitoring of tropical forests, see forestcompass.org/how/resources.

Global Health Initiatives (GHIs) are humanitarian initiatives that raise and disburse additional funds for infectious diseases – such as AIDS, tuberculosis, and malaria – for immunizations and for strengthening health systems in developing countries. GHIs classify a type of global initiative, which is defined as an organized effort integrating the involvement of organizations, individuals, and stakeholders around the world to address a global issue.

<span class="mw-page-title-main">Committee on Sustainability Assessment</span>

The Committee on Sustainability Assessment (COSA) is a global consortium of development institutions that work collaboratively to advance sustainability learning with systematic and science-based measurement. COSA applies a pragmatic and collective approach for using scientific methods to develop indicators, tools, and technologies to measure the distinct social, environmental, and economic impacts and are applied in performance monitoring, evaluation, return on investment (ROI) calculation, and impact assessment. COSA has a public mission to open its scientific methods and metrics up to widespread use.

<span class="mw-page-title-main">United States aid to Sudan</span>

United States aid to Sudan has three key objectives: a definitive end to conflict, gross human rights abuses, and genocide in Darfur; implementation of the north–south Comprehensive Peace Agreement that results in a peaceful post-2011 Sudan, or an orderly path toward two separate and viable states at peace with each other; and ensuring that Sudan does not provide a safe haven for international terrorists. Sudan has experienced two civil wars since 1955, the second of which lasted 22 years. During this time, the U.S. was the largest provider of foreign aid to Sudan, largely focused on humanitarian aid through the U.S. Agency for International Development. Sudan is listed as the U.S. government's highest priority in Africa due to "its importance for counter-terrorism and regional stability, as well as the magnitude of human rights and humanitarian abuses" U.S. foreign aid to Sudan has begun to see some positive indicators of performance although critical reaction has said that aid to Sudan is neither strategic nor focused.

The PRECEDE–PROCEED model is a cost–benefit evaluation framework proposed in 1974 by Lawrence W. Green that can help health program planners, policy makers and other evaluators, analyze situations and design health programs efficiently. It provides a comprehensive structure for assessing health and quality of life needs, and for designing, implementing and evaluating health promotion and other public health programs to meet those needs. One purpose and guiding principle of the PRECEDE–PROCEED model is to direct initial attention to outcomes, rather than inputs. It guides planners through a process that starts with desired outcomes and then works backwards in the causal chain to identify a mix of strategies for achieving those objectives. A fundamental assumption of the model is the active participation of its intended audience — that is, that the participants ("consumers") will take an active part in defining their own problems, establishing their goals and developing their solutions.

Policy monitoring comes a range of activities describing and analyzing the development and implementation of policies, identifying potential gaps in the process, outlining areas for improvement, and holding policy implementers accountable for their activities.

Monitoring and Evaluation (M&E) is a combined term for the processes set up by organizations such as companies, government agencies, international organisations and NGOs, with the goal of improving their management of outputs, outcomes and impact. Monitoring includes the continuous assessment of programmes based on early detailed information on the progress or delay of the ongoing assessed activities. Evaluation involves the examination of the relevance, effectiveness, efficiency and impact of activities in the light of specified objectives.

<span class="mw-page-title-main">Uganda National Health Consumers' Organisation</span>

The Uganda National Health Users'/Consumers' Organization or Uganda National Health Consumers' Organisation (UNHCO) is a Ugandan nonprofit organization established in 1999 to advocate for the realization of the right to health for all Ugandans.

A learning agenda is a set of questions, assembled by an organization or team, that identifies what needs to be learned before a project can be planned and implemented.

Monitoring Education for Sustainable Development (ESD) refers to measuring progress in ESD learning compared to policy commitments, provision, institutional support, resources and others. Monitoring and evaluation (M&E) of Education for Sustainable Development is widely discussed in literature on ESD, including debates regarding methodology and strategies for interpreting the data.

American International Health Alliance (AIHA) is a nonprofit organisation aiming for assisting the global health. The organisation has managed more than 175 partnerships and project across the globe. In 2012, AIHA obtained the support of President's Emergency Plan for AIDS Relief [PEPFAR] project to strengthen the blood service in Central Asia, Ukraine, and Cambodia. Due to its structure based on the programmatic modal and dynamic condition, this organisation is suitable to assist the community or worldwide countries which have limited resources, and it is beneficial for sustainable evolution. AIHA is contributing to improve the worldwide health conditions. This organisation has been associated and largely contributed in the HIV-related area since 2000.

References

  1. MEASURE Evaluation (March 2, 2016). "About Us". MEASURE Evaluation. Retrieved June 6, 2017.
  2. Nutley, Tara; Reynolds, Heidi W. (13 February 2013). "Improving the use of health data for health system strengthening". Global Health Action. 6 (1): 20001. doi:10.3402/gha.v6i0.20001. PMC   3573178 . PMID   23406921.
  3. Chan, Margaret; Kazatchkine, Michel; Lob-Levyt, Julian; Obaid, Thoraya; Schweizer, Julian; Sidibe, Michel; Veneman, Ann; Yamada, Tadataka (26 January 2010). "Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies". PLOS Medicine. 7 (1): e1000223. doi: 10.1371/journal.pmed.1000223 . PMC   2811154 . PMID   20126260.
  4. Frankel, N., & Gage, A. (rev. 2016) M&E Fundamentals: A Self-Guided Minicourse. Chapel Hill, NC, USA, MEASURE Evaluation. https://www.measureevaluation.org/resources/publications/ms-07-20-en
  5. World Health Organization (WHO). (2008). Health Information Systems. WHO. http://www.who.int/healthinfo/statistics/toolkit_hss/EN_PDF_Toolkit_HSS_InformationSystems.pdf
  6. MEASURE Evaluation (February 17, 2017). "HIS Strengthening Resource Center". MEASURE Evaluation. Retrieved March 6, 2017.
  7. MEASURE Evaluation (March 29, 2016). "Six Essential Functions of a High-Performing Health Information System". MEASURE Evaluation. Retrieved June 6, 2017.
  8. MEASURE Evaluation (April 18, 2017). "Countries". MEASURE Evaluation. Retrieved June 6, 2017.
  9. MEASURE Evaluation (February 20, 2008). "USAID Goals and Objectives for MEASURE Evaluation Phase II (2004-2008)" . Retrieved June 6, 2017.
  10. MEASURE Evaluation (February 8, 2017). "An Evolving Mandate to Improve Global Health and Health Information Systems". MEASURE Evaluation. Retrieved June 6, 2017.

Sources