Monitoring, Supervision, Evaluation and Reporting

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Monitoring, Supervision, Evaluation and Reporting

• CAPACITY BUILDING FOR TUBERCULOSIS CONTROL WITH
  FOCUS ON TB/HIV.

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Sustaining services

• Initial success ?complacency ?resurgence of
  cases? emergence and spread of MDR.
• Preserving achievements requires sustained
  effective implementation of the NTBP -? ongoing
  analysis of data, evaluation of care provided and
  patient response ? continuous improvement of
  quality of services? social dynamics and changing
  scenario in public health.

3
Cont

• Supervise Skills, technical accuracy
• Monitor Process/progress? quality, efficiency,
  efficacy, effectiveness? adjust programme
  accordingly.
• Evaluate Impact ? Result.
• TB-HIV/AIDS? Monitor treatment outcome, supervise
  activities.
• Monitor target objectives achievement i.e. 85
  cure rate of all cases diagnosed.
• Collect and analyze data PERIODICALLY. i.e. case
  detection rate, treatment outcomes, programme
  management indicators, others.

4
Cont

• Supervise compliance with policies? identify
  training needs, motivate and support staff.
• Review registers.
• Follow up on results.
• Report on progress.
• Evaluate results ? for programmatic decisions and
  to inform policy i.e. extend coverage, initiate
  vaccination, implement DOTS.

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Proper ME v.s Program design and implementation

• Assess realistically what and how much you can
  accomplish, set realistic expectations
  /objectives
• What are the areas of need?
• Which activities will help to answer to the
  needs?
• What resources are available? Time, staff,
  budget, information, time, tools (guidelines,
  manuals), surveillance system.
• What to monitor and /or evaluate ?indicators
  (Q-Q-T), independent, specific, measures what is
  important.

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Cont

• What community activities, organizations and
  other contributing factors exist?
• What barriers are there?
• Which activities would best utilize the resources
  identified and can fit within constraints
  identified ? PRIORITIES
• What are the alternatives to cope with limited
  resources
• Is the ME system based on a standardized
  process?

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Focus for ME skills enhancement

• Establish ME system instruments, periodicity,
  define objectives, assess needs.
• Designing training programmes for health
  personnel ME competency development.
• Increase capacity for data collection/analysis/int
  erpretation and cohort analysis
• Conduct exercises leading to monitoring and
  evaluation based on epidemiological analysis and
  programme evaluation.
• Utilize output of monitoring and evaluation
  exercises to further develop skills and improve
  quality of care provided

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GATHERIGN NEW DATA PRIMARY REGISTRY-- RESEARCH

• Recognition response capacity is proportional
  to information available on the problem.
• What information? On the problem, on services
  available, on the target population
• Data-- Information Timeliness, consistency,
  reliability, representative, quality Auditing
  data registry and information systems.

9
Cont

• Cost effective Surveys versus structured
  information system.
• Use of information inform policy, trigger
  action, monitor advances, make adjustment,
  demonstrate results, evaluate impact.

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Quantitative and Qualitative Analysis

• Quantitative information is usually summarized as
  percentages, numbers, and averages ( of
  defaulters from TB programme)
• Qualitative information allows you to look for
  similarities across several different
  observations, interviews or documents, and can be
  analyzed using various techniques. (Why did they
  default?)
• Both can be analyzed manually and/or with the
  help of a computer.

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Cont

• Quantitative research a survey sampling a
  segment of the group to that will allow to assess
  patterns for the whole target group.
• Qualitative research fewer respondents such that
  represent the group less rigorous, open
  methodology, faster and cost effective focus
  group, key informers, others
• Combination of both focus groups small-scale
  survey

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Quantitative Research

• Large statistical representative sample with
• Structured questions
• Face to face interview
• Collecting vital statistics
• Baseline
• Track changes
• Set priorities
• Inform participants but do not provide
  qualitative data from them
• Will not indicate unexpected factors or influences

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Qualitative Research

• Explores the why
• Provide information on perceptions
• Identify target audience issues perceive as
  related and important
• Facilitate in depth discussions
• But cannot be considered a representative sample
  or be projected to a population

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Interpreting the information

• Interpretation involves attaching meaning or
  significance to the analysis, that is, explaining
  what the patterns or categories mean or tell you
  about the experience.
• Interpret the results taking into account
  purpose and objectives of the initiative and of
  ME.
• Consider the limitations of the ME process.
• Explore whether there are alternative
  explanations for the results.
• Examine if all data collection methods used to
  look at a particular outcome or activity show
  similar results.
• Determine what factors influenced the results and
  through what mechanisms.

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Reflecting on the results

• FUNDAMENTAL to the participatory evaluation
  process in order to
• Allow for an in-depth comprehension of your
  initiative and the response obtained.
• Encourage a continuous, evolving process.
• Support those involved in being alert, and open
  to recognize and explore the questions that
  arise.
• Create a holistic image of the initiative and of
  the process conducted so far.

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These are different processes!

• ANALYSIS refers to organizing the information
  collected into patterns, categories and basic
  descriptions.
• INTERPRETATION involves attaching meaning or
  significance to the analysis, that is, explaining
  what the patterns or categories mean or tell you
  about the experience.
• REFLECTION implies thinking about the results and
  achieving consensus about its meaning to the
  initiative.

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Purpose of ME Institutional strengthening

• Requires developing staff skills that will
  facilitate important elements for programme
  management such as
• Capacity to plan strategically (National and
  Local)
• Communicate, advocate, educate (Health promotion)
  
• Execute (Provide services)
• Monitor and evaluate (Surveillance and
  health/programme information system)

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• Caribbean TB-HIV Control

Thank you.