LET US PLAY

PA SS T HE
BA LL!
 UNSCRAMBLE ME!

nigrotimno
WHAT AM I ?
 COMPLETE ME!

A AT N
 S MO NIT OR ING
HMI N
AND EV AL UA TIO
Lesson 7
illan , Nieves
Mendoza , M
Lintapan ,
 At the end o
f the lesson
should be a , the studen
ble to: ts

Explain the
purpose ,pl
and framew an,
lesson intended Describe th
orks of an H
MIS;

learning between M
e relationsh
ip
outcomes indicators ;a
and E with H
nd
MIS

Establish th
e relationsh
HMIS indica ip of
tors with he
programs alth
7.1. DEFINE, EXPLAIN, AND DISCUSS THE MONITORING AND
EVALUATION PURPOSE, PLAN, AND FRAMEWORKS
7.1.1. Monitoring and evaluation (m and e) defined
Monitoring is the systematic collection, analysis, and use of
information from programs for three purposes:
Learning from experience.
Accountability for resource use and results.
Decision-making (steering function).
Evaluation is the systematic and objective assessment of a program
or policy, focusing on:
Relevance, effectiveness, efficiency, impact, and sustainability.
Identifying what worked, what didn’t, and areas for improvement.
Both monitoring and evaluation have:
Learning function: Lessons learned for future proposals.
Monitoring function: Reviewing implementation based on objectives and resources.
Monitoring and evaluation are complementary processes.
7.1.2 M&E PUrpose
The goal of M&E is to have a strong system for reviewing the national
health strategic plan, covering major disease programs and health
systems.
A robust M&E system is needed to assess the impact of integrated
service delivery.
It requires the use of appropriate indicators, data collection systems,
and data analysis to support decision-making.
M&E helps guide the successful implementation of services and
measures their effect on service delivery and use.
 7.1.3 M&E PLAN 7.1.4 M&E FRAMEWORK
National M&E plans should cover all aspects of
M&E Framework is crucial for improving health
the health framework and be the foundation for
systems.
regular reviews.
It builds on principles from the Paris Declaration
Country M&E systems must provide information
and IHP+, focusing on aligning country health
for global monitoring while reducing the
strategies and M&E processes.
reporting burden.
The framework aims to:
Tools like JANS and the Health Systems Funding
Strengthen a common M&E platform for health
Platform help align global and national efforts.
system strengthening (HSS).
M&E tracks progress through monitoring
Align country and global M&E systems.
reports, HMIS, surveys, and evaluation studies.
Monitor health systems funding and specific
M&E strategies should:
program performance.
Focus on country needs but support global
It covers:
monitoring.
Indicator selection.
Track inputs, processes, and results of health
Data sources and analysis.
systems.
Performance review and communication.
Use data to inform decision-making.
Combine disease-specific monitoring with
health system performance tracking.
7.2 RELATIONSHIP BETWEEN M&E WITH HMIS INDICATORS 7.2.1 INDICATORS FOR MONITORING FP/
IMMUNIZATION INTEGRATION
An INDICATOR can be defined as a
1. variable whose value changes. The table includes a variety of quantitative
2. measures the value of the change in meaningful units indicators. It is also important to complement
that can be compared to past and future units. collection of these data with the use of qualitative
3. It focuses on a single aspect of a program or project– techniques in order to better understand nuances
i.e., of the integration processes and solicit feedback
an input, output or the overarching objective. on the approach.

There are different HMIS indicators which can be

used for monitoring of key aspects of the health
system performance.
7.2.2 INDICATORS FOR MONITORING FP/
These are from among the five broad categories IMMUNIZATION INTEGRATION
1. Reproductive health,
2. Immunization,
3. Disease prevention and control,
4. Resources utilization and
5. Data Quality
7.3 RELATIONSHIP BETWEEN M&E WITH HEALTH PROGRAM 7.3.1 THE MATERNAL SURVIVAL STRATEGY
AND HMIS INDICATORS
Campbell and Graham (2006) discuss the
HMIS is a source of routine data necessary for monitoring
following about Maternal Survival Strategies and
different aspects of various health programs implemented
HMIS indicators:
in a country.

The Maternal Survival Strategies lay down a framework for

HMIS indicators should be carefully selected to meet the
achieving the fifth Millennium Development Goal of reducing
essential information necessary for monitoring the
maternal mortality.
performance of various health programs and services and
to present an overview of available health resources.
Given the complexity of country contexts and the
determinants of maternal health, maternal survival
These diseases data provide an in-depth understanding of
intervention alone cannot reduce the maternal mortality
how HMIS can be used for monitoring program performance
rate.
and how it encourages similar in-depth analysis for all
health programs and services such as:
Rather, evidences support packaging of health facility-
oriented interventions is highly effective and has high
Maternal survival intervention
coverage of the intended target group.
Child mortality and child survival intervention
Stop TB program.
The HMIS indicators are related to the following:
1. Pregnancy care interventions 3. Postpartum care
a. 1st antenatal care attendances a. 1st postnatal care attendance
b. 4th antenatal care attendances b. Institutional cases of maternal morbidity and mortality due to
c. Cases of abnormal pregnancies attended at out- postpartum hemorrhage (PPH) and puerperal sepsis
patient departments (OPD) of health facilities
d. Institutional cases of maternal morbidity and 4. Inter-partum period
mortality due to antepartum hemorrhage (APH), a. Family planning method acceptors (new and repeat)
hypertension and edema reported by in-patient department b. Family planning methods issued by type of method
(IPD) of health facilities
e. Cases of abortion attended at health facilities
f. Cases of medical (safe) abortions conducted at health These indicators, although not complete to monitor all aspects of
facilities maternal survival strategies, capture data related to pregnancy,
2. Intrapartum care. such as intrapartum and postpartum care, and are sufficient to
a. Deliveries by skilled attendants (at health facilities) give a broad indication of the performance of the package of
b. Deliveries by health extension workers (HEW) (at home of maternal survival interventions.
health
posts) More so, using these indicators help prompt further
c. Institutional cases of maternal morbidity and mortality investigations when problems on issue arise.
due to obstructed labor
7.3.2 CHILD MORTALITY AND CHILD SURVIVAL INTERVENTIONS:
Ethiopia is one of those countries who Ethiopia is implementing interventions
have made great strides towards targeting under-5-year-old children through:
reducing the under-5 mortalities based
on Ethiopia Maternal and Child Health Universal immunization Coverage
Data (2012) Nutrition program
Integrated Management of Childhood
Under-5 mortalise still remain high at 106 per 1000
Illnesses and the Community Case
Live Birth (LB) in 2010 and the country faces the Management of Childhood Illnesses
challenges of reducing it to 61/1000 LB by 2015
The EDHS 2011 estimated under-5 mortalities to be
Through Health Development Army to improve
88 per 1000 LB, that is, a 47% decline from 166/1000
LB in 2000
water, sanitation, and hygiene; Malaria
Diarrhea, pneumonia, measles, malaria, HIV/AIDS, prevention through Integrated Household
birth asphyxia, preterm delivery, neonatal tetanus, Spraying and Distribution of Insecticide Treated
and neonatal septis. Nets (ITN) (USAID,2013).
 7.3.3 THE STOP TB PROGRAM Ending the global TB epidemic: The program supports
the WHO's "End TB Strategy," which aims to reduce TB
deaths by 90% and cut new cases by 80% by 2030
compared to 2015 levels.
The goal of the Stop TB Program is to eliminate
tuberculosis (TB) as a public health problem globally.
Promoting research and innovation: The program
Specifically, the program seeks to dramatically reduce
pushes for the development of new TB diagnostics,
the global burden of TB by 2015. In line with Millennium
vaccines, and treatments.
Development Goals and Stop TB Partnership targets
of the World Health Organization (2006). Hence, one if
Increasing access to TB care: It seeks to ensure universal
the targets linked to the MDGs and endorsed by the
access to TB prevention, treatment, and care,
Stop TB Partnership is by 2050 to reduce prevalence
particularly for vulnerable populations.
and deaths due to TB by 50% compared with baseline
of 1990.
Mobilizing political commitment: It advocates for high-
level political engagement to ensure sustained global

THE MAIN GOALS OF STOP TB and national efforts in tackling TB.

PARTNERSHIP Community engagement: The program emphasizes

INCLUDE: involving affected communities in TB control efforts to

make strategies more effective and tailored to specific
local needs.
The HMIS indicators to monitor STOP TB Program:
TB patients in DOTS Proportion of newly diagnosed TB
cases to HIV
Number of new-smear pulmonary
TB cases enrolled in the cohort HIV+ new TB patients enrolled in
DOTS
TB case Detection
Treatment completed PTB+
Number of new smear positive
pulmonary TB cases detected Cured PTB+, Defaulted PTB+, Deaths
PTB+

Number of new smear negative

pulmonary TB cases detected These indicators provide essential data
to assess the impact and effectiveness
Number of new extra pulmonary of TB control programs and guide
TB cases detected •HIV- TB Co- further interventions aimed at
infection eradicating TB.
THA NK
YOU !