Unit Five:

Controlling and Decision Making

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 Session Objectives
• Define controlling , monitoring & evaluation
• Determine the purpose of M&E
• Describe the relationship b/n M&E
• Identify the types of evaluations
• Evaluate the characteristics of indicators

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 Controlling
Management Control
 is the process of ensuring that actual activities conform
to planned activities.
 Taking preventive / corrective action to keep things on
track is an essential part of control process
 primary aim of control is to improve performance

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 Stages /steps of Controlling

1. Establish standards of Expected performance

2. Measure actual performance
3. Compare performance against standard
4. Evaluate the comparison and take appropriate
corrective action.

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 Steps of Controlling

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 Controlling….
Types of Controls
1.Feed forward Control
• The active anticipation and prevention of problems,
rather than passive reaction.
• Monitor inputs
2.Concurrent Control
• Monitoring and adjusting ongoing activities and
processes.
3.Feedback Control outputs/products
• Checking a completed activity and learning from
mistakes.
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 Forms of Management Control:
There are three basic forms of management control:
1. Monitoring
2. Supervision
3. Evaluation.

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 1. MONITORING
- Monitoring = routine and continuous tracking of
planned activities
- It is the day-to-day watch on, or continuous follow up
of, the on going activities.
- It is regularly checking to see that program activities
are being done as planned.
- It is carried out through observation, discussion and
review of reports, statistical data.

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 MONITORING…

• The goals of monitoring are:

 To identify any problem early, and
 To solve without delaying the progress of the
program.
• Hence it is a basic part of implementation management.

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 2. Supervision:
• Intermittent processes to be conducted by the management in line
with controlling.
• A single person should not go for supervision
• Autocratic supervisions tend to injured the dignity of people,
make them irresponsible and mostly one way.
• It may dry up the creativity of people .
• Democratic supervision helps people to grow
• become responsible for their own work to show initiative

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 3. Evaluation
• Evaluation = periodic (e.g., annual) assessment of whether
program objectives have been achieved
 Is systematical and periodical gathering, analyzing and
interpreting of information on the operation as well as the effects
and impacts of a development programme/project.
• It involves the comparison of the actual performance of the
system

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 Evaluation….
The results of evaluation are expected to show:
• What a program has been trying to do;
• What actually happened;
• Where there are differences/gaps between plans
and what happened
• The reasons for the difference/gaps, and
• What needs to be done about them?

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 Distinctive Characteristics of M & E
Characteristics Monitoring Evaluation
Purpose/objective Specific Broad
Scope Narrow Broad
Frequency Continuous Periodic
Data Gathered Primarily Primarily
Quantitative Qualitative
Focus Inputs/Outputs Impact and
Sustainability
Provides detailed
Alerts when to take
Uses information on what
action type of actions to take

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 Distinctive Characteristics of M & E…
Character Monitoring Evaluation
What does - Activities performed - Why and how
it answers? - Problems encountered results were achieved or not
- Strategy and policy options

Actors Internal Internal/External

Analysis Simple Comparative Analytical tools

Primary Small group/project Large group /Project

Users Managers Managers, planners,
Financers, etc.)

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 Types of Evaluation

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 TYPES OF EVALUATION…
Some authors use the terms
• Input, Process, output ,Outcome &Impacts to determine
the value of a program
Others use the term
• Formative/diagnostic or progressive Evaluation to
Evaluate input and process. it is performed during
implementation.
• Summative or Terminal Evaluation
• to evaluate output, outcome, & impact it is done at the
conclusion of the program.
• focus on long term “ultimate” results
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 Types of Evaluation .….
• Based on people primarily responsible to lead
evaluation activities, evaluation could be classified as:
– Internal Evaluation

– External Evaluation

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 Internal Evaluation
• Evaluation activities designed and implemented
primarily under a leadership from program
implementers

• Usually serve information for program improvement

by supplementing monitoring activities

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 External Evaluation
• Evaluations designed and implemented primarily by
people who are relatively more detached from the
program (external evaluators)
• Used when:
– objectivity is a concern because of issues related to
the purpose of the evaluation
– concerns of multiple stakeholders included in
evaluation questions
– evaluation expertise beyond the organization’s
capacity is required to answer evaluation questions
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 Program Components

INPUTS Processes OUTPUTS OUTCOMES IMPACTS

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 Program Components
• Inputs
– Resources used in a program, such as money, staff, core
curriculum, and materials. Examples:
• Health workers
• Anti-TB drugs
• Laboratory reagents
• Processes/ Activities
– Services that the program provides to accomplish its objectives
– Examples:
• Training health workers for counseling and testing
• Screening patients for opportunistic infections
• Conducting supervision
• Educating women
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 Program Components…
• Outputs
– Are the immediate products of the inputs utilized and
program activities conducted
– Examples:
• Number of patients treated
• Number of clients counseled
• Number of condoms distributed
• Number of HIV tests carried out

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 Program Components…
• Outcomes
– Benefits that individuals, groups, communities realize.
– The change that occur on the target beneficiaries due to
program output.
– such as changes in knowledge, attitudes, beliefs, skills,
behaviors, access, policies, and environmental conditions
– Examples:
• Increase of condom use
• Improvement of quality of healthcare
• Reduction of risky sexual behaviors

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 Program Components…
Impacts
– Long-term results of one or more programs over time,
such as changes in HIV infection, morbidity, and
mortality
– Examples:
• Reduction in incidence of HIV infection
• Reduction of HIV/AIDS mortality
• Improvement in quality of life of patients

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 INDICATORS
Development & selection for M&E

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indicators are:
 A variable or summary of variables that
Measures key elements of a program or project
 Indicators provide critical M&E data at every
stage of program implementation
 Inputs, process, outputs, outcomes and
impact

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Indicators are signals which show;
 Whether we are on the right track & direction,
 How far we have progressed
 How far we still have to go to reach our
objectives

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 Types of indicators
 Indicators could be classified based on different
aspects:
 Relationship with the subject of interest
 The nature of information they provide
 The component of a program they measure

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 Types of indicators con’t…
 Based on their relationship with the
subject of interest

• Direct indicators

• Indirect indicators

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 Types of indicators con’t…
Direct indicators
 Are indicators directly related to the subject
intended to be measured
E.g. Proportion of children vaccinated in X district is
direct measure of EPI program output

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 Types of indicators con’t…
Indirect indicators
 They speak about a subject of interest only indirectly
 are used to measure change or results where direct
measures are not feasible
– Example:
• Client satisfaction may be used to measure the quality of
service

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 Types of indicators con’t…
 Based on the nature of information,
indicators could be classified as

– Quantitative indicators
– Qualitative indicators

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 Types of indicators con’t…
Quantitative indicators
 Are indicators which are measured numerically
 Include counts/frequencies, ratios, percentages,
rates, averages
Example
• Number of patients treated
• Prevalence of HIV

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Types of indicators con’t…
Qualitative indicators
 Are indicators which are measured non-
numerically
 Usually applied when quantitative indicators are
not applicable
 are more subjective than quantitative indicators
Example
• Cleanliness of a hospital

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 Types of indicators con’t…
• Based on the component of a program the indicator measures,
indicators could be classified as:
1. Input indicators: Measures the actual use of resources
2. Process indicators: Measures the activities performed
3. Output indicators: Measures what is accomplished with inputs
4. Outcome indicators: Measures the direct and immediate impact
5. Impact indicators: Measures the indirect and longer-term impact

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INPUT PROCESS OUTPUT OUTCOME IMPACT
• Human and • Conduct one • Providers •Increased use • Reduced
financial PMTCT training trained in of PMTCT perinatal
resources workshop in PMTCT services transmission
each district service of HIV
for providers provision
Indicator: percent of
infants HIV- born to
Indicator: # of providers who have HIV+ women
completed clinical training
Indicator: percent of HIV+
Indicator: % of pregnant women who are women receiving a complete
HIV tested course of ARV prophylaxis

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 Features of Good Indicators
• Valid: accurate measure of a behavior, practice or task
• Reliable: constantly measurable in the same way by
different observers
• Precise: operationally defined in clear terms
• Measurable: measurable using available tools and
methods
• Timely: provides a measurement at time intervals in
terms of program goals and activities

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 Data sources to measure Indicators

• Using Pre-Defined Indicators

 Surveillance
 Routine service reporting
 Special program reporting systems
 Administrative systems
 Vital registration systems
 Facility surveys
 Household surveys
 Censuses
 Evaluation and special studies
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 Decision making

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At the end of the session students be able:

• Define decision making

• Describe the relationship b/n decision making and other

functions of mgt

• Describe categories of decisions

• Decision making steps

• Identify factors influencing problem solving & decision

making
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 Decision Making . . .
Decision-making: the process of identifying and selecting a
course of action to solve a specific problem.
Decision making is a major part of management because :
• When planning, organizing, staffing, leading, and controlling,
managers make decisions on a daily basis.
• It requires choosing among alternative courses of action.
Decisions must be made at many levels in an organization from
executive decisions on the goals to the day to day repetitive
operations performed by lower level managers.

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Interrelations of the mgt process functions
Planning

Controlling Organizing
Decision
making

Leading Staffing

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 Decision making….

The formal decision making process may be described in 7 steps:

1. Identifying and defining the problem

2. Identifying limiting factors

3. Developing potential alternatives

4. Analyzing the alternatives

5. Selecting the best alternatives

6. Implementing the decision

7. Establishing monitoring and evaluation system

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 Decision making….
Types of decisions
1. Ends-means
• Ends: decision making based on our objectives/outputs
• Means: decision making based on our Strategies /operational
programs/and activities
2. Administrative-operational
• Administrative decisions: made by senior managers
“Policy decisions”
Resource allocation and utilization
• Operational decisions: made by mid-level and first-line managers
Day-to-day activities, e.g. personnel placement, purchases,
specific work assignments
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 Decision making…

3. programmed – non-programmed

• Programmed decisions are elements of some decisions which are

similar and made so often repetitive and routine.

Includes procedures, rules and manuals. E.g. patient admission,

scheduling, inventory and supply ordering

 Non-programmed decisions are unique and non-routine and may

have unclear implications for the organization, requiring creative
problem solving because they are unfamiliar.

E.g. Decision to expand, add or closes services

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Ways of decisions making
1. Individual decision making:
Depends on :
 Style of the leader
Ability to set priorities
Timing of decision
Creativity of the manager
2. Group decision making:
Process of solving problems jointly
It plays a key role in health care management

E.g. task force

Especially very important in non-programmed decision making.
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 Outcomes of group decision making
• Uncertainty: failure to decide (disagreement)

• Authority rule: decision by the team leader

• Minority rule: decision dominated by few influential individuals.

• Majority rule: the majority agree

• Consensus: immediate agreement without thorough discussion

• Agreement: agree after through discussion and argument

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Think twice before you decide!!

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