Monitoring and Evaluation

To maintain oversight and promote program accountability to the defined priorities of a health system or objectives of a specific initiative, a strong monitoring and evaluation (M&E) component should be built-in to the program from the start. In the context of health programs, M&E is essentially the process by which specific health indicators are analyzed to measure the impact of the program on the target population and identify gaps in program implementation. Appropriate use of data gathered through M&E activities can guide actions at all levels of health system—from formulating national health policies to day-to-day decision-making within community health centers, even households—to help to ensure that health interventions have the greatest impact possible and can be taken scale. Other basic M&E functions include: documenting program results to provide accountability, for example to donors and ministries; contributing to the evidence base on high-impact health interventions; and strengthening health information systems.

Factors that help determine the overall success of M&E work include:

  • Collective action:  Keeping primary focus on the contribution of the collective efforts to scale-up the health sector response in countries.
  • Alignment with country processes: Building upon the national processes countries have established to monitor and evaluate the progress of implementation of national plans.
  • Balance between country participation and independence: Being driven by country needs but aiming to maintain independence of evaluation.
  • Harmonized approaches: Using common protocols and standardized outcome indicators and measurement tools, with appropriate country adaptations.
  • Capacity building and health information system strengthening: Systematically involving country institutions.
  • Adequate funding: Setting funds aside for monitoring, performance, evaluation, and operational research and strengthening health information systems.