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Webinar: Developing Gender-Sensitive M&E Systems

DevelopingGenderSensitiveMESystems-webinar

Join MEASURE Evaluation for a webinar on developing gender-sensitive monitoring and evaluation (M&E) systems. The webinar will take place August 3 at 11:00am EDT and will be led by MEASURE Evaluation’s Samantha Herrera and Debra Prosnitz.

The important role gender plays in health and overall development has been increasingly recognized in the past decade. This recognition includes several global and US policies and strategies being developed to guide international health and development programming with the aim of addressing gender inequities as a key strategy in attaining improved health and development outcomes. With these important shifts in policy, program design, and interventions comes the need to adapt and align our M&E systems—and more broadly, country health information systems—to capture data to track progress on the implementation of gender strategies, to assess their effectiveness, and inform decisions on how to continue to best implement gender-sensitive health interventions and programs.

In this webinar, the presenters will discuss the importance of applying a gender lens to M&E processes and structures and how to think about gender in the context of the development of an M&E system. We will walk participants through how to think about and address gender in each of the main components of an M&E system, and we will provide guidance on how to integrate gender-specific questions and how to plan and conduct an M&E system assessment. The main aim of this work and the guidelines the presenters have developed is to help build gender-sensitive M&E systems that are able to adequately collect, analyze, and use gender data for improved healthcare decision making.

Access the related Guidelines for Integrating Gender into an M&E Framework and System Assessment, also available in French.

Register to attend the webinar.

Health Information System Performance Monitoring Tool – A Source of Evidence to Help National Authorities Prioritize HIS-Strengthening Interventions

fs-17-213The Health Information System Performance Monitoring Tool (HISPMT) provides evidence to help national authorities prioritize interventions to strengthen health information systems (HIS).

The HISPMT guides HIS managers through a systematic review of the main HIS data sources and provides an objective appraisal of the alignment of each data source with relevant national and international standards. Conducting this kind of review across data sources is important, because countries need data from sources both within and outside the health sector to monitor their health systems, and they also need objective evidence as a basis for prioritizing HIS strengthening investments. The HISPMT can be administered periodically to compare results and monitor the strengthening of the HIS over time.

The HISPMT automatically evaluates the results from the completed modules and the indicator mapping. The summary score for each data source and the relative demand on each data source are plotted on a scatter plot. Presenting the results on the scatter plot allows decision makers and other interested parties to see at a glance how well data sources are performing and the demand for data from each.

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Building Capacity for Resilient Health Systems – Lessons Learned from Sierra Leone, Guinea, and Liberia in the Time of Ebola

tr-17-158In the wake of the Ebola outbreak, the United States Agency for International Development (USAID)-funded MEASURE Evaluation implemented health systems strengthening interventions, all with a strong capacity building (CB) component, in Liberia, Sierra Leone, and Guinea. All three interventions consisted of an assessment followed by strategic planning. Two technical advisors from MEASURE Evaluation were embedded in these countries’ health ministries for three months to implement the assessment and strategic planning. This effort was followed by virtual technical assistance (TA).

The uniform approach used across the three countries presents a unique opportunity to compare and contrast the experience of CB in different countries. This comparison is of particular interest, because a MEASURE Evaluation-wide capacity building policy that promotes this same process—an assessment followed by action planning—was recently enacted for all CB efforts.

The purpose of this report is to provide insight into strategies for CB for resilient health systems, by documenting and comparing the experience of capacity assessment followed by strategic planning in Guinea, Sierra Leone, and Liberia. Information was gathered from key informant interviews with MEASURE Evaluation staff and supplemented by an extensive desk review of MEASURE Evaluation’s internal documentation.

Lessons learned consisted of insights into the importance of assessing and planning for CB, the value of stakeholder engagement within that process, ideas for planning for the transition of responsibilities from MEASURE Evaluation to the ministry of health, the need for realistic scopes of work, and the value of implementing such an intervention during a time of crisis. Implementing an assessment of the health information system—including both system and staff capacity—in each country allowed the rest of the process to be tailored to that country’s needs. This allowed for each country to plan for systematic CB going forward.

By engaging stakeholders throughout the process, these strategic plans are more likely to find champions in the countries and to be implemented after MEASURE Evaluation’s activities end. Different transition experiences in each country imparted valuable knowledge about various aspects of these handoffs. These experiences were part of a larger lesson involving intervention in a time of crisis. Crisis situations present urgent staffing challenges and role changes are needed to address emergent issues quickly. This type of instability can make any intervention difficult to implement, but is especially challenging for CB efforts that rely on the presence of specific people within a health system in order to move forward.

These lessons provide important information to guide future CB efforts. The importance of systematic CB—including assessment and planning—further validates best practices at MEASURE Evaluation and elsewhere. Given the global focus on human resources for health—of which CB is an important part—and health systems strengthening, we hope that these insights will also be of use outside of the project.

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Monitoring and Evaluation Toolkit for the Scale-Up of Emergency Obstetric and Newborn Care (EmONC) in Kenya

emoncThe call to address the high rates of maternal and newborn mortality has received unprecedented support from governments and development partners over recent years. Increased investments in programs targeting maternal and newborn health have fueled demand for reliable and timely data to promote the rational allocation of resources where the burden of deaths is greatest. In Kenya, the Ministry of Health and county governments have committed to ensuring universal access to emergency obstetric and newborn care (EmONC). The United States Agency for International Development (USAID) is a major partner of the Government of Kenya (GOK) in the effort to increase the national coverage of EmONC under its Ending Preventable Child and Maternal Deaths Strategy.

EmONC is an integrated strategy developed by the World Health Organization (WHO), the United Nations Population Fund (UNFPA) and the United Nations Children’s Fund (UNICEF) that aims to equip health facilities with the capacity to provide evidence-based, cost-effective interventions to attend to the leading causes of maternal and newborn mortality. Two levels of care are recognized under this approach: basic (BEmONC) and comprehensive (CEmONC). BEmONC, provided at primary care facilities such as dispensaries and health centers, has seven essential medical interventions, known as signal functions. CEmONC, provided at hospitals, covers the seven BEmONC signal functions plus two more.

The toolkit incorporates experiences from the first two phases of the national EmONC scale-up exercise launched in July 2013. The national scale-up of the monitoring and evaluation (M&E) of EmONC was based on the theoretical framework drawn from the Donabedian model, which categorizes quality of care in three interlinked unidirectional dimensions: (1) structure, (2) process, and (3) outcome. Through periodic assessments of health facility capacity to provide the EmONC signal functions, it is possible to infer the progressive capabilities to reduce maternal and newborn mortality.

This toolkit is the result of collaborative work by MEASURE Evaluation PIMA, USAID, the Maternal and Child Survival Program (MCSP), University Research Company/ASSIST, APHIAplus, AMPATH PLUS implementing partners, the Ministry of Health (MOH), and county health management teams targeted in the initial phase of the national scale-up of BEmONC.

This toolkit is intended primarily for county M&E officers, reproductive health coordinators, and other members of county health management teams and partners involved in implementing EmONC. It is also useful for national M&E officers and other professionals and donors who are involved in maternal and newborn health programs.

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Using Routine Data to Improve Antiretroviral Treatment Retention: Examples and Lessons Learned from the Literature and Experts in the Field

sr-17-141As is almost always the case, the key to helping people be healthy lies with people. In the case of increasing retention in antiretroviral therapy (ART), one key is a strong cadre of community health workers, empowered by a staff of data managers who provide quality data and good data analysis.

Good-quality data and better use of them are the low-hanging fruit to achieve retention on ART—because we can do that now.

All this may sound simple. It’s not. Harnessing data to increase ART retention involves a diverse set of skilled practitioners, motivated to collect, analyze, and use routine health facility data. It also requires quality controls for data, sharing data across systems, and the support of country health-program managers and facility staff to sustain achievements.

This document summarizes the three main ways that routine data are currently used to improve adult ART retention in low-resource settings, challenges to their use, and recommendations on how to strengthen data use for improved HIV outcomes.

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Investigating Risky Sexual Behaviours among Youth in the Context of the HIV Epidemic in Mbeya Region, Tanzania

risky-behav-tzMitigating HIV and AIDS among youth has been a major policy agenda both internationally and nationally, within Tanzania. Two concerns associated with mitigation efforts are increasing sexual activity at young ages and a burgeoning population of out-of-school youth whom poverty, lack of supervision, and unemployment seem to push into alternative life patterns that present risks to their health. This situation poses a serious challenge for Tanzania, where half the population is categorized as young.

The study focused on 54 individuals (27 males and 27 females) from three identified categories: youth ages 15–24 years old (30 respondents); gatekeepers (16 respondents); and health service providers (8 respondents). Data collection involved qualitative techniques: in-depth interviews (IDIs), focus group discussions (FGDs), and document review.

The majority of youth studied had heard about HIV and its related effects; however, condom use, and attendance at SRH services is very low among this population. The government, parents, nongovernmental organisations (NGOs), religious institutions, and health service providers play a role in addressing risky sexual behaviours among youth. Parents have some responsibility for engagement by youth in risky sexual practices: poor marital relationships and instability in the home, supervising their children poorly, failing to communicate with their children about HIV and prevention, and putting their children in unsafe and vulnerable situations. However, many other factors contribute to participation by youth in risky sexual practices.

Despite increased government and NGO measures against HIV and attempts to minimise youths’ vulnerability to the disease, the community still does not fully support these efforts, and youth behaviour change remains a challenge. The study recommends that the Tanzanian government remain engaged and demonstrate leadership by effectively contributing to initiatives that address the HIV epidemic and create an environment supportive of access and use by youth to SRH services.

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Family Planning Programming in Kenya

To reduce the burden of unwanted pregnancies and the risk of maternal deaths of teenage mothers from unsafe abortions, more effort is required to address the high unmet need for contraceptives among youth and adolescents.

For county-specific information see Murang’a County Family Planning – January to June 2016Migori County Family Planning – January to June 2016, and Kilifi County Family Planning – January to June 2016.