Data Demand and Information Use:

Using Data to Inform

Policies, Programs and Services

June 12, 9am

Session Objectives

 Raise awareness of the importance of using data

to inform decisions through examples of data use
 Discuss and share strategies for
 overcoming barriers
 ensuring that health-related data are being used to
make decisions at all levels;
 Discuss and learn strategies for using data in
program management, implementation, and
decision-making.
Session Outline

 Importance of monitoring and evaluation

 Possible uses of data and information
 Barriers to data and information use
 Tools to facilitate the use of data to inform
decision-making
 Discussion of information use in Nigeria
“… without information, things are done arbitrarily and
one becomes unsure of whether a policy or program
will fail or succeed. If we allow our policies to be
guided by empirical facts and data, there will be a
noticeable change in the impact of what we do.”

National-level Policymaker, Nigeria

Evidence-based decisions lead
to better health outcomes
Purposes of monitoring and evaluation

 Determine whether a plan or program is on

schedule with planned activities
 Assess whether a policy, plan or program has
produced desired impacts
 Generate knowledge:
• Identify factors (individual, community,
programmatic) that influence health outcomes
 Help inform policy, planning or program
decisions: new services, resource allocation,
corrections, etc.
M&E is not an enemy

 Policymakers, program managers and

M&E/Strategic Information specialists can be
partners
 Strong decision-making and management relies
on high quality M&E / strategic information
 Data quality is linked to data use
Brainstorm Activity

How do you and your

organization use data and
information?
We can use information to…
 Inform policies and plans
 Raise additional resources
 Strengthen programs and improve results
 Ensure accountability and reporting
 Improve quality of services provided
 Contribute to global lessons learned
 Policy to Program Operations

Declining school enrollment

among children orphaned or
made vulnerable by HIV/AIDS
 Policy to Program Operations

Declining school enrollment…

Revised national policy on

educational support for MVC
 Policy to Program Operations

Declining school enrollment…

Revised national MVC policy

National budget line item for

educational support for MVC
 Policy to Program Operations

Declining school enrollment…

Revised national MVC policy

National MVC budget

• Select priority districts

 Budget allocations for each
district
 Policy to Program Operations

Declining school enrollment…

Revised national MVC policy

National MVC budget

• Select priority districts

Select local organizations and

design activities
 Policy to Program Operations

Declining school enrollment…

Revised national MVC policy

National MVC budget

• Select priority districts

Select local organizations

• Train community workers

• Identify households
• Implement activities
 Policy to Program Operations

Declining school enrollment…

Revised national MVC policy

National MVC budget

• Select priority districts

Select local organizations

• Implement activities

• Monitor progress
• Identify problems
 Policy to Program Operations

Declining school enrollment…

Revised national OVC policy

National OVC budget

• Select priority districts

Select local organizations

• Implement activities

• Monitor progress

Modify budgets, activities

 Decisions and Information Flow

Declining school enrollment…

Revised national OVC policy

National OVC budget

• Select priority districts

Select local organizations

• Implement activities

• Monitor progress

Modify budgets, activities

 “Making Data Speak” in Thailand
 Decisions: Strengthen commitment of policy makers to HIV
Prevention
 Data: Behavioral and epidemiological data
 Response:
 Analyzed data with Asian Epidemic Model and Goals model
 Determined responses and resources needed
 Communicated data to stakeholders
 Results:
 Successfully emphasized prevention agenda in national
strategic plan and developed "UA operation plan"
 Now working to mobilize resources
Using NNRIMS data to inform resource
allocation
 HIV/AIDS M&E focal person for LACA in
Doma, Nassarawa State, submitted NNRIMS
quarterly report to LGA Chairman;
 53 people in Doma tested HIV positive in the
first quarter of 2006;
 Chairman procured 480 HIV Test Kits to be
distributed through 4 local health facilities,
enabling more people to get tested in Doma.
Using information in Tanzania
Diagnosis
 Low use of PMTCT services
Decision
 Publicize the list of service locations
Data and Information
 New study showed that most people did not believe it
was possible to prevent mother to child transmission
of HIV
Alternate decision
 The MOH decided to implement a mass media campaign
to convince population that it is possible to prevent mother
to child transmission
Data Demand & Information Use
Demand for Data and Information

 Demand refers to the value the decision-

maker places on the information, whether or
not he/she actually uses the information
 We say the decision-maker demands
information if he/she
 Understands what information is needed to
make the decision, and
 Proactively seeks out the information he/she
needs.
Information Use

 Use refers to the decision-making process

 We say the decision-maker uses information if
he/she
 Is explicitly aware of the decision to be made,
 Considers at least two possible courses of
action, and
 Considers relevant information in making the
decision, even if the information is outweighed
by other factors.
Conceptual Framework
 Barriers to Data and
Information Use

What barriers have you faced to using or

getting others to use data and
information?
Data are often underutilized
because of…
 Organizational structures
 Lack of a “data culture” among decision makers
 Low staff motivation
 Lack of technical skills and technology,
particularly at local levels
 Training often ad hoc and not sustainable
 Structural constraints– roads, telecommunication
 Unclear staff roles and poor flow of information
 Poor funding for M&E
 Political interference
 What Determines Data and Information
Demand & Use?

CULTURE
SYSTEMS TECHNICAL
APPROACH APPROACH

POLITICS INDIVIDUAL SOCIETY

BEHAVIOR

Decision making occurs within political, cultural, and social contexts

 Information is used to make
diagnoses and inform decisions

What do we do next?
What information do we need?
 How can we ensure that
information is being used to make
diagnoses and inform decisions?
Context of decision-making

Information

Decision-
Decisions
makers

How?
Context of decision-making

Information

Decision-
Decisions
makers

How?
Who can use data and information?
Who are your stakeholders?

What can they do with your data

and information?
Stakeholders
 Government
 Donors
 Implementing Agencies
 Non-governmental organizations
 Beneficiaries
 Program Managers
 Service providers
 Policy Makers
 Journalists/Media
 Private Sector
Implications for Data Use and
Communication
 Different stakeholders
 view activities from different perspectives

 have different degrees of understanding

 need/want different information

 need information at different levels of complexity

 have different intensities of interest

Context of decision-making

Information

Decision-
Decisions
makers

How?
Decisions
Facilitate use of data by stakeholders

 Policies and plans

 Program design and planning

 Program management, improvement

and operations
Policies and Plans

 Advocate for new policies and plans

 Select priorities for strategic plans

 ….
 Can you provide other examples?
Program Design

 Select messages for prevention

campaigns
 New strategies to increase coverage

 ….
 Can you provide other examples?
Management & Operations

 Training and supervision of program

staff
 Logistics and supply management
 ….
 Can you provide other examples?
 Factors other than evidence-based
information influence decisions

 Power relationships  Arbitrariness

 Timing  Local culture of
 Competing priorities decision-making
 Public opinion  Other information
 Political ideology sources
Examples of decisions made without
adequate consideration of information

 Setting targets for ARV coverage

 Location of facilities
 Procurement of drugs
 Procurement of supplies/test kits
 OVC programming
What do they need to know?

Decision-
Decisions
makers
Data and Information
 Census
 Vital events data
 HIV/AIDS, TB, Malaria surveillance data
 Household surveys
 Facilities level service statistics
 Mapping of health facilities and services
 Behavioral surveillance
 National health accounts
 Financial and management information
 Modeling, estimates and projections
 Health research
Different Needs for Different
Stakeholders: Program Managers & Staff
What M&E measures: What decisions are guided
by M&E results:
 Quality of activities and/or services
 Resource allocation
 Why some sites are more successful
 Replication and scaling up of
 Program coverage intervention
 Fund-raising
What M&E results identify:  Motivating staff
 Priorities for strategic planning  Policy advocacy
 Training and supervision needs
 How to improve reporting to funding
agency
 Feedback from clients
 Why program is not accomplishing
what it set out to do
Different Needs for Different Stakeholders:
Funding Agencies & Policy Makers
What M&E measures:
 Evidence of achievement of program
objective
 Program outcome and impact
 Program cost-efficiency
 Data about the target population
What M&E results identify:
 Priorities for strategic planning
 Programs that qualify for donor
assistance
 Best practices
 Impact of donor assistance
 What decisions are
guided by M&E results:
 How much funding should be
allocated to a program
 What types of programs
should be funded
 Which programs approaches
should be presented as
models
 New strategic objectives,
activities or results packages
 Replication and scaling up of
successful programs
Different Needs for Different Stakeholders:
Communities & Youth
What M&E measures: What decisions are
 Youth behavior related to reproductive health guided by M&E
results:
 Young peoples’ needs
 Degree to which
 How program funs are being spent community members and
 The process and impact of community youth should participate
participation in and support the
program
 How to better coordinate
What M&E results identify: community actions to
 Actual and potential benefits of youth address ARH
programs  How many and what type
 Need for new and better youth services of local resources should
be allocated to ARH
 Community resources that can be used to
support ARH programs
 Need for local support for ARH issues and
actions
Different people need information for
different kinds of decisions

Engage in dialogue with stakeholders to fully

understand the
 decisions they make,
 information they need, and
 best way to present that information.
Decision Calendar
 Purpose
 To help explicitly and systematically align decisions
with appropriate data resources

 Description
 Helps identify and prioritize key decisions and the
information needed
 Timeline for monitoring the decision-making
process
Part A. Policy, planning and advocacy decisions

Decision Frequency Decision-maker and Required information Next steps Timeline

other stakeholders

Incorporate demand One time Permanent Secretary, Ministry Analysis of Information, Review draft Review policy
creation for family of Health Education and Reproductive Health draft August-
planning in the new Family planning non- Communication (IEC) Policy and identify November 2005
Reproductive Health governmental organizations trends from the places to insert Publish final
Policy (NGOs) and donor agencies Demographic and Health recommendations for Reproductive
Surveys (DHS) demand creation. Health Policy in
Revised IEC and Advocacy February 2006
Strategy

Part B. Program design and improvement decisions

Decision Frequency Decision-maker and Required information Next steps Timeline

other stakeholders

Convene conference One time Division of Reproductive Analysis of CBD trends Prepare a concept Complete concept
to review community- Health, Ministry of Health from the DHS surveys paper for the paper January
based distribution Family planning NGOs and Inventory of current CBD conference. 2006
(CBD) strategies for development partners programs Mobilize resource to Convene
Kenya Studies on cost and hold the conference. conference
benefits of CBD programs October 2006

Part C. Program management and operations decisions

Decision Frequency Decision-maker and Required information Next steps Timeline

other stakeholders

Finalize agreement One time Development partner: Japan Analysis of IEC trends Prepare detailed Negotiations from
with development (on contract International Cooperation Revised IEC and Advocacy project agreement August-December
partner on the renewal, every Agency (JICA) Strategy and implementation 2005
Population Education three years) Division of Reproductive plan. Signed agreement
and Advocacy Project Health, Ministry of Health Finalize negotiations in December 2005
Family planning NGOs with JICA.
Kenya Institute of Mass
Communications
Working Toward a Culture of
Information
 Commitment and support for high quality data and
information use at all program levels
 Depends on objectivity and a willingness to be self-
critical
 Sharing information between levels in info system
 Information becomes an integral part of decision
making processes, including planning, problem solving,
choosing alternatives, feedback, etc.
 Empowers people to ask questions, seek improvement,
learn, and improve quality through useful information
To sum up
In order to make information useful, we need:
 To engage others to discuss what decisions they make
and what information they may find helpful.
 Understanding of how programs work, how they collect
and report information.
 Training and supervision to support reporting and
documentation.
 Common understanding among those who deliver
services and report on them, those who analyze the
data and those who need the information.
Key Messages
 Decisions based on evidence lead to better health outcomes
 We all have a role in M&E – partners in progress
 Involve new counterparts beyond M&E specialists
 High quality information is needed for decision-making at
policy, planning and program levels
 Purpose of M&E is not just to produce more information but
to improve action
 Investments made to improve information systems will be
wasted if it is not used to inform policy and program
decisions
 THANK YOU!
MEASURE Evaluation is funded by the U.S. Agency
for International Development (USAID) through
Cooperative Agreement GPO-A-00-03-00003-00 and
is implemented by the Carolina Population Center at
the University of North Carolina in partnership with
Futures Group, John Snow, Inc., ORC Macro
International, and Tulane University.

Visit us online at http://www.cpc.unc.edu/measure.

Small Group Work

 Assessment of Barriers to Data Use

 Brainstorm possible barriers – use tool to probe
 Complete matrix on “Addressing Barriers”
 Decision Calendar
 Consider decisions that