Professional Documents
Culture Documents
Indicators
M&E Indicators:
Module Objectives
• Examples of measures
– Days of drug stock outs
– Total Fertility Rate
– Indicators related to Poverty Reduction Strategy
Characteristics of
Good Indicators: Timely
Provides a measurement over periods of time of
interest
with data available for all appropriate intervals
• Timeliness Considerations
– Reporting schedules
– Recall periods
– Survey schedules
– Length of time over which change can be detected
Characteristics of Good Indicators:
Programmatically Important
Linked to a public health impact or
to achieving the objectives needed for impact
• Challenges
– Subjective judgment
– Local conditions
– Unclear yardsticks
Common Indicator Metrics
• Counts
– Number of providers trained
– Number of condoms distributed
• Calculations: percentages, rates, ratios
– % of facilities with trained provider
– Maternal mortality ratio, Total fertility rate
• Index, composite measures
– Quality index comprising the sum of scores on
six quality outcome indicators
– DALY (Disability Adjusted Life Years)
• Thresholds
– Presence, absence
– Pre-determined level or standard
Anatomy of an Indicator Metric
Indicator 1: # of ANC care providers trained
“providers” include any clinician providing direct clinical
services to clients seeking ANC at public health facilities
“trained” refers to attending every day of a five-day
training course offered by the program
Indicator 2: % of facilities with a provider trained in ANC
Numerator: # of public facilities with a provider who
attended all 5 days of ANC training offered by the
program
Denominator: total # of public facilities providing ANC
services
Always Specify the Details!
Threshold indicator for post-abortion family planning
• Facility provides post-abortion FP if
– 90% PAC clients received FP counseling
– 90% PAC clients who want no more children were informed
about sterilization services
– Facility has all of 6 relevant IEC materials
Composite Indicators
• How to measure, “Infection Prevention at facilities providing
obstetric care” ?
Could construct an index, have various measurement options:
– “Facility Readiness,” from facility audit
• Has regulation sharps container
• Up to date guidelines on hazardous and medical waste
disposal
• Leak-proof lidded container for medical waste, etc.
– Knowledge, from Provider interview
– Practice, from Provider-client observation
Issues with Composite
Indicators
• How to “scale” the index
– Weighted v. un-weighted components
– Value of each component: yes/no,
present/absent, count of sub-components
(e.g., drugs in stock)
– Zero/one total indicator value? % of
maximum possible score? At least 8 out of
10 positive (=1) scores?
– How to interpret and report?
Example of Composite Indicator:
Proper Disposal of Medical Waste
Percent of Facilities
100
80 74
69
64 64
60
39 41
37
40
27
23
20 15
0
Infection Regulation Leakproof, lidded Lidded plastic All Items
Prevention or Container for container for bucket for CL Available
Hazardous disposal of Medical Waste solution
Waste Protocol sharps
Government Private
Sources of Indicators:
Using Pre-Defined Indicators
• From past years of the program
• From related or similar programs
• From lists of global or recommended
indicators
– Millennium Development Goals
– HIV/AIDS: UNAIDS/WHO
– Reproductive Health: Compendium of Indicators
for Evaluating Reproductive Health Programs
– Poverty Reduction Strategy Goals (World Bank)
Indicator Pyramid
Decreases
Global Number of
Compare countries
Overview world-wide situation Indicators
Increases
National/Sub-national
Assess effectiveness of response
Reflect goals/objectives of national/sub-national response
District or Facility
Identify progress, problems, and challenges
Indicator Matrix
Outputs
• Bertrand, Jane T., Magnani, Robert J, and Rutenberg, Naomi, 1996. Evaluating
Family Planning Programs, with Adaptations for Reproductive Health, Chapel
Hill, N.C.: The EVALUATION Project.
• Bertrand, Jane T. and Escudero Gabriela, 2002. Compendium of Indicators for
Evaluating Reproductive Health Programs, vols. 1 and 2, Chapel Hill, N.C.:
MEASURE Evaluation.
• Tsui, Amy. 1998. Frameworks (ppt). Presented at the Summer Institute,
University of North Carolina, Chapel Hill.
• Tsui, Amy. 1999. Frameworks (ppt). Presented at the Summer Institute,
University of North Carolina, Chapel Hill.
• UNICEF. 1998. State of the World’s Children.
• USAID/Tanzania Country Strategic Plan, 2005-2014.
• WHO, 1999. The Evolution of Diarrhoeal and Acute Respiratory Disease
Control at WHO: Achievement 1980-1995 Research, Development and
Implementation (WHO/CHS/CAH/99.12).
Group Project
• Form groups
• For your project:
– Identify indicators and define metrics
– If frameworks are not finished, continue working on
frameworks
– For two indicators, complete indicator reference sheet