Chapter Fourteen

Community Health Planning, Monitoring, and

Evaluation
• CHNs plan programs, redesign existing services, monitor
implementation and evaluate impact

• Program planning and evaluation frameworks guide the types of

information that are assembled and the organization of information into
a coherent plan

• Impacts are the longer-term results of a program, often taking some

years to achieve

• Outputs indicate that a program is being implemented as planned

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• Authentic engagement of the community in planning, monitoring, and evaluating
community health programs is essential in addressing social determinants of health

• Determinants do not reside in isolation from each other; are nested/inter-related; as

one determinant changes, another may also shift

• The determinants of health approach recognizes the need to implement population

health interventions at multiple levels of the system

• Research to uncover the social determinants include etiological and laboratory

studies, integrative reviews, qualitative and quantitative

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• The classic planning-implementation-evaluation cycle: conduct a community
assessment; identify problems; consider solutions; select best alternatives; design,
implement, monitor and evaluate the program; analyze and interpret results; and
make modifications

• The steps in this cycle may need to be repeated

• Community health agencies have a standard planning framework for use across
departments

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• A logic model is a support to planning, analysis and evaluation preparation that
provides means of documenting “what the program is supposed to do, with whom,
and why” and offers a coherent structure for complex health programs, helps to
expose gaps, and yields a clear overview of programs

• Two planning stages in development of a logic model:

• CAT (components, activities, and target groups)
• SOLO (short-term outcomes and long-term outcomes)

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• It is important to look at ways to involve the community in the process of setting
priorities in beginning to more clearly define program components and activities

• The guiding principles for priority setting are buy-in, transparency, and communication
• Buy in: engaging community members and key stakeholders in discussing the problem
may help with buy-in but also runs the risk of backfiring if the priorities selected
suggest that community input and ideas were not considered
• Transparency: the process for selecting priorities is made apparent to those who were
not directly involved in the process
• Communication: one needs to communicate priorities to partners who have provided
input on the program

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• Increasingly, community health programs are targeting the complexity and root causes of
problems

• Multiple Intervention Program (MIP) Framework involves an iterative cycle whereby

emerging lessons from program implementation, and new research findings continuously
inform program adjustments

• Optimal application of the framework should be based on in-depth knowledge of the local
community (tacit knowledge)

• MIP framework consists of five main elements

• Identification of community health issue
• Describe socioecological features
• Intervention options
• Optimizing intervention strategies
• Monitoring and evealuating impacts, spin-offs, and sustainability

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 Chapter Fourteen
Community Health Planning, Monitoring, and
Evaluation
• In the final element, monitoring and evaluating program outputs, outcomes, impacts, spin-
offs, and sustainability are the central concern
• Outputs indicators are to be identified by looking at the critical steps that are required for
the program such as initiating community partnerships
• Outcomes are medium-term changes that can be attributed to the program with changes in
knowledge, attitudes, and behaviour among intended population
• Impacts outcomes are the longer-term results of a program and impact indicators should
be guided by what we know about effective interventions and the “dose” of intervention
expected to achieve a particular effect
• Spin-offs are unintended effects of a program and may be identified through reflective
approaches such as the maintenance of field notes
• Sustainability concerns the longer-term viability of program interventions that might be
evidenced when an intervention becomes part of the routine

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