MCHIP measured its Program results to provide accountability to donors and Ministries of Health and to inform its Program operations. Each MCHIP country or regional program with at least $500,000 of annual funding developed a Performance Monitoring Plan (PMP) tailored to that program’s needs and approved by the local USAID Mission or Regional Office. PMPs were included in countries’ workplans and provide a road map for how the programs would measure and report their results.
As MCHIP country programs developed their own PMPs, they were expected to abide by the monitoring and evaluation (M&E) principles and ensure that their objectives, planned results, and core indicators were aligned with the local USAID Mission’s Strategic Plan, Ministry of Health priorities and systems, and MCHIP global objectives and expected results. Indicators in common with the MCHIP global M&E framework were aggregated and reported to USAID/Washington on an annual basis. Countries also reported on the indicators in their PMP to their local USAID Mission on an annual basis.
Information produced through MCHIP country M&E systems was intended to meet the multiple needs and objectives of MCHIP to generate high-quality data to inform programmatic decision-making and report progress to stakeholders, build capacity of in-country partners, and contribute to the maternal, newborn and child health (MNCH) evidence base.
Strengthening Health Information Systems
At the country level, MCHIP M&E systems relied on existing health information systems to the extent possible rather than introducing new parallel information systems. An important M&E data source for many MCHIP country programs was the Ministry of Health’s national Health management information system (HMIS). MCHIP aimed to strengthen elements of the HMIS in countries working to improve the quality of MNCH care in facilities and/or communities and/or where the program was contributing to health systems strengthening efforts.
MCHIP worked to improve national HMIS by:
- Working with stakeholders to incorporate evidence-based MNCH indicators into client records (such as antenatal care [ANC] cards and maternity charts), facility registers/logbooks (family planning registers, ANC registers, maternity registers, postnatal registers) and registers used by community health workers (such as Health Surveillance Assistants in Malawi and Community Counselors in Bangladesh).
- Training health workers in how to use existing and new recordkeeping forms (Nigeria, Malawi, Bangladesh, Mozambique).
- Training health workers in how to aggregate and display health service statistics data (India, Nigeria, Malawi, Bangladesh, Mozambique).
- Revising district health management team supervision forms and training supervisors on how to use the forms and data for decision-making (India, Nigeria, Mozambique, Rwanda).
- Advocating at the national, regional and district/state levels for revision of HMIS forms (Nigeria, Malawi, Mozambique).
Building the Capacity of MCHIP Staff and Collaborators in Monitoring, Evaluation and Research (MER)
An important aspect of MCHIP’s M&E approach was to help build the capacity of its own M&E and program staff and collaborators in country to conduct MER activities. For example, as part of its efforts to strengthen HMIS, MCHIP built the capacity of health facility staff and supervisors to accurately record data, aggregate and display data, and use data for decision-making. When implementing special studies and evaluations, such as the Quality of Care MNC studies, MCHIP worked with Ministry of Health counterparts, clinical trainers, local research agency staff, CSHGP grantees and/or others in-country with an eye to improving MER knowledge and skills.
To build the capacity of its own M&E staff and share M&E best practices, MCHIP co-hosted with Jhpiego a five-day global M&E workshop in Kenya in May 2011. MCHIP staff had the opportunity to be trained in MCHIP/Jhpiego’s new enterprise-level results information system for excellence (RISE), which served as the Program’s new online information system with data repository, analysis, and charting and mapping capabilities.