Monitoring & Evaluation

This study sought to better understand how to sustain provider compliance with standards, using local (Mali) standards (on care for fever and structural quality). The intervention had two parts: a self-assessment instrument that providers used weekly to assess their performance with a feverish client and a review of that performance by a colleague who had observed the consultation. The study found that when used regularly, such an intervention can have a significant effect on compliance.

Research on the Integrated Management of Childhood Illness (IMCI) shows that it is a scientifically sound way to treat sick children, but ways to ensure that it is implemented properly are lacking. This 1997-98 study examined and compared three implementation approaches: structured feedback of performance data, structured feedback of performance data where quality improvement (QI) teams were in place, and the formal World Health Organization training in districts with QI teams.

This user’s guide contains materials needed to design and implement the Quick Investigation of Quality (QIQ) in a given country. QIQ refers to the set of three related data collection instruments designed to monitor 25 indicators of quality of care in clinic-based family planning programs. This volume includes an overview of the QIQ (including objectives, short list of indicators, and methodological and ethical issues), guidelines for sampling and training of field personnel, instruments and guidelines for data collection and summary results from short list of indicators (tabular and graphic forms).

Performance lmprovement (PI), a process pioneered in industry, is now helping to strengthen reproductive health organizations. PI focuses on meeting the needs of service providers and other staff members. When programs enable and inspire staff to do their best, the quality of care improves. [author’s description]


This Population Report covers how to: define desire performance, describe actual performance, measurs/describe performance gaps, find the root causes, select and implement interventions, monitor and evaluate performance and manage change.

This monograph provides an introductory overview of QA for developing countries. It will be of interest to policy makers, upper-level ministry of health (MOH) officials, and district-level health service managers. Part I describes how quality assessment and improvement have been carried out in less developed countries (LDCs). Part II discusses the feasibility and rationale for applying QA in the developing world. Part III proposes some definitions and dimensions of quality. Part IV reviews the definition and basic tenets of QA.

This monograph presents a conceptual framework to help healthcare systems and organizations analyze, plan, build and sustain efforts to produce quality healthcare. The framework synthesizes more than ten years of QA Project experience assisting in the design and implementation of QA activities and programs in over 25 countries. [author’s description]

The Quality Assurance Project investigated how job aids could increase compliance with guidelines for the Integrated Management of Childhood Illness (IMCI) in cooperation with the Zambia Central Board of Health beginning in 1999. One of the first countries to introduce IMCI, Zambia had a large number of IMCI-trained providers, and several IMCI job aids were already in use: a chartbook, recording form, poster, and mother card.

This tool permits countries to compare performance with objective standards for health information and provides the basis for evaluation of country health information systems. The tool consists of a standardized questionnaire through which the current status of the health information system is evaluated against specific criteria. The tool provides both a baseline asssesment, diagnosis of critical gaps in health information results, processes, context and resources; and also serves as an ongoing monitoring tool to gauge performance and achievements. [author’s description]

This framework paper is aimed at policy makers who are involved in the development or management of programmes in the health sector in developing countries. It provides a snapshot of the type of information and communication technology (ICT) interventions that are being used in the health sector, and the policy debates around ICTs and health…The paper describes the major constraints and challenges faced in using ICTs effectively in the health sector of developing countries.

While the need to measure performance in the field of family planning and reproductive health care FP/RH) is widely recognized, there is no consensus on a standard definition of the term. Consequently, when organizations and projects describe or measure performance, particularly in the context of health worker or program evaluations, the term may be used in ambiguous and confusing or even contradictory ways. [author’s description]

In family planning programs, good face-to-face interaction between the client and providers is key to meeting clients’ needs and program goals. Programs can best improve client-provider interaction (CPI) when they move beyond just training providers and strengthen CPI continuously in multiple ways. [summary]

Using all of the tools in the document will provide a comprehensive assessment of skills and service delivery. Each tool, however, may be used separately or combined with others to create a document appropriate for the content of a specific maternal and newborn health training course. [author’s description]

This document summarises underlying evidence and issues related to good human resource management (HRM)in the health sector with reference to: (a) indicators of performance and measurement of nursing outcomes; (b) performance issues related to individuals and teams; and (c) employee engagement, commitment and organisational citizenship behaviour (OCB). There are two key themes: What are the interventions and indicators associated with good HRM outcomes, and how can these be measured? [author’s description]

The Population Council and The Pubcomm Group, Inc. have developed simple, inexpensive, user-friendly computerized job aids to assist supervisors in improving the quality of family planning, maternity care, and postabortion care services. The software is free to download. [publisher’s description]

This paper describes strategies for improving the performance of health care workers. Many factors interact to affect the quality of health care. The structure of the health care system, educational opportunities for health practitioners, the administrative system, the pace of change, economic conditions and the technology available may influence the ability of the existing workforce to acquire new skills and implement them in practice. Thus, a comprehensive strategy is needed if the quality of the overall system is to improve, including the development of indicators to measure progress. [author’s description]

In a single electronic platform, the WHO’s Communicable Disease Global Atlas is bringing together for analysis and comparison standardized data and statistics for infectious diseases at country, regional, and global levels. The analysis and interpretation of data are further supported through information on demography, socioeconomic conditions, and environmental factors. The database includes a category for human resources for health information. Users can download information in reports, charts and maps as well as use the mapping interface to select geographic areas of interest and creat maps of diseases, the location of health facilities and the density of health personnel by category.

This study seeks to describe the existing systems for measuring and monitoring staff performance in the clinical setting and covered public and para-statal hospitals in Ghana. [author’s description]

The tools and guidelines collected in this book will assist health program managers, policymakers, and leaders to assess the impact of HIV/AIDS on the health workforce and its capacity to deliver and scale up HIV/AIDS services. The book provides materials to help decision-makers develop a strategy to mitigate the impact of HIV/AIDS, for both a short-term emergency response and a longer-term plan to strengthen HRM systems. This compilation also includes a tool developed by the World Health Organization to help HIV/AIDS programs to achieve a more sustainable workforce appropriately trained to provide ART.

Mystery clients are trained people (usually community members) who visit program facilities in the assumed role of clients, and then report (by completing a survey or through an interview) on their experience. They might be used in an effort to avoid the bias in the service delivery process that often results from having service transactions observed. Mystery clients can also serve to gather a sufficient number of observations of service transactions when the actual volume of service visits is low. [publisher’s description]

World Health Statistics 2006 presents the most recent statistics since 1997 of 50 health indicators for WHO’s 192 Member States. This second edition of World Health Statistics includes an expanded set of statistics, with a particular focus on equity between and within countries. It also introduces a section with 10 highlights in global health statistics for the past year. [publisher’s description]

The report includes a chapter on Health Systems which provides key HRH statistical data.

This paper examines the use of human resource indicators to support management-led initiatives to improve health service efficiency and effectiveness. [from abstract]

This rapid-assessment guide is designed to help users arrive at a global overview of a country’s HRH situation. The guide is designed to help users assess current HRH constraints and challenges to “scaling up” health interventions. HRH main issues include: Policy, regulation and planning; Management and performance improvement; Labour market; Education, training and research; HRH and priority health programmes; and Monitoring and evaluation. [author’s description]

A Village Development Committee Orientation organized to allow representatives of different organizations to discuss and identify causes of low coverage and high drop-out in their community. Special emphasis was placed on monitoring the immunization drop-out rate of each health facility. Indicators for VDCs have improved in 2003, and Parsa District is now regarded as one of the highest performing districts in the region.

This paper evaluates structural quality of hospital care in the context of an evaluation of contracting out district hospital services in South Africa. Three contractor hospitals, run by a private company and paid by public purchasers to provide district hospital care to a rural catchment population, were matched with three adjacent public hospitals and three private hospitals serving largely insured patients. A structured instrument was used to provide a quantitative measure of structural quality. Private hospitals scored highest overall, followed by public and then contractor hospitals.

This document intends to provide a policy and strategic framework for management of health information, use of information in planning and management of health services and monitoring health sector performance. [from preface]

This paper provides a framework for understanding the key factors that affect provider competence. Different methods for measuring competence are discussed, as are criteria for selecting measurement methods. Also, evidence from various research studies on measuring the effectiveness of different assessment techniques is presented. [author’s description]

This study investigated the uses of demographic census data for monitoring geographical imbalance in the health workforce for three developing countries, as a basis for formulation of evidence-based health policy options. [from abstract]

What makes one training experience better than another? Effective training can help providers of family planning/reproductive health (FP/RH) services to improve their performance. This handbook summarizes the tasks that should be completed at each stage of training to ensure an effective training course.

Human resources (HR) constraints have been reported as one of the main barriers to achieving the 2005 global tuberculosis (TB) control targets in 18 of the 22 TB high-burden countries (HBCs); consequently we try to assess the current HR available for TB control in HBCs. A standard questionnaire designed to collect information on staff numbers, skills, training activities and current staff shortages at different health service levels was sent to national TB control programme managers in all HBCs. [From abstract]

Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision making, drawing on a framework for health systems performance assessment. [from abstract]