FIRST ANNUAL MONITORING AND EVALUATION BEST PRACTICE CONFERENCE Unit 18T, Slide 1 What should be the roles of the M&E Universities on Technical Support to the Government of Tanzania 11- 14 December 2017 By. Claud J. Kumalija Principal Statistical Epidemiologist, Monitoring and Evaluation Specialist

Presentation Overview Preamble Situation Analysis of the current Monitoring and Evaluation in the Ministry of Health Structure of the Monitoring and Evaluation Capacity of M&E to perform its core functions Health Sector Data fragmentation Health Sector Data digitization Capacity on data analysis, dissemination and use Routine Data quality Data for decision making Recommendations

Preamble

Most M&E projects in Africa

“Many people can see data but very few can hear the voice of data” Unit 18T, Slide 5 “Many people can see data but very few can hear the voice of data”

Where do we see data and where do we hear the Voice of data Research Findings In Tanzania 30 mothers die of Maternal causes every day Breaking News The school bus carrying 30 pupils has crushed this morning and all pupils died

Situation Analysis of the Current Monitoring and Evaluation in the Ministry of Health

Perceptions of Ministry of Health Staff on the Positioning of M&E in the Ministry Currently the M&E is the Section under the Directorate of Policy and Planning (DPP) M&E Universities Guide where should M&E be positioned at deferent levels i.e. central, regional and council levels What should be the role of Monitoring and Evaluation in the Government Ministry and Ministry Department Agencies (MDAs) n=30

Perception of M&E staff in the Ministry on their Capacity to perform its core M&E functions 60% of proposed key skill/professional required to perform M&E functions do not exist in the M&E Section (including, Demographer, Public Health Specialist, ICT data analyst, Public Health Nurse, etc) The M&E cadre established at Regional and councils is not yet filled up No dedicated data personnel at facility level (hospital, Health Centre and dispensaries) to manage data M&E Universities Provide advise to the Ministry on key skills and number of staff to be available for effective and efficiency of M&E performance at all levels.

Recommended Number of Staff and Skills to perform M&E in the Ministry of Health

Health Sector Data fragmentation Existing of Multiple Sources of data in the Health Sector data National Census Demographic and Health Surveys Health Facility Assessments Routine Health Management Information System (HMIS and DHIS2) PORALG (CCHP, Plan-Rep, Epicar, GoT-HOMIS, etc) National, Specialised and Zonal Referral Hospitals Health Vertical Programs Health Institutions (MSD, NHIF, NIMR TFDA etc) Budget speech, MTEF, NHA etc Annual Reports and Progress reports International UN reports University and Research institutions Other Ministries and Agencies NIDA, Water, Agriculture, Education, Police, RITA, MOFP etc M&E Universities Urgent need for support on planning and implementation of National data warehouse

Health Data digitization Currently the Health Sector is digitizing the health data systems Number of initiatives is ongoing GoT- HoMIS eMR DHIS2 eLMIS Telemedicine HF Registry PlanRep, Epicar Etc Challenge on coordination of resources Currently Tanzania data is a mixed one. Paper based at health facilities and computerised at district up to national level M&E Universities Technically support the Ministry to develop roadmap for digitization of Health Sector data

Quality of Health Data It is generally perceived that Routine health data is of poor quality What should be data quality in the context of Tanzania ? M&E Universities, Do we have evidence on quality of Tanzania routine health data?

Capacity on data analysis, dissemination and use Health staff has low capacity on data analysis Health staff are overburdened by tedious data collection process Data results is poorly disseminated at all levels No evidence on use of health data for decision making and planning We collect to much but we use less No evidence research to demonstrate capacity of health staff on data analysis, dissemination and use M&E Universities Support the government to advocate on culture of data use for evidence based decision making

Data for decision making Who influence decision making at National, region, councils and at facility levels? What is the influence of politics on decision making? If collected data is not used for decision making then it is wastage M&E Universities Do we have evidence on use of data for decision making

Conclusion “Monitoring and Evaluation is under-performing because it is not implemented according to the Government guidelines”

Recommendations Call for working together between the M&E universities and the government of Tanzania. The government to strengthen the capacity to Monitoring and Evaluation Staff at all levels Recruit M&E staff at Regional and Councils, and dedicate staff for data management at facility levels. It is high time for training institutions to establish Diploma, first Degree courses and introduce short courses on Monitoring and Evaluation. The Government should recognize M&E cadre in the manning level Funding partners supporting Monitoring and Evaluation through vertical Programs should align with the Central M&E Operation plan.

Thank You All