1. Monitoring & Evaluation in NIE
Module 20
This session is designed for a duration of approx. 90 min.
Note: this presentation focuses on M&E of programmes, NOT situations such as early warning systems etc
27-Mar-17

2. Learning objectives
Be familiar with the basic concepts and main characteristics of monitoring and evaluation
Understand the differences between various kinds of evaluations
Explain the different kinds of indicators
Describe the very basics of a ‘log frame’
Optional: Be familiar with the monitoring and evaluation of CMAM interventions
27-Mar-17

3. Has anyone been involved in Monitoring & Evaluation?
How?
27-Mar-17

4. The project cycle ASSESSMENT EVALUATION Monitoring PROGRAMME DESIGN
Disaster
The project cycle
ASSESSMENT
EVALUATION
Monitoring
PROGRAMME DESIGN
IMPLEMENTATION
source: IFRC 3Ps/SPHERE
27-Mar-17

5. Monitoring &Evaluation
What is M&E?
Source: UCL + Makerere University School of Public Health, Uganda
Through group debate the first key words related to M&E will appear. Later the formal definitions will be presented. The following slide might capture of of the key words that participants might mention *

6. M&E assessment performance A WASP NEST………? efficiency target Logframes
outputs
effectiveness
appropriateness
outcomes
Quantitative indicators
Qualitative indicators
target
Logframes
impact
assessment
DO NO HARM
coverage
A WASP NEST………?
INPUTS
Source: MTV for UCL + Makerere University School of Public Health, Uganda
A lot of difficult terms are related to M&E. This sessions tries to deal with them and aims to make M&E more understandable.
connectedness
accountability
timeliness *

7. Definition Monitoring It is NOT only about PROCESS
‘The systematic and continuous assessment of the
progress of a piece of work over time….’
‘To continuously measure progress against programme
objectives and check on relevance of the programme’
It involves collecting and analysing data/information
It is NOT only about PROCESS
There are various definitions but they all aim at the same: we measure progress and changes need to be made if progress is not made. Obviously ‘progress’ has all to do with what our programme originally aimed for, i.e. the objectives. Are we in the process of reaching them? If not, we need to make adjustments to ensure we reach these objectives eventually.
‘The systematic and continuous assessment of the progress of a piece of work over time….It is a basic and universal management tool for identifying the strengths and weaknesses in a programme. Its purpose is to help all the people involved make appropriate and timely decisions that will improve the quality of the work.’
Gosling and Edwards, 1995 cited in ALNAP Review of Humanitarian Action 2003 *

8. Purpose of monitoring to document progress and results of project
to provide the necessary information to Management for timely decision taking and corrective action (if necessary)
to promote accountability* to all stakeholders of a project (to beneficiaries, donors, etc)
Source: MTV for UCL + Makerere University School of Public Health, Uganda
*accountable = being responsible to someone for some action
Monitoring and evaluation, though two distinct activities are very closely linked. Monitoring is a routine activity with data collected on a regular e.g. daily or monthly basis. Its basic purpose is to keep track of programme activities and improve the efficiency of interventions. Evaluation tends to be episodic, undertaken at critical points in a project cycle and its basic purpose is more to do with improving effectiveness and informing future programming. Monitoring data provides essential inputs into more episodic evaluation. Monitoring data may highlight specific issues in the programme’s implementation that require deeper investigation through evaluation to be resolved. In turn, evaluation can help to identify what needs to be monitored in the future. In a well designed M&E system, data routinely collected through monitoring activities can contribute greatly towards evaluation *

9. Information collected for monitoring
must be:
Useful and relevant
Accurate
Regular
Acted upon
Shared
Timely
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

10. Monitoring is an implicit part of an evaluation.
It is often done badly:
Routine data collection not done routinely!
Data collection done poorly
Information not processed/used in a timely manner
Focus only on process indicators and neglecting (lack of) preliminary impact
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

11. Can you give examples of Monitoring in your current work?
For example
- From a CMAM programme?
From a Micronutrient programme?
From a General Food Distribution?
From a Health programme?
From a Livelihoods programme? *

12. Monitoring Monitoring compares intentions with results
It guides project revisions, verifies targeting criteria and whether assistance is reaching the people intended.
It checks the relevance of the project to the needs.
It integrates and responds to community feedback
It enhances transparency and accountability

13. Difference between Process/activities Impact/results Monitoring of *
Both are important and fulfil their own specific role: monitoring process/activities refer to whether the programme implementation is on track and whether the planned activities are taking place.
Monitoring results look whether the intended impact is on track to be reached. *

14. The project cycle ASSESSMENT EVALUATION Monitoring PROGRAMME DESIGN
Disaster
The project cycle
ASSESSMENT
EVALUATION
Monitoring
PROGRAMME DESIGN
IMPLEMENTATION
source: IFRC 3Ps/SPHERE *

15. Why would you do an evaluation of a programme?*

16. Definitions Evaluation It involves the objective assessment of an
The aim is to determine relevance and fulfilment of
objectives, as well as efficiency, effectiveness, impact
and sustainability of a project.
It involves the objective assessment of an
ongoing or completed project/programme, its
design, implementation and results.
These are all terms we will look at more in detail.
Evaluations are also very important to identify LESSONS LEARNT *

17. There has been an increased focus on evaluation of
humanitarian action as part
of efforts to improve quality and standards
Quality and standards will be more presented in detail in Module 21. *

18. Evaluation Improve policy and practice Enhance accountability
It aims to
Improve policy and practice
Enhance accountability
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

19. Evaluations are done when / because:
Monitoring highlights unexpected results
More information is needed for decision making
Implementation problems or unmet needs are identified
Issues of sustainability, cost effectiveness or relevance arise
Recommendations for actions to improve performance are needed
Lessons learning are necessary for future activities
Additionally, the donor (often from one or various Governments) that funds the project is accountable to its tax payers, and the donor wants to know what exactly is done with the money and whether the objectives were reached. And if not, why not.

20. Evaluations
Evaluation involves the same skills as assessment and analysis
Evaluation should be done impartially and ideally by external staff
Evaluation can also occur during (e.g. mid-term) and after implementation of the project
Why?
Evaluation should be done impartially and ideally by external staff: people that have been involved or are responsible for the project might not be objective towards the data collected, results, etc. They might have a stake and therefore lose their objectivity. Some might be defending negative findings or the opposite: they might be extra negative towards their project as they might not have agreed with certain decisions in the past. This will not enable a neutral and objective process of learning. External people might have a fresh eye on all the findings and are likely to be more impartial.
One of the most important sources
of information for evaluations is
data used for monitoring
27-Mar-17 *

21. The OECD-DAC criteria Organisation for Economic Co-operation and Development
The Development Assistance Committee (DAC) evaluation criteria are currently at the heart of the evaluation of humanitarian action.
The DAC criteria are designed to improve evaluation of humanitarian action.
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

22. Evaluation looks at
Relevance/Appropriateness: Doing the right thing in the right way at the right time.
Connectedness (and coordination): Was there any replication or gaps left in programming due to a lack of coordination?
Coherence: Did the intervention make sense in the context of the emergency and the mandate of the implementing agency? Are their detrimental effects of the intervention on long run?
Coverage: Who has been reached by the intervention, and where: linked to effectiveness?
Efficiency: Were the results delivered in the least costly manner possible?
Effectiveness: To what extent has the intervention achieved its objectives?
Impact: Doing the right thing, changing the situation more profoundly and in the longer-term.
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

23. Evaluation looks at
Relevance/Appropriateness: Doing the right thing in the right way at the right time.
Connectedness (and coordination): Was there any replication or gaps left in programming due to a lack of coordination?
Coherence: Did the intervention make sense in the context of the emergency and the mandate of the implementing agency? Are their detrimental effects of the intervention on long run?
Coverage: Who has been reached by the intervention, and where: linked to effectiveness?
Efficiency: The extent to which results have been delivered in the least costly manner possible.
Effectiveness: The extent to which an intervention has achieved its objectives –
Impact: Doing the right thing, changing the situation more profoundly and in the longer-term.
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

24. Example on General Food Distribution
Relevance/Appropriateness: Doing the right thing in the right way at the right time.
Was food aid the right thing to do, not cash?
Connectedness: Are their detrimental effects of the intervention on long run?
Did food aid lower food prices? Did local farmers suffer from that?
Source: UCL + Makerere University School of Public Health, Uganda
Relevance / appropriateness
-> assessing whether the project is in line with local needs and priorities/tailoring of activities to local needs, increasing ownership, accountability and cost-effectiveness. It assesses whether the type of intervention was the ‘best fit’ for a situation.

25. Were those that needed food aid indeed reached?
Coverage: Who has been reached by the intervention, and where: linked to effectiveness?
Were those that needed food aid indeed reached?
Efficiency: Were the results delivered in the least costly manner possible?
Was it right to import the food or should it have been purchased locally? Could the results have been achieved with less (financial) resources? Food aid was provided, would cash have been more cost-effective?
Source: UCL + Makerere University School of Public Health, Uganda
Coverage
Reaching major population groups facing life-threatening suffering wherever they are.
Can target geographical area (flooded area) or specific groups (malnourished children).
In all cases, baseline information is required on the area or the population targeted. Estimates are often used to compensate lack of baseline.
Efficiency:
The outputs achieved by maximizing resources
Discussions and debates around efficiency as decisions taken cannot always aim towards efficiency, mainly in early stages of an emergency
Looks at method employed for achieving a result: cash or food aid for prevention of malnutrition? BP5 or local food?
Needs for intervention to be rapid often limits possibility of focus on efficiency in early stages of emergencies

26. Did food aid avoid undernutrition? (assuming it was an objective)
Effectiveness: To what extent has the intervention achieved its objectives?
Did food aid avoid undernutrition? (assuming it was an objective)
Impact: Doing the right thing, changing the situation more profoundly and in the longer-term.
Did the food aid avoid people becoming displaced? Did the people become dependent on food aid?
Source: UCL + Makerere University School of Public Health, Uganda
Effectiveness: the extent to which an activity achieves its purposeFor supplementary feeding programmes (for example) effectiveness is measured through exit indicator such as cure, death and defaulter rates.
Impact
Impact evaluation in emergency situations has numerous difficulties as many factors can interfere with the ‘normal’ running of any intervention, and the cause-and-effect chain varies for different types of intervention..
Same interventions have very different impact in different settings or contexts.
Measure of impact requires an adequate baseline information (often absent), but even if available, it is required to understand what causal factors have influenced the measured impact.

27. Impact:
Very much related to the general goal of the project
Measures both positive and negative long-term effects, as well as intended and unintended effects.
GFD: did it lower general food prices with long-term economic consequences for certain groups ? Were people that received food aid attacked because of the ration? (therefore more death…?)
Need for baseline information!!!!
(to measure results against….)

28. To evaluate projects well is a real skill! And you often need a team…
Source: UCL + Makerere University School of Public Health, Uganda *

29. M&E in emergencies?
YES
Any project without Monitoring and/or Evaluation is a BAD project
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

30. Help!
Source: MTV for UCL + Makerere University School of Public Health, Uganda
This slides aims to ‘monitor’ how the participants are doing on M&E. Do they feel they belong to the category on the left: they all understand most of the issues dealt with so far. Or are many people feeling lost in the terminology? If so, try to find out what is difficult and refer back to previous slides. *

31. The “M” and the “E”… Monitoring Evaluation Primary use of the data
Project management
Accountability
Planning (future projects)
Frequency of data collection
Ongoing
Periodic
Type of data collected
Info on process and effects
Info on effects
Who collects the data
Project staff
External evaluators
Source: UCL + Makerere University School of Public Health, Uganda

32. Evaluations in Humanitarian Context
Single-agency evaluation (during/after project)
There is an increasing move towards:
Inter-agency evaluations: the objective is to evaluate responses as a whole and the links between interventions
Real-time evaluations: carried out 8 to 12 weeks after the onset of an emergency and are processed within one month of data collection
Source: MTV for UCL + Makerere University School of Public Health, Uganda
Many evaluations are done on work conducted by a single agency. However, more and more one also sees evaluations that cover interventions done by various agencies at the same time. In this way the whole response can be evaluated rather than just one agency’s work.

33. Real-time evaluations (1)
WHY?
Arose from concern that evaluations came too late to affect the operations they were assessing
Various groups of organizations aim to undertake real-time evaluations
Same purpose as any other evaluation
Common characteristics:
Takes place during the course of implementation
In a short time frame
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

34. Real-time evaluations (2)
It is an improvement-oriented review; it can be regarded more as an internal function than an external process.
It helps to bring about changes in the programme, rather than just reflecting on its quality after the event.
A real-time “evaluator” is a “facilitator”, working with staff to find creative solutions to any difficulties they encounter.
It helps to get closer to the people affected by crisis, and this enables to improve accountability to ‘beneficiaries’.
Source: MTV for UCL + Makerere University School of Public Health, Uganda *

35. Monitoring & Evaluation systems
Main components of M&E systems:
M&E work plan for data collection and analysis, covering baseline, on-going M&E
Logical framework, including indicators and means/source of verification
Reporting flows and formats
Feedback and review plan
Capacity building design
Implementation schedule
Human resources and budget
27-Mar-17

36. Examples of data collection methods for M&E
Quantitative Methods
Qualitative methods
Administering structured oral or written interviews with closed questions
Semi structured interviews e.g. key informant
Population based surveys
Focus group discussion
Reviewing medical and financial records
Observing
Completing forms and tally sheets
Case studies
Direct measurement (anthropometry, biochemical analysis, clinical signs)
Mapping, ranking, scoring
Lot quality assessment
Problem sorting, ranking

37. Focus on INDICATORS
Source: UCL + Makerere University School of Public Health, Uganda

38. Indicators
An indicator is a measure that is used to show change in a situation, or the progress in/results of an activity, project, or programme.
Indicators:
enable us to be “watchdogs”;
are essential instruments for monitoring and evaluation.
are objectively verifiable measurements
Source: UCL + Makerere University School of Public Health, Uganda

39. What are the Qualities of a Good Indicator?
Specific
Measurable
Achievable
Relevant
Time-bound
The Sphere Project provides the most
accepted indicators for nutrition and
food security interventions in emergencies: see Module 21.
Source: MTV for UCL + Makerere University School of Public Health, Uganda
What are the characteristics of a good indicator?
A good indicator is SMART:
S for SPECIFIC:
By specific, we mean that it specifies the magnitude of the attribute that we’re measuring in a particular time frame and for a particular population
In other words, that they measure what they’re supposed to measure… blood retinol measures vitamin A status (not iron status, not any other vitamin…)
Can you think of another word starting with “S” that describes a good indicator? Good! it’s SIMPLE: clearly and precisely defined
M for Measurable:
Measurable indicators are objective: we are able to quantify them
You can measure the temperature, you can count how many correct answers students get on a test, you can observe if someone is washing their hands before they handle food
Can you think of other examples of indicators and how to measure them?
A for Achievable:
Achievable indicators means that we can actually obtain them: you need to have the resources and capacities to collect, store and process the information obtained from that indicator
R is for relevant:
Relevant to you project, your situation
And T is for Time bound:
Always stating the time period in which that indicator was measured
Beginning and end of projects are commonly used time-marks
Seasons and seasonality too: amount of grain produced in the month of July, total sales in the pre-holidays season, malnutrition rates in the lean (or hungry) season preceding the harvest.
Can you think of other examples of indicators that are time-bound?
SMART Initiative[1]
The Standardised Monitoring and Assessment in Relief and Transition (SMART) Initiative - is an interagency initiative, begun in 2002, to improve the M&E of humanitarian assistance interventions through:
• The development of standardised methodologies for determining comparative needs based on nutritional status, mortality rate and food security.
• Establishing comprehensive, collaborative systems to ensure reliable data is used for decision-making and reporting
A Standardised Training Package (STP) for SMART methodology has recently been released.
[1] More information available at
And there is also the SMART initiative….
Standardised Monitoring and Assessment in Relief and Transition
Initiative - interagency initiative to improve the M&E of humanitarian
assistance

40. Types of indicators Examples?
Indicators exist in many different forms:
Examples?
Direct
Direct indicators correspond precisely to results at any performance level.
Indirect or "proxy" indicators demonstrate the change or results if direct measures are not feasible.
Indirect / proxy
Indicators are usually quantitative measures, expressed as percentage or share, as a rate, etc.
Indicators may also be qualitative observations.
Qualitative
Quantitative
Source: UCL + Makerere University School of Public Health, Uganda
Direct - Number of children with acute malnutrition
Proxy – diet composition for nutritional status
Global / standardised
Standardised global indicators are comparable in all settings.
Other indicators tend to be context specific and must be developed locally.
Locally developed

41. Impact Outcome Output Input
Source: UCL + Makerere University School of Public Health, Uganda

42. Impact Outcome Output Input Related to Goal
Related to Objectives (or Purposes)
Output
Related to Outputs
Input
Related to Activities/Resources
Source: UCL + Makerere University School of Public Health, Uganda

43. Impact Outcome Output Input * Malnutrition rates amongst young
children reduced
Related to Goal
Outcome
% of young children
getting appropriate
complementary food
Related to Objectives (or Purposes)
X number of mothers
know about good
complementary food and
how to prepare that
Output
Related to Outputs
Nutritional education to mothers on complementary food
Input
Related to Activities/Resources
Source: UCL + Makerere University School of Public Health, Uganda *

44. All the previous terms, such as impact, outcome, etc can be put in this ‘tree’. It is just a different way of putting them together.

45. What is a Log Frame?
The logical framework or logframe is an analytical tool
used to plan, monitor, and evaluate projects. ? ? ?
The logical framework or logframe derives its name from the logical linkages set out by the planner(s) to connect a
project’s means with its ends. ?
Victim of a log frame?

46. Log Frames IMPACT OUTCOME INPUTS
Log frames appear in different shapes and with different names sometimes, but overall they look like this.
INPUTS

47. ? ? ? ? ? ? ? …and can be put in a ‘tree’ like this. INPUTS
Impact
Outcome
Output ? ?
Impact ?
Outcome
Output ?
Output
Output
Source: UCL + Makerere University School of Public Health, Uganda
…and can be put in a ‘tree’ like this. ?
INPUTS ? ?

48. Other terms that can be found in a logframe:
The means of verification of progress towards achieving the indicators highlights the sources from where data is collected. The process of identifying the means of verification at this stage is useful as discussions on where to find information or how to collect it often lead to reformulation of the indicator.
Assumptions are external factors or conditions that have the potential to influence the success of a programme. They may be factors outside the control of the programme. The achievement of a programme’s aims depends on whether or not assumptions hold true or anticipated risks do not materialise.
This slide is optional and should only be shown if the main issues on inputs, outcomes, outcomes and impact are well understood.
27-Mar-17 48

49. logical framework for M&E
Project description
Indicators
Source / mean of verification
Assumptions / risks
Goal
Objectives / outcomes
Deliverable outputs
Activities
If the OBJECTIVES are produced, then this should contribute to the overall GOAL
If OUTPUTS/RESULTS are produced, then the OBJECTIVES are accomplished
If adequate ACTIVITIES are conducted, then OUTPUT/RESULTS can be produced
This is another way of showing a log frame
If adequate RESOURCES/INPUTS are provided; then activities can be conducted 49

50. Activities versus Results
Completed activities are not results.
e.g. a hospital was built, does not mean that injured and sick people can be treated in the hospital, maybe the hospital has no water and the beds have not been delivered.
Results are the actual benefits or effects of
completed activities:
e.g. Injured and sick people have access to a fully functional health facility. *

51. Log frames

52. Example
More examples to illustrate the aforementioned theory. This example shows Vit A supplementation, but in a reversed order, starting with input and then subsequently working its way down to impact.

53. Another Example… *

54. Source: UCL + Makerere University School of Public Health, Uganda
Time for questions, discussion, recap, etc

55. Key messages
The monitoring of nutrition interventions in emergencies is an integral part of saving lives and maintaining nutrition status of the affected population.
Successful monitoring systems allow for improvements in interventions in ‘real time’.
Evaluations are important tools for learning, assessing interventions, comparing the costs of the interventions and their impact. Essential evaluation parameters are: effectiveness; efficiency; relevance/appropriateness; impact and coverage
Involving communities in M&E places the affected population at the heart of the response, providing the opportunity for their views and perceptions to be incorporated into programme decisions and increases accountability towards them.
A common mistake of designing M&E systems is creating a framework which is overly complex. Always make an M&E system practical and doable.
The logical framework or logframe is an analytical tool used to plan, monitor, and evaluate projects.

56. Monitoring for CMAM interventions
Types of monitoring, e.g.
Individual case monitoring,
Programme / activities monitoring
The following slides are explaining more information on M&E in CMAM programmes. If an extended session on this topic is requested, this part can be used.
27-Mar-17

57. Individual monitoring for CMAM
It is the basic follow up of cases in SFP / OTP / SC services:
Anthropometric / clinical assessment
Tools for individual case follow up include:
Medical / nutrition and action protocols
Individual follow up card
Referral forms …
27-Mar-17

58. Objectives of monitoring CMAM activities
Assess service performance / outcomes
Identify further needs
Support decision-taking for quality improvement (staffing, training, resources, site location,…)
Contribute to the analysis of the general situation
Assessing the nutrition trends in the area
27-Mar-17

59. Methods and tools for monitoring CMAM interventions
Monthly / weekly reporting:
Reporting needs to be done per site (service unit) and compiled per area (district…) up to the national level
Routine supervision
External evaluations
Coverage surveys are one of the most important tools for evaluation of CMAM interventions
27-Mar-17

60. Routine data collection for monitoring CMAM interventions
Routine data is collected for specified time-periods:
Nb. of new admissions ,
Nb. of discharges (total and by category: cured, died, defaulted, non-recovered
Nb. of cases in treatment (nb. of beneficiaries registered at the end of the reporting time-period)
Data on admissions should be disaggregated by gender
27-Mar-17

61. Criteria (Children 6 – 59 months)
Category
Criteria (Children 6 – 59 months)
New admissions for children 6 – 59 months
(or > 60 months but <130 cm height)
MUAC <11.5 cm or
W/H < -3 Z scores (WHO) or <70% of median (NCHS)
Bilateral pitting oedema grade + or ++
and
child is alert, has appetite, and is clinically well
 Other new admissions
Carer refuses inpatient care despite advice
Returned Defaulter
Child has previously defaulted and has returned to OTP
(the child must meet admission criteria to be re-admitted).
Readmissions/Relapses
A child is treated in OTP until discharge after meeting discharge criteria but relapses hence need for readmission
Transfer from inpatient care (SC)
From in-patient care after stabilisation treatment
Transfer from OTP
 Patients moved in from another OTP site 
Ensure that the definitions are clear for everybody when monitoring is done.
27-Mar-17

62. Criteria (Children 6 – 59 months)
Category
Criteria (Children 6 – 59 months)
 Cured
MUAC > 12.5cm and WFH > -2Z scores and no oedema for two consecutive visits
 And
Child is clinically well
Defaulted
Absent for 3 consecutive visits
Died
Died during time registered in OTP
Non-Cured
Has not reached discharge criteria within four months of treatment
Link the child to other programmes e.g. SFP. IYCF, GMP, targeted food distributions
Transferred to SC
Condition has deteriorated and requires inpatient care
Transfer to other OTP
Child has been transferred to another OTP site
27-Mar-17

63. Monitoring of CMAM interventions: key indicators for SAM (Sphere)
The proportion of discharges from therapeutic care should be:
Recovered > 75 %
Deaths < 10 %
Defaulter < 15 %
They are primarily applicable to the 6–59 month age group, although others may be part of the programme.
Distance: > 90 % of the target population is within less than one day’s return walk (including time for treatment) of the service / site.
Coverage is > 50 % in rural areas, > 70 % in urban areas and >90 % in camp situations
27-Mar-17

64. Monitoring of CMAM interventions: key indicators for MAM (Sphere)
The proportion of discharges from targeted SFP should be:
Recovered > 75 %
Deaths < 3 %
Defaulter < 15 %
They are primarily applicable to the 6–59 month age group,
although others may be part of the programme.
Distance: > 90 % of the target population is within less than one day’s return walk (including time for treatment) of the programme site for dry ration SFP and no more than one hour’s walk for on-site wet SFP
Coverage is > 50 % in rural areas, > 70 % in urban areas and > 90 % in a camp situation
27-Mar-17

65. Additional data for monitoring CMAM interventions
Derived from routine monitoring and other sources:
Sources of data:
Average length of stay
Average weight gain
Relapse rate
Distribution of admissions per type, per age, per origin…
Causes of death
Reasons for defaulting
Investigation of non-recovery cases
Registration books
Individual follow up charts
Interviews and Focus group discussions
Observation, home-visits …
27-Mar-17

66. M&E for CMAM interventions: Supervision
Supportive supervision visits to sites are designed to ensure / improve the quality of care offered by:
Identifying weaknesses in the performance of activities, taking immediate action and applying shared corrective solutions
Strengthening the technical capacity of health workers and motivating staff through encouragement of good practices
Supervisors and managers ensure that the performance of activities and organization of the services meet quality standards.
27-Mar-17 66

67. Evaluation of SAM management interventions
Effectiveness: programme performance with a strong focus on coverage
Appropriateness: e.g. distribution and time of opening of treatment sites
Connectedness: relates to the links with health system and shows levels of possible integration
Cost-effectiveness has also been measured with various methods and showing high differences between contexts and different approaches
27-Mar-17

68. M&E of CMAM interventions: population level assessments
Community level assessment can be done through:
Repeated anthropometric surveys
Programme coverage
27-Mar-17

69. Evaluation of coverage for CMAM
Coverage is one of the most important elements behind the success of the CMAM approach.
It is measured through studies using two main approaches:
The centric systematic area sampling (CSAS)
The Semi-Quantitative Evaluation of Access and Coverage (SQUEAC)
Coverage should reach at least 90% of severe cases in camps situation, 70% in urban setting, 50% in rural setting (SPHERE standards)
27-Mar-17

70. Evaluation of management of MAM interventions
Same criteria as for all other interventions (relevance, efficiency, etc.)
SFP evaluations are rarely shared, but evidence showed that defaulting and non-response are very common
Needs for evaluating use of Ready-to-Use-Supplementary Food products in terms of efficiency: gain of weight, effect of defaulting, effect on easiness for beneficiaries, etc.
27-Mar-17