M&E >> Information Use
In the MoH, use of M&E information is recognised to occur in four, identified and distinct situations. These are – during implementation (health service delivery), planning and budgeting sessions, at the three levels (i.e. facility, region and HQ), policy development or review, and for programme development and growth.
Infrastructure to Supply M&E Information
M&E information in this regard refers to information products that contain analyses of health data according to the key health indicators for the sector. There are two process involved in the supply of M&E information:
  • There is the gathering (at points of service delivery), processing (collating raw data) and storing of health data (into the HMIS database). This is a core HMIS function.
  • Then there is the process of mining the HMIS database and other data sources such as the vital registration databases, DHIS to generate analyses of key health indicators. This is the distinguishing function of M&E in the MoH. It's important to recognise the symbiotic relationship between these two functions.

The HMIS, through the integration efforts, is in the process of consolidating the first aspect of data collection. A key indicator of this is the development of the HMIS strategic plan. For the second aspect, the M&E department has identified four levels (i.e. facilities, regions, health programmes at HQ and policy and planning levels) that will require the supply of 'mined data.' These are described in a separate presentation.
Mechanisms to Demand M&E Information
The demand and use for M&E information is affected by the existence of formal policies, procedures or requirements on how performance monitoring & evaluation information gets 'used' by the health sector. Currently, there are no such structures to facilitate the use of M&E information. In this regard, the SID, through the M&E unit, has put together a set of policy proposals aimed at ensuring that management functions (e.g. planning, policy or programmes; programme growth, strategy review, decision-making; budgeting) are supported by the information they require to make them evidence-based. It is important to note that for these proposals to be accepted and for them to function, there is need to ensure that other aspects such as the availability of information products, existence of analytic expertise and an organization-wide commitment to results are guaranteed. These proposals will at act as rewards for those individuals who demand and use information while retaining an element of sanctions for those who don't fulfill the expectation.

In the previous section, we highlighted the introduction and importance of Critical reflection events. These will be the major fora, for facilitating information use (see Part- B for an elaboration on critical reflection events).
Strategies for Entrenching a Culture of M&E
Over and above these two critical conditions for facilitating information use, the SID will employ the following strategies:
Advocacy for M&E: Over the duration of the existence of this document, The SID will vigorously lobby, senior health management echelons to help entrench a culture of Monitoring and Evaluation. Lobbying mechanisms include but will not be limited to ...
  • specially designed one and half-day SI courses aimed at raising awareness, appreciation and support for the SID; and
  • topic-centric discussion events (such as 'brown bag and shop talk') highlighting the work of the SID in generating information from health data and modelling the use of that data and information in various settings as depicted in the graphic above;

Establishing Decision Support Systems: Broadly defined, Decision Support Systems (DSS) are interactive computer based systems that help people use computer communications, data, documents, knowledge, and models to solve problems and make decisions. These systems are auxiliary; they are not intended to replace skilled decision makers . Due to their nature, DSS will be introduced at the HQ level. Their successful use will determine the roll out to other levels i.e. regions and facilities.
Health indicators to monitor and evaluate
This section presents the indicators based on the HSSP results framework that will be used in the MoH. The HSSP results framework was designed to be:
  • A guiding document for other national documents such as the national strategic framework (NSF) for HIV and AIDS, strategic plan for male circumcision, etc.
  • Supportive of the country's regional and global reporting requirements (Global Fund, UNGASS, SADC and others);
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