Objectives for Session
Objectives
-To understand the steps in generating the MATRIX and MONITOR.
-To show that the MATRIX and MONITOR can reveal the types of health
equity problems that are most and least pronounced in a city, and who is
most and least affected.
Urban HEART MATRIX
-A basic MATRIX is a colour-coded chart that helps you to see inequities
across multiple indicators.
-The MATRIX does not track inequities over time.
-The steps below describe the process to develop a MATRIX for within-city
comparisons but you could also produce comparisons between cities, if
you have data for multiple cities.
Producing the MATRIX
MATRIX: Displays inequalities across multiple indicators
1) Decide on the reporting year and the units of comparison (usually
geographical districts in your city) for your MATRIX
2) Label the data columns (districts/wards) and data rows (health
outcomes, environment, etc)
Policy Domain
Indicator
Health outcomes
Infant mortality (per
1000 live births)
Physical
infrastructure &
environment
Access to safe water
(%)
Social & human
development
Completion of
primary education
(%)
Fully immunized
children (%)
District A
District B
District C
District D
MATRIX
3) Add columns for benchmarks and targets
Policy Domain
Indicator
Health outcomes
Infant mortality (per
1000 live births)
Physical
infrastructure &
environment
Access to safe water
(%)
Social & human
development
Completion of
primary education
(%)
Fully immunized
children (%)
District A
District B
District C
District D
Benchmarks
External targets
MATRIX
4) Enter data into the cells
District A
District B
District C
District D
City average
National
targets
Health outcomes
Infant mortality
(per 1000 live
births)
22
19
21
41
26
15
Physical
infrastructure &
environment
Access to safe
water (%)
88
58
89
58
83
100
Completion of
primary
education (%)
85
78
89
n.a.
84
85
Fully immunized
children (%)
75
70
71
62
65
80
Social & human
development
MATRIX
5) First, fill in the GREEN cells (indicates performance that is
equal to or better than both the internal benchmark and the
desired target)
District A
District B
District C
District D
City average
National
targets
Health outcomes
Infant mortality
(per 1000 live
births)
22
19
21
41
26
15
Physical
infrastructure &
environment
Access to safe
water (%)
88
58
89
58
83
100
Completion of
primary
education (%)
85
78
89
n.a.
84
85
Fully immunized
children (%)
75
70
71
62
65
80
Social & human
development
MATRIX
6) Next, fill in the RED cells (indicates performance that is
worse than the internal benchmark)
District A
District B
District C
District D
City average
National
targets
Health outcomes
Infant mortality
(per 1000 live
births)
22
19
21
41
26
15
Physical
infrastructure &
environment
Access to safe
water (%)
88
58
89
58
83
100
Completion of
primary
education (%)
85
78
89
n.a.
84
85
Fully immunized
children (%)
75
70
71
62
65
80
Social & human
development
MATRIX
7) Finally, fill in the YELLOW cells (indicates performance that is equal to
or better than the internal benchmark, yet lower than the desired target)
Note: Cells with missing data can remain white
District A
District B
District C
District D
City average
National
targets
Health outcomes
Infant mortality
(per 1000 live
births)
22
19
21
41
26
15
Physical
infrastructure &
environment
Access to safe
water (%)
88
58
89
58
83
100
Completion of
primary
education (%)
85
78
89
n.a.
84
85
Fully immunized
children (%)
75
70
71
62
65
80
Social & human
development
8) Check your work again
– All cells should be red, yellow or green unless the data are not
available
Urban HEART MONITOR
-You can now develop the MONITOR to track the health equity gap in your
city (the gap between best and worst performance) over time and to
assess progress against an equity target.
-The steps below describe the process to develop the basic MONITOR for
your city. If you have performance data for multiple cities, you can also use
the basic MONITOR to track an equity gap between cities in a region or
country.
Producing the MONITOR
• Monitor: Tracks the health equity gap (between best and worst
performance) in your city over time and displays progress against and
equity target
• 1) Decide on the indicator you want to monitor over time and the years
you will analyse
• 2) Decide on your internal benchmark
– Should represent a particular year
• 3) Identify a relevant target
– Examples: MDG, national target, city target, etc.
– Must be a higher standard than the internal benchmark
MONITOR
4) Label your data columns and data rows
Year
1990
1995
2000
2005
Worst district
performance
Best district
performance
City average
Benchmark:
City average
1990
Target:
National
average
2010
MONITOR
5) Enter data into the cells
Year
Worst district
performance
Best district
performance
City average
1990
70%
10%
30%
1995
2000
2005
80%
86%
90%
10%
20%
10%
40%
40%
45%
Benchmark:
City average
1990
Target:
National
average
2010
30%
90%
MONITOR
6) Colour-code the data cells using GREEN (indicates
performance that is equal to or better than both the internal
benchmark and the desired target)
Year
Worst district
performance
Best district
performance
City average
1990
10%
70%
30%
1995
2000
2005
10%
20%
10%
80%
86%
95%
40%
40%
45%
Benchmark:
City average
1990
Target:
National
average
2010
30%
90%
MONITOR
7) Colour-code the data cells using RED (indicates performance
that is worse than the internal benchmark)
Year
Worst district
performance
Best district
performance
City average
1990
10%
70%
30%
1995
2000
2005
10%
20%
10%
80%
86%
95%
40%
40%
45%
Benchmark:
City average
1990
Target:
National
average
2010
30%
90%
MONITOR
8) Colour-code the data cells using YELLOW (indicates
performance that is equal to or better than the internal
benchmark, yet lower than the desired target)
Year
Worst district
performance
Best district
performance
City average
1990
10%
70%
30%
1995
2000
2005
10%
20%
10%
80%
86%
95%
40%
40%
45%
Benchmark:
City average
1990
Target:
National
average
2010
30%
90%
MONITOR
9) Double-check your work
10) Create a basic graph
Inequity in skilled birth attendance in City A
100%
80%
60%
40%
20%
0%
1
2
3
4
Make Urban HEART MONITOR
Modifications
11)
• Enter the year of data for each
observation.
100%
City target 2010
•
•
Assign markers to the data points:
– Circles for the average
measures
– Diamonds for the bestperforming units
– Squares for the worstperforming units.
Colour-code the markers
according to the data table.
Inequity in skilled birth attendance in City A
80%
60%
40%
City average 1990
20%
0%
•
Add lines to indicate the internal
benchmark and desired target.
1990
1995
2000
2005
[Note for Facilitator]
-For activity on MATRIX & Monitor, please see “Step 4 Activity” in
Training Manual.