Food and Nutrition Surveillance and Response in Emergency Session 24 MONITORING AND EVALUATION ( Nutrition Programmes During emergency Situation) The purpose of covering the topic To equip learners with the knowledge that can can enable them to: • • • Design an M&E system for a nutrition Programme Conduct M&E Effectively use a M&E data base to monitor progress in Programme implementation M&E cont. • The M&E session covers the following areas: – Purpose of M&E in programming. – Components of an M&E plan /framework for a nutrition Programme – Conducting M&E activities – M&E indicators – Evaluation of nutrition programmes in emergency situations Monitoring and Evaluation • Monitoring: what is it? It is the ongoing collection and review of information on project implementation, coverage and utilization that is reported and acted on, on on-going basis. M&E cont. • Why do monitoring? – To improve intervention programmes by identifying aspects that are working as planned and those that need correction. – To modify Programme as per identified need. – To ensure that all needy cases are reached: General food ration reaches all targeted persons By maximising on inclusion of deserving cases and exclusion of undeserving cases in special targeting I.e severely malnourished – To track ( and demonstrate) results at the program or population level. Monitoring cont. • Thus monitoring is used to determine how well a Programme is being implemented – At different levels – At what cost – Also tracks the changes occurring due to interventions being implemented (positive or negative M&E cont Evaluation: What is it? • A process of data collection designed to assess the effectiveness of the project in attaining its originally stated objectives and the extent to which observed changes are attributable to the project. • Done at the end of the project but could be planned at strategic periods during during the life of the projects;inform of reviews e.g. mid- term reviews, or biennial reviews. Evaluation can use rigorous study designs e.g., experimental design or quasi-experimental-involving control groups. M&E • M&E happens only after the decision to implement a certain intervention has been made • Both monitoring and evaluation need – clearly stated goals – clearly stated objectives. Components of M&E • Usually four components are considered – Inputs – Processes – Outputs – Outcomes Components • Inputs are the set of resources dedicated to a Programme: • They include human and financial resources, physical facilities, equipment and operational policies that enable services to be delivered,I.e., – Personnel – Facilities – Space: storage, room for admitting children onTFP, for conducting SFP and space for guardians. – Equipment – Supplies Components • Process refers to the set of activities in which Programme inputs are utilized in pursuit of the results from the Programme • process refer to multiple activities that are carried out to achieve the objectives of the projects – Service delivery operations (food distribution) – Management oriented activities – Training, IES, research, etc. Components • Outputs are the results obtained at the Programme level through execution of activities using its resources (inputs): Outputs cont. • Outputs – Could be staff performing better as a result of having been trained – As a result of clear policy environment – Staff better informed about policies- better in taking decisions. Components • Outputs classified into three levels: • Functional outputs: number of nutrition IEC talks, food preparation demonstration, people trained • Service outputs:e.g, number benefiting/accessing TFP,SFP, quality of service, acceptability/ image • Service utilization: number using the service(collecting rations, visiting ANC clinics for supplements) Outcomes • Outcome: the set of results expected to occur at the population level due to Programme activities and generation of Programme outputs. The intermediate effects are often behavioral and result directly from project outputs. They may be necessary to achieve a desired impact. Outcomes cont. • Outcomes may be divided into two components: Intermediate outcomes and long-term outcomes. • Immediate outcomes:are set of results at the population level that are closely and clearly linked to the Programme activities. • Long-term outcomes: refer to set of results at the population level that are long- term in nature and are produced through action of immediate outcomes. Outcomes cont. • There is generally a considerable time lag 5-10 years between inception and change in long range outcomes.Good health, reduced mortality rates. Components • Outcomes- two levels • Intermediate outcomes Occur at population level and are closely associated with Programme inputs(drop in prevalence of severe cases of malnutrition, anemia). • Long range outcomes Refer to results at population level that are long term in nature and come through action of intermediate outcomes (drop in overall prevalence of malnutrition, deaths, better health) Outcomes cont. • Six key outcomes for nutrition – – – – – – Exclusive breastfeeding Appropriate complementary feeding, Adequate iron intake Adequate vitamin A intake Adequate iodine intake Adequate nutritional care during illness and severe malnutrition Elements of M&E Indicators • Indicators are variables that measure the different aspects of a given Programme. – The inputs, processes, outputs and outcomes. • An indicator can be assigned a numeric value, a percentage, a mean value, a ranking, an absolute number of yes/ no score e.g., presence verses absence. Indicators cont • Selection of indicators Indicators must be selected to provide evidence that defines the extent to which project interventions are successful in achieving the set objectives. Indicators cont. Criteria for selection of indicators • Validity: It measures what it is intended to • Sensitivity: its changes reflect desired changes • Reliable: It produces the same results when repeated • Uni-dimensional: it measures only one phenomenon • Operational: it is measurable • Objective: it is not subject to Measurer’s biases • Practical: its data collection is reasonably feasible • Comparability (from time to time/ place to place) Policy environment (indicators) • Existence of a policy development plan • Number of appropriately disseminated policy analysis • Number of policy awareness raising events targeted at leaders • Quality of Programme leadership • Extent of commercial sector participation Components of M&E plan • Introduction: The country region and background of what the project is addressing • Conceptual framework-maps the linkages inputs-processes-outputs-outcomes M&E plan cont. • Data types • Mechanisms for M&E – Data collection methods – Establishing baseline – Data storage/analysis – Management of collection, who collects, when? – Routine review of data – How does evaluation fit in. M&E plan cont. • Indicators for M&E • Use of data/dissemination to result in regular adjustments of activities for enhanced effect. M&E plan • Work plan needed to implement the plan • Work plan lists: – Activities – Time they shall be conducted – Targeted numbers – Milestones e.g. by-after 18 months – Implementation- what is expected in terms of achievements (objectives) Bibliography • Bertrand J.T. et al (1996). Evaluating FP programs. USAID. • Medicins Sans Frontiers (1995).Registration and Monitoring/Evaluation of Feeding Programmes, In:Nutrition Guidelines(Nutritional programmes in Emergency Situations).1st Ed.Paris. • Sphere project (2004). Humanitarian Charter and Minimum Standards in Disaster Response.ISBN 9291390976. • UNAIDAS(2000).National AIDS Programmes.A Guide to Monitoring and Evaluation.Geneva. • Veneya and Kaluzny (1984). Evaluation and Decision Making for Health Services Programmes. • WHO,BASICS and UNICEF (1999).Nutrition Essentials.A Guide for Health Managers.