HMIS Monitoring and
Evaluation
HIS
DEFINITION
Lesson Intended Learning Outcomes (LILO):
Monitoring is the systematic collection, analysis and use of
information from programs for three basic purposes:
(1) Learning from the experiences acquired (learning function);
(2) Accounting internally and externally for the resources used; and the
results obtained (monitoring function) and
(3) taking decisions (steering function).
Meanwhile, Evaluation is assessing an ongoing or completed program
or policy as systematically and as objectively as possible. The object is
to be able to make statements about their relevance, effectiveness,
efficiency, impact and sustainability.
HIS
Lesson Intended Learning Outcomes (LILO):
M&E Purpose
The primary aim is to have a strong M&E and review system in
place for the national health strategic plan that comprises all
major disease programs and health systems.
A robust monitoring and evaluation (M&E) system is required to
assess the effect of integrated service delivery. Appropriate
indicators, data collection systems and data analysis to support
decision-making help guide successful implementation of
integrated services and measures the effect on both service
delivery and use of services (FP/Immunization Integration
Working Group, n.d.).
HIS
M&E Framework
Lesson Intended Learning Outcomes (LILO):
Monitoring and evaluation (M&E) is a core component of current efforts to
scale up for better health. Global partners and countries have developed a
general framework for M&E of health system strengthening (HSS).
The framework builds upon principles derived from the Paris declaration on
aid harmonization and effectiveness and the IHP+, putting country health
strategies, and the related M&E processes such as annual health sector
reviews, at the center.
The core is the strengthening of a common country platform for M&E of
HSS, which should result in better alignment of country and global M&E
systems and can be used both for monitoring:
1. health systems funding platform
2. tracking the performance of specific programs.
The framework addresses indicator selection, related data sources, analysis
and synthesis practices (including quality assessment), performance review,
communication and use (World Health Organization, 2009). HIS
Lesson Intended Learning Outcomes (LILO):
The World Health
Organization’s M&E of
Health Systems
Strengthening
Framework presents
the indicator domains
and considerations for
data collection,
synthesis and use
along the pathway for
achieving health
impact at scale.
HIS
Figure 7.: WHO Framework for Monitoring and Evaluation of Health Systems
Reform/Strengthening
Relationship between M&E with HMIS Indicators
Lesson Intended Learning Outcomes (LILO):
An indicator can be defined as a
1. variable whose value changes.
2. measures the value of the change in meaningful units that can be compared to
past and future units.
3. It focuses on a single aspect of a program or project – i.e., an input, output or
the overarching objective.
There are different HMIS indicators which can be used for monitoring of key aspects
of the health system performance.
These are from among the five broad categories
1. Reproductive health,
2. Immunization,
3. Disease prevention and control,
4. Resources utilization and
5. Data Quality
HIS
Lesson Intended Learning Outcomes (LILO):
HIS
The STOP TB Program
Lesson Intended Learning Outcomes (LILO):
With the vision to have a TB free world, the goal of the STOP TB Program (STP)
is to dramatically reduce the global burden of TB by 2015, in line with the
Millennium Development Goals and the Stop TB Partnership targets of the
World Health Organization (2006).
One of the main objectives of the program is to achieve universal access to
high-quality care (i.e. universal access to high quality diagnosis and patient
centered treatment) for all people with TB (including those co-infected with
HIV and those with drug-resistant TB).
TB case detection and successful completion of the treatment/cure of the TB
remains at the core of the Stop TB Strategy. Hence one of the targets linked to
the MDGs and endorsed by the Stop TB Partnership is by 2050 to reduce
prevalence and deaths due to TB by 50% compared with a baseline of
1990.The following flowchart puts the HMIS indicators (in green shaded boxes)
in the context of the STOP TB Program.
HIS
Lesson Intended Learning Outcomes (LILO):
HIS
Figure 7.6:Routine Monitoring data on TB program captured through HMIS
HMIS Indicators to Monitor STOP TB Program
TB patients on DOTS
1.Number of new smear pulmonary TB cases enrolled in the cohort
2. TB Case Detection
3. Number of New smear positive pulmonary TB cases detected
4. Number of new smear negative pulmonary TB cases detected
5. Number of new extra pulmonary TB cases detected
6. HIV – TB – Co-infection
7. Proportion of newly diagnosed TB cases tested to HIV
8. HIV+ new TB patients enrolled in DOTS
9. TB Treatment outcome
10. Treatment completed PTB+
11. Cured PTB+, Defaulted PTB+, Deaths PTB+
HIS
