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Monitoring & Evaluation

HP+ More recent Monitoring & Evaluation publications are available.

  • The presence of supportive FP/RH policies is considered an integral component to successful programs. However, much remains to be known about how policies are implemented, especially in a complex political, sociocultural and economic environment. This poster outlines the various methodologies that can be used to study policy implementation, which include descriptive methodologies such as literature reviews and case studies; analytic methodologies such as stakeholder mapping and analysis, cross-sectional surveys and system dynamics; quasi-experimental and experimental studies; studies describing policy implementation within complex adaptive systems, such as, path dependence; and mixed methods as well including focus groups, document analysis and interviews. This poster was presented at the Population Association America conference on May 1, 2014.

  • For several decades, civil society organizations (CSOs) in Nigeria have been advocating for increased resources for reproductive health (RH) and family planning (FP) services and commodities. Many people assume that once policymakers make a public commitment to provide funding for a specific purpose, the funds are assured. However, such a commitment is only the first step in securing budgetary allocation. The necessary steps include formal approval for the budgetary allocation, inclusion of the funds in the approved budget, release of the funds for the program, and expenditure of the funds intended.

    CSOs can play a key role in ensuring that public funds are used for the intended purpose and actually reach the intended beneficiaries. To do so, they need to understand the budgetary process and the role of nongovernmental stakeholders in the process. The inner workings of the state-level budget process in Nigeria are not well understood, and there is little documentation of the process to provide guidance.

    To help CSOs in Nigeria understand and actively participate in the budget process, the Health Policy Project conducted an assessment to identify the differences between theory and practice in state-level budgeting. In doing so, several entry points emerged for CSOs to make a difference in FP/RH funding; the key tasks identified include

    • Advocate for increased funds for FP/RH programs and commodities
    • Ensure that adequate funds are budgeted, obligated, and released in a timely manner
    • Track state-level budget expenditures, especially funds actually expended for FP/RH services and commodities
    • Hold policymakers and program managers accountable for the effective use of public funds

  • When it was established, Kenya’s Inter-Agency Coordinating Committee on Health Care Financing (ICC-HCF) was intended to provide a forum for health financing stakeholders to share knowledge, deliberate, and reach consensus on contentious issues. Yet the ICC-HCF became stalled in 2011. Shortly after, the Kenya government requested assistance from the Health Policy Project (HPP) to revitalize the forum. This brief provides an assessment on the impact of HPP’s support to the ICC-HCF, the constraints that affected Kenya finalizing its healthcare financing strategy, and offers a series of recommendations for how best to support the work of the ICC-HCF going forward.   

  • In 2013, the government of Kenya abolished all user fees in public dispensaries and health centers. In 2015, the Health Policy Project conducted a nationally representative study to examine how the removal of user fees affected health utilization; whether facilities were adhering to the policy; how health workers and clients perceived the policy; and whether quality of service before and after the policy’s implementation had changed. This evaluation report provides findings from the study and recommendations for the successful implementation of Kenya’s abolition of user fees policy.  

  • This series of Capacity Development Resource Guides was produced by the Health Policy Project as part of an Organizational Capacity Assessment (OCA) Suite of Tools. The guides highlight the key technical areas of expertise needed to effectively influence health policy design, implementation, and monitoring and evaluation. Each guide identifies the specific skills, knowledge, and capacities that individuals and organizations should possess in the technical area. The guides also include individual and organization capacity indicators mapped to HPP’s Capacity Indicators Catalog, which can be used for facilitated organizational capacity assessments in the areas of policy, advocacy, governance, and finance. In addition, they provide illustrative activities and useful resources for designing and delivering capacity development technical assistance.

  • This brief describes the Health Policy Project’s perspective on systems change, the expertise needed for effective engagement in the policy process, implementation steps for capacity initiatives, and evaluation. It will be of particular use for those interested in capacity-strengthening approaches specific to policy, advocacy, governance, and finance. For sustained change, HPP encourages its partners to take a systems approach that addresses capacity needs at interrelated levels: individual, organizational, and systems.

    For information on the project's implementation of this approach, see the Capacity Development Topics page, which also includes practical resources such as HPP's recently developed Organizational Capacity Assessment (OCA) Suite of Tools. The tools are specifically designed to assist organizations with building their capacity related to health policy by 

    • Establishing a baseline of the organization’s capacity in key areas
    • Promoting organizational dialogue, learning, and standard setting
    • Informing the development of a capacity-strengthening plan for addressing organizational priorities

  • Costed Implementation Plans (CIPs) are concrete, detailed plans for achieving the goals of a national family planning program over a set number of years. A CIP details the program activities necessary to meet the goals and the costs associated with those activities, thereby providing clear program-level information on the resources a country must raise both domestically and from donors. The Health Policy Project, with various partners, has developed a collaborative, 10-step approach to creating a CIP that aligns with ongoing government planning and coordination efforts. This brief outlines these 10 steps, which when implemented, should result in a consensus-driven strategy, roadmap, and budget for achieving family planning targets under the Ouagadougou Partnership, FP2020, and/or other national programs. To date, the following countries have completed CIPs for family planning: Senegal, Burkina Faso, Niger, Togo, Mauritania, Guinea, and Zambia.

  • This report covers an evaluation of the collaboration between the Ministry of Health of the Indian State of Jharkhand and the Health Policy Project to conduct a program (Nov. 2012-July 2013) to strengthen capacities at state, district, and sub-district levels to effectively implement the 2010 family planning  strategy.  It included training, mentoring, and supportive supervision. A State Resource Group of master trainers from government and civil society supported the 4-person Family Planning Cell. A pre/post-implementation quantitative and qualitative assessment highlighted that although the implementation period was short, systems were strengthened and laid a solid basis for achieving  Jharkhand’s FP goals.  The assessment highlighted improvements in timely data updates (from 27% to 91%),  increased stocks of FP commodities and IEC materials, and wider availability of doctors trained in clinical services. Budget allocations for spacing methods increased and the FP Cell invested in training health staff on counseling and  IUD skills. Staff reported an improved attitude toward information sharing and joint problem solving.  The 3-district pilot program has been scaled up in 11 additional high-need districts.  

  • A lack of comprehensive knowledge about HIV/AIDS and sexual reproductive health (SRH), financial insecurity, gender-based violence, and other risk factors can leave students of higher education institutions (HEIs), especially women, more vulnerable to HIV infection. It is therefore important to consider the specific needs of this population group when designing and implementing HIV interventions. In Ethiopia, the Health Policy Project (HPP) is supporting the Federal HIV/AIDS Prevention and Control Office and HEIs to prioritize and target HIV interventions in HEI settings. As part of this effort, HPP assisted the government's HEI Partnership sub-Forum against HIV/AIDS with developing a Planning, Monitoring, and Evaluation Framework for HIV/AIDS and SRH interventions in HEIs. Establishing a standardized system for planning, monitoring, and evaluating interventions will facilitate the generation and use of high-quality program-related data to inform decision making, thus helping to boost program effectiveness. Training and implementation of the framework has begun, and the next step will be to evaluate its effectiveness and standardization across HEIs in Ethiopia.

  • To improve FP services and availability in Jordan, the Higher Population Council (HPC), with support from the Health Policy Project and in cooperation with all stakeholders, developed the National Reproductive Health/Family Planning Strategy 2013–2017. The strategy assesses the reproductive health (RH)/family planning (FP) environment in Jordan and describes the interventions required to improve RH/FP services and use and ultimately achieve the goals of the Demographic Opportunity Policy.

    This brief summarizes the three main challenges to Jordan’s FP program—policy, access, and beliefs and behaviors—and outlines the interventions planned to address them.

  • In March, the Kenya Ministry of Health convened an international consultation forum in collaboration with the World Bank Group and the United States Agency for International Development (USAID) through the Health Policy Project to deliberate on the challenges of providing universal health coverage (UHC) to all Kenyans, regardless of their ability to pay, and to explore strategic and sustainable health financing options. The Kenya Health Policy Forum reviewed options and lessons learned from other countries, and proposed recommendations on how the country can improve efficiency to achieve UHC.

    The meeting brought together local and international experts with diverse expertise spanning the health sector, including both the public and private sectors. Participants from Kenya included representatives from both levels of government, nongovernmental organizations, faith-based organizations, and the private sector. International speakers shared experiences from Brazil, Ethiopia, Ghana, India, and Mexico. Development partners who support Kenya’s health sector were also represented, including the USAID, the UK Department for International Development, the German Federal Enterprise for International Cooperation, and the World Bank.

  • Through this case study, the USAID- and PEPFAR-funded Health Policy Project (HPP) seeks to share Thailand’s experience implementing the AIDS Zero Portal (AZP) and its initial impact at the national and provincial levels. The AZP offers a potential model for other countries looking to institutionalize and leverage information systems as part of their routine monitoring and evaluation, strategic planning, and resource allocation efforts.

  • As part of a joint activity, the Health Policy Project (HPP), University of Washington, United States Agency for International Development (USAID), and Centers for Disease Control and Prevention conducted a global analysis of planned policy interventions across the 22 publicly accessible PEPFAR (President's Emergency Plan for AIDS Relief) Partnership Frameworks, with the purpose of understanding how the interventions are related to PEPFAR and country or regional priorities. In addition to the desk review, the team conducted multi-country and multi-stakeholder capacity-building workshops for monitoring the policy process within PEPFAR-supported countries. This poster, produced by HPP, provides an analysis of the data collected as well as conclusions about the need to strengthen policy monitoring. The poster was presented at the Second Global Symposium on Health Systems Research in Beijing, China, on October 31–November 3, 2012.  

  • In close collaboration with MCFDF, the USAID-funded HPP AKSE conducted an assessment of the sexual and gender based violence (SGBV) referral monitoring and reporting system in Haiti. The following report includes results from the assessment and recommendation to strengthen the existing system.

  • This suite of tools, developed by the USAID-funded Health Policy Project, the University of Washington, USAID, and the U.S. Centers for Disease Control and Prevention, was designed to strengthen the capacity of key stakeholders to engage in and monitor health policy development and advocacy interventions. The Road Map consists of eight different tools that can be used separately or together to help stakeholders systematically review the policy process and take steps toward full implementation. Each tool is meant for a different stage of the policy process and helps users fully view the different actions necessary to move the policy process forward from development to implementation and evaluation. The Road Map is also available in French and Spanish.

  • At the Ouagadougou Partnership and Family Planning 2020 (FP2020) meetings, governments committed to improving access to family planning services and information. Costed Implementation Plans (CIPs) for family planning services and information provide a framework and tools for governments to achieve their international family planning commitments. This booklet, prepared by the Health Policy Project, highlights the methodology behind CIPs, walks through 10 steps for designing and implementing a national CIP for family planning, and shares experiences from seven African countries that have developed national CIPs for family planning to inform their decision making. It is estimated that implementation of the CIPs will accelerate each country's progress toward both achieving its target contraceptive prevalence rate and reducing maternal and child mortality.  

  • Part of an Organizational Capacity Assessment (OCA) Suite of Tools and developed by the Health Policy Project, the Strengthening Capacity in Policy, Advocacy, Governance, and Finance: A Facilitator Guide for Organizational Capacity Assessments is a facilitated self-assessment tool tailored to an organization’s mission as it relates to health policy. The participatory capacity assessment process supports an organization by

    • Establishing a baseline of the organization’s capacity in key areas
    • Promoting organizational dialogue, learning, and standard setting
    • Informing the development of a capacity-strengthening plan for addressing organizational priorities

    The process outlined in the guide supports staff members and other key stakeholders to share their perspectives about the organization’s functioning, strengths, and challenges to undertake work related to health policy. Accompanying the guide are a Capacity Indicators Catalog that identifies the key capacities needed to support relevant technical policy areas and an OCA Results Spreadsheet that creates an electronic report and visual depictions of the capacity assessment based on the indicators chosen from the catalog and a participatory scoring process.

  • The Gender, Policy and Measurement program, funded by the Asia bureau of the U.S. Agency for International Development and implemented by the Health Policy Project (HPP) and MEASURE Evaluation, undertook a comprehensive, systematic review of the impact of gender-integrated programs on health outcomes. The findings are primarily intended to inform the work of government officials, donors, nongovernmental organizations, and other key stakeholders involved in health programming in India, as well as other low- and middle-income countries around the world.

    This review presents evidence showing how gender-integrated programming influences health outcomes in low- and middle-income countries: in particular, reproductive, maternal, neonatal, child, and adolescent health; HIV prevention and AIDS response; gender-based violence; tuberculosis; and universal health coverage.

    To read the full report—Transforming Gender Norms, Roles, and Power Dynamics for Better Health: Findings from a Systematic Review of Gender-integrated Health Programs in Low- and Middle-Income Countries—please visit www.healthpolicyproject.com?zp=381.

  • The Gender, Policy and Measurement program, funded by the Asia bureau of the U.S. Agency for International Development and implemented by the Health Policy Project (HPP) and MEASURE Evaluation, undertook a comprehensive, systematic review of the impact of gender-integrated programs on health outcomes. The findings are primarily intended to inform the work of government officials, donors, nongovernmental organizations, and other key stakeholders involved in health programming in India, as well as other low- and middle-income countries around the world.

    This review presents evidence showing how gender-integrated programming influences health outcomes in low- and middle-income countries: in particular, reproductive, maternal, neonatal, child, and adolescent health; HIV prevention and AIDS response; gender-based violence; tuberculosis; and universal health coverage.

    This report was authored by Arundati Muralidharan, Jessica Fehringer, Sara Pappa, Elisabeth Rottach, Madhumita Das, and Mahua Mandal.

    To read the subject briefs associated with this report, please visit: http://www.healthpolicyproject.com/index.cfm?id=publications&get=pubID&pubId=382.