viii Introduction and objectives of the handbook
The monitoring and evaluation framework shows how health inputs and processes (e.g. health workforce and infrastructure) are reflected in outputs (e.g. interventions and available services) that in turn are reflected in outcomes (e.g. coverage) and impact (morbidity and mortality). The added value of the framework is that it brings together indicators and data sources across the results chain in its entirety, i.e. from “inputs/processes”, “outputs”, and “outcomes”, to “impact”. It is designed to address monitoring and evaluation needs for different users and multiple purposes, including: • monitoring of programme inputs, processes and results, required for the management of health system investments; • health systems performance assessment, as the key for country decision-making processes; and • evaluating the results of health reform investments and identifying which approaches work best.
Figure 2. Monitoring and evaluation of health systems strengthening
Source: (4)
Monitoring and evaluation of health systems strengthening
Inputs and processes Outputs Outcomes Impact
Infrastructure; Information and communication technologies Health workforce
Supply chain
Information
Intervention access and services readiness
Intervention quality, safety
Coverage of interventions
Prevalence risk behaviours and factors
Improved health outcomes and equity Social and financial risk protection Responsiveness
Efficiency
Administrative sources Financial tracking system; NHA Databases and records: HR, infrastructure, medicines etc. Policy data
Facility assessments Population-based surveys Coverage, health status, equity, risk protection, responsiveness
Clinical reporting systems Service readiness, quality, coverage, health status
Civil registration
Data collection
Analysis and synthesis
Data quality assessment; Estimates and projections; In-depth studies; Use of research results; Assessment of progress and performance and efficiency of health systems