Strengthening monitoring and evaluation (M&E) and building sustainable health information systems in resource limited countries: lessons learned from an M&E task-shifting initiative in Botswana

Abstract

BackgroundThe demand for quality data and the interest in health information systems has increased due to the need for country-level progress reporting towards attainment of the United Nations Millennium Development Goals and global health initiatives. To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt.MethodsThis qualitative assessment included in-depth interviews at the national level (n = 12) with officers from government institutions, donor agencies, and technical organizations; and six focus group discussions separately with district M&E officers, district managers, and program officers coordinating different district health programs.ResultsReported achievements of the cadre included improved health worker capacity to monitor and evaluate programs within the districts; improved data quality, management, and reporting; increased use of health data for disease surveillance, operational research, and planning purposes; and increased availability of time for nurses and other health workers to concentrate on core clinical duties. Lessons learnt from the assessment included: the importance of clarifying roles for newly established cadres, aligning resources and equipment to expectations, importance of stakeholder collaboration in implementation of sustainable programs, and ensuring retention of new cadres.ConclusionThe development of a dedicated M&E cadre at the district level contributed positively to health information systems in Botswana by helping build M&E capacity and improving data quality, management, and data use. This assessment has shown that such cadres can be developed sustainably if the initiative is country-led, focusing on recruitment and capacity-development of local counterparts, with a clear government retention plan.

Exploring barriers and enablers for scaling up a community‐based grain bank intervention for improved infant and young child feeding in Ethiopia: A qualitative process evaluation

“…Several well known challenges of M&E systems in low resource settings were also identified in this study, such as technical limitations, human resource constraints, and lack of appreciation of the importance of program monitoring and its consequences (Karim et al, ; Kusek & Rist, ; Nash et al, ; The World Bank & Inter‐American Development Bank, ). Increased training and ongoing supervision and feedback have shown to improve quality of reporting (Mpofu et al, ; Nash et al, ). However, additional research is needed to provide guidelines on how to develop and foster local commitment and ownership towards M&E efforts.…”

“…On management level, scaling up was undermined by complex management structures and limited monitoring of the grain bank activities. Increased training and ongoing supervision and feedback have shown to improve quality of reporting (Mpofu et al, 2014;Nash et al, 2009). However, additional research is needed to provide guidelines on how to develop and foster local commitment and ownership towards M&E efforts.…”

Monitoring Sustainable Development Goals 3: Assessing the Readiness of Low- and Middle-Income Countries

“…Previous works drawing from international experiences have well-documented a myriad of challenges affecting comprehensive M&E leading to weak HSPAs. [15][16][17][18] Some of these include the lack of good quality data, data incompleteness, poor timeliness to inform decision-making and exclusion of data from the private sector among others. 17 On the other hand, high political interest and stewardship, clarity of vision for M&E with roles and responsibilities of actors spelt out, the involvement of stakeholders and strengthening of existing information systems as opposed to creating new ones are some of the promising lessons from countries.…”

Kesiapan Kader Posyandu dalam Edukasi Program Jaminan Kesehatan Nasional kepada Masyarakat

“…Hasil penelitian lain di negara-negara berkembang lain menunjukan bahwa tidak ada dampak yang signifikan antara pelatihan dan peningkatan kinerja kader dalam melaksanakan program kesehatan. 16 Apalagi hasil penelitian ini menunjukkan bahwa kader merasakan kurangnya mendapatkan pelatihan informasi seputar program JKN. Pelatihan saja tidak cukup diberikan kepada kader, tetapi pemantauan setelah pelatihan dengan memanfaatkan teknologi informasi menjadi hal yang penting untuk menilai kinerja kader setelah pelatihan.…”