SESSION 9:

MONITORING AND
EVALUATION OF HEALTH
PROMOTION
INTERVENTION
DR. J.MZATULA (MD)
Learning Objectives

 By the end of this session, students are

expected to be able to:
Define monitoring and evaluation in health
promotion
Explain the importance of monitoring and
evaluation
Describe methods of collecting for
monitoring and evaluation
Describe the process of monitoring and
evaluation

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Monitoring

 A systematic and continuous assessment of the

progress of an activity over time
 It is a part of implementation
 It can be done through the process of collecting,
coordinating, processing, measuring and
communicating information to assist
management to make decisions
 It involves follow up of:
Inputs (funds, personnel and others)
Process (such as activities/tasks being done
according to planned interventions)

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Evaluation
 The systematic collection, analysis, and reporting of
information about a program in order to improve planning or
implementation of current and future program activities.
 It is also done during implementation (formative evaluation)
to identify areas for changes or modifications.
 It is done at the end of intervention (summative evaluation)
to assess project or programme effect, outcomes and aim at
obtaining information on:
 Effectiveness of the programme in achieving its stated objectives.
 Its contribution to developmental goals.
 Efficiency of the programme or project on utilization of resources.
 Sustainability of the project results.
 Whether to continue, modify or terminate the project.

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The Importance of Monitoring
 To make sure that work progresses according to schedule
 To ensure that agreed upon rules and regulations are maintained
 Resources are used rationally as planned
 Required information is available and used
 Detection of problems during implementation and to take corrective
action
 Verification whether plans are being implemented accordingly
 There are many tools which can be used to monitor health
intervention, among them are:
 Plan of action
 Quarterly technical and financial reports on the implementation of the
intervention
 Supervision reports
 Activity progress reports.
 Outputs/outcomes (are the intended objectives and expectations met?)

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The Importance of Evaluation
 To determine performance effectiveness and efficiency of
services/or program which include:
 Decision whether an activity is worth doing
 Determine whether the objective set were achieved
 Identify ways of improving a program, such as ensuring that all
activities are relevant and appropriate to the health needs of
community members, and removing potential barriers to participation
 Determine (formative evaluation) whether activities should be
continued or not
 Use of the evaluation information for a range of purposes, including
promotion, fundraising, attracting potential partners, and lobbying and
advocating for policy changes to create healthier communities
 Determine the project should be extended else where
 Justifying the program to management
 Providing evidence of success or the need for additional resources
 Increasing organizational understanding of and support for health
promotion
 Encouraging ongoing cooperative ventures with other organization
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Evaluation Process

 Produce useful feedback for program

refinement
 Provide feedback to a funder on how
resources were expended
 Determine program activities’ success rates
 Document successful processes so they can
be repeated in the future
 Demonstrate program activity to the media
or community even before outcomes have
been attained

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Methods Collecting Data for Evaluation

 Depending on the evaluation purpose,

evaluations can use qualitative or quantitative
data collection methods or a combination of both
 The selection of data collection methods
depends on a number of factors, including:
The purpose of your evaluation
The questions the evaluation is seeking to answer
Financial resources
Time and skills

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Methods Collecting Data cont...
 If you want to explore participants’ or workers’
experiences, it would be more appropriate to
use qualitative methods. This will allow you to
ask ‘how’ and ‘why’.
 If you want to measure the numbers of
participants in a program or measure the
degree of change in a health measure (such
as body mass index) or behavior (such as
participation in physical activity), then it may
be most appropriate to use quantitative
methods
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Methods Collecting Data cont...
 Quantitative methods answer who, what, where,
and how much
 They target larger numbers of people and are more
structured and standardized (meaning that the same
procedure is used with each person) than qualitative
methods.
 Qualitative methods answer why and how and
usually involve talking to or observing people.
 When using qualitative methods it is best to use
several approaches. This concept is often
referred to as ‘triangulation’ and using it
strengthens your evaluation.
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Key Steps In Evaluating Any Health
Program (HP)

 Clarify your program

What underlying needs and resources must be
addressed?
Goals, what are the goals, target population, and
desired outcome objectives?
What should the members of the intended
population think, feel, or do as a result of the
health promotion program in contrast to what they
thought, felt, or did before?

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Key Steps cont...
 Define program activities and outputs
 How can these changes be measured? Establish measurable
program indicators
 Input indicators: measures the resources that are used in the
provision of services e.g. human, materials and finances
 Output indicators: measures the output following a process
resulting from certain inputs e.g. community trained, number of
latrines constructed, number of health education sessions
conducted
 Outcome indicators: measures result following some activity e.g.
number of people came for counselling and testing services.
 Impact indicators: Show the long term effects of an intervention
e.g. reduced number of malnutrition in the community, leading to
improved health status of children in a given time
 Engage stakeholders/community members in the HP program
 Understand stakeholder interests and expectations (needs
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Key Steps cont...
 Assess resources for the evaluation
 Determine availability of staff and resources
 Determine amount of money allocated for
evaluation
Conduct a resource mapping and asset
assessment
 Examine the community resources and
other assets that exist (or do not exist) to
respond to the targeted problem/issue in
the community

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Key Steps cont...
 Design the evaluation
 Select type of evaluation to be conducted
 Design evaluation framework
 Consider ethical and confidentiality issues
 Develop evaluation questions (based on program goals and
objectives and stakeholder interests and expectations)
○ Select a target area to be assessed. Be specific in defining the target
area so you can remain focused on the types of data to collect
○ Gather data to develop a clear ‘picture’ of the nature and extent of the
problems in that geographic area
○ Gather data that help describe the nature and causes of the problem.
Examine all data sources that provide information on the problem
including contributing
○ Assess the risk and protective factors of participants in the target area
○ Once you have identified a target group, conduct a systematic
assessment of those risk conditions that contribute to the
problem/issues and those protective factors that improve risk conditions
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Key Steps cont...
 Determine appropriate methods of
measurement and procedures
Select the most appropriate qualitative and
quantitative methods for collecting
information about your program.
Consider qualitative versus quantitative
methods; and
Select your sampling design.
 Develop work plan, budget and timeline
for evaluation
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Key Steps cont...
 Collect the data using agreed-upon methods and
procedures
 Pilot test
 Determine data collection techniques
 Use tips for data collection
 Process and analyze of data
 Prepare the data for analysis
 Analyze the data
 Interpret and disseminate the results
 Interpret the results
 Present the results
 Share the results
 Take action

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Selecting Evaluation Type for HP
Programme
 When selecting types of evaluation for your
HP program, it is important to consider:
The length of time the program has been in
operation
Your program’s stage of development
What, if any, types of evaluation have already
been conducted
The amount of resources you have to devote to
evaluation
The interests of your program stakeholders

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Selecting Evaluation Type cont...
 How do you expect change to occur?
Will it be slow or rapid?
What measurable intermediate
outcomes (steps toward the desired
behaviour) are likely to take place
before the behaviour change can occur?
The behaviour change map you created
in should provide the answers to these
questions.

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Selecting Evaluation Type cont...
 How long will the program last? What
kinds of changes can we expect in that
time period (e.g., attitudinal, awareness,
behaviour, policy changes)?
Sometimes, programs will not be in place long
enough for objectives to be met when
outcomes are measured (e.g., outcomes
measured yearly over a 5-year program).
To help ensure that you identify important
indicators of change, decide which changes
could reasonably occur from year to year.
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Selecting Evaluation Type cont...
 Which aspects of the outcome evaluation
plan best fit with your organization’s
priorities?
You may have to illustrate your program’s
contribution to community priorities to ensure
continued support
If this is the case, then it may be wise to
evaluate those aspects most likely to
contribute to the community’s interest
(assuming that those are also the ones most
likely to result in measurable changes)
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Selecting Evaluation Type cont...
 Other factors to consider when deciding on
an evaluation type
Obtain community members support
Establish healthy community committee –
partnership with population from all levels should
be actively engaged in the program
Conduct situational assessment to understand
the needs and preferences of the people
Develop a healthy promotion plan
Implement plan
Generate evaluation report

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CONDUCTING OUTCOME
EVALUATION
Questions to Ask and Answer

 How can we use outcome evaluation to

assess the effectiveness of our program?
 How do we decide what outcome
evaluation methods to use?
 How should we use our evaluation results?
 How can we determine to what degree we
have achieved our communication
objectives?
 How can we make our communication
program more effective?
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Conducting Outcome Evaluation: How Well
is the Program Working?

 Conduct outcome evaluation by following these

steps:
Determine what information the evaluation must
provide that help to answer important questions, such
as
○ Did the program work? Why? Why not?
○ Should we continue the program?
○ What can be modified to make the program more
effective?
○ What evidence proves that funders should continue to
spend their money on this program?

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Conducting Outcome Evaluation
cont...
Define the data to be collected
 Knowledge: What people learn about a subject (e.g.
the short- and long-term health risks of smoking)
 Attitudes: How people feel toward a subject (e.g.
smoking is dangerous to their health)
 Skills: How peoples’ skills and abilities affect a
problem by themselves (e.g. variety of ways to say
‘no’ to smoking and awareness of smoking cessation
classes)
 Behaviours: How people actually change their way of
doing things (e.g. a measurable decrease in
participants who smoke)

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Conducting Outcome Evaluation
cont...
 Decide on data collection methods
 Develop and pretest data collection
instruments
 Collect data
 Process data
 Analyze data to answer the evaluation
questions
 Write an evaluation report
 Disseminate the evaluation report
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Key Points

 Monitoring is a systematic and continuous assessment of the

progress of an activity over time, and is part of implementation.
 Evaluation is the systematic collection, analysis, and reporting of
information about a program in order to improve it.
 Evaluation done during implementation (formative evaluation) to
identify areas for changes or modifications.
 Evaluation is done at the end of intervention (summative
evaluation) to assess outcome/effectiveness and efficiency of a
program
 Conducting outcome evaluation, quantitative and qualitative
design methods are used
 Evaluation process is done in steps: clarify program, engage
stakeholders/community members, assess resources, design
evaluation method, determine measurement tools and
procedures, develop work plan, budget, and timeline, collect
data, process data,J MZATULA
06/17/2024
analyze, interpret and disseminate results
(MD)-MONITORING AND EVALUATIO 27