HEALTH INFORMATION SYSTEM FOR MEDICAL LABORATORY SCIENCE

Lesson 7: HMIS Monitoring and Evaluation

HMIS Monitoring and Evaluation M&E Framework

→ Aims primarily at assisting in the planning and A general framework of M&E of health system
management of a national health strategy plans: strengthening (HSS)
˃ Thus, continuous monitoring and evaluation
→ This framework places health strategy and related M&E
are necessary.
processes of each country at the center.
→ Monitoring and Evaluation are complimentary by
→ The core of the framework is strengthening of a common
definition and function.
country platform from the M&E of HSS:
The collection, analysis, and use of info ˃ By doing so, there is a better alignment and
Monitoring gathered from programs for the purpose the monitoring of fundings for health
of: systems is easy.
→ developed by various global partners and countries,
(1) Learning Function derived from:
→ learning from the acquired o Paris Declaration on Aid Effectiveness
experiences.
o International Health Partnership (IHP+)
(2) Monitoring Function
→ accounting the resources used Paris Declaration on Aid Effectiveness
both internal and external.
→ a practical, action-oriented roadmap to improve the
(3) Steering Function quality of aid and its impact in development.
→ obtaining results and making → gives a series of specific implementation measures and
decisions. establishes a monitoring system to assess progress and
ensure that donors and recipient hold each other
The systematic assessment of the accountable for their commitments.
Evaluation completed programs or policies to gauze
its effectiveness and adjust in areas that Five fundamental principles
need improvement.
1. Ownership
(1) Learning Function 2. Alignment
→ lessons learned need to be 3. Harmonization
incorporated into future
proposals. 4. Results
5. Mutual Accountability
(2) Monitoring Function
→ concerned parties reviews the
implementation of policy based International Health Partnership (2002)
on the objectives and resources.
→ a group of partners committed to improving the health of
citizens in developing countries.
Purpose of M&E → In 2016, IHP+ transformed into International Health
Partnership for UUC 2030
• Primary aim is to have a strong M&E review system in ˃ to respond to the health-related SDG and
place for the national health strategic plan. expanded its scope to include health
• A robust monitoring and evaluation system is required to system’s strengthening to achieve universal
assess the effect of an integrated service delivery. health coverage.
• Appropriate indicators, data collection systems, and
i.e.
data analysis to support decision-making helps:
o guide the successful implementation of o International Organization
integrated services and; o Bilateral Agencies
o measure the effects on both service delivery and o Country Governments (World Health Organization &
use of services. World Bank)
 (4) Four components of the framework M&E and HMIS Indicators

Indicator Domains Analysis & Synthesis Indicator

→ Is a variable which measures the value of the change
Data Collection Communication Use in units that can be compared to past and future
units.
→ the focus is on a single aspect of a program such as
˃ Intended for achieving great health impact. input, output, among others (like outcomes and
impact)
For monitoring medical services:
→ HMIS uses various indicators to monitor key aspects
• Indicators should be tracked to access processes and of health performance.
results associated with the various indicator domains. USAID’s 5 Indicator Categories
˃ In this way, the strengths and weaknesses
implementation are provided and can be Key Key indicator
used for troubleshooting in the system. Performance
Area
In terms of outcomes and impact indicators:

• The changes may not be directly caused by the service Reproductive (1) Family planning acceptance rate
delivery efforts for there are other factors to consider Health (2) Antenatal care coverage
that influences the changes. (3) Proportion of deliveries attended
˃ However, these data are still useful in by skilled health personnel.
understanding the current health status and (4) Proportion of deliveries attended
context within a country. by HEWs.

NOTE:
Shifts in outcome and impact indicators may not be directly Immunization (5) DPT-3 (Pentavalent-3) coverage (>1
attributable to integrated service delivery efforts, as there child)
are many other factors which influence these indicators (6) Measles Immunization coverage
(>1 child)

M&E PLAN
Disease (7) Malaria case fatality rate among
• The M&E plan and system should address all Prevention and patients under 5 years of age
components of the framework and establishes the Control (8) New malaria cases per 1,000
foundation for regular reviews during implementation of population
the national plan. (9) New pneumonia cases among
• Existing country health-sector review processes are key children under 5 per 1,000
factors to assess progress and performance. population of<5 yrs
(10) TB case detection rate
• Local M&E system generate information for global
(11) TB cure rate
monitoring based on the health sectoring review
(12) Clients receiving VCT services.
processes. (13) PMTCT treatment completion rate
• Medical Institutions are monitored and evaluated (14) PLWHA currently on ART
through the assessment of reports, surveys, HMIS, and
other evaluation studies.
Resource (15) Trace drug availability (in stock)
Implementation of the Framework
Utilization (16) OPD attendance per capita
The framework should be: (17) In-patient admission rate
(18) Average length of stay (in-patient)
(1) Be Localized
(2) Address the need for multiple users and purposes.
(3) Facilitate the identification of indicators and data Data Quality (19) Bed occupancy rate
sources, and (20) Reporting completeness rate
(4) Be able to use the M&E in disease specific programs. (21) Reporting timeliness rate
 Components Definition Questions Example

Resources used during project activities to What do you put in? People, space, materials,
Inputs product outputs knowledge, skills

The processes, tools, events, technology, What are you doing? Teaching good hygiene practices,
Activities and/or actions that are carried out to teaching how to make soap,
achieve the objectives demonstrating new gardening
techniques, home educating on
good nutrition

The direct result of the activities of a Who came? 8 women, 14 girls under 15, 10
Outputs project. Outputs may be goods, How many came? boys under 15 attended. 8 hand-
infrastructure, services, or people reached What was developed? washing stations were produced,
by services. 25 bars of soap were made, 35
trees were planted.

Changes in specific knowledge, attitudes, What changed? A month later, six women were
Outcomes behaviors, or conditions that result from Of the number who using the hygiene practices they
project activities. participated, how many learned in their homes.
showed changes?

The long-term, cumulative effect of an What is the long-term Community members, especially
Impact intervention or interventions effect? children under 5, are not
(Goal/Objective) (e.g., the long-term results stemming from contracting hygiene- and
participants’ activities over the life of a sanitation-related illnesses (like
project). chronic diarrhea) as often as they
once did; community members
are able to work more
consistently, and students are
performing more effectively in
school because they aren’t out
sick as often.

HMIS Indicators and Health Programs [MSI Indicators]

• HMIS is a source of routine data necessary for (1) Pregnancy care intervention
monitoring different aspects of various health programs (2) Intrapartum care
implemented in a country. (3) Postpartum care
• HMIS indicators should be carefully selected to meet the (4) Interpartum period
essential information necessary for monitoring the
performance of various health programs and services and
to present an overview of available health resources.

Maternal Survival Interventions

→ The fifth millennium development goal targets to reduce

the maternal mortality ratio by 75% and to achieve
universal access to reproductive health.
→ Packaging of health facility-oriented interventions is
highly effective and has high coverage of the intended
target group.
→ The use of indicators will help prompt further
investigations when problem on issues arise.
 Child Mortality and Child Survival Interventions Stop TB Program

→ The leading cause of under-5 child mortality in the PH in → The goal is to dramatically reduce the global burden of
2012, was Pneumonia with 2,051 reported cases. tuberculosis by 2015.
→ Aims to push TB up the world political agenda.
→ One of the main objectives is to achieve universal access
Top 10 leading causes of child mortality
to high-quality care for all people with TB.
1. Pneumonia 6. Accidental drowning & → Targets to reduce the prevalence of and death by 50%
submersion compared with the 1990 baseline by 2050.

2. Diarrhea & 7. Chronic lower respiratory HMIS indicators to monitor Stop TB Program
Gastroenteritis disease
(1) TB patients on DOTS
3. Congenital Anomalies 8. Dengue fever and (2) TB case Detection
dengue-hemorrhagic fever (3) HIV-TB co-infection
4. Other diseases of the 9. Meningitis (4) HIV+ new TB patients enrolled in DOTS
nervous system (5) TB treatment outcome

5. Septicemia 10. Pulmonary and heart

disease

Various strategies launched by DOH to help ensure good

(tanawa nlng sa book ang indicators kay kapoy na type)
health of Filipino children by 2025.

Or the Philippine Strategic Framework

for Plan Development for Children 2000
Child 1 to 2025

Serves as a framework for policymaking

and
program planning and as a roadmap for
intervention aimed at safeguarding the
welfare of Filipino children.

Part of the Philippines’ commitment to

the UN CRC.

Children’s Focuses on the development of Filipino

Health 2025 children and the protection of their
rights

Integrated a strategy that aims to lower child

Management of mortality caused by common illness
Childhood
Illness

Enhanced Child Aimed to improve the health and

Growth nutrition of Filipino children