Solved Questions (NSC504: Monitoring and Evaluation of Health Programme and Services)

Question 1

a. Describe in detail the steps your team will take in designing an effective monitoring and evaluation
system.

1. Identifying Objectives and Goals: Start by determining the purpose of the system and aligning it
with health program goals and outcomes.

2. Stakeholder Engagement: Consult with relevant stakeholders such as community leaders,

healthcare workers, and management for their input.

3. Developing Indicators: Identify measurable indicators (input, process, output, outcome, impact)
to track progress.

4. Data Collection Plan: Outline methods for data collection (surveys, interviews, reports) and tools
like forms and digital platforms.

5. Baseline Assessment: Conduct a baseline survey to gather pre-intervention data for comparison.

6. Resource Allocation: Allocate personnel, budget, and technology needed for implementation.

7. Implementation and Data Monitoring: Monitor the program activities, ensuring continuous data
gathering at all stages.

8. Evaluation Design: Choose evaluation methods (formative, summative) to assess outcomes.

9. Analysis and Reporting: Analyze the collected data and compile reports for decision-makers.

10. Feedback Mechanism: Ensure results are shared and adjustments are made based on findings.

b. Discuss the components of a Monitoring and Evaluation Plan.

1. Introduction: Defines the scope, purpose, and objectives of the monitoring and evaluation plan.

2. Indicators: Specifies key indicators (quantitative and qualitative) to measure program progress.

3. Data Sources and Collection Methods: Identifies where data will come from (e.g., health
records, surveys) and how it will be collected.

4. Data Analysis and Reporting: Describes how data will be analyzed, presented, and
communicated to stakeholders.

5. Roles and Responsibilities: Defines personnel responsible for M&E activities.

6. Budget and Resources: Outlines the financial and material resources needed.

7. Timelines: Sets a timeline for data collection, reporting, and evaluation.

8. Data Use: Explains how the findings will inform decision-making and program improvement.
c. Enumerate four (4) features of a monitoring and evaluation plan.

1. Clarity: The plan should have clear and well-defined objectives.

2. Specific Indicators: It should contain SMART (Specific, Measurable, Achievable, Relevant, and
Time-bound) indicators.

3. Comprehensive Framework: Integrates both monitoring (ongoing) and evaluation (periodic)

components.

4. Stakeholder Involvement: Ensures the active participation of all relevant stakeholders.

Question 2

a. As a public health nurse, how would you evaluate the roll-back malaria program in your
community?

1. Baseline Data Collection: Assess the prevalence of malaria before intervention.

2. Program Objectives: Review if the goals (e.g., reducing malaria incidence) are being achieved.

3. Indicators: Use specific indicators like malaria cases, bed net coverage, and access to treatment.

4. Surveys and Field Reports: Conduct community surveys to measure program reach.

5. Treatment Records: Analyze hospital/health center records for malaria-related cases.

6. Feedback Mechanisms: Involve stakeholders (nurses, patients) to gather feedback on program

effectiveness.

7. Comparison: Compare current malaria rates with pre-program baseline data.

8. Report Writing: Document successes, challenges, and recommendations for improvement.

b. Discuss formative and summative evaluation using the following guide:

1. Description:

o Formative Evaluation: Conducted during program implementation to improve

processes.

o Summative Evaluation: Done after program completion to measure impact and

outcomes.

2. Uses:

o Formative: Identifies weaknesses during implementation and suggests immediate

changes.

o Summative: Determines whether the program achieved its objectives and informs
future planning.
 3. Examples:

o Formative: Mid-term review of a malaria prevention program.

o Summative: End-of-year assessment showing reduced malaria cases.

Question 3

a. Define the concept of Annual Project Report.

An annual project report is a comprehensive document that summarizes a project’s progress,
achievements, challenges, and financial expenditures over a year.

b. State the uses of annual project report.

1. Provides accountability to stakeholders.

2. Monitors and tracks progress toward project goals.

3. Identifies achievements and challenges faced during the year.

4. Guides decision-making and planning for the next year.

5. Serves as a reference document for funding agencies and policymakers.

c. Discuss the contents of an annual project report you intend to write following a health center visit.

1. Executive Summary: A brief overview of the project objectives, activities, and key findings.

2. Introduction: Purpose and goals of the project.

3. Achievements: Outcomes achieved during the reporting period.

4. Challenges: Difficulties encountered and mitigation strategies.

5. Financial Report: Detailed budget, expenditures, and variances.

6. Recommendations: Suggestions for future actions.

7. Annexes: Supporting documents like data tables, photos, or charts.

Predicted Questions for Tomorrow's Exam

1. What are the differences between monitoring and evaluation in healthcare programs?

2. List and describe the types of indicators used in monitoring and evaluation.

3. Explain the role of stakeholders in monitoring and evaluation of health programs.

 4. Discuss three challenges commonly faced in the implementation of monitoring and evaluation
systems.

5. How can monitoring and evaluation improve healthcare delivery in rural settings?

6. Describe the steps in conducting a formative evaluation for a new immunization program.

7. Discuss the advantages of using both qualitative and quantitative methods in evaluation.

8. Explain the concept of 'impact evaluation' and its significance in health programs.

9. Enumerate five ethical considerations in conducting monitoring and evaluation.

10. Describe the steps for writing a mid-term project evaluation report.

Conclusion

This comprehensive solution and set of predictions will prepare you for the exam tomorrow. Focus on
the topics of evaluation systems, indicators, stakeholder roles, and program challenges. Good luck, and
I’m sure you’ll ace it! 🌟

1. What are the differences between monitoring and evaluation in healthcare programs?

Aspect Monitoring Evaluation

Definition Ongoing, systematic collection of data to Periodic assessment of a program’s

track program activities and progress. effectiveness, relevance, and impact.

Focus Focuses on inputs, activities, and outputs. Focuses on outcomes, impact, and
lessons learned.

Purpose Ensures activities are on track and identifies Assesses whether goals were achieved
immediate issues. and measures long-term impact.

Frequency Continuous and regular (daily, weekly, Conducted at specific times (mid-term,
monthly). end of program).

Tools Used Checklists, progress reports, field visits. Surveys, interviews, baseline-endline
comparisons, case studies.

Responsibilit Implementing team and field workers. Independent evaluators, program

y managers, or external agencies.

Example:

 Monitoring: Tracking the monthly number of malaria nets distributed in a community.

 Evaluation: Assessing whether malaria rates have decreased due to the program intervention.
2. List and describe the types of indicators used in monitoring and evaluation.

1. Input Indicators: Measure the resources invested in a program.

o Example: Budget spent, number of staff recruited, equipment supplied.

2. Process Indicators: Assess the activities and implementation processes.

o Example: Number of immunization campaigns conducted, training sessions delivered.

3. Output Indicators: Measure immediate results from program activities.

o Example: Number of children vaccinated, number of health centers renovated.

4. Outcome Indicators: Measure short- to medium-term changes achieved.

o Example: Percentage increase in immunization coverage, reduction in child mortality

rates.

5. Impact Indicators: Measure long-term and sustainable effects of a program.

o Example: Decrease in malaria incidence, improved life expectancy in a community.

3. Explain the role of stakeholders in monitoring and evaluation of health programs.

1. Program Designers/Managers: Provide guidance, set objectives, and ensure M&E aligns with
program goals.

2. Healthcare Workers: Collect accurate data, implement interventions, and provide ground-level
insights.

3. Community Members/Beneficiaries: Provide feedback on the effectiveness, accessibility, and

satisfaction with program activities.

4. Government Agencies: Support policy formulation, provide resources, and ensure

accountability.

5. Funding Organizations: Ensure funds are used effectively and verify program results for
continued investment.

6. Independent Evaluators: Conduct unbiased assessments to ensure transparency and objectivity.

Importance:
Involving stakeholders promotes ownership, transparency, and ensures programs meet community
needs.
4. Discuss three challenges commonly faced in the implementation of monitoring and evaluation
systems.

1. Lack of Resources:

o Insufficient funds, technology, or skilled personnel to effectively implement M&E

systems.

o Solution: Advocate for dedicated budgets and provide staff training.

2. Inadequate Data Collection Systems:

o Poor data quality, irregular reporting, and lack of standardized tools can hinder progress
tracking.

o Solution: Develop robust data collection tools and train field staff on data accuracy.

3. Resistance to Evaluation:

o Stakeholders may fear criticism or see evaluation as a policing mechanism.

o Solution: Sensitize stakeholders on the benefits of evaluation for program improvement.

5. How can monitoring and evaluation improve healthcare delivery in rural settings?

1. Identifies Gaps: M&E helps identify service delivery challenges, such as lack of healthcare
workers or resources.

2. Improves Accountability: Ensures efficient use of limited resources and promotes transparency.

3. Enhances Program Design: Data from M&E informs tailored interventions to address rural health
needs.

4. Tracks Progress: Regular monitoring measures the success of programs like immunization
campaigns.

5. Supports Decision-Making: Provides evidence-based recommendations to policymakers for

improving services.

Example: An M&E system for antenatal care can track attendance rates and ensure timely interventions
for pregnant women in rural communities.

6. Describe the steps in conducting a formative evaluation for a new immunization program.

1. Define Objectives: Determine what the formative evaluation aims to achieve (e.g., identify
barriers to immunization).

2. Engage Stakeholders: Collaborate with program staff, community leaders, and beneficiaries to
gather inputs.
 3. Develop Evaluation Questions: Identify specific areas to evaluate, such as awareness levels or
service delivery.

4. Choose Data Collection Methods: Use surveys, interviews, focus group discussions, and field
observations.

5. Analyze Data: Identify weaknesses in program implementation, such as poor vaccine storage or
community resistance.

6. Provide Recommendations: Suggest improvements (e.g., community education campaigns or

better vaccine logistics).

7. Implement Changes: Use feedback to refine and optimize the program before scaling it up.

7. Discuss the advantages of using both qualitative and quantitative methods in evaluation.

1. Comprehensive Understanding:

o Quantitative data provides measurable results, while qualitative data explores

underlying reasons and perceptions.

2. Triangulation of Data:

o Combining both methods improves accuracy and validates findings.

3. Captures Diverse Perspectives:

o Quantitative surveys reach large populations, while qualitative interviews capture

individual experiences.

4. Improved Decision-Making:

o Quantitative results identify trends, while qualitative insights guide program

adjustments.

Example: Measuring immunization rates (quantitative) and exploring barriers to immunization uptake
(qualitative).

8. Explain the concept of 'impact evaluation' and its significance in health programs.

 Definition: Impact evaluation assesses the long-term effects and changes attributable to a
program.

 Significance:

1. Measures program effectiveness and sustainability.

2. Determines if desired goals, such as reduced disease burden, are achieved.

3. Provides evidence to justify resource allocation and funding.

 4. Identifies unintended positive or negative consequences.

Example: Assessing whether malaria mortality reduced in a region due to bed net distribution programs.

9. Enumerate five ethical considerations in conducting monitoring and evaluation.

1. Informed Consent: Participants must understand the purpose of the evaluation and agree
voluntarily.

2. Confidentiality: Ensure data privacy and anonymity of respondents.

3. Non-Maleficence: Avoid causing harm to participants during the evaluation process.

4. Cultural Sensitivity: Respect cultural beliefs and practices when collecting data.

5. Transparency: Share findings with stakeholders honestly and ensure results are not manipulated.

10. Describe the steps for writing a mid-term project evaluation report.

1. Title Page: Project title, evaluation period, and key stakeholders.

2. Executive Summary: Brief summary of objectives, findings, and recommendations.

3. Introduction: Background of the project, purpose, and evaluation objectives.

4. Methodology: Describe data collection methods and tools used.

5. Findings: Present results using tables, charts, and analysis of key indicators.

6. Challenges: Highlight difficulties faced during implementation.

7. Recommendations: Suggest practical actions for program improvement.

8. Conclusion: Summarize key insights and next steps.

9. Annexes: Include survey tools, raw data, and photos where relevant.

Conclusion

These detailed answers align with exam expectations and provide clarity, depth, and examples for each
question. Review thoroughly, and you’ll secure the A++ you desire. Best of luck—you've got this! 🌟

Why Monitoring is Important for a Nursing Programme

Monitoring is a crucial component of any nursing programme as it ensures that health interventions,
policies, and practices are aligned with established objectives. It enables nurses to track progress,
identify challenges, and implement timely corrective actions. Effective monitoring supports evidence-
based decision-making, optimizes resource utilization, and enhances accountability. Furthermore, it
ensures quality care, improves patient outcomes, and fosters continuous professional development
within the healthcare setting.

Nursing Roles at Different Levels of Monitoring

1. Top-Level Monitoring

 Role: At this level, nurses may participate in strategic planning and policy development. They
ensure that healthcare goals are clear, achievable, and aligned with organizational objectives.

 Responsibilities:

o Contributing to the development of nursing-related health plans.

o Advising on the allocation of resources, such as staffing and budgets.

o Ensuring compliance with national or institutional healthcare standards.

2. Middle-Level Monitoring

 Role: Nurses in this role function as intermediaries, implementing and coordinating the
organization’s plans while ensuring departmental efficiency.

 Responsibilities:

o Translating top-level strategies into actionable plans for lower levels.

o Monitoring the performance of nursing teams and units.

o Identifying and addressing gaps in service delivery or policy execution.

o Designing and tracking group-level performance indicators, such as patient satisfaction

scores.

3. Operational-Level Monitoring

 Role: Nurses at this level are directly involved in the execution and supervision of healthcare
activities, ensuring compliance with planned schedules and procedures.

 Responsibilities:

o Overseeing day-to-day patient care and nursing operations.

o Collecting and analyzing routine data on care delivery.

o Ensuring adherence to clinical guidelines and protocols.

o Providing immediate feedback and adjustments to improve care quality.

 o Supervising and motivating staff to maintain high performance.

Domains of Information Required in Monitoring

1. Inputs: Resources allocated to nursing programs, such as personnel, equipment, and funding.

2. Processes: Activities carried out, such as training sessions, patient care procedures, or public
health interventions.

3. Outputs: Immediate results, such as the number of patients served, vaccinations administered,
or nursing hours logged.

By actively participating in monitoring across these levels, nurses help bridge the gap between strategic
objectives and practical outcomes, fostering a culture of excellence and accountability in healthcare
delivery.