HMIS Monitoring and Evaluation

MONITORING- are the systematic collection,

❖ Progress of any medical institution are
analysis, and use of information for three basic
purposes: monitored and evaluated through
various activities such as monitoring
1. Learning from experience reports, HMIS, surveys and evaluation
studies.
2. Accounting internally and externally for
resources used ❖ Be primarily country-focused but also
offer the basis for global monitoring;
3. The results obtained and taking decisions
❖ Address M&E needs for multiple users
EVALUATION- assessing an on-going or
and purposes, including monitoring
completed program or policy as systematically
program inputs, processes and results,
and as objectively as possible.
tracking health systems performance
The object is to be able to: and evaluation;
❖ Facilitate the identification of
❖ Make statements about their relevance,
indicators and data sources, provide
effectiveness, efficiency, impact and tools and guidance for data analysis,
and show how the data can be
communicated and used for
decision-making
❖ Bring together the monitoring and
evaluation work in disease-specific
programs with cross-cutting efforts
sustainability.
such as tracking human resources,
logistics and procurement, and health
service delivery.

The primary aim is to have a strong M&E

and review system in place for the national
health strategic plan that comprises all major
disease programs and health systems.
❖ The framework builds upon principles
derived from the Paris declaration on
aid harmonization and effectiveness
and the IHP+, putting country health
The national M&E plan and system should strategies, and the related M&E
address all components of the framework and processes such as annual health sector
lay the foundation for regular reviews during reviews, at the center.
the implementation of the national plan. ❖ The core is the strengthening of a
common country platform for M&E of
 HMIS Monitoring and Evaluation

HSS, which should result in better

alignment of country and global M&E
systems An indicator can be defined as a
variable whose value changes. It is a
measurement that measures the value of
the change in meaningful units that can be
compared to past and future units
The World Health Organization Monitoring
and Evaluation Health System Strengthening
Framework
 HMIS Monitoring and Evaluation

Common Framework for Monitoring

Performance & Evaluating Progress in The
Scale For Better Health

❖ HMIS is a source of routine data snapshot of the available health

that is necessary for monitoring resources.
different aspects of various health
programs implemented in the Example:
country.
❖ The HMIS indicators have been ❖ Maternal Survival Intervention Child
carefully selected to meet the key ❖ Mortality and Child Survival
information needs of monitoring the Intervention
performance of various health ❖ STOP TB Program
programs and services and provide a
 HMIS Monitoring and Evaluation

The Maternal Survival Strategy and

HMIS indicators

❖ The Maternal Survival Strategies

lays down a framework for achieving
the fifth Millennium Development
Goal of reducing maternal mortality.
❖ Given the complexity of the country
contexts and the determinants of
maternal health, none of the maternal
survival intervention alone can
reduce the maternal mortality rate.
❖ Rather, evidences support packaging
of health facility oriented
interventions is highly effective and
has high coverage of the intended
target group.

HMIS INDICATORS RELATED TO

INTRAPARTUM CARE:

❖ Deliveries by skilled attendance (at

health facilities)
❖ Deliveries by Health Extension
Workers (HEW) (at home of Health
Posts)
❖ Institutional cases of maternal
morbidity and mortality due to
Obstructed labor

❖ 1st postnatal care attendance

❖ Institutional cases of maternal
morbidity and mortality due to
postpartum hemorrhage (PPH)
and Puerperal sepsis
 HMIS Monitoring and Evaluation

❖ Family planning method acceptors

(New and Repeat)
❖ Family planning methods issued by
type of method

❖ Ethiopia is one of those countries

who have made great strides
towards reducing the under-5
mortalities based on Ethiopia
Maternal and Child Health Data
(2012).
❖ However, under-5 mortalities still
remain high at 106 per 1000 live
births (LB) in 2010 and the country
Ethiopia is implementing interventions
faces the challenge of reducing it to
targeting under 5-year-old children
61/1000 LB by 2015.
through:
❖ The EDHS 2011 estimated under-5
mortalities to be 88 per 1000 LB that ❖ Universal Immunization Coverage,
is a 47% decline from 166/1000 LB ❖ Nutrition program,
in 2000. Diarrhea, pneumonia, ❖ Integrated Management of
measles, malaria, HIV/AIDS, birth Childhood Illnesses and the
asphyxia, preterm delivery, neonatal Community Case Management of
tetanus and neonatal sepsis are the Childhood Illnesses
major causes of under-5 deaths in ❖ Through Health Development Army
Ethiopia, with under-nutrition to –improve water, sanitation and
attributing to over one third of these hygiene–Malaria prevention through
deaths. Integrated Household Spraying and
distribution of Insecticide Treated
Nets (ITN) (USAID, 2013).

In the context of the above these child

survival interventions, the related HMIS
indicators are:
 HMIS Monitoring and Evaluation

❖ Number of treatments for children ❖ The following flowchart puts the

under five provided by health facility HMIS indicators (in green shaded
by disease: Diarrhea, dysentery, boxes) in the context of the STOP
pneumonia, measles, malaria, TB Program.
neonatal tetanus
❖ Number of infants immunized for
measles
❖ Latrine coverage
❖ Safe water coverage
❖ Household with ITN

❖ With the vision to have a TB free

world, the goal of the STOP TB
Program (STP) is to dramatically
reduce the global burden of TB by
2015, in line with the Millennium
Development Goals and the Stop
TB Partnership targets of the HMIS Indicators to Monitor STOP TB
World Health Organization (2006). Program
❖ One of the main objectives of the
❖ TB patients on DOTS
program is to achieve universal
❖ Number of new smear pulmonary TB
access to high-quality care (i.e.
cases enrolled in the cohort
universal access to high quality ❖ TB Case Detection
diagnosis and patient centered ❖ Number of New smear positive
treatment) for all people with TB pulmonary TB cases detected
(including those co-infected with ❖ Number of new smear negative
HIV and those with drug-resistant pulmonary TB cases detected
TB). ❖ Number of new extra pulmonary TB
❖ TB case detection and successful cases detected
completion of the treatment/cure of ❖ HIV –TB –Co-infection
the TB remains at the core of the ❖ Proportion of newly diagnosed TB cases
tested to HIV
Stop TB Strategy. Hence one of the
❖ HIV+ new TB patients enrolled in
targets linked to the MDGs and
DOTS
endorsed by the Stop TB Partnership ❖ TB Treatment outcome •Treatment
is by 2050 to reduce prevalence and completed PTB+
deaths due to TB by 50% compared ❖ Cured PTB+, Defaulted PTB+, Deaths
with a baseline of 1990. PTB+