1. Using Data for Decision Making

2. Learning Objectives By the end of the session, participants will be able to: 1. Raise awareness of the importance of using data to inform decisions 2. Discuss and share strategies for overcoming barriers ensuring that health-related data are being used to make decisions at all levels 3. Learn strategies for using data in program management, implementation, and decision-making

3. What is Decision Making? The process of choosing from among various alternatives using information in light of a given objective

4. Stake- holders Decisions Data Context of decision-making

5. Who is a decision-maker? One person responsible for acting at any level –Lower levels: Parent of a sick child –Middle Level: Regional M&E Officer –Top level: Program Manager –Global Level: RBM, Global Fund, WHO staff

6. Examples of Decisions Policy Making: ITN/IRS/Case management Policy Strategic Planning: ITN/IRS Targeted Program Management: Scheduling of staff for supportive supervision and monitoring Resource allocation: Drugs and Commodities Human resources Infrastructure/Equipment

7. Who is a Stakeholder? Any person or group with a particular interest in a policy or program

8. Stakeholders in the Decision-Making Process StakeholderInformation Needs Program Managers and Implementation Partners Efficacy Effectiveness Clientele Quality Coverage Health PartnersEffectiveness Policy Implications Sustainability Cost-efficiency Policy MakersCorrect/improve policy Quality Cost-efficiency Data ProducersAll of the above

9. Stakeholder Matrix Name of Stakeholder Organization (and specific individual if required) Stakeholder Description Potential Role in Activity and Use of Results Level of Knowledge of Topic Level of Commitment (positive and negative) Constraints to Participate in Activity When to Involve NMCP- Program Manager Oversees Malaria control service delivery Primary audience Access to sites. Service guideline revision High, extensive Strongly supports scale-up of malaria control strategies Busy schedule. Need 4 week lead time Through- out

10. Different people need information for different kinds of decisions Engage in dialogue with stakeholders to fully understand the decisions they make, information they need, and the best way to present that information

11. Why address data demand & use?

12. Uses of Data In what ways can we use data? Inform policies and plans Raise additional resources Strengthen programs and improve results Ensure accountability and reporting Improve quality of services provided Contribute to global lessons learned

13. Data Use Use refers to the decision-making process We say the decision-maker uses data if he/she Is explicitly aware of the decision to be made Considers at least two possible courses of action, and Considers relevant data in making the decision, even if the data is outweighed by other factors

14. Data Demand –Demand refers to the value the decision- maker places on the data, whether or not he/she actually uses the data –We say the decision-maker demands data if he/she Understands what data is needed to make the decision, and Proactively seeks out the data he/she needs

15. Data Demand and Use

16. The Response Monitoring & Evaluation Systems Better Health Outcomes Data- informed Decisions

17. What is the role of M&E personnel in decision making? Provide the data needed to make decisions Help decision-makers interpret data Help decision-makers understand what kinds of questions they should ask from the data

18. “… without information, things are done arbitrarily and one becomes unsure of whether a policy or program will fail or succeed. If we allow our policies to be guided by empirical facts and data, there will be a noticeable change in the impact of what we do.” National-level Policymaker, Nigeria

19. Class Discussion Consider the last time you used or wanted to use data to make a decision or recommendation about a program –Who were the decision-makers/stakeholders? –What information was used? –What decision was made?

20. Factors other than evidence-based information influence decisions Power relationships Timing Competing priorities Public opinion Political ideology Funding/Donors Arbitrariness Local culture of decision-making Other information sources

21. Stakeholders Involve new counterparts Strengthening the Decision-making Process Decisions Understand service delivery realities Data May require additional data

22. Class Discussion: Barriers to Data Use What barriers have you faced to using or getting others to use data?

23. Data are often underutilized because of… Lack of a “data culture” among decision makers Low staff motivation Organizational structures Lack of technical skills and technology, particularly at local levels Training often ad hoc and not sustainable Structural constraints– roads, telecommunication Unclear staff roles and poor information flow Poor funding for M&E Political interference

24. How Can We Increase the Use of Data? Provide timely reports and review on a regular basis Involve program staff in M&E Ensure data quality Demonstrate use of information Ensure consistency of indicators Mandate performance monitoring

25. How Can We Increase the Use of Data? Increase knowledge and availability of data Share findings & recommendations with broad audiences in appropriate formats Create action plan for the implementation of recommendations

26. “Making Data Speak”! Example of drug policy change Decision: Changing from chloroquine to ACTs in Ghana Data/information: –Antimalaria Efficacy Data –Malaria In Pregnancy Survey Results –Malaria Morbidity/mortality –Cost-Effectiveness –Benefit Analysis of Drug Options –WHO Guidelines Response: –NCMP analyzed data with user-friendly charts, graphs –Compared results with WHO Guidelines –Determined responses and resources needed –Communicated data to stakeholders (series of fora ) Results: –Stakeholders took informed decision to change from chloroquine to ACTS

27. Working Toward a Culture of Data  Support for high quality data at all program levels  Sharing data between levels in info system  Empower people to ask questions, seek improvement, learn, and improve data quality through useful data

28. In order to make data useful, we need to: Discuss what decisions they make and what data they may find helpful Understand of how programs work, how they collect and report data Train and supervise in order to support reporting and documentation Create a common understanding among: Those who deliver services and report on them Those who analyze the data and those who need the data Working Toward a Culture of Data

29. Key Messages Decisions based on evidence lead to better health outcomes We all have a role in M&E – partners in progress Involve new counterparts beyond M&E specialists High quality information is needed for decision-making at policy, planning and program levels Purpose of M&E is not just to produce more information but to improve action Investments made to improve information systems will be wasted if it is not used to inform policy and program decisions

30. References MEASURE Evaluation, Addis Ababa University. Decision-Making and Strategic Information. Workshop on M&E of PHN Programs July 24-August 11, 2006 Addis Ababa Available at: https://www.cpc.unc.edu/measure/training/materials

31. MEASURE Evaluation is a MEASURE program project funded by the U.S. Agency for International Development (USAID) through Cooperative Agreement GHA-A-00-08-00003-00 and is implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill, in partnership with Futures Group International, John Snow, Inc., ICF Macro, Management Sciences for Health, and Tulane University. Visit us online at http://www.cpc.unc.edu/measure.