Objectives and Indicators for MCH Programs MCH in Developing Countries January 25, 2011

Objectives and Indicators Session goals – Promote an understanding of the importance of good objectives and indicators, and their contribution to effective program management –Provide or refine skills needed to develop MCH program objectives

Objectives and Indicators Session objectives -- by the end of the session, participants should be able to: – explain the terms “goal,’ “objective,” “indicator” and “target” –describe the characteristics of objectives and indicators that are useful for program management – write a “smart” objective for the country project and state its corresponding indicator

Why discuss MCH program objectives? – How will you know if you are successful if you don’t identify what you want to do? –There are always limited resources –Clear objectives are often a donor requirement – Developing appropriate and useful objectives is not always simple or intuitive... (Note -- they are NOT a substitute for “doing the right thing” based on a needs assessment)

Logic model flow chart - how program efforts contribute to the program’s goals Causality InputsActivities Processes Outputs Objectives OutcomesImpact

InputsActivities Processes Outputs Objectives OutcomesResults Activities are any action, funded or unfunded, undertaken to achieve a program result Assignments, tasks, stuff we do to achieve our objectives!

InputsActivities Processes Outputs Objectives OutcomesImpact Objectives can include anything that is clearly intended to be achieved through the program or project Output level objectives are those resulting from first order activities Impact level objectives refer to the desired long-term or ultimate result Intermediate objectives that fall somewhere between these two are usually referred to as outcomes - also known as “effects”

InputsActivities Processes Outputs Objectives OutcomesResults Output level objectives are those that result from activities -- things your program does –In most instances don’t represent population change –Important area for program/project monitoring Frequently “bean counting” –Useful for program management purposes –And -- donors may hold you accountable for the beans

InputsActivities Processes Outputs Objectives OutcomesImpact Impact and outcomes are… –Changes in the condition or behavior of a program participant or changes in conditions that affect a participant: results Whether an objective is a impact or outcome depends on its level in the causality chain –Impact describes the long-term results –Outcomes describe the immediate effects on participants The ability of a program to produce results (i.e., outcomes, impact, or both) depends on your resources, program duration, and many, many social, economic and cultural conditions that affect participants in the program

InputsActivities Processes Outputs Objectives OutcomesImpact Objectives should be the highest order objectives for which you can be held accountable They should be S M A R T : –S - simple –M - measurable (in the program setting) –A - appropriate (technically correct, important) –R - realistic –T - time-limited

InputsActivities Processes Outputs Objectives OutcomesImpact Let’s consider this objective... The project will improve the understanding of mothers about the importance of oral rehydration therapy and how to correctly mix ORS.

Let’s try again …. InputsActivities Processes Outputs Objectives Outcomes Impact By the end of the project, 80% of mothers of children under age 5 in the project area will give their child increased fluids when the child has diarrhea

InputsActivities Processes Outputs Objectives OutcomesImpact Let’s consider another objective... The project will increase immunization coverage to 80%

Let’s try again …. InputsActivities Processes Outputs Objectives Outcomes Impact By the end of the project, 80% of children aged months in the project area will have completed their basic immunizations

InputsActivities Processes Outputs Objectives OutcomesImpact Additional terms: Indicators… “How will we measure what we have achieved?” –Answer the question, “How will we measure what we have achieved?” Target a specific level of achievement

By the end of the project, 80% of children aged months in the project area will have completed their basic immunizations What is the indicator and target for this objective?

The % of children aged months in the project area who have completed their basic immunizations Indicator: Target : 80%

SelectingIndicators Who to involve in setting objectives and indicators? –Project staff –Others familiar with relevant data –The community, partners –Published literature, project reports When? –Iterative - As work on program development proceeds –Check feasibility before finalizing It’s usually OK to revise objectives if rationale is provided

19 Practicality Are the data associated with the indicator practical? –How will you collect the data? –Are quality data currently available? –Can routine data can be procured on a regular and timely basis? –Will you need to conduct a survey or special studies?

All of these contribute to the program goals -- broad, long-term intended results InputsActivities Processes Outputs Objectives OutcomesImpact Indicators

Final thoughts on the selection of objectives and indicators Indicator quality presumes data quality: be aware of the limitations (regarding validity, reliability, and timeliness) of your data More indicators aren’t necessarily better; you need enough information to get an honest reckoning Meaningful qualitative indicators are often okay and sometimes preferable Use objectives for management —it’s the main reason we measure performance Take a practical approach—get adequate information that is available at a reasonable cost to the program Indicators should make sense to a development professional, but be understandable to interested persons

Your task: Move into your country groups Choose an intervention that you might address Write a measurable, SMART outcome objective for that intervention