Objectives and Indicators for MCH Programs MCH in Developing Countries 1

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 program goals Processes Objectives Inputs Activities Outputs Outcomes Impact Terms will vary!

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

Processes Objectives Inputs Activities Outputs Outcomes Impact Objectives can include anything 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 Outcomes -- Intermediate objectives that fall somewhere between these two

Outputs vs. Outcomes Example: Number of pregnant women delivering in a health facility is an output. Percentage of those delivering in a health facility who deliver a newborn without complications is an outcome. Not how many worms the bird feeds its young, but how well the fledgling flies (United Way of America) Source: University of Wisconsin Extension, Program and Evaluation 8

Frequently “bean counting” Processes Objectives Inputs Activities Outputs Outcomes Results 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

Processes Objectives Inputs Activities Outputs Outcomes Impact 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

Causality Processes Objectives Inputs Activities Outputs Outcomes Impact Causality 11

Processes Objectives Inputs Activities Outputs Outcomes Impact 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

Processes Objectives Inputs Activities Outputs Outcomes Impact 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…. Processes Objectives Inputs Activities Outputs Outcomes Impact Let’s try again….

The project will increase immunization coverage to 80% Processes Objectives Inputs Activities Outputs Outcomes Impact Let’s consider another objective... The project will increase immunization coverage to 80%

Let’s try again…. Processes Objectives Inputs Activities Outputs Outcomes Impact Let’s try again….

Measures By…, v% coverage By …, coverage will increase from w% to x% By…, coverage will increase by y% By…, coverage will increase by z percentage points 17

Additional terms: Indicators… Target… Inputs Activities Processes Outputs Objectives Outcomes Impact Indicators… Answer the question, “How will we measure what we have achieved?” Target… the specific level of achievement

What is the indicator and target for the immunization objective?

Indicator: Target :

Who to involve in setting objectives and indicators? Selecting Indicators 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

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 and economical basis? Will you need to conduct a survey or special studies?

All of these contribute to the program goals -- broad, long-term intended results Inputs Activities Processes Outputs Objectives Outcomes Impact Indicators