Performance Indicators: Readers’ Digest Edition

Performance indicator: definition A measure of a situation to detect any change. A feature or characteristic used to measure whether, and/or the extent to which, a stated result has been achieved. The definition suggests 2 elements: - indicator reflects the change that has occurred (i.e.: from on status to another) - indicators are applied to demonstrate the level of achievement over a period of time. Indicators are essential for demonstrating achievement and for supporting accountability.

Performance indicator: concept Using indicators to support program management involves: - establishing the baseline (to determine the situation at the beginning of the planning period) setting a target (commitment) measuring achievement (actual result) The concept of performance indicator includes the notions of baseline, target and achievement: - Baseline: the value of the indicator at the beginning of the planning period. - Target: the value of the same indicator reflecting a commitment to result for a given period - Achievement: the actual value of the same indicator at the end of the planned timeframe The baseline, target and achievement are values of the indicator at different times.

How many indicators? The fewer indicators per stated result the better The general recommendation is that we should use as few indicators as possible. The main limit is that of practicality: - cost - effort - usefulness Is it easy to get the information? If not, you may need to choose a different indicator. One indicator per result may be sufficient depending of the complexity of the stated result. An indicator can be disaggregated (broken down into categories) to reflect various perspectives (e.g. by region, type of economy, target groups). If that is the case, we should keep in mind the amount of data to be handled and use less but more meaningful indicators. PME (former BMR) has prepared “Guidelines on the development of Expected Results and indicator” (WHO/BMR/01.5 December 2004). It includes illustrative examples.

Indicators: technical qualities Sound indicators have the following qualities: Validity: The measurement captures what it is . supposed to measure Reliability: The measurement is consistent and comparable across time and place Sensitivity: The measurement can detect the extent and direction of the change during the . required timeframe There is a difference between an indicator that is well written and one that measures the right thing. These qualities are not absolute, but indicators have these qualities to varying degrees. The stronger each quality, the more precise the indicator.

Indicators: practical qualities The chosen indicator(s) should be: Simple: consensus on meaning, easy to interpret, to assess and to use Practical: timely data collection, at reasonable cost Useful: for decision-making, and learning for better planning and implementation In addition to the technical qualities of validity, reliability and sensitivity, we should have in mind various practical considerations. This slide provides a summary of issues on indicators that managers need to keep in mind when developing a set of indicators. Completing the performance measurement matrix (see further detail in slides 26 and 27) will also help managers see whether their indicators are sufficiently simple, practical and useful.

Indicators: Essential Traits CREAM: Clear, Relevant, Economical, Adequate, Monitorable QQTP: Quantity, Quality, Time, and Place or Population DOPA: Direct (closely related to the intended change), Objective (operationalized and unambiguous), Practical (reasonable cost combined with high utility), and Adequate (no more or less than what’s necessary to measure intended change)

In summary, good indicators are… Relevant to the stated result Reliable signals that convey information about real changes Objectively verifiable and not just subjective in their nature Measurable with reasonable cost and effort Helpful to managers: in assessing whether the program is successful in achieving results in improving the program Indicators must : Be congruent with the statement of the results, ensure that the nature of the change stated in the result is what is being measured. If the formulation is not clear, or is somehow ambiguous or subjective by its nature, you will not expect the indicator to be used to objectively verify the result. If you cannot afford to collect the information or if you have to struggle to get it, then your indicator will not be helpful. Indicators should ensure that the achievements can be measured within the planned period, and that the information from the indicators will assist decision-making.

MDG Indicators #1-- Eradicate extreme poverty and hunger Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day 1. Proportion of population below $1 (PPP) per day 2. Poverty gap ratio [incidence x depth of poverty] 3. Share of poorest quintile in national consumption

MDG Indicators #1-- Eradicate extreme poverty and hunger Target 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger 4. Prevalence of underweight children under-five years of age 5. Proportion of population below minimum level of dietary energy consumption

MDG Indicators #2-- Achieve universal primary education Target 3: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling 6. Net enrolment ratio in primary education 7. Proportion of pupils starting grade 1 who reach grade 5 8. Literacy rate of 15-24 year-olds

MDG Indicators #3-- Promote gender equality and empower women Target 4: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 9. Ratios of girls to boys in primary, secondary and tertiary education 10. Ratio of literate women to men, 15-24 years old 11. Share of women in wage employment in the non-agricultural sector 12. Proportion of seats held by women in national parliament

MDG Indicators #4-- Reduce child mortality Target 5: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate 13. Under-five mortality rate 14. Infant mortality rate 15. Proportion of 1 year-old children immunized against measles

MDG Indicators #5--Improve maternal health Target 6: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio 16. Maternal mortality ratio 17. Proportion of births attended by skilled health personnel

MDG Indicators #6--Combat HIV/AIDS, malaria and other diseases Target 7: Have halted by 2015 and begun to reverse the spread of HIV/AIDS 18.HIV prevalence among pregnant women aged 15-24 years --19a. Condom use at last high-risk sex --19b. Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS --19c. Contraceptive prevalence rate 20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years

MDG Indicators #6--Combat HIV/AIDS, malaria and other diseases 21. Prevalence and death rates associated with malaria 22. Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures 23. Prevalence and death rates associated with tuberculosis 24. Proportion of tuberculosis cases detected and cured under directly observed treatment short course DOTS (Internationally recommended TB control strategy) Target 8: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

MDG Indicators #7--Ensure environmental sustainability Target 9: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources 25. Proportion of land area covered by forest Ratio of area protected to maintain biological diversity to surface area Energy use (kg oil equivalent) per $1 GDP (PPP) Carbon dioxide emissions per capita and consumption of ozone-depleting CFCs (ODP tons) 29. Proportion of population using solid fuels

MDG Indicators #7--Ensure environmental sustainability Target 10: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation 30. Proportion of population with sustainable access to an improved water source, urban and rural 31. Proportion of population with access to improved sanitation, urban and rural

MDG Indicators #7--Ensure environmental sustainability Target 11: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers 32. Proportion of households with access to secure tenure

Measuring performance Baseline Target Income Improvement Measurement at the end of the period “Readings” on the same indicator “Readings” at different times The key point is the use of the same indicator at 3 different times (i.e. three “reading”). The measurement at the end of the period (achievement) will be assessed against the measurement at the beginning of the period (baseline) and results stated as a commitment to be achieved (target). The performance will be the difference between the achievement, and the baseline measured at the beginning of the period. It is important to assess and record each of these “readings” at the appropriate time.

An approach for developing indicators: Step #1 (determine focus) Review MDG indicators Determine feasibility of adapting an existing indicator If existing indicators are unsatisfactory, determine what might be useful

An approach for developing indicators: Step #2 (refine focus) Quantitative or Statistical Measures: Number of Frequency of % of Ratio of Qualitative Judgments or Perceptions: Congruence with Presence of Quality of Extent of Level of

An approach for developing indicators: Step #3 (combine quantity & quality) Indicator: % of births attended Add Quantity: % of births attended INCREASED from 60% to 90% Add Quality: Births attended by TRAINED health personnel increased from 60% to 90% Add Time: Births attended by trained personnel increased from 60% to 90% by 2012 Add Place: Births attended by trained personnel in X District increased from 60% to 90% by 2012

Developing Indicators: good practices for Results Framework Discuss results and indicators in parallel Consult and get consensus among relevant staff regarding indicators Apply the selection principles and discard those indicators that do not have the required qualities Valid Simple Reliable Practical Sensitive Useful Valid Reliable Sensitive Retain the best mix of indicators and keep alternatives in reserve (1or 2 indicators per stated result is sufficient) Check the relevance of indicators to the state result

RF performance measurement matrix This matrix is a tool to outline the operational requirements for measuring indicators. It would be used after completing the results framework: - the results framework is used at the planning stage to develop the various levels of results and the associated indicators. - after that, this matrix is used to outline the requirements for using the indicators. This matrix can also assist with planning the work associated to performance measurement.

Another View: Essential RF Indicator Information Definition of terms Disaggregation Baseline Data collection techniques Associated instrumentation or tools Data verification Data analysis Data reporting Data use Population Data collectors Frequency