Understanding Monitoring & Indicators

What is Monitoring?  A continuing function that uses systematic collection of data on specified indicators to provide management and the main stakeholders of an ongoing development intervention with indications of the extent of progress and achievement of objectives in the use of allocated funds

How can monitoring help?  It allows to continuously improve the programme at each stage. E.g. to monitor condom usage, the following indicators can be used: a. Input Indicator – Number of condoms supplied b. Process Indicator – Number of condoms distributed c. Output Indicator – Condom usage rate

Indicators – What are they?  An indicator is a co-efficient of measurement E.g. proportion of individuals referred to VCTC = number of individuals referred to (VCTCs) number of HRG individuals mapped (broad mapping estimate)

Types of Indicators  Input Indicators - It helps to measure the inputs provided for the achievement of objective E.g. the number of FGDs conducted on HIV & STI It shows how many people were made aware about HIV and STI.

Contd.  Process indicators - It helps measure the performance of activities carried on to achieve objectives E.g. proportion of people who come to the clinic every month = number of HRG individuals visiting all types of clinics (programme, referral and outreach) at least once during the specified month number of HRG individuals mapped (broad mapping estimate)

Contd.  Outcome Indicator - It helps measure the outcome of the programme E.g. STI prevalence rate = number of people who are found STI positive total number of people who visited clinics A reduction in STI prevalence rate shows that the programme is successful in achieving its objective (depending upon good performance within other indicators too)

Monitoring Responsibilities

Programme Manager At NGO level ( on regular basis)  Ensure the schedule of training programmes s for the TI for the month are completed as per plan  Ensure the monthly field visit plan is prepared based on the monthly meeting for PM, ORW, PE  Ensure network analysis is available for every site for tracking the number HRGs  Ensure all the project based registers are available at the project office and updated regularly  Ensure the HRG master list, event register, advocacy register, condom register, medicine stock register is updated  Ensure that agendas for weekly and monthly meetings are circulated before conducting the meetings and meetings are documented  Ensure drug procurement procedures are followed for TI and through WHO-GMP provider  Ensure that data collected is analyzed for tracking the performance of project progress  Ensure ratio of PE:HRG is maintained as per guidelines TI component

Contd. At Outreach/Site Level  Ensure all the PEs are of same age group as HRGs in a given site  Ensures that ORWs fill in registers within 24 hours of the activity conducted  Ensure that ORWs have filled in the ‘HRG registration form’ for the new HRG within 5 days of identification  Ensure sufficient IEC/BCC material is available with ORW for distribution at site level  Once in a week, interact with selected HRGs (8-10 members) to know the programme inputs and quality services given  Visit referral centers to know status on patients referred with regards to those availing services at referral centers

Contd. At clinic level  Observe the doctor’s approach to patients ( if s/he is friendly and follows SCM guidelines)  Check clinic patients records to ensure they are as per prescribed format and procedures are followed  Ensure counsellor maintains confidentiality and proper documentation of counselling as per prescribed formats. Also that the counsellor is adhering to 4Cs – compliance, condoms, contacts tracing, counselling  Ensure the drug stock registers are updated on a daily basis and ensure no stock out of medicines is reported

Outreach Workers  Develop weekly plan of activities for each PE during the month  Prepare weekly movement plan for self and share with PM  Meet all the PEs at site level and provide field level support. Check daily diaries and types of services being given during every visit  Ensure the PEs are conducting activities as per weekly activity plan  Ensure all the new HRGs identified by the PE during the month have been registered with the programme  Collate the site level information on weekly basis from the PE daily diaries  Gather information about the field challenges faced by the PEs and resolve the issues

Contd.  Ensure that sufficient IEC/BCC materials are available with each PE  Ensure to give feedback on the performance, based on the field observations during weekly and monthly meeting  Conduct group meetings at each site during the month  Conduct mid-event activities as per plan during the month  Support PM in conducting advocacy meeting

Peer Educators  Contact all the listed HRGs at the site once in 15 days  Identify new HRGs and ensure s/he is registered under the site  Ensure contacting all the listed HRGs at least twice in each month.  Distribute condoms to each HRG and ensure enough condoms are distributed as per condom gap analysis  Report incidents of violence at the site level to the ORW

Contd.  Ensure all the listed HRGs are visiting the clinic once in a quarter for presumptive treatment  Ensure all the HRGs have been tested at ICTC  Accompany the HRG for testing at ICTC  Ensure all the HRGs, who are under ART, are taking regular treatment at the ART center  Ensure that the referred HRG is taking treatment at TB/DOT center

Conducting Participatory Review  Involve the community in the review  Involve team members, donors and other stake holders  Provide them information about project’s goal, objectives, performance indicators, targets and achievement  Discuss qualitative impact of the programme  Identify gaps in the programme  Discuss the solutions  Prepare an action plan

Conclusion  Having a good monitoring system is very important for the success of any programme  The PM should regularly monitor the work of all staff members and periodically review the achievements of the programme  The feedback from the review should then be incorporated in programme implementation