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Monitoring and Evaluation |
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The purpose of the PAIMAN monitoring and
evaluation component is:
- To track implementation of project activities, as planned
and suggest corrective actions where needed.
- To document and disseminate lessons learned from project
planning and implementation
- To evaluate the impact of the project on maternal and
neonatal health status
- To provide evidence regarding the effectiveness and
reliability of interventions for possible scale-up
- To increase the capacity of the health system, especially at
the district level, to monitor and evaluate MNH activities.
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| Conceptual Framework |
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The conceptual framework for the M&E plan builds
on the “Pathway to Care and Survival” framework and specifies the
causal linkages among project outcomes, behavioral and systems
strengthening components of the MNH project. It assumes that
improvement in health status of the mothers and children are the
results of better knowledge, skills and practices of the mothers,
family members, especially husband, and care providers (Fig 1).
Improved behaviors of mothers and family members and care
providers, in turn, are assumed to be brought about by
strengthening the health systems processes. Thus, by measuring
changes in each component and relating it to outcomes, it would be
possible to separate out the direct and indirect impact as well as
the overall magnitude of the impact created by both components and
their specific activities.
The outcomes of the project are operationalized as a) increased
demand for health services as reflected by improved health seeking
behaviors of the mothers and b) decreased complications of
pregnancy, decreased case fatality rate for hospitalized mothers
and children (Fig 1). Changes in behaviors of the mothers and care
providers will be the immediate impact of the systems
strengthening interventions. Illustrative indicators include
improved knowledge of pregnancy-related risk factors,
complications during pregnancy, safe birthing practices and
health-seeking practices. The project would improve health
providers’ skills to provide essential obstetric care, better
counseling, and maintaining quality of services. By improving the
skills and quality of care, it is assumed that utilization rate of
the facility would increase. There is also a causal link between
counseling skills of the care providers and changes in the
mothers’ knowledge and practices, which would be tested during the
project life.
Health systems strengthening interventions are varied and would
target both non-government organizations and public health sector
(Fig 1). NGOs and other civil society partners/members would
assure community participation in and accountability of the health
system. Increased accountability of the health system would mean
community representatives taking actions to improve staff
availability, lower absenteeism, essential supply availability,
quality of care and service target monitoring. NGOs will play an
important role in ensuring improved community participation in
promoting maternal and neonatal health. |
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| Proposed Conceptual
Framework of PAIMAN M&E Plan |
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