c ommunicating f indings & l inking d ata with a ction module 5

COMMUNICATING FINDINGS & LINKING DATA WITH ACTION

Module 5

PART I: PROVIDING FEEDBACK ON DATA COLLECTED / ANALYZED

Part 1: Session Objectives

Understand the importance of feedback in program

improvement and management

Consider how to improve feedback mechanisms in

own work

3

“We are always giving patient forms and data to our M&E Unit, who then gives data to donors and the government. I am the head doctor and I never have the chance to look through the data before they go up. We just keep giving data up and up, and we never hear back about it…”

Head of ART facility, Nigeria

Importance of Feedback

Information needs to be shared At timely and regular intervals

Within, between, up, and down

Paves path between data collectors and users at all levels of the health system

Importance of Feedback

Leads to greater appreciation of data: Improved data quality

Influencing collection of appropriate data

Important element of management and supervision Creates opportunity to monitor & improve

program services

Incentive for staff

Examples of Feedback

Sharing information within a facility or organization

Sharing aggregated service provision data from facilities within a district or between provinces

Meetings between facility and supervising agency to review and discuss information

Meetings between donor and NGO to review information and discuss challenges and opportunities

Working Toward a Culture of Information Use

Information becomes an integral part of decision-making processes, including planning, problem solving, choosing alternatives, feedback, etc.

Empowers people to ask questions, seek improvement, learn, and improve quality

Higher Levels: District, Province, National

Analysts, Evaluators

Service Delivery Point

Feedback Managers,

Government, Donors

Program

Compiled Data

Clinical Histories, Service

Statistics

Reports

Information Flow

Variety of Formats

Narratives Summaries, bulleted items, graphs, charts

In-person discussion One-on-one

Staff meetings, district meetings

Speeches to staff

Supervision visits

Community Distribution ProgramMonthly Performance Review

Distributor: _______________ Supervisor: _________________Region: __________________ Month: _______ Year: ________

Number of NEW clients: _____MARK WITH AN X ON THE BAR BELOW

0 5 22

Number of RETURNING clients: _____MARK WITH AN X ON THE BAR BELOW

0 12 73

Community Distribution ProgramMonthly Performance Review

Distributor: _______________ Supervisor: _________________Region: __________________ Month: _______ Year: ________

Number of NEW clients: _____MARK WITH AN X ON THE BAR BELOW

0 5 22

Number of RETURNING clients: _____MARK WITH AN X ON THE BAR BELOW

0 12 73

Quarterly Performance Indicators

# Indicator Numerator Denominator Percentage

ART

1 % of eligible clients placed on ART

# of new clients on ART Sum of # of new clients on ART and clients on ART waiting list 100%

39 39

2 % of current ART clients

# of active clients on ART # of cumulative clients on ART 92%

1620 1765

3 % of ART clients in 6 month cohort undergoing repeat CD4 testing

# of clients for whom repeat CD4 testing was done at 6 months

Total # of active ART clients in 6 month cohort

94%147 156

Pediatric ART

1 % of children current on ART

# of active children on ART # of cumulative children on ART 78%

45 58

ART Care Follow-up

1 % of non active ART patients who have stopped ART.

# of patients who stopped ART.

# of non active ART patients.

0%0 145

2 % of non active ART patients who transferred out.

# of patients who transferred out.


6%8 145

3 % of non active ART patients who died.

# of patients who died. # of non active ART patients.73%

106 145

4 % of non active ART patients who have been lost to follow-up.

# of patients who have been lost to follow-up.


16%23 145

When developing feedback mechanism, consider…

The information being shared

Who will benefit from feedback

The format of the feedback mechanism

The forum in which the feedback will be shared

How often the feedback will be provided

How the feedback will move to the next level

Document the process

Potential barriers to providing feedback

Hierarchy

Role clarification – data clerk & M&E officer

Approval requirements to distribute data

Lack of knowledge of what information stakeholders need

Group Participation

Discuss barriers to providing feedback that you have experienced in your work

Discuss the benefits of feedback that you have experienced in your work

Identify: Two stakeholder groups that would benefit from

receiving feedback The ideal mechanism to provide feedback to them

PART 2: LINKING DECISIONS/QUESTIONS WITH POTENTIAL DATA SOURCES

Part 2: Session Objectives

Identify priority decisions and programmatic questions

Link decisions/questions with potential data sources

Create a time-bound plan for using data in decision making (Framework for Linking Data with Action)

18

Building Data Use into Your Work

PLAN PLAN PLAN !

Regularly review your data – schedule time

Use the Framework for Linking Data with Action

Engage in dialogue with stakeholders to fully understand the

decisions they make

information they need

best way to present that information

Elements of the Framework

Decision makers and stakeholders with potential interest in your data

Decisions / actions that the stakeholder makes (possible uses of data)

Questions to which the stakeholder requires answers

When the decision will be made

Elements of the Framework (cont’d)

Indicators and/or data of interest (to respond to stakeholder need)

Source of data

How will data be presented (what types of analyses, graphs, formats)?

FRAMEWORK FOR LINKING DATA WITH ACTION

Framework for Linking Data with Action

Decision/ Action

Program/Policy Question

Decision Maker(DM), Other Stakehold-ers (OS)

Indicator/Data

Data Source

Timeline(Analysis) (Decision)

Commu-nication Channel

What Are Decisions?

Choices that lead to action

All decisions are informed by questions

All questions should be based on data

Decisions Allocation of resources across IPs/ states /

districts/facilities

Revising OVC program approaches to emphasize fostering and adoption

Develop and institute workplace policies on HIV/AIDS in all institutions in state X

Hire and allocate staff to facilities

Programmatic Questions What percentage of HIV+ pregnant women in

care actually are delivering in health facilities?

What percentage of clients starting ART are lost to follow-up?

Are the number of family planning clients decreasing?

What percentage of pregnant patients who are HIV+ actually are receiving ART?


Decision/ Action


Decision Maker (DM), Other Stakeholders (OS)

Indicator/Data

Data Source

Timeline(Analysis)(Decision)

Commu-nication ChannelDMOS

Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse: client ratio?


Decision/ Action



Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse: client ratio?

DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training


Decision/ Action



Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse:client?





Indicator/Data

Data Source



Are we reaching testing targets in PMTCT?Do we have sufficient test kits?What is nurse:client ratio?


711 form indicators K41, B73, B 91

Service statistics; Logistics manage-ment system


Decision/ Action



Indicator/Data

Data Source


Commu-nication ChannelDM OS






Decision/ Action



Indicator/Data

Data Source







Dec. 2010,March 2011,June 2011, September 2011,December 2011


Decision/ Action



Indicator/Data

Data Source


Commu-nication Channel DMOS





Dec. 2010


Decision/ Action



Indicator/Data

Data Source







Dec. 2010 Short summary presented to facility manager at weekly clinic meeting


Decision/ Action



Indicator/Data

Data Source



Hire more PMTCT counsel-ors





Dec. 2010 Short summary presented to facility manager at weekly clinic meeting


Creates a time-bound plan for information-informed decision making

Encourages greater use of existing information

Monitors the use of information in decision making

Small Group Activity 6 – Instructions

Select a note taker

On flip chart paper, create the Framework table

Brainstorm three decisions or questions in columns 1 & 2

Complete the remaining columns

Time: 1 hour

Small Group Activity – Report Back

Each group will have 10 minutes to present its completed Framework

Group discussion – are there other data sources that might have been used in this decision? Were there other stakeholders who should have been considered? (10 minutes)

Building Data Use into Your Work

PLAN PLAN PLAN !

Regularly review your data – schedule time

Use the Framework for Linking Data with Action

Engage in dialogue with stakeholders

Consider other tools or methods related to data demand and use

Improving Data Demand & Use: Multifaceted Approach

Applying a combination of: Assessment of current data use, capacity building

needs, and barriers to data use Capacity building initiatives around data use concepts,

use of tools, data analysis… Tool application Organization development (e.g., leadership, systems

improvement) Collaborative efforts between data users and producers

Multifaceted Approach in Nigeria

Large amount of data collected, feeding NNRIMS

Data were not being used effectively at sites or within project

Pervasive mistrust of data

Lack of understanding of how RHIS data could be used

Lack of understanding of how indicators were calculated and used for program improvement

Capacity Building Assessment Organizational Support

Data Users & Data Producers

Data System Improvements

Multifaceted Approach in Nigeria

Multifaceted Approach in Nigeria: Results

86% of respondents implemented solutions to identified barriers to data use

76% reported assisting decision makers with data interpretation

THANK YOU!MEASURE Evaluation is a MEASURE project funded by the U.S. Agency for International Development and implemented by the

Carolina Population Center at the University of North Carolina at Chapel Hill in partnership with Futures Group International, ICF Macro, John Snow, Inc., Management Sciences for Health, and Tulane University. Views expressed in this presentation do not necessarily reflect the views of USAID or the U.S. Government.

MEASURE Evaluation is the USAID Global Health Bureau's primary vehicle for supporting improvements in monitoring and

evaluation in population, health and nutrition worldwide.

Visit us online at http://www.cpc.unc.edu/measure

c ommunicating f indings & l inking d ata with a ction module 5

Documents

active art patients

active art clients

art facility

pediatric art

current art clients

active clients

art care followup

art waiting list