Dimension
I: Health and Health services
Component
I.1: Health status
- The
Review of Health and Agriculture Monitoring Tools for Title
II Funded PVOs/NGOs (prepared by Davis, T. and Mobley, J.) inventories
tools for monitoring proxies of health outcomes at the beneficiary-level
(“adoption of practices and acquisition of knowledge,”)
as well as “quality of service delivery and key processes,”
and “client satisfaction.”
http://www.foodaidmanagement.org/MandEToolkit.html
Component
I.2: Services, delivery, approach and quality
- The
Quality Assurance Project (QAP) presents tools for monitoring
the quality of care at the Primary Care and Hospital level,
and many resources on quality improvement and evaluation.
http://www.qaproject.org/index1.html
- EngenderHealth
has Quality Assessment / Quality Improvement tools for FP/RH
and CS services, using the Client-Oriented Provider-Efficient
(COPE) method: handbook, self-assessment guides for Reproductive
Health Services, Child Health and Maternal Health Services
- Community
COPE® is a participatory process and set of tools designed
to help health care workers build partnerships with community
members in order to improve local health services http://www.engenderhealth.org/pubs/pubslist.html#quality
Email: info@engenderhealth.org
-
Sustaining the benefits: a field guide for sustaining reproductive and child
health services. (Abrar A. Kahn and Lisa Hare. 2003. The CEDPA training manual
series.) focuses on the sustainability of services through Social Enterprises.
It deals with service approaches, institutional sustainability assessment
for NGOs, financial and cost issues.
http://www.cedpa.org/cgi/cedpastore/new00013.html?id=Vpcp2gsx
- The
International Planned Parenthood Federation has a “Sustainability
Initiative” of its own and presents strategies relating
to sustainability - Sustainability of Service, Institutional
Sustainability and Financial Sustainability – its focus
is case studies more than M&E tools. http://www.ippf.org/initiatives/sustainability/2000feb/index.htm
- WHO
offers a rating of Maternal and Neonatal Health services
according to emergency and routine services, including family
planning, at health centres and district hospitals, access
to these services for both rural and urban women, the likelihood
that women receive particular forms of antenatal and delivery
care, and supporting elements of programmes such as policy,
resources, monitoring, health promotion and training. www.who.int/bulletin/pdf/2002/
bul-9-E-2002/80(9)721-727.pdf
- Child survival and health
interventions might want to assess more rigorously whether services are
targeting poor communities as part of their approach. One tool,
which might allow doing so, the CGAP Poverty Assessment Tool,
has been developed and used to assess the depth of outreach of MFIs
(micro finance institutions). It provides rigorous data on the
levels of poverty of clients relative to people within the same
community through the construction of a multidimensional poverty index.
The tool, however, involves a survey of 200 randomly selected clients and
300 non-clients, takes about four months to complete and costs around $10,000.
http://www.microfinancegateway.org/poverty/pat.htm
MCDI uses a "Household Health Financing Survey" tool along with an assessment
of health expenditures to look at issues of financial accessibility of services.
Resources
helpful for both health status and services components
- USAID’s
Development Experience Clearinghouse has a page of Evaluation
Publications, including the useful TIPS series, which provides
guidance on using the Results Framework, measuring institutional
capacity and the general quality of indicators and performance
measures. http://www.dec.org/evals.cfm#1

Dimension
II: Local Organizational Dimension
Component
II.1.: Local Organizational Capacity
-
"A Guide to Monitoring and Evaluation of Capacity-Building Interventions
in the Health Sector in Developing Countries" (LaFond A and Brown L.
March 2003. MEASURE Evaluation Manual Series, No.7.) offers practical
guidelines for measuring capacity in the health sector at different levels:
individual, organizational, system-wide and in the community.
http://www.cpc.unc.edu/measure/publications/manuals/manuals.html
-
The older MEASURE publication by the same authors, "Mapping Capacity
Building in the Health Sector" is a useful orientation to the measurement
of capacity and suggests a mapping process before defining indicators.
Examples of indicators of capacity at different levels and for different
steps of a process chain are provided.
http://www.cpc.unc.edu/measure/publications/special/special.html
- Food
Aid Management (FAM) has a number of resources on capacity
building (PVO approaches, links) as well as assessment tools
at the organizational and community level. The organization
of indicators is comparable to the recommendations of MEASURE’s
publication and gives examples of composite indicators
for specific elements of capacity. http://www.foodaidmanagement.org/capacitydocs3.htm#Docs
- CSTS+’s
Institutional Self-Assessment methodology, targets the organizational
capacity of a PVO in its support and guidance to field based
health programs. It has also been adapted in the field
to assess a PVO Program Office capacity to support a local
partner. http://www.childsurvival.com/tools/project_planning.cfm
- The
Organizational Capacity Assessment Tool (OCAT) is presented
in detail as an annex to USAID Center for Development Information
and Evaluation’s TIP N.15 “Measuring Institutional Capacity”
http://www.dec.org/evals.cfm#1
- There
is an overlap between service assessment and capacity—particularly
technical capacity— assessment. See above for the TIPS
publications
Component
II.2.: Local Organizational Viability
- Partnerships
for Health Reform (Abt Associates) provides data collection
instruments for a “Cost Study of Maternal Health Services.”
(Some tools do not provide indicators, but may be used in
developing some by assessing on cost issues.) http://www.cpc.unc.edu/measure/cmnht/tool29.pdf
- EngenderHealth
offers a Cost Analysis Tool: Simplifying Cost Analysis for
Managers and Staff of Health Care Services A tool health
care staff can use to measure the direct costs of providing
specific health services. Includes a description of the
process, as well as a simple manual and computer worksheets
to measure the costs of staff time and supplies used in
the provision of a particular service. Results can be used
to improve the efficiency of service delivery and to adjust
user fees for services. http://www.engenderhealth.org/pubs/pubslist.html#quality
Email:
info@engenderhealth.org
-
CIDR (Centre International de Développement et de Recherche) has developed a
methodological guide and a survey guide to assess the viability of primary
health care centers in developing countries. The two guides are available
in French and posted on CSTS+'s website with authorization from CIDR.
http://www.childsurvival.com/tools/mon_eval.cfm
Methodological support in using the methodology is available from Dr Bruno Galland
(cidr@compuserve.com ).
Resources
helpful for both organizational capacity and viability
components
- There
is an overlap between service assessment and capacity--particularly
technical capacity--assessment. See the COPE
tool.

Dimension
III: Community and Social Ecological Dimension
Component
III.1.: Community Competence / Capacity
- World
Vision has field-tested Transformational Development Indicators
in 43 sites and 21 countries, looking at Community Capacity
issues. The Measurement section of the CSSA presentation
chapter presents examples of elements assessed, indicators
and performance criteria. With permission from World Vision,
we are happy to make the complete set of tools available to the
rest of the Child Survival and Health community.
While not all projects/communities will want to use the tool as
systematically as WV does throughout its ADPs, many will see that
it presents a very articulated and methodological approach to the
assessment of community capacity and social change.
- Johns
Hopkins University’s Center for Communication Programs has
developed a “Model for Measuring the Process and Its Outcomes
in Communication for Social Change” interventions. This
will provide guidelines and tools for the development of
indicators of social change and community capacity. http://www.rockfound.org/Documents/540/socialchange.pdf
- Save
the Children has used the Rifkin pentagram model to measure
the capacity of Health Committees and the nature and extent
of community participation in their management. The Measurement
section of the CSSA presentation chapter presents examples
of elements assessed, indicators and performance criteria.
Component
III.2.: Social ecological environment
A number of tools and resources are really
outside of the parameters of what a CS project could address
on its own, but they address the larger systemic component
of the CSSA framework
- USAID’s
New Partnership Initiative (NPI) Strategic Framework represents
the set of results that are necessary to achieve more effective
response by civil society, business and democratic local
governance in collaboratively addressing development challenges.
A resource guide is available. http://www.usaid.gov/pubs/npi/npiresrc.htm
- The
Millennium Development Goals provide indicators at the national
level (actually including global health outcomes indicators
also). www.developmentgoals.org
- The
“Compendium of Sustainable Development Indicator Initiatives
and Publications” provides an overview of initiatives on
sustainable development indicators being carried out at
the international, national and provincial/territorial/state
levels. It also presents useful reviews of models and examples
of indicators and their development. http://iisd1.iisd.ca/measure/compindex.asp
http://iisd.ca/cgsdi/intro_dashboard.htm
- The
United Nations Development Program (UNDP) has resources
on capacity building and its assessment, generally focusing
on larger systemic issues (governance, poverty, public sector).
http://magnet.undp.org/cdrb/DEFAULT.htm
- Unfortunately
lacking in a developing country perspective, "Measuring
Community Success and Sustainability" is a workbook
describing a process to help communities learn how to measure
the local impacts of development processes that enhance
community sustainability http://www.ncrcrd.iastate.edu/Community_Success/about.html
- The
WHO tool presented above
also addresses policy, resources, monitoring, health promotion
and training relating to Maternal and Neonatal Health.
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