Building Capacity for Monitoring and Evaluation of Large Scale Nutrition Programs

Jonathan Gorstein Suzinne Pak-Gorstein

1. Rationale for intensified M&E for Nutrition

2. Activities: Development and Strengthening of M&E

3. Lessons learned/Experiences

Outline

1. Rationale for intensified M&E for Nutrition

2. Activities: Development and Strengthening of M&E

3. Lessons learned/Experiences

Outline

• Lancet conceptual framework • Increasing complexity of national nutrition strategies

with engagement from multiple sectors – Nutrition specific interventions – Nutrition sensitive interventions

• The need to generate evidence and robust data requires a fresh look at tools and methods

• Consideration of capacity and sustainability

Intensified M&E for Nutrition

Key Determinants of Optimal Fetal and Child Nutrition (Lancet 2013)

1. Rationale for intensified M&E for Nutrition

2. Development and Strengthening of M&E

3. Lessons learned/Experiences

Outline

Overall Goal • Build capacity at country level among individuals

and institutions (Government, Academic) to generate evidence on nutrition interventions through rigorous M&E

Development and Strengthening of M&E

UW-WACh Activities • Provide technical assistance • Develop skills with country counterparts

• Design M&E systems • Methods (surveys, surveillance, routine systems) • Data analysis and presentation • Use and interpretation of data to improve nutrition

• Long-term placement of UW Fellows, working with UW faculty, in direct engagement with Ministries of Health, National Planning Agency

Development and Strengthening of M&E

Landscape Analysis for Undernutrition Maternal and Child Nutrition, Infant and Young Child Feeding Practices (IYCF) & Food Insecurity in high-risk districts

Strengthen/Develop Process Monitoring Systems - Improve the effective monitoring of nutrition interventions - Identify bottlenecks in service delivery

Assess integration of Social Protection and Nutrition interventions - Measure links between poverty reduction services with child nutrition

Design M&E system - Comprehensive M&E of large-scale national multi-sector nutrition program

Laos Philippines Indonesia

Philippines Nepal

Indonesia

Nepal Indonesia

Nepal

Support Activities

Development and Strengthening of M&E

Development of M&E systems

Approach

• M&E systems need to be simple and accessible

• Develop frameworks and indicators that are accessible and programmatically meaningful

• Based on theory of change (linking activities to outcomes) using project impact pathways (PIP)

• Distinguish between impact evaluation and process monitoring

Impact Evaluation

• Measures changes in key nutrition outcomes – Use of anthropometry, biomarkers – Robust probabilistic survey designs

• IE is the focus of most M&E resources and investments

Measurement of program outcomes

Logic Model – Indonesia PKH Prestasi

Process Monitoring

• BUT, just to know what happened is not sufficient

Not only need to know ‘what’ or ‘how much’ change has occurred, but ‘why’

• Focus on process monitoring and bottleneck analysis to inform program implementation

• Engagement with local stakeholders, rapid data analysis leads to timely programmatic modification

PKH Prestasi Logic Model

Focus on determinants of effective coverage, and identify where things are going well, or not

MONITOR PROCESS

Focus on Implementation • Regular Monitoring of Process • Indicators of Supply / Demand /

Enabling • Identify contraints in delivery (ie

bottlenecks)

Corrective Actions • Local-based solutions • Corrective actions

integrated into process

Healthy outcomes

Refocusing on the Implementation Process

Stakeholder Engagement • Local ownership • Highlight utility of data –driven

decisions • Encourages quality data • Timely and relevant feedback

1. Rationale for intensified M&E for Nutrition

2. Development and Strengthening of M&E

3. Lessons learned/Experiences

Outline

• UW Fellowship model can be effective and efficient – Country expectations and needs should be well-defined

– Match the fellow background to the country requirements

• Partnering to train in-country personnel works – Pair UW fellow with national junior professionals

• Next steps: enhanced professional development, networking, curriculum focused on M&E

Lessons Learned

Thank you