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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
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“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
ART1 % 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%
39 392 % 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 156Pediatric ART
1 % of children current on ART
# of active children on ART # of cumulative children on ART 78%
45 58ART 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 1452 % of non active ART
patients who transferred out.
# of patients who transferred out.
# of non active ART patients.6%
8 1453 % 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.
# of non active ART patients.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)
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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 makeinformation 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
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?
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
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?
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
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?
DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
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?
DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training
Framework for Linking Data with Action
Program/Policy Question
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?
DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
Decision Maker (DM), Other Stakeholders (OS)
Indicator/Data
Data Source
Timeline(Analysis)(Decision)
Commu-nication ChannelDM OS
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
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
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?
DM – Head of Regional Health Committee OS – Other providers, Division of Clinical Training
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Dec. 2010,March 2011,June 2011, September 2011,December 2011
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
Decision Maker (DM), Other Stakeholders (OS)
Indicator/Data
Data Source
Timeline(Analysis)(Decision)
Commu-nication Channel DMOS
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
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Dec. 2010
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
Decision Maker (DM), Other Stakeholders (OS)
Indicator/Data
Data Source
Timeline(Analysis)(Decision)
Commu-nication Channel DMOS
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
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Dec. 2010 Short summary presented to facility manager at weekly clinic meeting
Framework for Linking Data with Action
Decision/ Action
Program/Policy Question
Decision Maker (DM), Other Stakeholders (OS)
Indicator/Data
Data Source
Timeline(Analysis)(Decision)
Commu-nication Channel DMOS
Hire more PMTCT counsel-ors
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
711 form indicators K41, B73, B 91
Service statistics; Logistics manage-ment system
Dec. 2010 Short summary presented to facility manager at weekly clinic meeting
Framework for Linking Data with Action
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
Capacity Building Assessment Organizational Support
Data Users & Data Producers
Data System Improvements
Multifaceted Approach in Nigeria
Capacity Building Assessment Organizational Support
Data Users & Data Producers
Data System Improvements
Multifaceted Approach in Nigeria
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