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Monitoring

Primary Eye Care

Dr. Sandeep ButtanMS (Ophth), MSc CEH (LSHTM, UK)

Dr Shroffs Charity Eye Hospital

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A program is a specific set of activities that are directedtowards one or more defined objectives to achieve a

goal

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Monitoring

A continuous and systematic process

Carried out at regular intervals during the

duration of an intervention,

Generates quantitative or qualitative data on

the implementation of the intervention against

defined milestones.

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Monitoring

Continuous surveillance of implementation ofthe program to ensure that it is proceedingaccording to plan

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The intention is to correct any deviation from

the operational objectives, and thus improve

the performance of the project as well as

facilitate subsequent evaluation.

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Objectives of Monitoring

Are we efficient?

Are we productive?

Are we doing a good job?

What is the outcome?

Is it what we wanted to be?

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Benefits of Monitoring

It helps in setting norms of performance

It helps in measuring level of performance

It helps in comparing performance levelwith standards or norms

It helps in identifying deviations and explain

the reasons for the deviation for takingnecessary corrective action

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Levels of Monitoring

Monitoring Interval: monthly, quarterly,

yearly, every 5 years

Levels of data collection: local, district,

provincial, national, regional, global.

Project plan level: Process, Outcome, Impact

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Levels of Monitoring

Process Outcome Impact

GOAL

OBJECTIVE1

Activity 1

Activity 2

OBJECTIVE2Activity 3

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Monitoring tools: Indicators

Indicators can be: numbers, proportion, ratio

Indicators measure the extent to which: program activities are taking place

program objectives are being met

program goals are achieved

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Monitoring tools: Indicators

Indicators should be SMART

Specific

Measurable

Attainable

Relevant

Time bound

DO NOT MEASURE TOO MUCH

USE ALL THAT YOU MEASURE

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MONITORING IN EYE CARE

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What to Monitor

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Monitoring : Cataract program

Process Outcome Impact

Improve QOL byproviding GOODVisual outcome

Demand forCataract

Raise Awareness

Screening

Provide Cataractservices

Develop surgicalunits

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Monitoring: Vision Centers

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Outpatients services

New OP

Review OP

Total OP

New OP per day

40 + in Total OP

Annual growth in New OP

Cataract services

Cataract surgery

CSR as an option

Refraction services

Eye glasses prescription

Acceptance rate

Specialty services

New GlaucomaDiabetic (Known

& diagnosed)

Diab. Retinopathy

Total speciality diag.

Referral to Hospital

Acceptance rate

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Monitoring: Visual Outcomes

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Nov-11 Total Cases

Loss to

Follow Up

UCVA

(>6/18)

BCVA

(>6/18)

BCVA

Corrected for

Co morbidity Poor

Total 530 58

380 438 452 20

80.51% 92.80% 95.76% 4.24%

ECCE 31 5

11 18 22 4

42.31% 69.23% 84.62% 15.38%

SICS 162 25

93 121 127 10

68% 88.32% 92.70% 7.30%

Phaco 337 28

276 299 303 6

89.32% 96.76% 98.06% 1.94%

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Paying : Subsidy : Free surgery Ratio

Cataract Surgery Rate

Surgery per Ophthalmologist

Outreach Productivity

Sustainability?

Coverage?

Efficiency?

Cost Effective?

Key Indicators to measure Organizations performance

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What is required for a monitoring

system? A good network of motivated people

SMART indicators

Efficient data collection system

Performing basic analysis of all levels of health

service

Provision of feedback

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Planning & Monitoring

If you cant plan it, You cant do it

If you cant measure it, you cantmanage it

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