Promoting rational drug use in the community
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Promoting Rational Drug Use in the Community. Monitoring and evaluation. Objectives Session on Monitoring and Evaluation. Understand functions of monitoring and evaluation Define what should be monitored Formulate evaluation questions Identify methods

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Promoting rational drug use in the community

Promoting Rational Drug Use in the Community

Monitoring and evaluation


Objectives session on monitoring and evaluation

Objectives Session on Monitoring and Evaluation

  • Understand functions of monitoring and evaluation

  • Define what should be monitored

  • Formulate evaluation questions

  • Identify methods

  • Make a plan for monitoring and evaluation

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Place of monitoring and evaluation in the planning cycle

Place of Monitoring and Evaluation in the Planning Cycle

Problem

Goal

Objective

Activity

Monitoring

Evaluation

Monitoring Refers to Activities

Evaluation refers to Objectives

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Functions of monitoring

Functions of monitoring

  • See that everything goes according to plan

  • Find out if there are unexpected difficulties

  • Adjust plans

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Functions of evaluation

Functions of Evaluation

  • Prove that the intervention worked

  • Assess if costs were reasonable

  • Convince others that intervention works

  • Share experiences - to allow replication

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Indicators

Indicators

  • Indicators are needed for both monitoring and evaluation

  • Monitoring requires process indicators

  • Evaluation requires outcome indicators

  • Planning to collect indicators is an important part of any plan

Monitoring and evaluation

Promoting Rational Drug Use in the Community


What to monitor

What to monitor

  • Formative research(RAP) done?

  • Intervention pre-tested?

  • Activities implemented according to plan?

  • Are costs in accordance with budget?

  • Are staff carrying out assigned duties?

  • Is collaboration with others taking place?

Monitoring and evaluation

Promoting Rational Drug Use in the Community


How to monitor

How to monitor

  • Record keeping

  • Making reports on activities

  • Field or supervisory visits

  • Regular project/programme meetings

Monitoring and evaluation

Promoting Rational Drug Use in the Community


What to evaluate

What to evaluate?

  • Preparation

  • Planning

  • Implementation

  • Effect

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Preparation

Preparation

  • How was the problem identified?

  • Was formative research done

  • Who is involved in the intervention

  • How comprehensive is the intervention (consider the factors which cause the problem)

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Planning

Planning

  • What objectives were set?

  • Which activities were planned?

  • What target audiences were identified?

  • Were the interventions pre-tested?

  • Was a plan for monitoring and evaluation made?

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Implementation

Implementation

  • Which of planned activities were carried out?

  • What messages were disseminated?

  • How many people did the message reach?

  • Did the target audience pay attention?

  • Did the target audience understand?

  • What problems were encountered

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Effect

Effect

  • Change in knowledge?

  • Change in behaviour?

  • Change in health service quality?

  • Change in policy?

  • Improvements in health?

  • Negative or unexpected effects?

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Four evaluation designs

Four evaluation designs

  • Randomised control design

  • Quasi experimental design

  • Time-series design

  • Pre-post design

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Four evaluation designs1

Randomised control design

intervention group

receives education

random assignment of

è

intervention and

measure change

control group;

after intervention

at the beginning

è

of the intervention

control group receives

no education

Quasi-experimental design

intervention group

receives education

specifically selected

è

intervention and

measure change

control group;

after intervention

at the beginning

è

of the intervention

control group receives

no education

Four evaluation designs

Type of designActionMeasuringchange

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Four evaluation designs2

Time-series design

measure change

measure baseline

twice (for example

è

implement intervention

at the beginning of

at one + six month

the intervention

intervals) after

intervention

and ask questions

to find out why

people changed

behaviour

Pre-post design

measure change

measure baseline

è

after intervention

at the beginning of

implement intervention

and ask questions

the intervention

to find out why

people changed

behaviour

Four evaluation designs

Type of designActionMeasuringchange

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Define key outcome measures

Define key outcome measures

  • Review communication objectives

  • Identify what behaviours are likely to change

  • Limit the number of outcome measures

  • But, measure more than one dimension

  • Choose outcome measures that can be clearly defined and reliably measured

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Examples of key outcome measures

Examples of key outcome measures

  • The percentage of childhood diarrhea cases treated with antidiarrhoeal medicines

  • The percentage of total antimalarial sales which included an adequate dosage

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Methods

Methods

  • Review of project documents, including monitoring reports

  • Semi-structured interviews

  • Short quantitative surveys

  • Focused weekly illness recalls (change in common health problems)

  • Structured observations

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Problems in proving effects

Problems in proving effects

  • Contamination

  • Intervention changes over time

  • Difficult to measure mix of methods

  • Unplanned interventions by others

  • Confounding factors

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Summary guidelines

Summary guidelines

  • Decide at beginning of an intervention how you will evaluate

  • Prepare good outcome measures

  • Evaluate process and effect

  • Look for short- and long-term change

  • Encourage participation of target audience

  • Share successes and failures

  • Make an evaluation plan

Monitoring and evaluation

Promoting Rational Drug Use in the Community


An evaluation plan

An evaluation plan

  • Statement of communication objectives

  • Evaluation questions

  • Key outcome measures

  • Evaluation design/methodology

  • Data collection methods

  • Plan for data processing and analysis

  • Plan for dissemination of results

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Promoting rational drug use in the community

will depend on the complexity of behaviour, its reinforcement in culture,the presence/absence of opposing forces and the resources at your disposal

Short term

knowledge,skills, awareness

What can be achieved?

Medium term 1-3 yrs

behaviour change

Longer term <5 yrs

Change in health

Monitoring and evaluation

Promoting Rational Drug Use in the Community


Activity 1 evaluate a shopkeeper intervention uganda

Activity 1: Evaluate a shopkeeper intervention/Uganda

  • Read the description, page 16

  • Formulate: Evaluation questions

  • Select key outcome measures

  • Advise on study design: quasi-experimental or time-series design?

  • Propose limited set of data-collection methods

Monitoring and evaluation

Promoting Rational Drug Use in the Community


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