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## Data analysis

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**Data analysis**Module 4**Part 1 – Key ConceptsLearning Objectives**• Understand the definition and purpose of data analysis • Define statistical and M&E key concepts in data analysis**Data Analysis**• Turning raw data into useful information • Purpose is to provide answers to questions being asked at a program site or research questions • Even the greatest amount and best quality data mean nothing if not properly analyzed—or if not analyzed at all**Data Analysis**• Analysis does not mean using computer software package • Analysis is looking at the data in light of the questions you need to answer: • How would you analyze data to determine: “Is my program meeting its objectives?”**Answering programmatic questions**• Question: Is my program meeting its objectives? • Analysis: Compare program targets and actual program performance to learn how far you are from target. • Interpretation: Why you have or have not achieved the target and what this means for your program. • May require more information.**Descriptive analysis**• Describes the sample/target population (demographic & clinic characteristics) • Does not define causality – tells you what, not why • Example – average number of clients seen per month**Basic terminology and concepts**• Statistical terms • Ratio • Proportion • Percentage • Rate • Mean • Median**Ratio**• Comparison of two numbers expressed as: • a to b, a per b, a:b • Used to express such comparisons as clinicians to patients or beds to clients • Calculation a/b • Example – In district X, there are 600 nurses and 200 clinics. What is the ratio of nurses to clinics? 600 200 = 3 nurses per clinic, a ratio of 3:1**Calculating ratios**• In Kwakaba district, there are 160 nurses and 40 clinics • What is the nurse-to-clinic ratio? 160 40 4:1 or 4 nurses to 1 clinic = 4**Proportion**• A ratio in which all individuals in the numerator are also in the denominator. • Used to compare part of the whole, such as proportion of all clients who are less than 15 years old • Example: If 20 of 100 clients on treatment are less than 15 years of age, what is the proportion of young clients in the clinic? • 20/100 = 1/5**Calculating proportions**• Example: If a clinic has 12 female clients and 8 male clients, then the proportion of male clients is 8/20, or 2/5 • 12+8 = 20 • 8/20 • Reduce this, multiple of 4 = 2/5 of clients = male**Percentage**• A way to express a proportion (proportion multiplied by 100) • Expresses a number in relation to the whole • Example: Males comprise 2/5 of the clients, or 40% of the clients are male (0.40 x 100) • Allows us to express a quantity relative to another quantity. Can compare different groups, facilities, countries that may have different denominators**Rate**• Measured with respect to another measured quantity during the same time period • Used to express the frequency of specific events in a certain time period (fertility rate, mortality rate) • Numerator and denominator must be from same time period • Often expressed as a ratio (per 1,000) Source: U.S. Census Bureau, International Database.**Infant Mortality Rate**• Calculation • # of deaths ÷ population at risk in same time period x 1,000 • Example – 75 infants (less than one year) died out of 4,000 infants born that year • 75/4,000 = .0187 x 1,000 = 18.7 19 infants died per 1,000 live births**Calculating mortality rate**In 2009, Mondello clinic had 31,155 patients on ART. During that same time period, 1,536 ART clients died. 1,536 31,155 49 clients died (mortality rate) per 1,000 clients on ART = .049 x 1,000 = 49**Rate of increase**• Calculation • Total number of increase ÷ time of increase • Used to calculate monthly, quarterly, yearly increases in health service delivery. Example: increase in # of new clients, commodities distributed • Example: Condom distribution in Jan. = 200; as of June = 1,100. What is the rate of increase? • 1,100 - 200 = 900/6 = 150 (150 condoms per mo)**Calculating rate of increase**In Q1, there were 50 new FP users, and in Q2 there were 75. What was the rate of increase from Q1 to Q2? Example: 75 - 50 = 25/3 = 8.33 new clients/mo**Central tendency**Measures of the location of the middle or the center of a distribution of data • Mean • Median**Mean**• The average of your dataset • The value obtained by dividing the sum of a set of quantities by the number of quantities in the set • Example: (22+18+30+19+37+33) = 159 ÷ 6 = 26.5 • The mean is sensitive to extreme values**Calculating the mean**• Average number of clients counseled per month • January: 30 • February: 45 • March: 38 • April: 41 • May: 37 • June: 40 • (30+45+38+41+37+40) = 231÷ 6 = 38.5 • Mean or average = 38.5**Median**• The middle of a distribution (when numbers are in order: half of the numbers are above the median and half are below the median) • The median is not as sensitive to extreme values as the mean • Odd number of numbers, median = the middle number • Median of 2, 4, 7 = 4 • Even number of numbers, median = mean of the two middle numbers • Median of 2, 4, 7, 12 = (4+7) /2 = 5.5**Calculating the median**• Client 1 – 2 • Client 2 – 134 • Client 3 – 67 • Client 4 – 10 • Client 5 – 221 • = 67 • = 67+134 = 201/2 = 100.5**Key messages**• Purpose of analysis is to provide answers to programmatic questions • Descriptive analyses describe the sample/target population • Descriptive analyses do not define causality – that is, they tell you what,not why**Part 2: Learning Objectives**• Identify approaches for setting targets • Understand common analyses that calculate program coverage and retention • Calculate program coverage and retention**Terminology**• Indicator • Target • Program coverage • Service availability • Service utilization • Program retention**Indicator**• Program element that needs tracking • Measures an aspect of a program’s performance • Measures changes over a period of time • # of new family planning users • # of clients currently on ART • Expressed as a number or percentage**Target Definition**• A specified level of performance for a measure (indicator), at a predetermined point in time (i.e., achieve ‘x’ by ‘y’ date) • Overall target • Annual targets**Why Set Targets?**• Targets help program staff with: • Planning • Staffing and service delivery • Commodities • Monitoring progress • Break long-term goals into manageable pieces • Check progress on indicators**Setting Reasonable Targets**• The range of values for a given indicator can be from 0% to 100%. • Example: The theoretical range for the Polio indicator is between 0% of children immunized (bad) and 100% immunized (ideal) • Is it appropriate to set the Polio indicator target at 100% for a given program? Why/why not?**Setting Reasonable Targets**• Example: In Somalia, the national CPR from 2007 to 2009 was15%. The following year, a national target was set for 70%. • Is it appropriate to set the CPR target for Somalia at 70%? Why/why not?**Overall Target Setting Approaches**• There are three approaches to set a target : • Established long-term goals by contacting that national program • Past performance (of your program, increasing by no more than 10%) • Local high performer (a stellar program nearby) • Consider the number of clients your program can realistically expect to serve during a given period of time**Annual Target Setting**• Determine the increase your program needs to gain to reach your overall target • Divide that number by the number of years in which you would like to achieve the target • Add the number to your baseline indicator for each year**Considerations for Target Setting**• Ensure you have an agreed-upon and realistic definition of target population • Set a realistic target to achieve in the long term and short term**Importance of Defining the Target Population: Case Example**• Target was 372 children to be immunized • Actual was 488 children immunized • To calculate the % target achieved, use (Actual/Target) * 100 • 488/372 = 1.31*100 = 131% • How could the clinic have surpassed its target by so much?**Implications of Incorrect Target Setting: Case Example**• You don’t really know to what extent you’re fully immunizing the children in your setting • If your program purchases commodities (e.g., vaccines) based on the target set, supply could run out • If you set your target too low, you may not have enough vaccines, leading to disease outbreaks**Common Analyses**• Program Coverage • Extent to which a program reaches its intended target population, institution, or geographic area • Compare current performance to prior year/quarter • Compare performance between sites • Program Retention • Extent to which the range of services is being delivered as initially intended so that client drop-outs are minimal**Why do we need to measure coverage?**• To understand program progress • To determine if the target is reached • Clients, commodities, adherence… • To determine if one target is reached more effectively than another • Are there underserved area/regions, subpopulations?**Program coverage**• Extent to which a program reaches its intended target population, institution, or geographic area • Utilization: • Is the target population utilizing services, accessing commodities, being reached with services? • Availability: • Are the services available where there is a need?**Utilization calculation**Percentage of the target population utilizing services # of individuals in target population using a service ------------------------------------------- X 100 # of individuals in target population**Utilization calculation: Example**• No. of persons educated as of 6/12/09 = 300 • Goal for 12/31/09 = 900 300 900 • You have reached 33% of your target group with education messages • = 0.33 x 100 = 33%**Comparison of time periods**• Compare percentage achieved toward target for different time periods, different sites, etc. • Rate of increase • As of January, 70 people educated; by June, 300 people • 300 – 70 = 230 increase in people educated • 230/6 = 38.3 new people educated per month over the 6 months**Utilization of PMTCT Programs**All pregnant women (2,000) Utilization = Service users Target population PMTCT Target (1,000) Sought prenatal care (600) Utilization = 600/1,000 = 0.6 0.6 x 100 = 60% Counseled & Tested for HIV (500)**Program coverage**• Extent to which a program reaches its intended target population, institution, or geographic area • Utilization: • Is the target population utilizing services, accessing commodities, being reached with services? • Availability: • Are the services available where there is a need?**Availability calculation**• Number of service outlets available per target population • # of clinics with PMTCT per # of pregnant women • Expressed as a ratio**PMTCT clinic availability**• There are 8 clinics offering PMTCT & 100,000 pregnant women in region X. • Ratio of clinics to pregnant women 8:100,000 • Reduce to (1:12,500) pregnant women • The standard recommendation is 1 clinic with PMTCT services per 10,000 pregnant women • Clinic availability is not reaching the target**Availability + Utilization = Coverage**• Service availability is 1:12,500 • Service availability target is 1:10,000 • PMTCT service utilization is 25% off the target • What can we conclude? • Service availability and utilization are too low; the program is not meeting the needs of pregnant women.**Program retention**• Measures if the range of services are being delivered as initially intended • Determines program retention, i.e., is the project keeping clients through entire package of services? • Important in clinical programs where drug adherence is an issue (TB, HIV/AIDS, immunization) and there are multiple steps (PMTCT)**Retention example: Immunization**Utilization Completion