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Data Demand & Use (DDU). Why we collect health-related data. Session Overview. Understanding the need for data Importance of improving data informed decision making Explain the context of decision-making R ole of monitoring and evaluation data in decision making

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Data Demand & Use (DDU)


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    data demand use ddu

    Data Demand & Use(DDU)

    Why we collect health-related data

    session overview
    Session Overview
    • Understanding the need for data
      • Importance of improving data informed decision making
      • Explain the context of decision-making
      • Role of monitoring and evaluation data in decision making
    • Highlight determinants of data use
      • List potential barriers to data use
      • Assessment of Barriers to Data Use Tool
    • Explain the relationship of stakeholders to the data use in decision making cycle
      • Stakeholder Assessment and Engagement Tools
    • Linking decisions and questions with potential data sources
      • Identify priority decisions and programmatic questions
      • Create a time-bound plan for using data in decision making
      • Framework for Linking Data with Action Tool
    decisions within programs
    Decisions Within Programs
    • Ensure program activities are executed as planned & services are delivered as intended
      • Are we doing the right things, doing them right, and reaching those we intended?
      • Decisions about:
        • employment & manpower
        • mobilization & allocation of resources
        • needed information and developing feedback channels
    factors other than evidence based information influence decisions
    Power relationships

    Timing

    Competing priorities

    Public opinion

    Political ideology

    Arbitrariness

    Local culture of decision-making

    Other information sources

    Factors other than evidence-based information influence decisions
    understanding decision making
    Understanding Decision-Making
    • What is the decision to be made?
    • Who makes it?
    • When and why is the decision made?
    • How is the decision made?
    • What information is needed?
    • What is my role in decision making?
    why improve data informed decision making
    Why Improve Data Informed Decision Making?

    HIV epidemic

    Resurgence of TB

    Continued prevalence of malaria

    Pockets of stalled fertility decline

    Population burden

    Shortage of health care workers

    context
    Context

    Pressing need to develop health policies, strategies and interventions

    why improve data informed decision making 1
    Why Improve Data Informed Decision Making?

    Increased financial investments for service delivery

    Increased accountability requirements

    Improved national HMIS

    Increased demand for evaluation and other research

    level of dissatisfaction that policy is based on scientific evidence
    Level of Dissatisfaction that Policy is Based on Scientific Evidence

    Percent dissatisfied

    Overseas Development Institute, Jones et al., 2008.

    challenges
    Challenges

    Integrated HMIS still not fully functioning

    Little or no communication between data producers and data users

    Low capacity to collect, analyze & interpret data

    Limited or no culture of data use

    Data collection and use not a priority

    the response
    The Response

    Better Health Outcomes

    Data Informed Decisions

    Monitoring & Evaluation Systems

    group participation
    Group Participation

    How do you and your organization use data and information?

    we can use information to
    We can use information to…
    • Inform health policies and plans
    • Raise additional resources
    • Strengthen programs and improve results
    • Ensure accountability and reporting
    • Improve quality of services provided
    • Contribute to global lessons learned
    making data speak in thailand
    “Making Data Speak” in Thailand
    • Need: Strengthen commitment of policy makers to HIV Prevention
    • Data: Behavioral and epidemiological data
    • Response:
      • Analyzed data with Asian Epidemic Model and Goals model
      • Determined responses and resources needed
      • Communicated data to stakeholders
    • Decision/Action:
      • Successfully emphasized prevention agenda in national strategic plan and developed an operation plan to guide prevention programming
    key messages
    Key Messages
    • Decisions based on evidence lead to better health outcomes
    • We all have a role in M&E – partners in progress
    • High quality information is needed for decision-making at policy, planning and program levels
    • Purpose of M&E is not just to produce more information but to inform action
    what determines data demand use

    TECHNICAL

    ORGANIZATIONAL

    BEHAVIORAL

    What Determines Data Demand & Use?

    * Based on PRISM analytical framework (LaFond, Fields et al. 2005 The PRISM: An Analytical Framework for

    Understanding Performance of Health Information Systems in Developing Countries. MEASURE Evaluation).

    data are often underutilized because of
    Data are often underutilized because of…

    Technical constraints

    • Individual technical skills,
    • Availability of computers,
    • Data system design,
    • Definition of indicators,
    • Lack of data quality assurance protocols
    data are often underutilized because of 1
    Data are often underutilized because of…

    Organizational constraints

    • Structural – roads, telecommunication
    • Organizational – clarity of roles, support, flow of information
    • Political interference
    data are often underutilized because of 2
    Data are often underutilized because of…

    Individual constraints

    • Decision maker attitudes,
    • Staff motivation,
    • Lack of “data culture”
    what determines data demand use 1

    TECHNICAL

    ORGANIZATIONAL

    BEHAVIORAL

    What Determines Data Demand & Use?

    CULTURE

    SOCIETY

    POLITICS

    * Based on PRISM analytical Fields et al. 2005 The PRISM: An Analytical Framework for

    Understanding Performance of Health Information Systems in Developing Countries. MEASURE Evaluation).

    discussion

    Discussion

    What barriers have you faced to using or getting others to use data and information?

    assessment of data use constraints tool
    Assessment of Data Use Constraints Tool
    • Purpose
      • To improve understanding of the demand for data and the constraints to data use
    • Description
      • Key informant interview guide designed to identify constraints
      • Identifies effective practices in data use
      • Two versions - Facility level assessment & national and sub-national assessment
    activity assessment of data use constraints tool
    Activity:Assessment of Data Use Constraints Tool

    Choose a note taker

    Discuss barriers to data use experienced in your work. Here are some questions to start your discussion:

    • Have you ever had an experience while making a policy or program related decision when you were concerned about the quality of the information being used?
    • Does your agency have the technical capacity to ensure access to and availability of reliable data?
    • What specific challenges have you experienced among your staff when it comes to using data?
    • How does your organization support having the necessary information to make decisions?

    Time for activity: 45 minues

    report back on the assessment of data use constraints tool
    Report Back on the Assessment of Data Use Constraints Tool
    • Share priority barriers
    • Discuss solutions crafted
    • Present action plan for two priority barriers
    • Report back: 2 groups, each 10 minutes
    discussion 1
    Discussion

    How can we ensure that information is being used to make diagnoses and inform decisions?

    context of decision making 1

    Context of Decision-making

    Data

    Stake-holders

    Decisions

    context of decision making 2

    Context of Decision-making

    Data

    Stake-holders

    Decisions

    what is a stakeholder
    What is a Stakeholder?

    Any person, group or organization with a particular interest in a policy or program

    • Government agencies
    • Beneficiaries
    • Policymakers
    • Funding agencies
    • Providers / Implementers
    • Civil society
    • Researchers
    • M&E Specialists
    stakeholders
    Stakeholders
    • Non-governmental organizations
    • Professional associations
    • Religious leaders
    • Journalists/media
    • Private sector/business
    data p roducers vs data users
    Data Producers vs. Data Users

    Data producers think that decision-makers:

    • Value “political” considerations over evidence
    • Are unprepared to measure or evaluate the consequences of their decisions

    Decision makers or data users think that health researchers and M&E specialists:

    • Lack responsiveness to priorities
    • Favor numbers / jargon to transparent communication
    • Prefer written reports to face-to-face conversation
    importance of knowing your stakeholders
    Importance of Knowing Your Stakeholders
    • View activities from different perspectives
    • Have different degrees of understanding
    • Need/want different information
    • Need information at different levels of complexity
    • Have different intensities of interest
    • Have different roles in the decision making process
    results of involving stakeholders in data use process
    Results of Involving Stakeholders in Data Use Process

    Relevance of data

    Ownership of data

    Appropriate dissemination of data

    Use of data

    stakeholder analysis matrix engagement plan
    Stakeholder Analysis Matrix & Engagement Plan
    • Clarifies who has interest in a program and what that interest is
    • Identifies who can help a program and how, and who can hurt it
    • Helps you use this information for the success of the planning effort
    stakeholder analysis matrix
    Stakeholder Analysis Matrix

    The Stakeholder Analysis tool is a matrix framework and process for:

    • Identifying stakeholders
    • Defining their roles and resources
    • Identifying dynamics among stakeholders
    • Setting the optimum stakeholder group
    stakeholder analysis matrix 2

    Stakeholder Analysis Matrix

    Program issue Develop plan (inc. M&E plan) to scale-up PMTCT programs throughout system

    Proposed activity Convene stakeholders to identify priorities based on available data and develop action plan

    Date November 2006

    how to involve stakeholder
    How to Involve Stakeholder
    • Quarterly program management meetings
      • Quarterly meetings to interpret RHIS data
      • Involvement of facility staff to interpret program data
    • M&E System improvement
      • Indicator planning and/or harmonization
      • Data quality review meetings
    stakeholder engagement plan
    Stakeholder Engagement Plan

    Program issue

    Proposed activity

    Date

    stakeholder engagement plan 1

    Stakeholder Engagement Plan

    Program issueDevelop plan (inc.M&E plan) to scale-up PMTCT programs throughout system

    Proposed activity Convene stakeholders to identify priorities based on available data and develop action plan

    DateNovember 2006

    context of decision making 3

    Context of Decision-making

    Data

    Stake-holders

    Decisions

    decision areas
    Decision Areas
    • Program design and evaluation
    • Program management and improvement
    • Strategic planning
    • Advocacy and policy development
    program design evaluation
    Program Design & Evaluation
    • Design
      • Select messages for prevention campaigns
    • Evaluation
      • Determine if new program approaches are needed to ensure that health impact objectives are met
    program management and improvement
    Program Management and Improvement
    • Management
      • Determine if the program is meeting its process objectives
    • Improvement
        • Develop new strategies to increase coverage
    strategic planning
    Strategic Planning
    • Identify geographic areas of highest need
    • Determine human resource allocation
    • Determine which of offered services is making the greatest impact
    advocacy and policy development
    Advocacy and Policy Development
    • Identifying and quantifying underserved populations
    • Identifying focus areas for new policies
    context of decision making 4

    Context of decision-making

    Data

    Stake-holders

    Decisions

    data and information
    Data and Information
    • Census
    • Vital events data
    • Surveillance data
    • Household surveys
    • Facilities level service statistics
    • Financial and management information
    • Modeling, estimates and projections
    • Health research
    factors other than data that influence decisions

    Factors Other than Data that Influence Decisions

    Political Ideology

    Arbitrariness

    Data

    Competing Priorities

    Public Opinion

    Decisions

    Stake-holders

    Power Relationships

    strengthening the decision making process
    Strengthening the Decision-Making Process

    Stakeholders

    Involve new counterparts

    Decisions

    Understand service delivery realities

    Data

    May require additional data

    activity stakeholder matrix engagement plan
    Activity: Stakeholder matrix & engagement plan
    • Break into small groups
    • Each group should select a decision that they make in their work settings and complete the stakeholder analysis around that decision.
    • A minimum of 7 stakeholders should be identified
    • Complete the matrix across the columns for 1-2 stakeholders.
    • Select one stakeholder and complete the stakeholder engagement plan for that stakeholder
    • Time for activity: 45 minutes
    group work report back
    Group Work Report Back
    • Have note taker transfer your final Stakeholder Analysis Matrix onto flip chart paper
    • Share the decision your group chose
    • Share the priority stakeholders selected
    • Choose 1 stakeholder and share the entire row from the matrix for that stakeholder
    • Share the Engagement Plan for the same stakeholder
    • 2 groups report back: 10 minutes each
    building data use into your work
    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 make
      • information they need
      • best way to present that information
    elements of the framework
    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
    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)?
    what are decisions
    What Are Decisions?
    • Choices that lead to action
    • All decisions are informed by questions
    • All questions should be based data
    decisions
    Decisions
    • Allocation of resources across countries/ 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
    Programmatic Questions
    • What percentage of HIV+ pregnant women in care are actually 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+ are actually receiving ART?
    framework for linking data with action 11
    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
    activity framework for linking data with action
    Activity:Framework for Linking Data with Action
    • Select a note taker
    • On flip chart paper create the Framework table
    • Brainstorm 3 decisions or questions in columns

    1 & 2

    • Complete the remaining columns
    • Time: 1 hour
    small group activity report back
    Small Group Activity - Report Back
    • Remaining group will have 10 minutes to present their completed Framework
    • Group discussion - are there other data sources that might have been used in this decision? Were there other stakeholders that should have been considered? (10 minutes)
    measure evaluation is a measure project funded
    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.