Programmes

Monitoring & Evaluation

Monitoring is the systematic collection, analysis and use of information from programmes for three basic purposes:

  • Learning from the experiences acquired (learning function);
  • Accounting internally and externally for the resources used and the results obtained (monitoring function);
  • Taking decisions (steering function)

Evaluation is assessing an ongoing or completed program or policy as systematically and objectively as possible. The object is to be able to make statements about their relevance, effectiveness, efficiency, impact and sustainability. Based on this information, it can be determined whether any changes need to be made at a programme or policy level, and if so, what they are, what went well, where is there room for improvement?

Evaluation thus has both a learning function - the lessons learned need to be incorporated into future proposals or policy - and a monitoring function - partners and members review the implementation of policy based on objectives and resources mobilized. Monitoring and evaluation are complementary.

Progress of NRHM are monitored and evaluated through various activities such as monitoring reports, HMIS, E-Mamta, surveys and evaluation studies. The state has undertaken various activities as a part of established monitoring and evaluation system. To strengthen the system, it has also undertaken initiatives which are briefly outlined in this chapter..

State Health Society has strengthened HMIS right from Sub Center to State level. All the M&E Assistant, Data Assistant and ANMs have received training on HMIS.

The quality of E-Mamta and HMIS in districts and from blocks has considerably improved due to regular follow up. Reporting and recording of RCH formats (Plan and monthly reporting) is now regular, complete, and consistent review of data at the state level is regular and is shared with the District Health Societies and DPMUs on a monthly basis, however proper review at the district and PHC level is still lacking. Feedbacks are provided to the districts on their data inputs.

M&E Unit in the State are responsible for monitoring and evaluation of the programme in the state and the districts. The data gathering is being facilitated by the State, Regional, District and PHC. Additionally all the districts have been provided training in uploading information in the HMIS.

At district level, there is a District Health Society which is responsible for the data dissemination from the sub-district level to the district level. District data manager and District M&E at the district level is responsible for management of HMIS and E-Mamta. Regional M&E are responsible for the same at the regional level.

HMIS Portal

The main objective of Health Management Information System is to provide accurate and reliable information on time to program managers and stakeholders for appropriate decision making. It acts as tool for monitoring and evaluation of the program and on the basis of the information available, appropriate planning can be done and can be executed for the people in need. The state aims to build its HMIS as the main frame for integrating all other information and communication technology for health initiatives.

Govt. of India has been focusing on importance of HMIS and emphasized on quality of data so that the reports generated from the HMIS Portal can facilitate evidence-based decision making process. State has taken various initiatives to improve the quality of data and among them one of the major initiatives is to conduct HMIS training (including Mother and Child Tracking Systems- E-Mamta) of Data manager, District M&E and block M&E assistant and Data assistant at CHC/PHC level on recording and reporting. For that State Health Society has developed training module and reference material for health workers. The main content of the same is HMIS formats, definition of data element, difference between recording and reporting register/ formats, MCTS reporting formats, use of data for Sub Center level planning and technique of data validation. The reference manual for E-Mamta is printed in local dialect with user’s friendly methodology.

  • HMIS Portal is fully functional with all 26 districts and 8 corporation. HMIS data is triangulated with CRS, Surveys and E-mamta and put up for regular review to Health Commissioner, MD-NRHM, Senior State level officers and district officials.
  • The Infrastructure details are also integrated on the HMIS portal and it is regularly uploaded.
  • Inbuilt features are provided on the HMIS portal to check the consistency and validity of data is used by state for improving the quality of data.
  • The facility based reporting for improving physical performance (HMIS) of the State is emphasized on HMIS portal and it has been implemented from December 2012.
  • The State has taken a step to get the data from the private sector health facilities. For this, Private notional has been created taluka wise in each of district.

Mother and Child tracking application

Mother and Child tracking application –E-Mamta is a Gujarat Initiative. The application is fully operational in all Govt. health facilities with provision being made for private providers. A web based software application accessed through e-mamta has covered the entire population of Gujarat with special emphasis on rural, urban slum and slum like population. Health details of about 1.1 crore families in the entire state comprising about 5.3 crore individuals covering more than 85 percent of the population have been entered so far in the software’s database and system generated unique Health IDs have been provided to all.

Execution

Various health facilities have already started with tracking of left out Mother and Children through utilities namely

  • Work plans
  • SMS – timely SMS to beneficiaries for uptake of services
  • Variety of reports namely: HMIS reports, monthly stock reports, MCH indicators
  • Dash Board to give a brief overview of Data entry, Deliveries, Immunization services, maternal and Infant deaths. Detail analysis of data at each PHC, block, district, region and state.
  • Search on several parameters like Name, village name, Ration card number, mobile number, Health Id, Family Id, RSBY card number, BPL card number, UID.
  • Capturing the migration/ transfer issues in service delivery through provision of Unique ID to individuals.
  • Avoiding duplication of registration of mothers as all pregnancies of a single mother are recorded together.

Training

  • Regular regional, district, block level trainings are conducted for proper penetration of information. Trainings through SATCOM for ANM/FHW are also held.

Status

  • Currently, E-Mamta contains records of 1.1 crore families covering 5.3 crore individuals amounting to up to 85% population of the state.
  • Targeted to monitor 14.1 lakh Expected mother and 12.8 lakh births annually out of this 10.8 lakhs mother and 8.9 lakh births are registered form April-13 to February-14.
  • 47.9 lakh Pregnant woman and 35.8 lakh children registered so far
  • The application developed in January 2010 has been implemented all over Gujarat State. Government of India has appreciated and announced National replication of the software, trainings to 26 states already been provided by Government of Gujarat.

Server

  • Setting up of servers for E-Mamta at Health & Family Welfare Department.

Monitoring

  • The state office regularly monitors the data entry at each facility. Special reports to monitor timely registration of pregnant woman and infants have been developed - Daily statistics report, pregnant woman registration report. Regular communication is establishes with District officials for speeding up data entry.

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