Inventory of M&E practices and systems for global health organisations. 2004
Institution:
Econ Analysis AS and Karolinska Institutet IHCAR.
Authors:
not mentioned
Study comissioned by:
Sida (Swedish government agency for bilateral international development cooperation) for the Global Fund
Objectives:
(1) to provide input into the formulation of a monitoring and evaluation (M&E) strategy for the Global Fund (2) to review which multilateral and national M&E processes and initiatives currently being used by other relevant health organisations could be useful for the Global Fund to leverage off of, contribute to, or otherwise link to its M&E system; and to provide advice in implementing such a linkage strategy.
Methods:
review of documents
Results and conclusions:
Selected initiatives (tools, structures and processes) meant to be most relevant for the Global Fund to consider linking up to are identified and summarized. A special chapter reviews capability at country level to conduct M&E, with an emphasis on data collection, in order to provide an indication of the extent to which the Global Fund may be able to rely on national systems in place. Comments and proposals to the Global Fund regarding its M&E strategy are provided.
The main conclusions drawn by the authors regarding the Global Fund's strategy for M&E that includes linkages to external initiatives are:
Increased understanding of relations between progress on project implementation and disease reduction will generally require a broader scope than single project monitoring can offer. Data and analytical work from groups of development partners working in the same area, as well as ad hoc research activities planned by development partners at an early stage of project planning, are likely to be necessary for valid causal inferences.
Flexibility in application of the M&E Strategy is recommended, with careful observance of the type and context of the individual project. Different M&E formulae may be required in different circumstance, especially with respect to differences in national capacities and existing forms of M&E work among development partners in the country. An M&E ranking system for countries could be considered, with gradually increased national ownership depending on steps taken by government and civil society in partner countries.
Routine disease surveillance may benefit from Global Fund support for further standardisation of definitions, indicators, processes and capacity building. WHO and UNAIDS, in cooperation with USAID and the World Bank, have made much progress in this area. The Global Fund's use of such data in its M&E processes can help validate data quality and contribute to lower transaction costs for all. Separation of roles between "normative partners" such as WHO and UNAIDS, "implementing partners" such as UNICEF and most NGOs, and "financing partners" such as the Fund, can help to build standards and capacity in this area.
Fiduciary monitoring may be helped by coordination efforts to develop and use a standardised format with other development partners and national institutions that also support the integrity of the monitoring processes. SWAp processes seem to offer useful examples that could be be evaluated for use by the Global Fund.
With respect to project monitoring, rigorous application of "Log Frame" Approaches in cooperation with other development partners and national institutions to reduce monitoring transaction costs and national M&E system overload is recommended. The limited absorptive capacity in low income countries requires particular attention and common procedures (e.g., consortium approaches like RBM and STB) whenever possible.
Monitoring of additionality and sustainability calls for a long-term and broad mode of work that cannot be applied by the Fund working on its own. A strengthened reliance on SWAps (in countries where they function) and PRSP processes to improve integration of health investments in a broader poverty eradication context should prove beneficial to the objectives of the Global Fund in this regard.
SWAps and the processes around PRSPs can also serve the Global Fund with already functioning structures and processes in which it can review the results of its work. More integrated approaches between system-oriented development aid and disease-oriented programs, as observed in the IMCI for example, should also be of particular value.
