Monitoring & Evaluation

Factors Affecting Performance of Professional Nurses in Namibia

This study explores the factors that affect performance of nurses in Namibia with the aim of providing a management framework for improving the performance of professional nurses. [from author]

Healthcare Workers' Attitudes to Working During Pandemic Influenza: a Qualitative Study

The UK healthcare system's ability to cope during an influenza pandemic will largely depend on the number of healthcare workers (HCWs) who are able and willing to work through the crisis. This paper includes the results of a qualitative study exploring the views of UK HCWs on working during an influenza pandemic in order to identify factors that might influence their willingness and ability to work. [from abstract]

Programme Evaluation Training for Health Professionals in Francophone Africa: Process, Competence Acquisition and Use

While evaluation is, in theory, a component of training programmes in health planning, training needs in this area remain significant. Improving health systems necessarily calls for having more professionals who are skilled in evaluation. This article describes a four-week course taken by two cohorts of health professionals from 11 francophone African countries. We discuss how the course came to be, its content, its teaching processes and the master’s programme results for students. [from abstract]

Knowledge and Utilization of the Partograph Among Obstetric Care Givers in South West Nigeria

This cross-sectional study assessed knowledge and utilization of the partograph, an effective tool for monitoring labour that can prevent prolonged or obstructed labour, among health care workers in southwestern Nigeria. [adapted from author]

Human Resources for Health (HRH) Action Workshop Assessment

Several high-profile meetings have focused global attention on critical human resources for health (HRH) issues, providing much needed high-level support and calls for action to address the HRH crisis. The Capacity Project’s HRH Action Workshop series was intended to extend this work by focusing on specific HRH actions and experiences, what is being done in countries, what is working and what is not.

Poor Knowledge on New Malaria Treatment Guidelines among Drug Dispensers in Private Pharmacies in Tanzania: the Need for Involving the Private Sector in Policy Preparations and Implementation

Irrational drug use is contributed by many factors including care providers giving wrong drug information to patients. Dispensing staff in private pharmacy shops play a significant role in pharmaceutical management and provision of relevant information to clinicians and patients, enhancing the improvement of rational medicine use. This report offers an evaluation/staff assessment of pharmacist knowledge in a situation where they function as health workers in dispensing and prescribing medications. [adapted from introduction]

Male Circumcision for HIV Prevention: a Prospective Study of Complications in Clinical and Traditional Settings in Bungoma, Kenya

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

Payment for Performance (P4P): International Experience and a Cautionary Proposal for Estonia

Incentives such as P4P can be very powerful in their effects. Caution in their design and deployment is essential. However, ignoring their potential would be unwise, as they offer the possibility of improving value for money for taxpayers and patients. The first section of the paper will review evidence of common provider problems in all health care systems and their implications for introducing a P4P system. This will be followed by a review of P4P reforms in the United Kingdom and United States in particular. [from author]

Motivation of Health Care Workers in Tanzania: a Case Study of Muhimbili National Hospital

The Tanzanian health system is currently undergoing major reforms. As part of this, a study was commissioned into the delivery of services and care at the Muhimbili National Hospital. One of the main components of this comprehensive study was to measure the extent to which workers in the hospital were satisfied with the tasks they performed and to identify factors associated with low motivation in the workplace. [from abstract]

Global Knowledge/Local Bodies: Family Planning Service Providers’ Interpretations of Contraceptive Knowledge

This paper examines Tanzanian service providers’ perceptions of contraceptives to shed light on questions of local level dissemination of population knowledge and shaping of identities. The findings suggest that the family planning program serves in a process of differentiation between two groups of local women: the service providers and their clients. [adapted from abstract]

Healthcare Workers' Attitudes Towards Working During Pandemic Influenza: a Multi-Method Study

Healthcare workers (HCWs) will be key players in any response to pandemic influenza, and will be in the front line of exposure to infection. This study is designed to determine the range of factors associated with their responses to the prospect of working through pandemic influenza. The findings will be used to estimate of the likely proportion of HCWs affected by each factor, and how likely it is that they would be willing and/or able to continue to work during an influenza pandemic. [adapted from abstract]

Improving Retention and Performance in Civil Society in Uganda

This article describes the experience of the Family Life Education Programme, a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Human Resource Management Rapid Assessment Tool. [adapted from abstract]

Andhra Pradesh, India: Improving Health Services through Community Score Cards

The community score card process is a community-based monitoring tool that is a hybrid of the techniques of social audits and citizen report cards.The CSC is an instrument to exact social and public accountability and responsiveness from service providers. By linking service providers to the community, citizens are empowered to provide immediate feedback to service providers. [from author]

Guidelines and Mindlines: Why Do Clinical Staff Over-Diagnose Malaria in Tanzania? A Qualitative Study

Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. [from abstract]

Monitoring the Health Workforce: Measurement Issues and Selected Tools

Drawing upon a combination of complementary data sources, both new and existing, can result in useful and rich information for measuring and monitoring health workforce stock and flows, and the impact on health and health systems. [from author]

Monitoring Education and Training for Health Workers

Measuring and monitoring the whole education and training pipeline is essential to the planning, management and quality control of the health workforce in a country. This requires timely and reliable data on each of its phases. [from author]

Health Systems Database

This easy-to-use web-based tool compiles and analyzes country data from multiple sources, provides charting options, and generates automated country fact sheets, helping users to assess the performance of the country’s health systems.

Knowledge of Iraqi Primary Health Care Physicians about Breastfeeding

A questionnaire survey was conducted on 50 primary health care physicians in Iraq to assess their knowledge and identify misperceptions about breastfeeding. Basic knowledge about the main processes of breastfeeding was good (when to start feeding, frequency of feeding, relactation, importance of psychological factors), but there were deficiencies in their ability to deal with some practical problems related to breastfeeding. Steps for improving the knowledge and training are addressed. [from abstract]

Policy on Quality in Health Care for South Africa

Knowing that quality is never an accident, always the result of high intention, sincere effort, intelligent direction and skillful execution, and that it represents the wise choice of many alternatives, this abbreviated version of the Policy attempts to provide the strategic direction health facilities and officials need to follow to assure quality in health care and continuous improvement in the care that is being provided. Health care personnel are encouraged to use this copy of the Policy to focus their intentions and guide their efforts. [from foreword].

Provider Selection of Evidence-Based Contraception Guidelines in Service Provision: a Study in India, Peru, and Rwanda

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

Selecting Effective Incentive Structures in Health Care: a Decision Framework to Support Health Care Purchasers in Finding the Right Incentives to Drive Performance

This article discusses the development of a decision framework to assist policymakers in choosing and designing effective incentive systems. The researchers identified several models that have proven to be effective in changing or enabling a health provider’s performance.

Are You Being Served? New Tools for Measuring Service Delivery

Improving service delivery for the poor is an important way to help the poor lift themselves out of poverty. This resource presents and evaluates tools and techniques to measure service delivery and increase quality in health and education.

Key Factors Influencing High-Performing Healthcare Sites in Low-Resource Settings

This study focused on the positive traits and strategies exhibited by high-performing facilities to determine how to improve performance at average and low-performing sites. [from author]

Strengthening Management in Low-Income Countries: Lessons from Uganda: a Case Study on Management of Health Services Delivery

In an initiative to collate experiences on management development in low resource settings, WHO carried out case studies to explore management development approaches and how these impacted managerial and service delivery performance. [adapted from author]

Monitoring the Health Workforce: Measurement Issues and Tools

This brief provides a list of facility-based data collection tools that have been developed by the World Health Organization and other partners. The resources can be used to meet a wide range of specific information needs on human resources in health systems. [adapted from summary]

Insights About the Process and Impact of Implementing Nursing Guidelines on Delivery of Care in Hospitals and Community Settings

Little is known about the impact of implementing nursing-oriented best practice guidelines on the delivery of patient care in either hospital or community settings. The results of this study indicate that implementation of nursing best practice guidelines can result in improved practice and patient outcomes in some settings. [adapted from author]

Improving Quality of Reproductive Health Care in Senegal Through Formative Supervision: Results from Four Districts

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers’ competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. [abstract]

Performance Needs Assessment for IUD Revitalization

One of the most important steps in the Performance Improvement Approach is the performance needs assessment (PNA). The PNA focuses on understanding the environment in which service providers work, i.e. the different systems within an organization that affect their performance, as well as the client and community perspectives which influence their family planning access. The performance factors, or those elements that providers need to be able to perform well, are the framework that guides the PI approach and what the PNA is geared to capture. [author’s description]

Private Health Sector Quality Improvement Package: Implementation Guide for Midwives

This is a QI package for the private sector that includes a review of service statistics, accompanying a QI self-assessment tool for midwives to identify quality issues, and a linked action plan for midwives and supervisors to help solve issues the QI tool identifies. [publisher’s description]

Are Skilled Birth Attendants Really Skilled? A Measurement Method, Some Disturbing Results and a Potential Way Forward

Delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide – the fifth Millennium Development Goal. Though WHO tracks the proportion of women delivered by SBAs, we know little about their competence to manage common life-threatening obstetric complications. We assessed SBA competence in five high maternal mortality settings as a basis for initiating quality improvement. [from abstract]