SUPPORT tools for evidence-informed policymaking in health 18: Planning monitoring and evaluation of policies

Abstract

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. The term monitoring is commonly used to describe the process of systematically collecting data to inform policymakers, managers and other stakeholders whether a new policy or programme is being implemented in accordance with their expectations. Indicators are used for monitoring purposes to judge, for example, if objectives are being achieved, or if allocated funds are being spent appropriately. Sometimes the term evaluation is used interchangeably with the term monitoring, but the former usually suggests a stronger focus on the achievement of results. When the term impact evaluation is used, this usually implies that there is a specific attempt to try to determine whether the observed changes in outcomes can be attributed to a particular policy or programme. In this article, we suggest four questions that can be used to guide the monitoring and evaluation of policy or programme options. These are: 1. Is monitoring necessary? 2. What should be measured? 3. Should an impact evaluation be conducted? 4. How should the impact evaluation be done?

Figure 1

Results chain-model (definitions adapted from [2]).

Figure 2

Comparing change in performance in two areas: one with an intervention and one without*. * The Figure illustrates that attributing the change from 'Baseline' to 'Follow-up' in response to an intervention is likely to be misleading. This is because, in this instance, there is also an improvement in the 'Control'. Even with regard to the Control, it is uncertain whether the difference between the 'Intervention' and 'Control' (i.e. the 'Impact') can, in fact, be attributed to the programme or intervention. There may be other differences between the 'Intervention' and 'Control' settings that might have led to the observed difference in the indicator measured