Monitoring and evaluation
Focus on coverage, quality and health systems
WHO's Department of Maternal, Newborn, Child and Adolescent Health (MCA) supports countries to develop better monitoring and evaluation systems within the health sector to improve outcomes along the continuum of care for mothers, newborn infants, children and adolescents. Thus, within a health systems approach, MCA promotes improved monitoring of the quality of health service delivery as well the coverage of effective interventions for improving maternal, newborn, child and adolescent health.
It does this in collaboration with partners to support countries to develop and implement national monitoring and evaluation plans, to analyse data, to report on and disseminate results. The current work of the MCA Department includes monitoring progress in countries towards achieving the Millennium Development Goals and supporting the work of the Commission on Information and Accountability.
What we do
WHO uses the following measurement framework developed by the Health Metrics Network to ensure comprehensive monitoring and evaluation of health and health systems. It indicates three major measurement domains: determinants of health; health system; and health status. This framework is useful for illustrating these measurement activities which may be applied at global, regional, and national levels and at facility and community levels.
Examples of measurement activities undertaken include:
Determinants of Health
The MNCAH Household Survey collects data on the behaviours of caretakers that affect the use of maternal and child health interventions, and the behaviours of adolescents that affect their sexual and reproductive health outcomes. It also identifies "channels" and their functioning for the effective delivery health services for mothers and newborn infants, children and adolescents. This survey has been implemented in sub-national areas of 5 countries, where maternal, child and adolescent health interventions are in place.
Inputs to the Health System
The MNCAH Questionnaire collects health policy and systems related information that are critical for the implementation and improvement of the maternal, newborn, child and adolescent health agenda at global, regional and country level. The strategic information will inform MNCAH related policy and systems action and targeted response in countries. It also contributes to the updating of Countdown country profiles and other processes as relevant.
Outputs of the Health System
At sub-national level, the MNCAH Household Survey and at national level, the Service Availability and Readiness Assessment (SARA) tool provide valuable data on service availability.
The Health Facility Survey for services delivered to improve child health measures quality of services at first level facilities and the Hospital Assessment Tool can be used in district hospitals. Quality assessment tools are available for determining if standards are being met for the delivery of Adolescent Friendly Health Services.
Approaches used in Beyond the Numbers and the WHO Near- Miss Approach go beyond just counting deaths to developing an understanding of why deaths and severe morbidity happen and how they can be averted.
Achievement of Outcomes
The MNCAH Household Survey provides sub-national data on the coverage of key interventions for maternal, newborn infants, children and adolescents.
MCA also monitors and evaluates achievement of outcomes through the compilation, syntheses and analyses of secondary data, providing information for action.
MCA monitors and evaluates progress towards MDG4 through the assessment of trends in the distribution (including inequities) in under-five mortality at country, regional and global levels for informed action and changes in policies, strategies, and ultimately in health status. It also monitors the nutritional status of children under-five and evaluates trends towards the achievement of MDG1.
- GHO databases on selected key child health interventions
- GHO databases on causes of neonatal and under-five deaths
- GHO databases on under-five mortality and trends
- WHS 2011 - coverage indicators at country, regional and global levels
- Progress Report 2009
- Pneumonia: the forgotten killer of children
- Diarrhoea: why children are still dying and what can be done
- Documents on monitoring and evaluation