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Table 5 Programme monitoring and evaluation framework

From: A system approach to improving maternal and child health care delivery in Kenya: innovations at the community and primary care facilities (a protocol)

Goal:
To contribute to improvement of maternal and child health in Kenya through health system strengthening initiatives at community and primary care levels
Objective 1:Conduct a baseline survey on maternal and child health interventions to improve access and quality of care at tiers 1 and 2 in select counties
Activities/inputs Output/Deliverables Means of verification Objectively Verifiable Indicators Timelines
2015 2016 2017 2018 2019
Review and develop tools Reviewed tools
Develop tools
Survey tools # tools      
Recruit survey team Survey team in place Advertisements, Interviews letters of appointments      
Train survey team and pilot tools Trained RAs Logistics
Venue
# trainings,
# staffs trained
     
Prepare for Community entry Logistics and costs
Set dates for entry
Sensitized community # meetings with the community and county      
Conduct the survey Survey instruments Baseline data # field tools      
Develop data entry template Software Ready template Templates for qualitative & Quantitative data      
Data entry and interpretation Data clerks
Software
Entered data Data in template      
Analyze and write report Draft report Findings/Report # Reports      
Disseminate the findings Write ups Reports # dissemination meetings
# media appearances
# policy briefs
     
Objective 2:Adapt and implement the EHC package using the FLTR strategy to improve access and quality of care of maternal and child health at level 1 (community) and level 2 (primary care facilities) in the intervention cluster,
 1. Identification CORPs-Domiciliary nurses and CHVs in specified counties Write ups MOUs
Contract letters
#CORPs      
 2. Training Curriculum Pre & post assessment #trainings
#staffs trained
     
 3. Review HMIS forms Forms Types of forms #forms reviewed      
 4. Prepare the community for intervention   Minutes/
reports
#sensitization meetings
Budgets
     
 5. Roll out the intervention Intervention in place HF records, endline evaluation changes key indicators      
Objective 3: To explore and facilitate partnerships for innovative approaches (IGAs and Chama) to incentivize CORPs (Community owned resource persons - volunteers), CHWs and Community Midwives (CMWs) to effectively participate in increasing access and retention of pregnant women and children in the intervention cluster.
6. Review documents and identify potential partners Functional CBOs, Chamas, SACCO Agreements/ MOUs #partners
#MOUs
#Meetings with partners
     
6.Develop advocacy communication and social mobilization strategy for the programme sensitized community, policy makers, healthworkers Meetings
Minutes
Reports
Documents
#meetings
#media appearances
#ACSM strategy
     
 7. Create partnerships private sector engaged Minutes
MOUs
#CORPs engaged
#Task shifting- CORPs as birth a
     
 8. Review documents and identify potential partners sustainable partnerships Agreements/MOUs #partners
#MOUs
#Meetings with partners
     
Objective 4: To assess the effectiveness and sustainability of the implementation of FLTR and EHC in the improvement of the efficiency of the referral system between the community (level 1), primary care facilities (level 2) and County referral facilities (level 3) for pregnant women in the intervention area
Activities Output Means of verification Objectively Verifiable Indicators Timelines
     2015 2016 2017 2018 2019
Develop advocacy communication and social mobilization strategy for the programme sensitized stakeholders Meetings
Minutes
Reports
Documents
#meetings
#media appearances
#ACSM strategy
     
Provide Mobile telephony to CORPs quality data collected & used Numbers
Timely referrals
Usage
#mobile phones provided      
Conduct a customer satisfaction survey and use lessons learnt to improve service satisfied pregnant women & mothers Report
Survey Tools
Report
#recommendations
Improvement in quality
     
Determine numbers of still births reduced no. still births Numbers #still births      
Objective 5: To build capacity of health workers to conduct health systems research and inculcate a culture of use of evidence to strengthen the performance of health systems through on-job training, in-service certificate and degree programmes
Recruit program staff and monitor their performance SHWs Appointment letters
Reports
#staffs recruited
Improved service
     
Develop short courses and enhance capacities in leadership, governance and management of systems HSR, LMG skills Curriculum
Trainings
#Curriculum
#Trainings
     
Admit 4 masters’ students into the program and assist them choose topics relevant to the program, determine gaps and propose interventions graduates,
thesis and publications
Graduates
Titles of study
#graduate students admitted
Progression rates
#intervention gaps
Policy influence
Abstracts
Manuscripts
Conference appearances
     
Admit 2 PhD candidates within the 5 year period and involve them in identifying research problem and designing interventions admissions
graduates
thesis
articles
Candidates
Titles of study
#candidates admitted
Progression rates
#intervention gaps
Policy influence
Abstracts
Manuscripts
Conference appearances
     
Sensitize CORPs on safe motherhood sensitizes CORPs Sensitization sessions
Numbers
Reports
#trainings
Change in knowledge & attitudes
     
Training on indications for referral of pregnant mothers and sick child KSP for CHWs & CORPs enhanced
Curriculum
#CORPs trained
#health talks
     
Objective 6:Conductendline survey/evaluation on levels of maternal and child health indicators, status of health system and existing programs in the study areas at the end of the project in all the study clusters.
Review baseline tools to include indicators on program relevance and effectiveness revised tools hard copies # of tools      
Recruit and train RAs trained RAs, tools survey teams minutes, letters, list      
Collect data completed tools field schedule letters of release and payment schedule      
Analyze and interpret data tables, results hard copies outputs and verification forms      
Write evaluation report documenting findings; project report (overall) reports draft reports submission of drafts, feedback, meeting with stakeholders      
Disseminate findings to appropriate audience and partners report briefs minutes, emails, feedback letters/emails submission, final feedback