Objectives and Indicators for MCH Programs

1. Objectives and Indicators for MCH Programs MCH in Developing Countries January 27, 2009

2. Objectives and Indicators • Session purposes • Promote an understanding of the importance of good objectives and indicators, and their contribution to effective program management • Provide or refine skills needed to develop MCH program objectives

3. Objectives and Indicators • Session objectives -- by the end of the session, participants should be able to: • explain the terms “goal,’ “objective,” “indicator” and “target” • describe the characteristics of objectives and indicators that are useful for program management • write a “smart” objective for the country project and state its corresponding indicator

4. Why discuss MCH program objectives? • How will you know if you are successful if you don’t identify what you want to do? • There are always limited resources • Clear objectives are often a donor requirement • Developing appropriate and useful objectives is not always simple or intuitive... (Note -- they are NOT a substitute for “doing the right thing” based on a needs assessment)

5. Logic model flow chart - how program efforts contribute to the program’s goals Processes Objectives Inputs Activities Outputs Outcomes Impact Causality

6. Processes Objectives Inputs Activities Outputs Outcomes Results • Activities are any action, funded or unfunded, undertaken to achieve a program result • Assignments, tasks, stuff we do to achieve our objectives!

7. Processes Objectives Inputs Activities Outputs Outcomes Impact • Objectives can include anything that is clearly intended to be achieved through the program or project • Output level objectives are those resulting from first order activities • Impact level objectives refer to the desired long-term or ultimate result • Intermediate objectives that fall somewhere between these two are usually referred to as outcomes - also known as “effects”

8. Processes Objectives Inputs Activities Outputs Outcomes Results • Output level objectives are those that result from activities -- things your program does • In most instances don’t represent population change • Important area for program/project monitoring • Frequently “bean counting” • Useful for program management purposes • And -- donors may hold you accountable for the beans

9. Processes Objectives Inputs Activities Outputs Outcomes Impact • Impact and outcomes are… • Changes in the condition or behavior of a program participant orchanges in conditions that affect a participant: results • Whether an objective is a impact or outcome depends on its level in the causality chain • Impact describes the long-term results • Outcomes describe the immediate effects on participants • The ability of a program to produce results (i.e., outcomes, impact, or both) depends on your resources, program duration, and many, many social, economic and cultural conditions that affect participants in the program

10. Processes Objectives Inputs Activities Outputs Outcomes Impact • Objectives should be the highest order objectives for which you can be held accountable • They should be S M A R T : • S - simple • M - measurable (in the program setting) • A - appropriate (technically correct, important) • R - realistic • T - time-limited

11. Processes Objectives Inputs Activities Outputs Outcomes Impact • Let’s consider this objective... The project will improve the understanding of mothers about the importance of oral rehydration therapy and how to correctly mix ORS.

12. Processes Objectives Let’s try again…. Outputs Inputs Activities Outcomes Impact By the end of the project, 80% of mothers of children under age 5 in the project area will give their child increased fluids when the child has diarrhea

13. Processes Objectives Inputs Activities Outputs Outcomes Impact • Let’s consider another objective... The project will increase immunization coverage to 80%

14. Processes Objectives Let’s try again…. Outputs Inputs Activities Outcomes Impact By the end of the project, 80% of children aged 12-24 months in the project area will have completed their basic immunizations

15. Processes Objectives Inputs Activities Outputs Outcomes Impact Program effects flow chart Identify the indicators for each objective What else is needed?

16. Processes Objectives Inputs Activities Outputs Outcomes Impact Program effects flow chart • Indicators… • Answer the question, “How will we measure what we have achieved?” • Target a specific level of achievement

17. By the end of the project, 80% of children aged 12-23 months in the project area will have completed their basic immunizations What is the indicator for this objective?

18. The % of children aged 12-23 months in the project area who have completed their basic immunizations Indicator:

19. Selecting Indicators • Who to involve in setting objectives and indicators? • Project staff • Others familiar with relevant data • The community, partners • Published literature, project reports • When? • Iterative - As work on program development proceeds • Check feasibility before finalizing • It’s OK to revise objectives if rationale is provided

20. Practicality • Are the data associated with the indicator practical? Ask: • How will you collect the data? • Are quality data currently available? • Can routine data can be procured on a regular and timely basis? • Will you need to conduct a survey or special studies?

21. Processes Objectives Inputs Activities Outputs Outcomes Impact Indicators All of these contribute to the program goals -- broad, long-term intended results

22. Indicator quality presumes data quality: be aware of the limitations (regarding validity, reliability, and timeliness) of your data More indicators aren’t necessarily better; you need enough information to get an honest reckoning Meaningful qualitative indicators are often okay and sometimes preferable Final thoughts on the selection of objectives and indicators Use objectives for management—it’s the main reason we measure performance Take a practical approach—get adequate information that is available at a reasonable cost to the program Indicators should make sense to a development professional, but be understandable to interested persons