Transcript Data Demand and Information Use (DDIU): Strengthening

Data Demand & Information Use (DDIU):
Strengthening Programs through Improved Use of
Data
SESSION GOAL
 To enhance the understanding of key concepts of
data and information dissemination and utilization for
the purposes of information sharing, accountability,
and programme improvement.
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SESSION OBJECTIVES
 By the end of this session, participants will be able to:
 Define key concepts and the purposes of data and
information dissemination and utilization, and how it relates
to strengthening the overall M&E capacity.
 Demonstrate an understanding of decisions and decision
making.
 List common barriers to information dissemination and
utilization, and propose methods to overcome them.
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Introduction to Information Use
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Main Uses of Health & Management Information - 1
 To assist in planning health programmes by showing which
health and disease problems are significant and worthy of
specific intervention
 To monitor the implementation and effectiveness of a specific
control programme by comparing the extent of the problem
before and after the implementation of the programme
 To identify and effectively target an affected population
 high risk groups (e.g. by age, gender, occupation)
 geographical areas where a problem is common
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HMIS: Crucial Concepts
 Both health (service delivery) data and
management data are collected and processed
into information for decision-making
 It does not make sense to have a health
management information system unless it
contributes to decision-making and action at
different levels of the health service
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Decision Focus of HMIS
Information System
MIS:
User Management System
- Data/Information
Processes:
-Collection/compilation
Users: e.g.
-Calculation/analysis
-Reporting/dissemination
- Databanks: e.g.
-Population
-Service statistics
-Morbidity/mortality data
-Human resources
-Financial data
-Unit activities
-Transport pool
-Other organizations info
-Other data
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Information
-Top management
-Unit managers
-Planners
-Donors
-Operational staff
-Researchers
-Statisticians
Decisions
Used in: e.g.
- Reviews
- Media: reports
articles, minutes
- Meetings,
discussions
Actions
Decision Focus of a HMIS
SYSTEM DEVELOPMENT
Data Flows
Information
Flows
MIS
SYSTEM INTERFACE
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Decisions/
Actions
USERS
Decision Focus of a HMIS
USE(R) DEVELOPMENT
Information
Flows
Data Flows
MIS
Decisions/
Actions
USERS
USER INTERFACE
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COMMON PROBLEMS OF HMIS - 1
 Too much health oriented; too little attention is
given to management information
 Other sector information is virtually non-existent
 Despite much data being collected, too little of it
is processed, and used
 Most data collected and information processed is
numerical in nature
 Vertical programme information systems at
different levels of implementation and functioning
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COMMON PROBLEMS OF HMIS - 2
 Information systems are still too centralized
 No participatory selection of indicators
 No monitoring of the HMIS itself
 Resource requirements poorly assessed
 HMIS are not given sufficient time to mature and
perform
 HMIS as a health sector monitoring tool is too
minimal and (possibly therefore) marginalized
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HMIS Review in Tanzania (2-2000)
Problem
analysis
Consequences
Contributing factors
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HMIS Review in Zambia (3-2000)
 Lack of data validation due to lack of supervision
 Dissemination and feedback from national level lacking
 Difficulties in separation of hospital HMIS
 Difficulties in on-time reporting
 Stationary supply not sustained
 No pre-service training in HMIS done; pre-service training
does not train managers anyway
 Need better documentation on software
 The real costs of the system (human, financial, paper)
have not been quantified
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Common DDIU Concepts
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M&E IS AN ESSENTIAL PROCESS
that produces information to:
 Make informed decisions regarding operations
management and service delivery including effective
and efficient use of resources as well as future
programme planning
 Determine the extent to which the program/project is
on track and to make any needed corrections
accordingly
 Evaluate the extent to which the program/project is
having or has had the desired impact
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DATA VS. INFORMATION
Can be used interchangeably, but:
 Data often refers to raw data, unprocessed
information.
 Information usually refers to processed data, or
data presented in some sort of context.
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DISSEMINATION
The process of sharing information or systematically
distributing information or knowledge to potential users
and/or beneficiaries
 Should produce an effective use of information
Thus
 The goal of dissemination is utilization
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UTILIZATION
The process of putting:
 Information to use, such as to make decisions,
to make changes, or to take other specific
actions designed to improve outcomes.
 M&E information is to be applied in planning,
policy making, program administration/
management, and delivery of services
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FEEDBACK
 The transmission of information to parties for
whom it is relevant and useful so as to
facilitate learning.
 Collection and dissemination of information,
conclusions, recommendations and lessons
learned from the experience.
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WHY EMPHASIZE A FEEDBACK SYSTEM?
 Maintains interest & ownership of M&E stakeholders
 Validates M&E budget, results
 Motivates partners & participants for improved data
collection and data quality
 Increases collective stock of knowledge
Must be well-organized to be effective
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ESSENTIALS OF M&E INFORMATION
 M&E information must:
 be manageable and timely
 be presented according to the audience’s
 interest
 capacity to understand and analyze
 time, competing demands on time
 have transparent quality (VRIPT)
 focus on activities, results of interest
 focus on meaning and direction for action
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INFORMATION (MIS) USE
Focus should be knowledge generation
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Why disseminate & utilize M&E information?
 Strengthen programs
 Engage stakeholders
 Ensure accountability and reporting
 Advocate for additional resources
 Inform Policies
 Contribute to global lessons learned
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Understanding Decision-Making
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UNDERSTANDING DECISION-MAKING
Decision Making:
The process of choosing from among various
alternatives using information at hand
What decisions have you made
already today???
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In the process of understanding decisions and
decision making, it is important to understand:
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What is the decision to be made?
Who makes the decision?
When or why is the decision made?
How is the decision made?
What information is needed?
More over:
 What is my role in decision making?
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IDENTIFYING DECISION-MAKERS (WHO)
Sector
Decision Makers
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Health
Education
Commercial
Function
Policy
Planning
Budgeting
Service delivery
Advocacy
Evaluation
Level
National
Regional
Local
DECISIONS WITHIN PROGRAMS
(WHAT)
Decisions ensure program activities are executed as
planned and services are delivered as intended
 Are we doing the right things, doing them
right, and reaching those we intended?
 Decisions about employment & manpower
 Decision about mobilization & allocation of
resources (physical & financial)
 Decisions about needed information and
developing channels for feedback
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BRAINSTORM ACTIVITY
Decision Making Exercise
Divide in 5 groups:
What decisions are being made in a:
 ARV/Treatment programme
 HTC
 TB/HIV
 PMTCT
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TYPES OF DECISIONS
 Policy, Planning & Advocacy
 Program Design & Improvement
 Program Management & Operations
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POLICY, PLANNING &
ADVOCACY
 HIV/AIDS Workplace Policy
 Family Planning Counseling Protocol
 National allocation of funds to a Health
Information Unit
 HIV/AIDS National Strategy Document
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PROGRAM DESIGN &
IMPROVEMENT
 Design of Prevention of Mother to Child
Transmission of HIV/AIDS program
 Procurement of drugs and commodities
 Improving performance of family planning
counselors
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PROGRAM MANAGEMENT &
OPERATIONS
 Number of staff to support program monitoring
 Reporting mechanisms
 Allocation of national program funds to districts
or local implementers
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Decision Making Activity continued…
 THREE TYPES OF DECISIONS:
Policy, advocacy & planning
Program design& improvement
Program Management & operations
 ACTION:
 Organize the brainstorming answers by the 3 types of
decision-making.
 Post on wall accordingly.
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APPROACHES TO DECISIONMAKING (HOW)
 Rational/Scientific
 Political
 Routine
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Traditional Health Management
Decision Making
"Informed"
Intuitive
Political
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Data Demand and Information Use
(DDIU)
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DDIU-Specific Framework
Improved Health Decisions
Information
Availability
Data Collection
& Analysis
Information Use
(decisions made)
Data Demand
Improved Accountability
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What is DDIU?
 DDIU is a systematic approach that
 Applies best practices
 Applies appropriate tools
 Helps increase demand for quality health-related
data
 Ensures that resulting information is used in an
evidence-based decision-making process.
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4 Distinct Steps in the DDIU Process
Getting Ready to Engage: Identify Issue or Problem
Step 1: Assess Current Situation
•DDIU Supply & Demand Matrix
•DDIU Assessment Checklist
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Step 1. Assess the Situation
 Systematic approach to diagnose areas needing
attention
 DDIU assessment tools help identify
opportunities to increase data demand and use
 Supply & Demand Matrix
 DDIU Assessment Checklist
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Step 1a. Supply & Demand Matrix
Data Supply
Weak
Weak
Data
Demand
and
Information
Use
1Adapted
Statistics & other evidence
sources weak; policymakers
& program managers make
little use of them. Evidencebased program &
policymaking are not
practiced.
Statistics & other sources
of evidence weak but
increasingly used by
policymakers & program
Improving managers for variety of
purposes. Data
deficiencies reduce quality
of decision making.
Improving
Quantity & quality of statistics
& other sources of evidence
improving, but not used for
decision making because
policymakers & program
managers lack incentives &/or
capacity to use them.
Statistics & other sources of
evidence are improving &
being increasingly used for
decision making. This results
in better policy & program
design & implementation.
from C. Scott. 2005. “Measuring Up to the Measurement Problem: The role of statistics in evidence
based policy-making”. Prepared for Paris 21, 2005
Recall: Determinants of Information Use
 Behavioral aspects
 Decision maker attitudes, staff motivation
 Technical aspects
 Technical skills, availability of computers, data
system design
 Organizational aspects
 Structural – roads, telecommunication
 Organizational – clarity of roles, support, flow of
information
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Steps in the DDIU Process
Identify Issue
Step 1: Assess Situation
Step 2: Identify Strategic Opportunities
•DDIU Entry Point Analysis
•Identify anticipated results
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Step 2. Identify Strategic
Opportunities
Source of Data
Decision makers
(Stakeholders)
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Type of Decisions
Step 2. Determining Entry Points for
DDIU
 What decisions, data, & stakeholders involved?
 Is activity focused on RHIS, enhancing use of specific M&E
data set or research finding?
 Is activity focused on particular problem, issue or set of
decisions that need to be made?
 Is the activity focused improving information use at the
national, district, facility or community level?
 Is there a group of stakeholders that require DDIU skills?
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Step 2. Identifying the Entry Points
 Program Stages as entry points for DDIU. Each cell is an
entry point, as the intersection of
 Program Stages
 Problem identification
 Selection of response
 Implementation & program monitoring
 Evaluation
 Domains affecting decision making
 Decisions
 Types of data needed
 Stakeholders
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Step 2. Program Stages Matrix
Stage
1. Problem ID &
recognition
2. Selection of
response
3. Implementation
& program
monitoring
4. Evaluation
Decisions
Type of Data
Stakeholders
Steps in the DDIU Process
Identify Issue
Step 1: Assess Situation
Step 2: Identify Strategic Opportunities
Step 3: Develop Strategy (select tools & approaches)
Assessment tools: Stakeholder Analysis, PRISM,
Constraints to Data Use
DDIU Tools: Decision Calendar, Info. Use Mapping
DDIU Support Interventions: TA, Capacity building,
Targeted data use workshops
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Steps in the DDIU Process
Identify Issue
Step 1: Assess Situation
Step 2: Identify Strategic Opportunities
Step 3: Develop Strategy
Step 4: Apply and Assess Strategy
•Applying tools and approaches
•Verifying anticipated results
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In Summary:
DISSEMINATION AND UTILIZATION
STRENGTHENING M&E CAPACITY
Effective data use is the key to unlocking the door to
increased M&E capacity
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Data Use in Effective M&E
 M&E is an essential process that produces information
to:
 Make informed decisions regarding operations
management and service delivery including effective and
efficient use of resources
 Determine the extent to which the program/project is on
track and to make any needed corrections accordingly
 Evaluate the extent to which the program/project is
having or has had the desired impact
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PURPOSE OF M&E (THE BIG
PICTURE)
Program
Improvement
Share
Data with
Partners
Reporting/
Accountability
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Key Message on M&E
 There should be no enemies in M&E - we
are all (stakeholders) in it together
 We are dependent on each other –
together we can find solutions and
achieve much more than each on our own
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REMEMBER...
Information:
must be based on quality data in order to be useful
and
must be communicated effectively in order to be
useful
Information must be used in order
to strengthen overall M&E capacity
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FINALLY...
If you identify problems early in implementation, you can
respond promptly by modifying your program strategy,
reassigning staff or shifting financial resources to
improve the chances of meeting your program goals and
objectives.
Use Information Effectively
for decision-making and
action taking
and Disseminate Information
Consistently
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Quote’s on Information & Decisions
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Finagle’s Law:
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“much of the material remains unprocessed, or if processed, unanalyzed, or if
analyzed, nit written up, or if written up, not read, or if nor read, nor used or
acted upon. Only a miniscule proportion, if any, of the finding affect policy and
they are usually a few simple totals”
Sect. 5 Miscellaneous and Sacro Sardonic Laws of Science:
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have is not the information you want
want is not the information you need
need is not the information you can get
can get costs more than you want to pay
Robin Chambers:
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The information you
The information you
The information you
The information you
Good decisions come from wisdom
Wisdom comes from experience
Experience comes from bad decisions
THANK YOU!
MEASURE Evaluation is funded by the U.S. Agency for International
Development (USAID) through Cooperative Agreement GPO-A-00-0300003-00 and is implemented by the Carolina Population Center at
the University of North Carolina in partnership with Futures Group,
John Snow, Inc., ORC Macro International, and Tulane University.
Visit us online at http://www.cpc.unc.edu/measure.
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