Computer Based Tools to Improve Supervision, Monitoring and Evaluation of Reproductive Health Programs
To assist family planing supervisors to evaluate and improve family planning supervision and services.
This tool is a computerized instrument for supervisors of family planning services to assess the facility and personnel readiness to provide family planning. The tool seeks to identify the strengths and weaknesses of family planning supervision and allow the supervisors to provide constructive feedback and guidance to service providers and administrators.
Palmtop computers are used and loaded with Excel programs composed of simple checklists that provide the content and evaluation of the service performance. The checklists allow supervisors to easily identify strengths and weaknesses and instruct service providers or administrators on how best to improve their services for quality assurance.
The tool was developed by Population Council and Pubcomm, Inc. in 1998 for use in family planning clinics in Honduras. The project was funded by the U.S. Agency for International Development.
It can be used at the local, regional and central management levels for family planning services in the public or private sector.
The tool has been tested at the primary clinic level where patient load is not heavy and has been applied at the institutional and programmatic levels. Once the data are collected and stored on the individual palmtop computers, they can be aggregated on the palmtops or transferred to a desktop computer at the regional or central level to provide site, supervisor, regional or national statistics for each type of family planning service.
The guide is simple and user-friendly. The palmtop computers are theoretically convenient (approx. 5”x8”x1”), relatively inexpensive ($700-$900), powerful (16 to 32 MB RAM, color screens, windows), and useful (contain Word, Excel and Access software, can be used with a modified touch screen, and the battery life is 10-11 hours before requiring electrical recharge).
Provider performance and facility readiness may improve through the utilization of the palmtop computers by facilitating immediate feedback to providers by their supervisors. This information can be used to improve the quality of care and resolve supply problems. The information gathered facilitates the aggregate analysis of data between facilities and visits thus permitting the evaluation of the status of family planning services at a single point in time and over time, between clinics, and over time for monitoring and evaluation at policy level. Data aggregated at the regional and central levels can be analyzed to further detail the proportion of each service adequately delivered by site, supervisor or region. If used properly, this data can serve as the basis for management decisions and action planning for improvement, and also as a basis for follow-up monitoring.
Use of the tool is limited to family planning services. Many organizations may not be able to afford the computers or the training required (approximately 1 week for those with no prior experience) in using the computer. The tool may require modification as per local norms, however the programs are easily modifiable at the regional or national level. It also requires desktop PC with Windows 95 or above for data transfer to a desktop for statistical analysis beyond that available in the monitoring and evaluation (Analysis, XLS) program on the palmtop computer.
This tool does not measure the quality of the client/provider inter-action, or client satisfaction overall. It also does not address other supervisory issues such as joint work planning, developing teamwork, problem-solving or professional development.
Recommendations for Users:
Adequate time should be given for any modification of the checklists, for training in the use of the computers and “test-runs”. As with any supervisory tool, it is important that this not be used in a vacuum, but rather as part of a broader Human Resource Development system, with full support of management. It requires an investment in palmtop computers ($700-$900 each) and approximately 5 days of training per supervisor. This training should include how to use the palmtop computer, enter the master file and the guide, save data for both types of files, and open and close files. If funded, the Population Council can provide training for use of this software.
Reports and Publications:
Feasibility of Computer Based Supervision in Latin America. Guidelines: How to use the Guide/Como Usar La Guia. Key Instructions/Instrucciones Craves.
It is available in English, French and Spanish.
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