Indicator Guides for Measuring Health Outcomes in International Settings

By Stephanie Mullen, JSI Technical Advisor

Over the past decade as funding has increased for international public health programs so has the demand for information to monitor and evaluate them. Information is commonly used for reporting to donors and stakeholders and strategic decisionmaking for policy and improving program performance. However the methods, data collection tools, and indicators used have differed widely across programs due in part to Ministry of Health and donor requirements. This variation often results in data that are incomplete, incomparable across implementing partners and not focused on decisionmaking.

JSI joined the MEASURE Evaluation project in 1997 at the beginning of Phase I and remains a key partner today under Phase III (2008-2013). The project's mission is to provide technical leadership through collaboration at local, national, and global levels to advance the field of global heath monitoring and evaluation. A significant contribution from the project has been the harmonization and standardization of indicators, data collection tools and methods at national and international levels. Our strategy had included working closely with donors and host country institutions to standardize the most widely used indicators relevant to developing countries and to achieve uniformity in defining indicators to allow comparisons over time and between different programs. A critical next step in the process is to build the capacity of host country institutions to develop and implement monitoring and evaluation plans using standardized indicators and tools.

One example is MEASURE Evaluation's work in developing The Compendium of Indicators for Monitoring and Evaluating National Tuberculosis Programs. The compendium was compiled by a multi-institutional, global working group of experts in monitoring and evaluating (M&E) coordinated by MEASURE Evaluation. It provides a comprehensive and standardized listing of the most widely used tuberculosis (TB) indicators relevant to developing countries. With this compendium, we aimed to achieve uniformity in defining indicators to allow comparisons over time and between different programs.

To reinforce the concepts of the Compendium, MEASURE Evaluation conducted four regional workshops in Latin America, Sub-Saharan Africa, Asia and Eastern Europe, reaching over 80 TB professionals in 29 countries around the world. The workshops emphasized M&E skills (frameworks, indicators, performance monitoring plans) as well as the monitoring and evaluation of specific TB programs such as prison programs, TB & HIV/AIDS collaborative activities and multi-drug resistant TB. In addition, MEASURE Evaluation provided technical assistance to the National Leprosy and Tuberculosis Programme in Kenya and to the National Tuberculosis Program in Vietnam in the form of support for the development of national TB M&E Plans. Both the workshops and technical assistance to the national TB programs provided opportunities for MEASURE Evaluation to build M&E capacity, standardize existing indicators and expand M&E systems to include new TB initiatives such as DOTS expansion, TB/HIV, social mobilization and MDR-TB.

Other indicator resources developed under the MEASURE Evaluation Project include such topics as violence against women and girls, population, health and environment, avian influenza, HIV prevention programs for the most-at-risk-populations, malaria and building organizational capacity. These resources and many others are available on the MEASURE Evaluation website.

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