Monitoring and Evaluation. (MDS-3: Managing Access to Medicines and Health Technologies, Chapter 48)
(2012; 20 pages)


Monitoring refers to the ongoing review of the progress toward completing program activities and achieving objectives. It allows corrective action during program implementation. Monitoring systems focus on inputs and short-term outputs and should be an integral part of day-to-day management.

Fully developed monitoring systems, which may be established in phases, typically consist of a combination of four methods -

  1. Supervisory visits for continual, informal monitoring of workplan implementation and progress toward program plans
  2. Routine reporting of selected data through the pharmaceutical management information system (PMIS)
  3. Sentinel sites for more detailed reporting when new initiatives or rapid expansion requires more intensive monitoring
  4. Special studies whenever an implementation problem or planning question requires specific additional information

Performance indicators can facilitate tracking a program’s progress toward established performance targets or milestones and help compare this progress to that of other programs. Indicators should meet the criteria of clarity, usefulness, measurability, reliability, and validity, as well as acceptance by key stakeholders.

To be effective in improving program performance, monitoring requires -

  • Clear communication of plans and targets
  • Regular review and sharing of monitoring results
  • Follow-up to provide feedback and take corrective action

Evaluation is commonly discussed along with monitoring as part of an overall strategy. It refers to the periodic analysis of a program’s progress toward meeting established objectives and goals. Evaluations fall into three categories, which differ in timing and purpose -

  • Needs assessment (situation analysis, see Chapter 36)
  • Formative evaluation (midterm review)
  • Summative evaluation (final evaluation)

Evaluations use data collected through the ongoing monitoring system, supplemented by document review, interviews, additional data collection, and field surveys using standard pharmaceutical assessment indicators. Strategies for monitoring and evaluation are normally developed in parallel to ensure a comprehensive, unified evaluation strategy.

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