bangladesh performance monitoring plan (pmp)

Bangladesh Performance

Monitoring Plan (PMP)

September 2018

This publication was produced for review by the United States Agency for International Development.

It was prepared by the Health Finance and Governance Project.

II

The Health Finance and Governance Project

USAID’s Health Finance and Governance (HFG) project improves health in developing countries by expanding

people’s access to health care. Led by Abt Associates, the project team works with partner countries to

increase their domestic resources for health, manage those precious resources more effectively, and make

wise purchasing decisions. As a result, HFG increases the use of both primary and priority health services,

including HIV/AIDS, tuberculosis, malaria, maternal and child health, and population and reproductive health

services. Designed to fundamentally strengthen health systems, HFG supports countries as they navigate the

economic transitions needed to achieve universal health care.

September 2018

Cooperative Agreement No: AID-OAA-A-12-00080

Submitted to: Bangladesh USAID Mission

Recommended Citation: Health Finance and Governance Project. September 2018. Bangladesh Performance

Monitoring Plan (PMP). Rockville, MD Health Finance and Governance Project, Abt Associates Inc.

Abt Associates Inc. | 6130 Executive Blvd.| Rockville MD 20852 T: 301.634.1705 | www.abtassociates.com

Broad Branch Associates | Development Alternatives Inc. (DAI) | Futures Institute

| Johns Hopkins Bloomberg School of Public Health (JHSPH) | Results for Development Institute (R4D)

| RTI International | Training Resources Group, Inc. (TRG)

http://www.abtassociates.com/

I

Acronyms................................................................................................................. iii

1. Introduction .............................................................................................. 1

2. Project Goal and Objectives ................................................................... 3

3. Key Project Activities and Expected Results ........................................ 6

3.1 Alignment with USAID/Bangladesh Objectives ........................................................... 9 3.2 Results Framework ............................................................................................................. 9

4. Project Monitoring and Evaluation ...................................................... 11

4.1 M&E Approach ................................................................................................................... 11 4.2 Data Collection Procedures ........................................................................................... 11 4.3 Monitoring Visits ................................................................................................................ 12 4.4 Data Storage........................................................................................................................ 12 4.5 Data Quality Audit ............................................................................................................ 12 4.6 Data Analysis ....................................................................................................................... 12 4.7 Reporting, Data Use and Dissemination ..................................................................... 12

5. Performance Indicators ......................................................................... 14

5.1 Performance Indicator Summary Table ....................................................................... 15 5.2 Performance Indicator Reference Sheets ................................................................... 18

III

ACRONYMS

BHRF Bangladesh Health Reporter’s Forum

CBHI Community-Based Health Insurance

ESP Essential Service Package

HFG Health Finance and Governance

HPNSDP Health, Population, and Nutrition Sector Development Programme

HPNSP Health, Population, and Nutrition Sector Programme

icddr,b International Centre for Diarrhoeal Disease Research, Bangladesh

IR Intermediate Result

JPGSPH James P. Grant School of Public Health

M&E Monitoring and Evaluation

MAB Municipal Association of Bangladesh

MaMoni-HSS MaMoni-Health Systems Strengthening

MOHFW Ministry of Health and Family Welfare

N/A Not Applicable

NGO Non-Governmental Organization

NHA National Health Accounts

NHSDP NGO Health Service Delivery Project

OP Operational Plan

PHNE Population, Health, Nutrition, and Education

PMP Performance Monitoring Plan

PPRC Power and Participation Research Centre

TB Tuberculosis

UHC Universal Health Coverage

USAID United States Agency for International Development

USG United States Government

1

1. INTRODUCTION

USAID’s Health Finance and Governance project (HFG) was a six-year, $209 million project to increase

the use of priority health services, especially by women, girls, poor and rural populations, in developing

countries throughout the world.

Led by Abt Associates, Inc. (Abt), in partnership with Training Resources Group, Inc., Broad Branch

Associates, Development Alternatives Inc., Johns Hopkins Bloomberg School of Public Health, Results

for Development Institute, and Futures Institute, HFG worked with partner countries to improve the

health of their populations by expanding people’s access to health care.

This Performance Monitoring Plan (PMP) describes the performance by which HFG monitored

implementation of project activities in Bangladesh and measured achievements against planned targets in

Year 6 of the project. It describes the project’s goals and its alignment with USAID/Bangladesh

development objectives and results framework, key project activities, and expected results. It also

describes performance indicators and the procedures for data collection; data management; data quality

assurance and analysis; data reporting, use and dissemination; and contains an evaluation plan.

Monitoring and evaluation (M&E) was an integral performance management tool for HFG. M&E was used

not only to monitor project performance, but also, and more importantly, to inform the project’s

implementation approach and future programming. This PMP was designed to ensure programmatic

excellence and integrity throughout project implementation, and track whether the project was moving

in the right direction. The PMP was also designed to encourage learning both within the project team

and among key stakeholders and partners on the links between health system investments and access to

and utilization of priority health services in Bangladesh.

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2. PROJECT GOAL AND OBJECTIVES

The overall goal of HFG was to increase the use of priority health services, including primary health

care services, by partner countries’ populations through improved governance and financing systems

in the health sector. The focus of HFG’s work in Bangladesh was to support the goals of the

government’s Health, Population, and Nutrition Sector Development Program (HPNSDP) through a

multi-pronged technical assistance approach from the national to the community level.

During Years 1 and 2, HFG/Bangladesh focused on supporting the goals of the HPNSDP through

provision of technical assistance as follows:

HFG worked with Pathfinder, USAID’s implementing partner of the Non-governmental

organization (NGO) Health Service Delivery Project (NHSDP), to support the Smiling Sun

NGO network to better achieve its mission of serving the poor and underserved. HFG’s

focus was enhancing the quality and long-term sustainability of the network, thereby

improving access to health services as well as health outcomes, particularly for girls and

young women.

HFG provided technical assistance to the Health Care Financing Resource Task Force and

the Ministry of Health and Family Welfare (MOHFW) Health Economics Unit (HEU). These

entities are working together to implement the country’s Health Care Financing Strategy

through such initiatives as community-based health insurance and micro health insurance.

Beyond the health sector, HFG collaborated with key stakeholders to complete a final

report summarizing what has been learned about the short-term effects of the cash transfer

program on delaying age of marriage and presence of social norms around child marriage.

These stakeholders were UNICEF, the Ministry of Women and Children Affairs, the Ministry

of Social Welfare’s Department of Social Services, and NGOs and local Child Protection

Services Committees. In addition to the presentation of findings, the report provided

recommendations to UNICEF to strengthen the M&E approach and the program.

In Year 3, HFG’s work in Bangladesh built upon previous investments and further continued to

support implementation of the country’s Health Care Financing Strategy. The focus was supporting

transformational change in health care financing in Bangladesh towards achieving the objective of

universal health coverage (UHC). As part of HFG’s approach, both the needs of NGOs and the

formal private sector were addressed. HFG’s work was complimentary to support provided by

other development partners (e.g., World Bank, Swedish International Development Cooperation

Agency (SIDA), The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Kreditanstalt

für Wiederaufbau (KfW), and World Health Organization). HFG also collaborated with World Bank

and GIZ activities.

In Year 4, HFG:

Supported USAID to conduct a Health Financing Assessment (HFA), and with USAID co-

authored the report, “Universal Health Coverage and Health Financing in Bangladesh: Situational

Assessment and Way Forward”.

Worked with the James P. Grant School of Public Health (JPGSPH) at BRAC University to

develop a series of half- and full-day orientation sessions, as well as short courses, which

were offered to stakeholders from government, the private sector, and academia.

Supported development of the “Bangladesh Flagship Course on Health Systems Strengthening

and Universal Health Coverage” in May 2016.

4

Supported institutionalization of the National Health Accounts (NHA), including

dissemination and use of NHA estimates for policy and planning, and provision of Health

Account Production Tool training.

Finalized discussion on the Essential Service Package (ESP) with WHO and HEU, and co-

sponsored with WHO a half-day “Dissemination and Experience-Sharing on Costing Studies in

Health”.

Held a five-day training from September 24-28, 2016 on the OneHealth Tool to cost the

ESP, which was led by HFG partner Avenir Health.

In Year 5, HFG developed an action plan for UHC communication based on input from a core group

of experts and a brainstorming session organized by HFG. HFG continued to partner with JPGSPH

at BRAC University to conduct a series of half- and full-day orientation sessions, policy dialogues, as

well as short courses, which were offered to stakeholders from government, the private sector, and

academia. HGF contracted the Power and Participation Research Centre (PPRC) to conduct a series

of regional dialogues on UHC to raise awareness following TV talk shows. HFG also worked in

partnership with WHO and HEU to support a workshop on the OneHealth Tool designed to build

capacity in its use. Lastly, HFG worked with HEU on an organizational assessment for its

repositioning.

During Year 6, HFG/Bangladesh raised awareness about and advocated for UHC, so that a critical

mass of professionals could advance the UHC agenda in the path towards achieving the health

Sustainable Development Goals. In addition, HFG pursued activities to improve financing for health

in Bangladesh through modeling and analysis for domestic resource mobilization. The ESP work

continued with a focus on increased efficiency of health financing resources with evidence for

decision making. HFG supported the detailed costing and dissemination of the ESP with local capacity

development and policy dialogues. The project also provided technical assistance for the design and

implementation of an “HEU Business plan” within the HEU. HFG also explored more effective pro-

poor targeting approaches as part of its work towards UHC.

During Year 6, HFG/Bangladesh raised awareness about and advocated for UHC, so that a critical

mass of professionals could advance the UHC agenda in the path towards achieving the health

Sustainable Development Goals. In addition, HFG pursued activities to improve financing for health

in Bangladesh through modeling and analysis for domestic resource mobilization. The ESP work

continued with a focus on increased efficiency of health financing resources with evidence for

decision making. HFG supported the detailed costing and dissemination of the ESP with local capacity

development and policy dialogues. The project also provided technical assistance for the design and

implementation of an “HEU Business plan” within the HEU. HFG also explored more effective pro-

poor targeting approaches as part of its work towards UHC.

Project activities in Year 6 were:

Activity 1: Raising Awareness for UHC

Activity 1.1: UHC working sessions with selected Operational Plan (OP) managers at the MOHFW.

Activity 1.2: UHC dialogues and advocacy series

Activity 1.3: UHC technical discussions with journalists

Activity 1.4: UHC technical discussions with journalists

Activity 2: Costing the ESP and tuberculosis (TB) Services

Activity 2.1: Technical support for ESP costing

Activity 2.2: Policy brief and workshop on costing and use

Activity 2.3: Technical support for TB costing

Activity 3: Resource Modeling for the ESP, TB and Immunization

Activity 3.1: Resource modeling and analysis for the ESP

Activity 3.2: Resource modeling and analysis for TB and immunization financing

Activity 3.3: Policy discussion on use of results

5

Activity 4: Repositioning the HEU

Activity 4.1: Organizational assessment of HEU and business plan

Activity 4.2: Implementation support for HEU’s business plan

Activity 5: Reviewing Approaches for Targeting the Poor

Activity 5.1: Targeting the poor

6

3. KEY PROJECT ACTIVITIES AND

EXPECTED RESULTS

In Year 5, HFG developed an Action Plan for UHC communication based on a brainstorming session

organized by HFG and earlier input from a core group of experts. HFG partnered with JPGSPH at

BRAC University developed a series of half-day and full-day orientation sessions, as well as short

courses, which offered to stakeholders from the government, private sector and academia. In

addition, HFG supported the Bangladesh version of the global Flagship course, “Bangladesh Flagship

Course on Health Systems Strengthening and Universal Health Coverage”, offered in January 2017, in

partnership with the Health Economics Unit (HEU), World Health Organization (WHO) and the

World Bank. A roundtable policy dialogue was held on March 5, 2017 at Prothom Alo chaired by

Honorable Health Minister Mohammed Nasim. A full-page supplementary was published by Prothom

Alo on April 6, 2017. HFG partnered with PPRC to conduct regional dialogues, civic walks, and a TV

talk show to raise awareness about the UHC partnership with the Municipal Association of

Bangladesh (MAB). Regional dialogues in Bera, Pabna, and Jhenaidah and a TV talk show reached

almost 1,000 people. Over 15 experts/facilitators participated in the program. HFG also partnered

with USAID’s MaMoni-Health Systems Strengthening (MaMoni-HSS) project to conduct an

organizational assessment for HEU.

In Year 6, HFG helped raise awareness about and advocate for UHC with the goal of developing a

‘critical mass’ of professionals to advance the UHC agenda. In addition, HFG pursued activities to

improve financing for health in Bangladesh through modeling and analysis for domestic resource

mobilization. The ESP work continued with a focus on increased efficiency of health financing

resources with evidence for decision making. HFG supported the detailed costing and dissemination

of the ESP with local capacity development and policy dialogue. The project also provided TA for the

design and implementation of an “HEU Business plan” within HEU.

Implementation of Y6 activities against expected results:

Activity 1: Raising Awareness for UHC - expected results:

HFG intermediate results (IRs):

IR 2.1: Partner countries’ capacity to manage and oversee health systems at the national,

provincial and district levels increased.

IR 2.2: Capacity of civil society and private sector for meaningful engagement with host

country government strengthened.

Activity 1 progress resulted in the following:

One hundred and fourteen (114) personnel from eight OPs at MOHFW were capacitated to

implement OP activities with an UHC perspective; they were able to generate ideas and

input on how the planned OP activities can be implemented with additional focus on UHC.

HFG’s local partner PPRC conducted 11 divisional/district level multi-stakeholder dialogues

on UHC during Y5 and Y6, of which 9 dialogues were in Y6, with almost 2,300 participants

in Y6. The activity enhanced the capacity of and engagement with civil society and the private

sector for advancing of UHC.

HFG organized the UHC knowledge exchange national event titled "Awareness for Action:

Progressing on Universal Health Coverage" with local partner PPRC. The event showcased the

7

multitude of efforts linked to advancing UHC in Bangladesh. In addition to key national level

stakeholders, over 100 district-level UHC champions joined the event from eight districts

and developed district action plans on UHC. The event generated a lot of interest in UHC,

as desired.

HFG led five TV talks shows, which showcased the multi-stakeholders engaged in advancing

the UHC agenda in Bangladesh.

A series of five technical discussions on UHC with health journalists from Bangladesh Health

Reporter’s Forum (BHRF) helped them to understand more about UHC, healthcare

financing, and financial protection. As an outcome of this series of technical discussions, 55

articles related to UHC were published by journalists in several national Bengali and English

daily newspapers, covering topics relevant to healthcare financing and financial protection.

Activity 2: Costing the ESP and tuberculosis (TB) Services - expected results:

HFG IRs:

IR 1.3: Increased efficiency of health sector resource allocation.

IR 3.4: Increased capacity of partner countries to employ effective health sector strategy

and planning systems.


HFG in partnership with HEU, WHO, and the International Centre for Diarrhoeal Disease

Research, Bangladesh (icddr,b), conducted a detailed costing of the ESP. The analysis

estimated the total cost required to implement ESP services in the public sector to achieve

targets as in the Fourth Health, Population, and Nutrition Sector Programme (4th HPNSP)

and cost per program area of ESP for successful implementation.

Activity 3: Resource Modeling for the ESP, TB and Immunization – expected results:

HFG IRs:

IR 1.1: Financing of health from domestic resources increased.

IR 3.2: Improved health support system for efficient service delivery.


Building on the ESP costing, HFG conducted a resources gap analysis for the ESP, which

included a detailed resource gap analysis for TB and immunization programmes.

Findings from the resource modeling analysis showed the gap in resources required for

successful implementation of the ESP, TB, and immunization programmes in Bangladesh.

The report showed the allocated resources for ESP, TB, and immunization, and the gap in

resources for successful implementation of programs to achieve the 4th HPNSP targets by

2022.

Activity 4: Repositioning the HEU – expected result:

HFG IRs:

IR 1.3: Increased efficiency of health sector resource allocation.

IR 3.4: Increased capacity of partner countries to employ effective health sector strategy

and planning systems.

8


HFG, in partnership with USAID’s MaMoni HSS project, completed an organizational

assessment of the Health Economics Unit, which aimed to improve the organizational

structure and functions. This will enable HEU to be more efficient in supporting the

achievement of UHC in Bangladesh.

Activity 5: Reviewing Approaches for Targeting the Poor – expected result:

HFG IRs:

IR 1.2: Financial barriers that inhibit access to priority health services reduced.

IR 2.1: Partner countries’ capacity to manage and oversee health systems at the national,

provincial, and district level increased.


HFG worked closely with its local partner PPRC to complete a qualitative review of

approaches for targeting the poor. Findings from the review of six social safety net

programs highlighted the implementation modality of each program along with major

challenges. The report recommended a mixed approach to improve the efficient

implementation of targeting for social programs in the health sector and beyond.

Deliverables:

Activity 1 deliverables:

A technical note on conducting working sessions with selected Operational (OP) personnel

titled “Moving Towards Universal Health Coverage Through Implementation of Operational Plan

Activities.”

Three policy briefs on UHC awareness activities:

o Accelerating Progress on Universal Health Coverage Hinges on Local Level Awareness and

Engagement

o Harnessing Universal Health Coverage (UHC) Awareness: Evidence to Action in Bangladesh

o Sustaining Universal Health Coverage (UHC) Awareness: Healthy Bangladesh Platform

A media report titled, “Engaging the Media and Journalists to Progress the Universal Health

Coverage Agenda in Bangladesh, 2016-2018” based on technical discussions with journalists

on UHC and other -engagements with journalists.

“Universal Health Coverage Learning Resource” from UHC knowledge exchange activity.


Detailed ESP costing technical report titled, “Costs of the Bangladesh Essential Health Service

Package (2016-2022).”

Two technical briefs on ESP costing (one short one-pager and a longer four-pager):

o Estimating the Costs of Public Sector Provision of the Bangladesh Essential Health Service

Package (2016-2022).

o Estimating the Costs of Public Sector Provision of the Bangladesh Essential Health Service

Package (2016-202).

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Technical note on TB costing titled, “Technical Assistance to Build Capacity for Tuberculosis

Costing using the OneHealth Tool and Tuberculosis Impact Model and Estimates”.


A technical report on the resource gap titled, “Resource Gap Analysis for Public Sector Provision

of the Essential Service Package, Tuberculosis, and Expanded Programme on Immunization in

Bangladesh, 2017-2022”.

Three briefs based on the resource modeling analysis for ESP, TB, and immunization

financing:

o Resource Gap for Public Sector Provision of the Essential Service Package (ESP) in Bangladesh,

2017-2022.

o Resource Gap for Tuberculosis (TB) Programme in Bangladesh, 2017-2022.

o Resource Gap for Public Sector Provision of the Expanded Programme on Immunization (EPI) in

Bangladesh, 2017-2022.

Activity 4 deliverable:

Report on organizational assessment of HEU with implementation plan titled, “Repositioning

the Health Economics Unit: Final Report”.


A technical report on targeting the poor titled, “Targeting the Poor for Universal Health Coverage

Program Inclusion: Exploring a More Effective Pro-poor, Targeting Strategy”.

A brief titled, “Targeting the Poor for UHC Program Inclusion: Exploring a More Effective Pro-poor

Targeting Approach”.

3.1 Alignment with USAID/Bangladesh Objectives

HFG's activities aligned with the following USAID/Bangladesh IR under its Development Objective 3

(Health Status Improved):

IR 3.3 Strengthened Health Systems and Governance

3.2 Results Framework

The HFG results framework depicts the causal linkages between health system investments and the

project’s purpose of increasing the use of priority health care services. The framework is the

hypothesis of how selected inputs and processes (i.e., interventions) will lead to desired outputs,

outcomes, and impact. The IRs and sub-intermediate results (sub-IRs) combine to support the

project purpose. The framework serves as the foundation for all project and M&E activities, to guide

activities, measure progress toward results, and help HFG determine the impact of project work on

improving health system performance and the use of priority health services. All HFG activities were

aligned with the overall HFG results framework, presented in Figure 1 below.

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4. PROJECT MONITORING AND

EVALUATION

HFG Bangladesh M&E activities were led by HFG’s M&E team located at Abt headquarters. HFG

M&E team members included the M&E Manager as well as other support staff both at headquarters

and in the Bangladesh office. The HFG M&E Manager led all project M&E activities, including:

performance monitoring plan development and revisions; indicator development and revisions;

ensuring that all M&E requirements for HFG Bangladesh were met including data collection,

performance monitoring, and reporting; and quality assurance of all M&E activities. The HFG M&E

Manager was also the primary contact for all HFG Bangladesh M&E activities. Headquarters M&E

staff provided continuous support to Bangladesh activities. HFG Bangladesh field staff

coordinated/implemented M&E activities on the ground, including data collection and data transfer to

HFG headquarters.

4.1 M&E Approach

The M&E approach for HFG Bangladesh was based on the fundamental objective of supporting

evidence-based decision making to help guide course corrections during the project, as well as to

support USAID’s decision making with future initiatives. This was achieved through regular and

timely collection of evidence about progress, accomplishments, and outcomes; and regular and

frequent sharing of progress, lessons learned, and best practices with the HFG team and external

community.

As HFG was committed to outcomes-driven performance management, the M&E approach taken

ensured that M&E data was used to track progress, ensure mid-course corrections, and document

lessons learned. Annual work planning sessions (at the global project level) utilized historical M&E

data to inform programming direction and planning. Additionally, while the focus of the HFG

Bangladesh M&E was on project activities, the M&E team identified opportunities for M&E capacity

building of implementing partners, where appropriate.

4.2 Data Collection Procedures

HFG used standard data collection templates and forms across the project to ensure consistency in

data collection. Templates were customized as needed for each particular situation (e.g., with USAID

branding and appropriate questions), in collaboration with in-country partners and other

stakeholders. As the project evolved, new template requirements emerged. All physical copies of

completed forms were retained with the Abt headquarters team, with scanned/electronic copies

maintained within the M&E System.

Activity leads were responsible for collecting and providing the data needed to track indicators. The

M&E team managed and stored all the completed data collection forms. The M&E team received the

completed forms from technical/field staff who captured all data. The forms were used to update the

HFG M&E database.

The HFG M&E Manager ensured effective technical implementation of HFG M&E activities, including

design of M&E tools, and timely collection, reporting, and use of M&E data.

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4.3 Monitoring Visits

At regular intervals determined with mission collaboration, HFG conducted field monitoring visits

for routine data collection and to monitor progress on project activities. Monitoring visits were

conducted by HFG country and activity leads.

4.4 Data Storage

HFG used a centralized electronic M&E system for storing all M&E-related data. HFG files were

automatically backed up daily. The M&E system was located at HFG headquarters, but accessible by

HFG Bangladesh team members. The system allowed for export of all data to support analysis with

statistical software packages and other software tools.

4.5 Data Quality Audit

The M&E system had multiple mechanisms in place to ensure the data that was collected, stored, and

reported, was of the highest quality. Mechanisms included:

Data quality assessment: Measuring the success and improving program activities depended

on strong M&E systems that produced quality data related to program implementation. A data

quality audit was conducted on collected data, from both HFG (i.e., internal) and external data

sources, at intervals appropriate for the pace of activity progress. The primary purpose of the

audit was to validate the data coming from both program staff and external sources. In addition,

the data quality audit strengthened the data collection process. The audit provided information

for those responsible for data collection at all levels on the completeness of data, and what to

consider when collecting and filling in the forms. The auditors verified and validated the source

documents for completeness and consistency.

Data collection templates: These were standardized formats for data collection tools (e.g.,

forms, database) to support consistent data collection and aggregation across the project.

Collected forms: Throughout the data collection process, HFG monitored the quality of the

data. The M&E team ensured that the data collected was accurate, reliable, of high integrity,

complete, and submitted on time. The M&E team always checked hard copy forms for

completeness, consistency, and errors before entering them in the electronic database. The data

was treated with a high level of confidentiality.

4.6 Data Analysis

HFG Bangladesh data analysis was completed using the HFG M&E system. The HFG M&E System

brought together program plans, collected data, results and reporting in a centralized, customizable

application. All of the collected Bangladesh data was readily available for HFG analytical needs and

decision making.

4.7 Reporting, Data Use and Dissemination

HFG provided a variety of reporting options for knowledge dissemination to stakeholders and

partners, in order to support the management and performance monitoring of activities. The

reporting included both quantitative measures of activities, as well as narrative support information

where appropriate. The following options were initially used:

Quarterly report: The quarterly report, covering HFG technical and financial progress over

the most recent quarter, was a key document that allowed HFG to demonstrate its value to

USAID. The report:

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o Identified and related milestones and achievements; and

o Identified key implementation challenges, problems, or issues encountered, including

how they were resolved and, if required, recommended mission-level intervention to

facilitate timely resolution.

Annual Report: The fourth quarter report was an annual version, which covered the previous

12 months ending in September. In addition to the quarterly report components, the annual

report also contained:

o Discussion of impacts achieved to-date, supported with both quantitative and qualitative

evidence; and

o Planned timeline and achievements for every activity, including recommended follow-up

improvements, important issues, problems and recommendations, and documentation of

the use of funds and effort in the execution of activities.

Knowledge management: The M&E and Knowledge Management teams worked closely

together to develop other types of communication vehicles (e.g., success stories, newsletters,

and website articles), as needed.

Custom Reports: As needed, the M&E team were able to generate ad hoc, customized

reports (e.g., situation assessment, special study reports) for stakeholders.

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5. PERFORMANCE INDICATORS With the results framework as the guiding structure for the PMP, coupled with the project’s

operational plans (work plans and budgets), the HFG M&E team assisted country managers and

activity leads to identify and shape a set of performance indicators that effectively measured the

results of efforts for each specific activity. Indicators were identified that covered key outputs and

outcomes with an emphasis on reporting outcomes wherever possible. Country ownership and

sustainability of project interventions were also a consideration and the focus of outcome indicators.

In the selection of indicators, HFG attempted to minimize the burden of data collection and

reporting, while maximizing the ability to track the effects of HFG activities.

The indicators also measured national-level results, reflecting the contributions by HFG and also by

other stakeholders. HFG efforts were an indirect, longer-term contribution towards progress in

these indicators. HFG used existing data sources to report on these indicators, rather than project

resources. The indicators identified for the Bangladesh activities are summarized in the table below.

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5.1 Performance Indicator Summary Table

TABLE 1: INDICATOR SUMMARY

ID Performance

Indicator

Disaggregated

By

Data Source Baseline (Year/

month)

Baseline

value Results

FY 2013

Results

FY 2014

Results

FY 2015

Results

FY 2016

Results

FY 2017

Results

FY 2018

A1 Number of

organizations

contributing to

HFG-supported

work

Type of

Organization,

Type of

Contribution,

Technical Area

Project records;

organization

documentation

October

2012

0 3 2 9 8 8 9

A2 Number of

participants at

HFG-supported

events

Event Type,

Participant

Gender, Technical

Area

Project records,

HFG Event

Participant

Register

October

2012

0 42 27 139 290 1342 2,498

A3 Number of HFG-

supported

implementation

plans

Technical Area,

Type of HFG

Support (e.g.

financial, technical,

organizational,

etc.); Receiving

Organization Type

Project records,

plans created/

identified

October

2012

0 1 1 0 0 1 1

A4 Number of HFG-

supported

analytical reports

Technical Area,

Type of HFG

Support (e.g.


organizational,

etc.); Receiving

Organization Type

Project records,

reports created/

identified

October

2012

0 1 2 5 6 2 6

A5 Number of HFG-

supported M&E

tools

Type of M&E tool,

Type of HFG

Support (e.g.


Project records,

tools created/

identified

October

2012

0 2 0 0 NA N/A N/A

16

organizational,

etc.); Receiving

Organization Type

A6 Number of

organizations

where HFG-

supported

technical

resources are

used

Type of

Organization,

Type of Technical

resources,

Technical Area

Project records;

organization

documentation;

Technical

Resource Use

Questionnaire

October

2012

0 1 1 5 3 8 9

A7 Country

capacity to

perform NHA

estimations

Dimension

Capacity

assessment

questionnaire

May 2016 3.3 Not

applicab

le

Not

applicabl

e

Not

applicab

le

3.4 Not

applicable

Not

applicable

C1 Births attended

by skilled health

staff, % of total

births

Not Applicable BHDS/BMSS

2011

31.7%

31.7% 42.1% N/A 49.8% N/A N/A

C2 Percent of

children under 5

years with

Acute

Respiratory

Infection (ARI)

taken to a

health facility

Not Applicable BDHS 2011 35.2% 35.8% 42% N/A N/A N/A N/A

C3 Contraceptive

prevalence rate

Not Applicable BDHS 2011 61.2% 61.2% 63.2% N/A N/A N/A N/A

C4 Treatment

success rate for

new pulmonary

smear-positive

tuberculosis

Not Applicable WHO Country

Profile

2011 92% 92% 94% N/A 93% N/A N/A

17

cases

C5 Number of

people on

antiretroviral

therapy (ART)

Gender, age

group (<15 vs.

≥15 years)

UNAIDS 2012 831 1083 1287 1483 1817 2470 N/A

C6 General

government

expenditure on

health as a

percentage of

total health

expenditure

(THE)

Not Applicable BNHA Report 2012 34% 34% N/A 23% N/A N/A N/A

C7 Out-of-pocket

expenditure on

health as % of

total health

expenditure

Not Applicable BNHA Report 2012 63% 63% N/A 67% N/A N/A N/A

N/A: Not Available. A: Attribution indicator (indicators which are attributable to HFG efforts); C: Contribution indicator (indicators which HFG would

potentially contribute to. Changes in these indicators are affected by too many uncontrollable factors and as such, HFG cannot take credit for changes in these

indicators).

18

5.2 Performance Indicator Reference Sheets

In order to provide clear explanation of the indicators, the M&E team worked with the technical teams

to develop formal and comprehensive indicator definitions which are described on performance

indicator reference (PIR) sheets. Each PIR sheet provides details on:

1. Relationship to results framework;

2. Description, including definition, calculation, disaggregation;

3. Data collection plan, including method, source, frequency, estimated cost;

4. Data quality issues, including assessments, limitations, plans;

5. Responsibilities for collection and reporting;

6. Plan for analysis, review, reporting; and

7. Relationship to Foreign Assistance Framework (FAF).

A few universal definitions apply to all indicators:

“Support” is broadly defined and may include financial, technical, organizational, or any other

form of assistance that HFG provides to government and nongovernmental organizations.

The PIR sheets reflect the current, expected scope of HFG. If the scope of work for HFG changes over

the project period, some of the indicators may change as well. Therefore, the PIR sheets will be

reviewed and, if needed, revised after the finalization of the annual work plan each year. However, such

revisions of indicator definitions will not affect indicator names and will be done in a way that ensures

comparability of indicator values over time.

INDICATOR A1

HFG Project Performance Indicator Reference Sheet

INDICATOR: Number of organizations contributing to HFG-supported work

Indicator Type: Input

Attribution/Contribution: Attribution

USAID/Bangladesh

Development Objective: Improved Health Status

Intermediate Result 3.3: Strengthened health systems and governance

Is this an Annual Report

indicator? No Yes X for reporting Year(s) 2013-2018

DESCRIPTION

Purpose: HFG will be collaborating with a variety of in-country stakeholders throughout activity

implementation. This indicator will capture the breadth of organizations that are

contributing to HFG work, and especially HFG’s involvement with local partners to

promote sustainable development in accordance with USAID Forward.

Definition: Count of the number of organizations contributing to HFG-supported work.

Organizations: All groups or institutions, within the government sector or

outside the government sector. Examples include ministries, government groups,

units, or other organizational structures dealing with public health issues.

HFG-supported: Broadly defined and may include financial, technical,

organizational or any other form of assistance that HFG provides to government

and non–governmental organizations.

Contributing: Helping to bring about an end or result (e.g. providing input,

providing feedback, performing a service, reviewing, etc.)

Unit of Measure: Number

INDICATOR A1


Calculation: Count of organizations

Disaggregated by: Type of Organization, Type of Contribution, Technical Area

Direction of Change: Increase in number indicates greater success

DATA COLLECTION PLAN

Method: HFG documented descriptive information about each organization that has been

identified as a component of an activity. Activity Leads will document their contribution

to the HFG activity.

Data source(s): Project records; organization documentation

Collection Frequency: Quarterly

Estimated Cost of Data

Acquisition: Initial cost for baseline assessment and annual cost for continued assessment of

management capacity.

Critical Assumptions and

Risks/Challenges:

Location of Data Storage: HFG M&E System

DATA QUALITY ISSUES

Date of Initial Data

Quality Assessment Y1 Q4

Known Data Limitations

and Significance (if any): No data limitations anticipated for this indicator.

Actions Taken or Planned

to Address Data

Limitations:

Not applicable

Date of Future Data

Quality Assessments: Not applicable

Procedures for Future

Data Quality Assessments Not applicable

RESPONSIBILITIES FOR DATA COLLECTION AND REPORTING

Data Collection: Activity Leads

Validating Data Quality: M&E Team

Data Reporting: HFG M&E Manager

PLAN FOR DATA ANALYSIS, REVIEW, AND REPORTING

Data Analysis: Number of organizations by organization type and support

Presentation of Data: Indicator table(s)

Reporting Frequency: Quarterly

Reporting of Data: Quarterly Report

20

INDICATOR A1


PERFORMANCE INDICATOR VALUES

Notes on

Baselines:

Baseline=0

Year Target Actual Notes

FY 2013 8 3 Target: 1) WHO, 2) World Bank, 3) GIZ, 4) SIDA, 5) Rockefeller

Foundation, 6) UNICEF, 7) Pathfinder, 8) MOHFW

Actual: Smiling Sun, UNICEF, WHO,

FY 2014 2 2 Target: 1) Pathfinder-NGO Health Service Delivery Project; 2)

UNICEF

Actual: 1) Pathfinder-NGO Health Service Delivery Project; 2)

UNICEF

FY 2015 11 9 Target: Ministry of Health and Family Welfare; Ministry of

Establishment; Ministry of Local Government, Regional Development

and Cooperatives; Bangladesh National Health Accounts Cell; Smiling

Sun NGO network providers; BRAC; BIGH; World Bank; WHO;

GIZ; NHSDP

Target: Ministry of Health and Family Welfare; Ministry of Local

Government, Regional Development and Cooperatives; Bangladesh

National Health Accounts Cell; Smiling Sun NGO network

providers; BRAC; World Bank; WHO; GIZ; NHSDP

FY 2016 8 8 Target: 1) WHO, 2) World Bank, 3) GIZ, 4) SIDA, 5) Rockefeller


Actual:1) WHO, 2) World Bank, 3) GIZ, 4) SIDA, 5) Rockefeller


FY 2017 6 8 Target: 1) HEU 2) JPGSPH 3) IHE 4) WHO 5) WB 6) PPRC

Actual: 1) HEU 2) JPGSPH 3) IHE 4) WHO 5) WB 6) PPRC 7)

icddr,b 8) MaMoni-HSS project

FY 2018 9 9 Target: 1) MOHFW (HEU) 2) IHE 3) WHO 4) PPRC 5) BHRF 6)

Challenge TB project 7) icddr,b 8) MaMoni-HSS 9) RDM project

Actual: 1) MOHFW (HEU) 2) IHE 3) WHO 4) PPRC 5) BHRF 6)

Challenge TB project 7) icddr,b 8) MaMoni-HSS 9) RDM project

FOREIGN ASSISTANCE FRAMEWORK

Functional Objective: Investing in People

Program Area: 1 Health

Program Element: 1.1 HIV/AIDS, 1.2 TB, 1.3 Malaria, 1.5 Other Public Health Threats, 1.6 Maternal and

Child Health, 1.7 Family Planning and Reproductive Health

Program Sub-Element: 1.2.7; 1.3.7; 1.5.3; 1.6.8; 1.7.4 Health Governance and Finance

1.1.13 Other/Policy Analysis and System Strengthening

ADDITIONAL NOTES

Other Notes:

PIR Last Updated On

(Date): September 2018

PIR Last Updated by: Sohel

INDICATOR A2


INDICATOR: Number of participants at HFG-supported events

Indicator Type: Output

Attribution/Contributi

on: Attribution

USAID/Bangladesh

Objective: Improved Heatlh Status

Intermediate Result: 3.3 Strengthened health systems and governance

Is this an Annual

Report indicator? No Yes X for reporting Year(s) 2013-2018

DESCRIPTION

Purpose: HFG will support a number of events throughout the life of the project for capacity building,

knowledge transfer, knowledge dissemination, etc. HFG will capture descriptive information

from participants at these events to document the reach of HFG’s capacity building and

other event activities on an individual level.

Definition: Count of the number of participants at HFG-supported events. Key terms are defined as:

HFG-supported: broadly defined and may include financial, technical, organizational or

any other form of assistance that HFG provides to government and non–governmental

organizations

Participants: Any person who is present and participates in a meeting or event

Events: Any activities where a number of persons gather for a specific purpose. This

includes trainings, workshops, conferences, dissemination events, etc.


Calculation: Count of number of participants at events

Disaggregated by: Gender, Event Type, Technical Area



Method: HFG distributed a standardized collection form for descriptive data from participants at all

HFG-supported events. These participant forms were provided to the HFG M&E team and

logged within the HFG M&E system.

Data source(s): Project records, HFG Event Attendance Register


Estimated Cost of

Data Acquisition: Negligible cost for providing HFG Event Attendance Register at all HFG-supported events.

Critical Assumptions

and Risks/Challenges:

Location of Data

Storage: HFG M&E System

DATA QUALITY ISSUES



Known Data

Limitations and

Significance (if any):

No data limitations anticipated for this indicator.

Actions

Taken/Planned to

Address Data

Not applicable.

22

INDICATOR A2


Limitations:

Date of Future Data

Quality Assessments: Not applicable


Data Quality

Assessments

The HFG M&E Team completed an initial review of the collected data. Activity Leads

confirmed that the data is complete and correct. Follow-up discussions regarding data

accuracy and completeness were completed as needed with relevant parties.



Validating Data

Quality: M&E Team



Data Analysis: Number of participants, disaggregated by event type, participant gender, and technical area

Presentation of Data: Indicator table(s); descriptive summary of each HFG-supported event



INDICATOR A2



Notes on

Baselines:

Baseline=0


FY 2013 Not

Applicable

42 Target: N/A

Actual: 42 (Activity 2 Training events for data collectors (June 14, 2013 - 18

participants in Khulna; June 21, 2013 - 24 participants in Sylhet)

FY 2014 N/A 27 Target: N/A

Actual: 27 (Workshop on What Roles for CBHI/MHI in Health Care

Financing)

FY 2015 125 139 Target: 125

Actual: 139

18 (Two meetings on the demand side analysis, with 8 and 10 participants,

respectively)

+ 32 (4 small work meetings, 8 participants each)

+ 39 (Dissemination of DCE Study (39 participants)

+ 50 (Special session on urban health financing at the Urban Health

Conference in Dhaka in May 2015

FY 2016 100 290 Target: 100

Actual: 290

77 confirmed (not including particpants for the half-day orientation sessions

and ESP costing)

+ 22+36 (orientation sessions completed Aug)

+ 50 (Sept 22 costing policy discussion)

+ 20 (ESP costing training Sept)

+ 35 (one short course Sept)

+ 50 (25x2 orientation sessions by Sept 30)

= 290 reported in Y4 work plan.

FY 2017 340 1342 Target:

340 number of participants will be reached through orientation sessions,

short course, Flagship course and costing related activities.

Actual: 1279

25+44+22 (three orientation sessions completed in October 2016)

+ 23 (Short course completed in November 2016)

+ 31 (UHC day reception in December 2016)

+ 42 (Flagship Course in January 2017)

24

INDICATOR A2


+ 13 (roundtable policy dialogue in March 2017)

+ 6 (Braunstroming session on action plan for UHC communication)

+ 10 (Expert consulation meeting on targeting the poor in June 2017)

+ 7 (Expert consulatation meeting on regional dialogue in June 2017)

+ 72 (workshop and interview for HEU repositioning in July 2017)

+ 483 (Regional dialogue on UHC in Bera, Pabna in July 2017)

+ 18 (Journalist workshop on UHC in August 2017)

+ 511 (Regional dialogue on UHC in Jhenaidah in August 2017)

+ 35 (Experience sharing on building awareness on UHC)

= 1342 participated at HFG supporred events in Y5.

Based on attandance for three orientation sessionas, short courses, policy

dialogue, Flagship course, expert consultation meetins, regional dialogue

meetings and experience sharing on building UHC event.

FY 2018 1702 2,498 Target:

Total 1680 participants from following evnets

100 (5 sessions X 20 participants each) at working session with OP managers

1350 (9 dialogues X 150 participants each) at regional dialogue series

20 (5 discussions with same participants) at technical discussion with journalist

150 (1 event X 150 participants) at UHC knowledge exchaange event

30 (1 event X 30 participants) at workshop on costing and use

30 (1 event X 30 participants) at resource modeling policy workshop.

Actual: 2498

Total 2498 participants from following evnets

114 (33+24+18+19+20) from 5 workimg session with OP Managers

2037 (365+195+167+274+281+177+227+206+145) at regional dialogue

series

22 (5 discussions with same participants) at technical discussion with journalist

266 (1 event X 150 participants) at UHC knowledge exchaange event

59 participants in advancing health financing and governance in Bangladesh –

sharing lession from USAID’s Health Finance and Governance project




Program Element: 1.1 HIV/AIDS, 1.2 TB, 1.3 Malaria, 1.5 Other Public Health Threats, 1.6 Maternal and Child

Health, 1.7 Family Planning and Reproductive Health

Program Sub-

Element: 1.2.7; 1.3.7; 1.5.3; 1.6.8; 1.7.4 Health Governance and Finance


ADDITIONAL NOTES

Other Notes:

PIR Last Updated On


PIR Last Updated by: Sohel Rana

INDICATOR A3


INDICATOR: Number of HFG-supported implementation plans



USAID/Bangladesh

Objective: Improved Health Status




DESCRIPTION

Purpose: HFG will both lead and collaborate on the development of new implementation plans or

modification of existing implementation plans throughout the life of the project.

Examples of implementation plans that will be developed as a result of HFG’s activities in

Bangladesh include an implementation work plan for the M&E framework for the

UNICEF-led adolescent empowerment program, an implementation plan for the

government’s Health, Population and Nutrition Sector Development Program

(HPNSDP), and a Road map/work plan for social health insurance program for civil

servants. These implementation plans are important components towards achieving

HFG’s objectives and will be tracked.

Definition: Count of the number of implementation plans developed with HFG support. Key terms

are defined as:

HFG-supported: broadly defined and may include financial, technical,


and non–governmental organizations

Implementation plan: Any plan of action whose primary use will assist

individuals, groups, organizations, or governments to implement strategies, policies,

etc.


Calculation: Count of implementation plans

Disaggregated by: Technical Area; Type of HFG Support (e.g. financial, technical, organizational, etc.);

Receiving Organization Type



Method: All implementation plans identified as deliverables or as components of HFG activities

will be tracked within the HFG M&E system. The type of support provided for each of

these implementation plans will be documented throughout the entirety of HFG’s

involvement with the implementation plan.

Data source(s): Project records, plans created/identified



Acquisition: Data for this indicator will largely be recorded from project records and follow-up

discussions with no substantial additional costs anticipated.


Risks/Challenges:


DATA QUALITY ISSUES

Date of Initial Data Y1 Q4

26

INDICATOR A3


Quality Assessment



Actions Taken/Planned to

Address Data

Limitations:

Not applicable

Date of Future Data

Quality Assessments: Quarterly


Data Quality

Assessments



accuracy and completeness completed as needed with relevant parties.






Data Analysis: Number of implementation plans, disaggregated by technical area; type of HFG support

Presentation of Data: Table and descriptive summary of each implementation plan and type of HFG-support

provided



INDICATOR A3



Notes on

Baselines:

Baseline=0


FY 2013 2 1 Target: 1) Implementation work plan for the M&E framework for the

UNICEF-led adolescent empowerment program, and 2)

Implementation plan for the HPNSDP

Actual: 1) Research protocol and work plan to guide

implementation/testing (Activity 2)

FY 2014 1 1 Target: 1) Final report and dissemination on M&E assistance to an

adolesent empowerment program using conditional cash transfer.

Actual: 1) Final report and dissemination on M&E assistance to an

adolesent empowerment program using conditional cash transfer.

FY 2015 1 0 Target: Road map/work plan for social health insurance program for

civil servants

Actual: N/A

FY 2016 1 0 Target: 1) Health Financing Assessemnt Report

Actual: N/A

FY 2017 1 1 Target: 1) Action plan for UHC communication

Actual: 1) Action plan for UHC communication

FY 2018 1 1 Target: 1) Implementation support for HEU’s business plan

Actual: 1








ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR A4


INDICATOR: Number of HFG-supported analytical reports



28

INDICATOR A4


USAID/Bangladesh





DESCRIPTION

Purpose: HFG will both lead and collaborate on the development of analytical reports on a

number of subjects. Examples of analytical reports that will be developed as a result of

HFG’s activities in Bangladesh include reports on the Smiling Sun NGO network price

elasticity of demand analysis, re-analysis of the Smiling Sun NGO network impact

evaluation data and the contingent valuation household survey, results analysis report on

the implementation of the M&E framework for the UNICEF-led adolescent

empowerment program, and the CBHI review document, feasibility study of NGO

provider-based prepayment mechanisms, and demand analysis of a provider-based

prepayment scheme. These analytical reports are important components towards

achieving HFG’s objectives and will be tracked.

Definition: Count of the number of analytical reports developed with HFG support. Key terms are

defined as:




Analytical report: a detailed report on a subject or issue that requires in-depth

analysis and discussion of the subject or issue and includes proposed solutions or

recommendations for a plan of action.


Calculation: Count of analytical reports

Disaggregated by: Technical Area; Type of HFG Support (e.g. financial, technical, organizational, etc.);




Method: All analytical reports identified as deliverables or as components of HFG activities were

tracked within the HFG M&E system. The type of support provided for each of these

analytical reports were documented throughout the entirety of HFG’s involvement with

the analytical report.

Data source(s): Project records, reports created/identified



Acquisition: Data for this indicator was recorded from project records and follow-up discussions

with no substantial additional costs anticipated.


Risks/Challenges:

Location of Data


DATA QUALITY ISSUES





Actions Taken/Planned

to Address Data Not applicable

INDICATOR A4


Limitations:

Date of Future Data



Data Quality

Assessments



accuracy and completeness were completed as needed with relevant parties.






Data Analysis: Number of analytical reports, disaggregated by technical area; type of HFG support

Presentation of Data: Table and descriptive summary of each analytical report and type of HFG-support

provided



30

INDICATOR A4



Notes on

Baselines:

Baseline=0


FY 2013 4 1 Target: Reports on the 1) Smiling Sun NGO network price elasticity of

demand analysis, 2) re-analysis of the Smiling Sun NGO network impact

evaluation data, 3) results analysis report on the implementation of the

M&E framework for the UNICEF-led adolescent empowerment

program, and the 4) CBHI review document.

Actual: Smiling Sun NGO network price elasticity of demand analysis

FY 2014 1 2 Target: Report on the contingent valuation household survey

Actual: 1) L3M Report, 2) secondary analysis of evaluation

FY 2015 6 5 Target: 1) PIO analysis report, 2) NGO provider-based prepayment

scheme demand analysis report, 3) Facility study report, 4) Provider

based prepayment scheme, 5) NHA secondary analyses, 6) Urban

health landscape analysis

Actual: 1) PIO analysis report, 2) NGO provider-based prepayment

scheme demand analysis report, 3) Facility study report, 5) NHA

secondary analyses, 5) Urban health landscape analysis.

FY 2016 4 6 Target: 1) Health financing assessment report, 2) NGO feasibility

analysis 3) NHA secondary analyses 4) User fee retention report

Actual: 1) Health financing assessment report, 2) NGO feasibility

analysis 3) NHA secondary analyses 4) User fee retention report 5)

DRM Analysis Report

FY 2017 3 2 Target: 1) Report/brief on user fee retention, 2) ESP Costing Report, 3) DRM

analysis report

Actual: 1) Brief: Dissemination and Experience-Sharing on Costing

Studies in Health, 2) Brief: Building Awareness for Universal Health

Coverage; Advancing the Agenda in Bangladesh

FY 2018 6 6 Target: 1) Technical note on working sessions with OP managers, 2)

Report on ESP costing, 3) Technical note on TB costing, 4) Report on

resource modeling and analysis for the ESP, 5) Report on HEU

repositioning, and 6) Report on targeting the poor.

Actual: 1) Technical note on working sessions with OP managers, 2)

Report on ESP costing, 3) Technical note on TB costing, 4) Report on

resource modeling and analysis for the ESP, 5) Report on HEU

repositioning, and 6) Report on targeting the poor.








INDICATOR A4


ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR A5


INDICATOR: Number of HFG-supported M&E tools


Attribution/Contribution

: Attribution

USAID/Bangladesh





DESCRIPTION-

Purpose: HFG will both lead and collaborate on the development of new M&E tools or

modification of existing M&E tools. Examples of M&E tools that will be developed as a

result of HFG’s activities in Bangladesh include M&E framework design for the UNICEF-

led adolescent empowerment program, and the framework tools. These M&E tools are

important components towards achieving HFG’s objectives and will be tracked.

Definition: Count of the number of M&E tools developed with HFG support. Key terms are defined

as:




M&E tools: Any product whose primary use will assist individuals, groups,

organizations, or governments to design and/or implement M&E-related activities.

Products may include but are not limited to M&E plans, frameworks, data collection

tools, etc.


Calculation: Count of M&E tools

Disaggregated by: Type of M&E Tool; Type of HFG Support (e.g. financial, technical, organizational, etc.);




Method: All M&E tools identified as deliverables or as components of HFG activities were tracked

within the HFG M&E system. The type of support provided for each of these M&E tools

will be documented throughout the entirety of HFG’s involvement with the M&E tool.

Data source(s): Project records, tools created/identified



Acquisition: Data for this indicator recorded from project records and follow-up discussions with no

substantial additional costs anticipated.

32

INDICATOR A5



Risks/Challenges:

Location of Data


DATA QUALITY ISSUES






to Address Data

Limitations:

Not applicable

Date of Future Data



Data Quality

Assessments



accuracy and completeness completed as needed with relevant parties.






Data Analysis: Number of M&E tools, disaggregated by tool type; type of HFG support

Presentation of Data: Table and descriptive summary of each tool and type of HFG-support provided




Notes on

Baselines:

Baseline=0


FY 2013 2 2 Target: M&E framework design for the UNICEF-led adolescent

empowerment program, and the framework tools

Actual: M&E framework (Activity 2); CBHI survey tool (Activity 3)

FY 2014 0 0

FY 2015 1 0 Target: Develop monitoring and implementation research program

FY 2016 N/A N/A The activity ended in 2015








INDICATOR A5




ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR A6


INDICATOR: Number of organizations where HFG-supported technical resources are used

Indicator Type: Outcome


USAID/Bangladesh





DESCRIPTION

Purpose: HFG will both lead and collaborate on the development of new technical resources or

modification of existing technical resources throughout the life of the project. Examples

of technical resources that will be developed as a result of HFG’s three key activities in

Bangladesh include reports on the analysis of the Smiling Sun NGO network impact

evaluation data and the contingent valuation household survey, M&E framework for the

UNICEF-led adolescent empowerment program, a work plan for its implementation,

results analysis report, an implementation plan for the HPNSDP (2016), CBHI

document, etc. However, it is not given that the development of these technical

resources is indicative of the technical resources’ use. This indicator seeks to measure

that whether these technical resources have gone beyond development and are actually

being used by their target groups.

Definition: Count of the number of organizations where HFG-supported technical resources are

used. Key terms are defined as:

Organizations: All groups or institutions, within the government sector or

outside the government sector. Examples include ministries, government groups,

units, or other organizational structures dealing with public health issues.




Technical resources: Any product whose primary use will assist individuals,

groups, organizations, or governments. Products may include but are not limited to

assessments, strategies, plans, reports, manuscripts, published articles, training

courses, learning modules, software, etc.

Used: Product is directly assisting individuals, groups, organizations, governments,

or other recipients.


Calculation: Count of number of organizations

34

INDICATOR A6


Disaggregated by: Type of Organization, Type of Technical resources, Technical Area



Method: HFG documented descriptive information about each organization that has been

identified as a component of an activity or a target audience for an activity. Where

HFG-supported technical resources have been identified in an activity, the organizations

that are linked to these activities were issued a short questionnaire 6-12 months after

the technical resource has been delivered to the organization.

Data source(s): Project records; organization documentation; Technical Resource Use Questionnaire

Collection Frequency: Quarterly (beyond Year 1 since questionnaires will be administered 6 – 12 months after

the technical resource has been delivered to the organization).


Acquisition: The Technical Resource Use Questionnaire administered to organizations linked to

potential use of HFG-supported technical resources will be an additional cost beyond

project records and country/organization documentation. This questionnaire will be

administered virtually and will not require significant financial resources.


Risks/Challenges:


DATA QUALITY ISSUES




and Significance (if any): HFG identified organizations using technical resources if these organizations are in

communication with HFG as partners or in other capacities. HFG-supported technical

resources distributed by other organizations without HFG’s knowledge.


Address Data

Limitations:

The questionnaire to these organizations requested information regarding distribution of

HFG-supported technical resources to other parties by the organization.

Date of Future Data

Quality Assessments: Quarterly (beyond Year 1 since questionnaires will be administered 6 – 12 months after

the technical resource has been delivered to the organization).


Data Quality

Assessments



accuracy and completed as needed with relevant parties.






Data Analysis: Number of organizations, disaggregated by type of organization, type of technical

resource, technical area

Presentation of Data: Table and descriptive summary of how each technical resource was used by the

organization



INDICATOR A6


ERFORMANCE INDICATOR VALUES

Notes on

Baselines:

Baseline=0


FY 2013 3 1 Target: Smiling Sun NGO network, UNICEF, HPNSDP

Actual: UNICEF (Activity 2)

FY 2014 1 1

FY 2015 7 5 Target:

USAID

Smiling Sun Network

BRAC

Health Economic Unit (HEU)

Ministry of Establishment

National Accounts Cell

Ministry of Local Government

Actual:

USAID

Smiling Sun Network

BRAC

Health Economic Unit (HEU)

Ministry of Local Government

FY 2016 3 3 Target:

HEU

IHE

WB

Actual:

HEU

IHE

WB

FY 2017 5 8 Target:

MOHFW

IHE

JPGSPH

PPRC

WHO

Actual:

MOHFW

IHE

icddr,b

JPGSPH

BHRF

PPRC

MAB

WHO

FY 18 9 9 Target:

Bangladesh Health Reporters Forum (BHRF)

36

INDICATOR A6


Institute of Health Economics (IHE)

icddr,b (Activity 2)

MAB

MOHFW (HEU, DGHS, DGFP)

PPRC

WHO

RDM project

Press Institute of Bangladesh (PIB

Actual :

Bangladesh Health Reporters Forum (BHRF)

Institute of Health Economics (IHE)

icddr,b (Activity 2)

MAB

MOHFW (HEU, DGHS, DGFP)

PPRC

WHO

RDM project

Press Institute of Bangladesh (PIB








ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR A7


INDICATOR: Country capacity to perform NHA estimations



HFG IR: 1

HFG Sub-IR: 1.3

Linkage to Other IRs: 2, 3

Linkage to Other

Sub-IRs: 2.1, 2.3, 3.1, 3.4



DESCRIPTION

Purpose: HFG will support strengthening the country capacity to peform NHA estimations. This

INDICATOR A7


indicator will capture HFG’s progress in improving the capacity of these NHA actors.

This indicator will capture all NHA estimations supported through HFG activities.

Key Terms: Country capacity: Country capacity includes dimensions of knowledge and skills

of individuals, management, systems, support of local institutions, use of external

technical assistance, cost effectiveness, efficiency, use of technology, scope of NHA

and use of data.

NHA estimations: A NHA refers to a report which presents and provides

context for the core tables that summarize the flows of health spending through the

health system in a country over a 12-month period.

Unit of Measure: Score between 1 and 5; 1- Nonexistence, 2 – Startup, 3- Developing, 4 – Expansion, 5 -

Sustainability

Calculation: Average of scores for all country capacity dimensions

Disaggregated by: Dimension


Method: HFG will conduct a baseline assessment of NHA capacity against requirements of NHA

estimations. NHA capacity will be assessed upon completion of the activity. The

capacity assessment process consists of the following:

NHA assessment consisting of a capacity survey and interviews and focus groups to

determine strengths and weaknesses. The assessment will be done by a qualified

subject matter consultant.

After the consultant has collected information and determined findings, he or she

scores each cell of the dimension in the table on a 1-5 scale based on the criteria.

The consultant will then use each cell to determine an overall score in each

dimension – in effect a roll-up of the cells in that dimension. The overall score for

the dimension does not have to be mathematical – averaging all cells in each

dimension – since in specific contexts, some cells will be more important than

others. This allows some discretion to each consultant.

In the right hand column of the scoring sheet, the consultant lists the bullets to justify the

overall score.

Data source(s): NHA capacity assessment

Collection Frequency: Baseline/endline


Acquisition: Initial cost for baseline assessment will be minimal as this will done during existing

technical assistance visits. Endline cost for continued assessment of technical capacity.


Risks/Challenges: It is assumed that HFG can contribute to some, but not all, factors necessary for

countries to successfully produce Health Accounts going forward. HFG support is

designed to strengthen the technical capacity of local NHA teams but its influence on

factors such as an official NHA mandate and availability of domestic resources for Health

Acconts is less.

DATA QUALITY ISSUES




and Significance (if any): The NHA Capacity Assessment will be largely qualitative and therefore subject to the

limitations of qualitative data. In addition, as the consultants conducting each NHA

Capacity Assessment may differ, potentially causing issues in consistency in scoring.

Actions Taken or

Planned to Address Data HFG will use stringent methodolgies for the implementation of each NHA Capacity

Assessment. In addition, a standardized assessment tool will be used throughout the life

38

INDICATOR A7


Limitations: of the project. This tool will be accompanied by detailed documentation and justification

for scoring to alleviate any issues in scoring consistency between assessments.

Date of Future Data

Quality Assessments: Y5 Q4 or end of project


Data Quality

Assessments

The HFG M&E team will complete an initial review of the collected data. Activity Leads

will confirm that the data are complete and correct. Follow-up discussions regarding data

accuracy and completeness will be completed as needed with relevant parties.


Data Collection: Activity Leads, M&E Team


Data Reporting: M&E Manager


Data Analysis: NHA capacity score disaggregated by dimension

Presentation of Data: Indicator table(s); summary description of NHA capacity

Reporting Frequency: Baseline and endline

Reporting of Data: Quarterly/annual report


Notes on Baselines: Baseline= 3.3 (May 2016)


FY 2016 Not Applicable Not Applicable Activity not yet

implemented

FY 2017 Not Applicable Not Applicable Activity not yet

implemented

FY 2018 Not Available 3.4








ADDITIONAL NOTES

Notes on

Baselines/Targets:

Other Notes:

PIR Last Updated On


PIR Last Updated by: Son Phan

INDICATOR C1


INDICATOR: Births attended by skilled health staff, % of total births

INDICATOR C1



Attribution/Contribution: Contribution

USAID/Bangladesh





DESCRIPTION

Purpose: Service-level indicator used as a benchmark for the HFG Project. The rationale for the

indicator is that women should have access to skilled care during pregnancy and

childbirth to ensure prevention, detection and management of complications. This is an

MDG indicator used as a proxy to measure maternal mortality. It is important to note

that several factors external to HFG would influence this indicator and the results

associated with this indicator cannot be solely attributed to HFG’s efforts. Thus, this is

an HFG contribution indicator.

Definition: Percentage of total births attended by skilled health staff. Key terms are defined as:

Skilled health staff: Doctors, nurses or midwives trained in providing life-saving

obstetric care, including giving the necessary supervision, care and advice to

women during pregnancy, childbirth and the post-partum period; to conduct

deliveries on their own; and to care for newborns

Unit of Measure: Percent

Calculation: (Number of births attended by skilled health staff / total number of births in the same

period) x 100

Disaggregated by: N/A

Direction of Change: Increase in percentage indicates greater success


Method: Data was collected through available data sources. Generally this data was collected

through household surveys by national groups. But it’s also possible that facility

reporting systems may provide this data as well. International organizations then obtain

the data and undertake a process of data verification that includes correspondence with

field offices to clarify any questions.

Data source(s): Bangladesh Demographic Health Survey (BDHS)/ Bangladesh Maternal Mortality Survey

(BMMS)

Collection Frequency: Annually (or as often as data is collected at the country level)


Acquisition: Minimal, as HFG will leverage existing data sources.


Risks/Challenges:


DATA QUALITY ISSUES




and Significance (if any): Frequency of data collection will limit usefulness for HFG purposes


Address Data Limitations: Seek out national-level sources for this data

40

INDICATOR C1


Date of Future Data

Quality Assessments: N/A


Data Quality Assessments N/A


Data Collection: M&E Team




Data Analysis: Births attended by skilled staff, % of total births


Reporting Frequency: Annual

Reporting of Data: Annual Report


Notes on Baselines: Baseline=31.7% (2011)


FY 2013 N/A 31.7% No information available

FY 2014 N/A 42.1% Bangladesh Demographic Health

Survey (BDHS)

FY 2015 N/A N/A No information available

FY 2016 N/A 49.8% Bangladesh Maternal Mortality Survey (BMSS) 2016










ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C2


INDICATOR: Percent of children under 5 years with Acute Respiratory Infection (ARI) taken to a

health facility


INDICATOR C2



USAID/Bangladesh





DESCRIPTION

Purpose: Service-level indicator used as a benchmark for the HFG Project. This indicator is used

for coverage of intervention and care seeking related to child survival. It is important to

note that several factors external to HFG would influence this indicator and the results



Definition: Percentage of children under 5 years with ARI taken to a health facility. Key terms are

defined as:

ARI: Presumed pneumonia

Health Facility: Any provider trained in standard case management of children

with suspected acute lower respiratory infection. Providers include health staff in

hospitals, health centers, dispensaries, community health workers, mobile/outreach

clinics and private physicians


Calculation: Proportion of children aged 0-59 months who had presumed pneumonia (ARI) in the

last 2 weeks and were taken to an appropriate health-care provider





through household surveys by national groups. International organizations then obtain

the data and undertake a process of data verification that includes correspondence with

field offices to clarify any questions.

Data source(s): Bangladesh Demographic Health Survey (BDHS)





Risks/Challenges:


DATA QUALITY ISSUES







Date of Future Data

Quality Assessments: Annually

Procedures for Future The HFG M&E Team completed an initial review of the collected data. The Country

42

INDICATOR C2


Data Quality Assessments Manager confirmed that the data is complete and correct. Follow-up discussions

regarding data accuracy and completeness was completed as needed with relevant

parties.






Data Analysis: Percent of children under 5 years with Acute Respiratory Infection (ARI) taken to a

health facility





Notes on Baselines: Baseline= 35.2% (2011)


FY 2013 N/A 35.8% Bangladesh Demographic Health Survey (BDHS), 2014

FY 2014 N/A 42.0% Bangladesh Demographic

Health Survey (BDHS), 2014












ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C3


INDICATOR: Contraceptive prevalence rate


INDICATOR C3



USAID/Bangladesh





DESCRIPTION

Purpose: Service-level indicator used as a benchmark for the HFG Project. Contraceptive

prevalence rate is an indicator of health, population, development and women's

empowerment. It also serves as a proxy measure of access to reproductive health

services that are essential for meeting many of the Millennium Development Goals,

especially those related to child mortality, maternal health, HIV/AIDS, and gender

equality (WHO). It is important to note that several factors external to HFG would

influence this indicator and the results associated with this indicator cannot be solely

attributed to HFG’s efforts. Thus, this is an HFG contribution indicator.

Definition: Contraceptive prevalence rate is the proportion of women of reproductive age (15-49

years) using contraception. Key terms are defined as:

Contraceptive Prevalence Rate: Women aged 15-49 years, married or in-

union, who are currently using, or whose sexual partner is using at least one

method of contraception, regardless of the method used.


Calculation: Number of women aged 15-49 years, married or in-union, who are currently using or

whose sexual partner is using at least one method of contraception, regardless of the

method used x 100 divided by the number of women aged 15-49 years, married or in-

union




Method: The United Nations Population Division compiles data from nationally representative

surveys including the Demographic and Health Surveys (DHS), the Fertility and Family

Surveys (FFS), the CDC-assisted Reproductive Health Surveys (RHS), the Multiple

Indicator Cluster Surveys (MICS) and national family planning, or health, or household,

or socio-economic surveys.

Data source(s): World Development Indicators





Risks/Challenges:


DATA QUALITY ISSUES







44

INDICATOR C3


Date of Future Data



Data Quality Assessments The HFG M&E Team was complete an initial review of the collected data. The Country

Manager will confirm that the data is complete and correct. Follow-up discussions

regarding data accuracy and completeness completed as needed with relevant parties.






Data Analysis: Contraceptive prevalence rate





Notes on Baselines: Baseline = 61.2% (2011)


FY 2013 N/A 61.2% Source: Bangladesh

Demographic Health Survey

2014

FY 2014 N/A 62.4% Source: Bangladesh

Demographic Health Survey

2014












ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C4


INDICATOR: Treatment success rate for new pulmonary smear-positive tuberculosis cases



USAID/Bangladesh





DESCRIPTION

Purpose: Service-level indicator used as a benchmark for the HFG Project. Treatment success is

an indicator of the performance of national TB control programs. In addition to the

obvious benefit to individual patients, successful treatment of infectious cases of TB is

essential to prevent the spread of the infection. It is important to note that several

factors external to HFG would influence this indicator and the results associated with

this indicator cannot be solely attributed to HFG’s efforts. Thus, this is an HFG

contribution indicator.

Definition: Treatment success rate for new pulmonary smear-positive tuberculosis (TB) cases is

the percentage of registered TB cases that successfully completed treatment. Key

terms are defined as:

Treatment Success Rate: Tuberculosis treatment success rate is the percentage

of new, registered smear-positive (infectious) cases that were cured or in which a

full course of treatment was completed

Pulmonary smear-positive tuberculosis: a case of TB where Mycobacterium

tuberculosis bacilli are visible in the patient’s sputum when examined under the

microscope. The revised definition of a new sputum smear-positive pulmonary TB

case is based on the presence of at least one acid fast bacilli (AFB+) in at least one

sputum sample in countries with a well-functioning external quality assurance

(EQA) system


Calculation: (Number of registered TB cases that successfully completed treatment/Number of

registered TB cases) x 100




Method: Treatment success rates were calculated from cohort data (outcomes in registered

patients) as the proportion of new smear-positive TB cases registered under a national

TB control program in a given year that successfully completed treatment, whether

with (“cured”) or without (“treatment completed”) bacteriologic evidence of success.

The treatment outcomes of TB cases registered for treatment are reported annually by

countries to WHO using a web-based data collection system. Because treatment for

TB lasts 6–8 months, there was a delay in assessing treatment outcomes. Each year,

national TB control programs report to WHO the number of cases of TB diagnosed in

the preceding year, and the outcomes of treatment for the cohort of patients who

started treatment a year earlier.

Data source(s): Bangladesh Demographic Health Survey (BDHS)


46

INDICATOR C4





Risks/Challenges:


DATA QUALITY ISSUES







Date of Future Data



Data Quality Assessments The HFG M&E Team was complete an initial review of the collected data. The Country

Manager was confirm that the data is complete and correct. Follow-up discussions

regarding data accuracy and completeness was completed as needed with relevant

parties.






Data Analysis: Proportion of new smear-positive TB cases registered under a national TB control

program in a given year that successfully completed treatment





Notes on Baselines: Baseline = 92% (2011)


FY 2013 N/A 92% WHO Bangladesh Country

Profile

FY 2014 N/A 94% WHO Bangladesh Country

Profile


FY 2016 N/A 93% Source:

http://www.who.int/tb/data/en/

accessed on 15th Jan 2018






http://www.who.int/tb/data/en/

INDICATOR C4






ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C5


INDICATOR: Number of people on antiretroviral therapy



USAID/Bangladesh





DESCRIPTION

Purpose: Service-level indicator used as a benchmark for the HFG Project. This indicator is used to

determine the number of eligible adults and children currently receiving antiretroviral

combination therapy in accordance with the nationally approved treatment protocol (or

WHO/UNAIDS standards) at the end of the reporting period. It is important to note that

several factors external to HFG would influence this indicator and the results associated

with this indicator cannot be solely attributed to HFG’s efforts. Thus, this is an HFG


Definition: Count of the number of people receiving antiretroviral therapy. Key terms are defined as:

Anitretroviral therapy: is treatment of people infected with human

immunodeficiency virus (HIV) using anti-HIV drugs. The standard treatment consists of

a combination of at least three drugs (often called “highly active antiretroviral therapy”

or HAART) that suppress HIV replication and stop the progression of HIV disease.


Calculation: Count of eligible adults and children currently receiving antiretroviral combination therapy

at the end of the reporting period

Disaggregated by: Gender, Age (<15, ≥15 years)



Method: Data was collected through available data sources. Generally this data collected through

program monitoring: facility-based antiretroviral therapy registers or drug supply

management systems. International organizations then obtain the data and undertake a

process of data verification that includes correspondence with field offices to clarify any

questions.

48

INDICATOR C5


Data source(s): WHO Bangladesh Country Office





Risks/Challenges:

Location of Data


DATA QUALITY ISSUES






to Address Data

Limitations:

Seek out national-level sources for this data

Date of Future Data



Data Quality

Assessments

The HFG M&E Team complete an initial review of the collected data. The Country

Manager was confirm that the data is complete and correct. Follow-up discussions

regarding data accuracy and completeness completed as needed with relevant parties.






Data Analysis: Number of people receiving antiretroviral therapy





Notes on Baselines: Baseline = 831 (2012)


FY 2013 Not applicable 1083 UNAIDS





FY 2018 Not applicable Not available No information available





INDICATOR C5





ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C6


INDICATOR: General government expenditure on health as a percentage of total health expenditure

(THE)



USAID/Bangladesh





DESCRIPTION

Purpose: Indicator used as a benchmark for the HFG Project. This indicator is a core indicator

of health financing systems. This indicator contributes to understanding the relative

weight of public entities in total expenditure on health. It is important to note that

several factors external to HFG would influence this indicator and the results



Definition: Percentage of total health expenditure that is general government expenditure. Key

terms are defined as:

General Government Expenditure: Includes not just the resources channeled

through government budgets to providers of health services but also the

expenditure on health by parastatals, extra budgetary entities and notably the

compulsory health insurance payments. It refers to resources collected and pooled

by the above public agencies regardless of the source, so includes any donor

(external) funding passing through these agencies.

Total Health Expenditure: Government and all other sources of health

expenditure


Calculation: Government expenditure on health divided by total expenditure on health


Direction of Change: Increase in percent indicates greater success



through National Health Accounts. Expenditure data was collected within an

internationally recognized framework. Resources are tracked for all public entities

50

INDICATOR C6


acting as financing agents: managing health funds and purchasing or paying for health

goods and services. The NHA strategy is to track records of transactions, without

double counting and in order to reaching a comprehensive coverage. Specially, it aims

to be consolidated not to double count government transfers to social security and

extra budgetary funds. Monetary and non-monetary transactions are accounted for at

purchasers’ value. (WHO)

Data source(s): Bangladesh National Health Account (BNHA) Report





Risks/Challenges:


DATA QUALITY ISSUES







Date of Future Data









Data Analysis: General government expenditure on health as a percentage of total health expenditure




INDICATOR C6



Notes on Baselines: Baseline= 34% (2012)


FY 2013 Not applicable 34% Bangladesh National Health Accounts 1997-2015

Preliminary results


FY 2015 Not applicable 23% Bangladesh National Health

Accounts 1997-2015

Preliminary results











ADDITIONAL NOTES

Other Notes:

PIR Last Updated On



INDICATOR C7


INDICATOR: Out-of-pocket expenditure on health as % of total health expenditure



USAID/Bangladesh





DESCRIPTION

Purpose: Indicator used as a benchmark for the HFG Project. This is a core indicator of health

financing systems. It contributes to understanding the relative weight of direct payments

by households in total health expenditures. High out-of-pocket payments are strongly

associated with catastrophic and impoverishing spending. Thus it represents a key

support for equity and planning processes. (WHO). It is important to note that several

factors external to HFG would influence this indicator and the results associated with

52

INDICATOR C7


this indicator cannot be solely attributed to HFG’s efforts. Thus, this is an HFG


Key Terms: Percentage of total health expenditure that is out-of-pocket expenditure. Key terms

are defined as:

Out-of-pocket expenditure on health: any direct outlay by households,

including gratuities and in-kind payments, to health practitioners and suppliers of

pharmaceuticals, therapeutic appliances, and other goods and services whose

primary intent is to contribute to the restoration or enhancement of the health

status of individuals or population groups. It is a part of private health expenditure.

Total Health Expenditure: Government and all other sources of health

expenditure


Calculation: Out-of-pocket expenditure divided by total private expenditure on health


Direction of Change: Decrease in percent indicates greater success


Method: Data collected through available data sources. Generally this data collected through

National Health Accounts, administrative reporting systems and household surveys.

National health accounts traces the financing flows from the households as the agents

who decide on the use of the funds to health providers. Thus in this indicator are

included only the direct payments or out-of-pocket expenditure. NHA strategy is to

track records of transactions, without double counting and in order to reach a

comprehensive coverage. Thus reimbursements from insurance should be deducted.

Monetary and non-monetary transactions are accounted for at purchasers’ value, thus

in kind payments should be valued at purchasers’ price. International organizations then

obtain the data and undertake a process of data verification that includes

correspondence with field offices to clarify any questions.

Data source(s): Bangladesh National Health Account (BNHA)





Risks/Challenges:


DATA QUALITY ISSUES







Date of Future Data







INDICATOR C7




Data Analysis: Out-of-pocket expenditure on health as a percentage of total health expenditure





Notes on Baselines: Baseline= 63% (2012)



Accounts (NHA)

FY 2014 Not applicable N/A Bangladesh National Health

Accounts (NHA)


Accounts (NHA)











ADDITIONAL NOTES

Other Notes:

PIR Last Updated On

(Date): 24 September, 2018

PIR Last Updated by: Sohel Rana, Mursaleena Islam

bangladesh performance monitoring plan (pmp)

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