Objectives and Indicators for MCH Programs

MCH in Developing Countries

January 25, 2011

Objectives and Indicators

• Session goals– Promote an understanding of the importance of

good objectives and indicators, and their contribution to effective program management

– Provide or refine skills needed to develop MCH program objectives

Objectives and Indicators

• Session objectives -- by the end of the session, participants should be able to:– explain the terms “goal,’ “objective,”

“indicator” and “target”– describe the characteristics of objectives and

indicators that are useful for program management

– write a “smart” objective for the country project and state its corresponding indicator

Why discuss MCH program objectives?

– How will you know if you are successful if you don’t identify what you want to do?

– There are always limited resources– Clear objectives are often a donor requirement– Developing appropriate and useful objectives is

not always simple or intuitive...

(Note -- they are NOT a substitute for “doing the right thing” based on a needs assessment)

Logic model flow chart - how program efforts contribute to the program’s goals

Causality

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Inputs Activities

Processes

Outputs

Objectives

Outcomes Results

• Activities are any action, funded or unfunded, undertaken to achieve a program result

• Assignments, tasks, stuff we do to achieve our objectives!

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Objectives can include anything that is clearly intended to be achieved through the program or project

• Output level objectives are those resulting from first order activities

• Impact level objectives refer to the desired long-term or ultimate result

• Intermediate objectives that fall somewhere between these two are usually referred to as outcomes - also known as “effects”

Inputs Activities

Processes

Outputs

Objectives

Outcomes Results

• Output level objectives are those that result from activities -- things your program does– In most instances don’t represent population change

– Important area for program/project monitoring

• Frequently “bean counting”– Useful for program management purposes

– And -- donors may hold you accountable for the beans

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Impact and outcomes are…– Changes in the condition or behavior of a program participant or

changes in conditions that affect a participant: results

• Whether an objective is a impact or outcome depends on its level in the causality chain– Impact describes the long-term results

– Outcomes describe the immediate effects on participants

• The ability of a program to produce results (i.e., outcomes, impact, or both) depends on your resources, program duration, and many, many social, economic and cultural conditions that affect participants in the program

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Objectives should be the highest order objectives for which you can be held accountable

• They should be S M A R T :– S - simple

– M - measurable (in the program setting)

– A - appropriate (technically correct, important)

– R - realistic

– T - time-limited

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Let’s consider this objective...

The project will improve the understanding of mothers

about the importance of oral rehydration therapy and how

to correctly mix ORS.

Let’s try again….

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

By the end of the project, 80% of mothers of children under age 5 in the project area will give their child increased fluids when the child has

diarrhea

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Let’s consider another objective...

The project will increase

immunization coverage to 80%

Let’s try again….

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

By the end of the project, 80% of children aged 12-24 months in the

project area will have completed their basic immunizations

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Additional terms:

• Indicators…– Answer the question, “How will we measure “How will we measure

what we have achieved?”what we have achieved?”

• Target a specific level of achievement

By the end of the project, 80% of children aged 12-23 months in the project area will have completed

their basic immunizations

What is the indicator and target for this objective?

The % of children aged 12-23 months in the project area who have completed

their basic immunizations

Indicator:

Target :

80%

SelectingSelectingIndicatorsIndicators

• Who to involve in setting objectives and indicators?

– Project staff– Others familiar with relevant data– The community, partners– Published literature, project reports

• When?– Iterative - As work on program development proceeds– Check feasibility before finalizing

• It’s usually OK to revise objectives if rationale is provided

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Practicality

• Are the data associated with the indicator practical?

– How will you collect the data?

– Are quality data currently available?

– Can routine data can be procured on a regular and timely basis?

– Will you need to conduct a survey or special studies?

All of these contribute to the program goals -- broad, long-term intended results

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Indicators

Final thoughts on the selection of objectives and indicators

Indicator quality presumes data quality: be aware of the limitations (regarding validity, reliability, and timeliness) of your data

More indicators aren’t necessarily better; you need enough information to get an honest reckoning

Meaningful qualitative indicators are often okay and sometimes preferable

Use objectives for management—it’s the main reason we measure performance

Take a practical approach—get adequate information that is available at a reasonable cost to the program

Indicators should make sense to a development professional, but be understandable to interested persons

Your task:

• Move into your country groups

• Choose an intervention that you might address

Write a measurable, SMART outcome objective for that intervention