Monitoring and Evaluating Maternal and Neonatal Health Programs

What to know

CDC's Division of Reproductive Health (DRH) works with health agencies in lower resource countries to help reduce maternal and infant deaths. To improve health services, DRH uses monitoring and evaluation to:

What is monitoring and evaluation?

Monitoring and evaluation (M&E) activities may include the following three elements: monitoring, evaluation, and surveillance.

Illustration showing a curve that progresses through stages: 1st stage is goal setting and planning. Goals are set, associated with, “What does Project need to do or have to meet its goals?” 2nd stage has 3 subsections: (1) Monitoring, associated with, “Are all project components in place?” (2) Surveillance, associated with, “What are current health indicators?” (3) Implementation/Project Activities where both 1 and 2 feed into this subsection. 3rd stage is evaluation, associated with, “Did the Project reach its goals?” and “What effects did the Project have?” 4th stage has 2 sections: Outcomes, and Planning the Next Project/Phase.
Monitoring and evaluating process

Monitoring

Monitoring a program's progress toward its goals involves:

  • Periodically collecting program data (such as counting the number of midwives trained in emergency obstetric care).
  • Tracking data over time against the desired outcome.

The following are some examples of DRH's monitoring activities:

  • Counting all maternal deaths in areas where maternal mortality had never before been directly measured.
  • Collecting data on every birth outcome (for both mother and infant) in health facilities.
  • Conducting assessments on the implementation of project interventions, such as improving health facilities and transportation and referral systems.

Evaluation

Evaluating a program's success uses study designs and tools tailored to the program's goals. Evaluation looks at a program's effects on short- and long-term outcomes, such as reductions in mortality and improvements in quality of care.

The following are some examples of DRH's evaluation activities:

  • Documenting the reductions in specific causes of maternal death, such as obstetric hemorrhage and sepsis (infection).
  • Using geographic information system (GIS) mapping to evaluate project advancement.
  • Designing tools, questionnaires, trainings, and data management systems so programs can collect and analyze their data in a scientifically sound manner.

Surveillance

Surveillance of a population's health status over time is done through ongoing detection, investigation, and reporting of health events. These indicators are then analyzed to see if they're improving and can provide an early warning to the program if they are not.

The following are some examples of DRH's health program surveillance activities:

What has DRH M&E work shown?

DRH has worked with the Maternal and Reproductive Health in Tanzania program and the Saving Mothers, Giving Life initiative (SMGL).

CDC's M&E activities produced the evidence that:

  • The Maternal and Reproductive Health in Tanzania program contributed to reducing the maternal mortality ratio in health facilities in Kigoma region by 52% in 5 years.
  • In 5 years, SMGL activities contributed to reducing maternal mortality in SMGL study districts by 44% in Uganda and by 41% in Zambia.
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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); Division of Reproductive Health