Using Data to Effectively Manage the Family Planning Program

Evidence of Effectiveness

The Urban Health Initiative (UHI) experience showed that the use of data for program management could be a powerful, low cost means to increase access and quality of services as well as provider’s motivation and accountability. FP performance improved when available data was analyzed routinely (presented through simple line graphs and bar charts) in CMHO meetings and was utilized to inform progress of FP strategies against ELA over the given period. By reviewing and discussing the monthly program achievements and the trends over time, health officials were able to identify specific problems requiring attention and were able to take corrective actions including reallocation of human and other resources to address those problems. Furthermore, the routine review of data in these meetings led to increased visibility, attention and priority given to the FP program in general.

Specific examples from UHI include the following:

• Based on an analysis of the HMIS data, CMHOs requested for funding to increase the number of obstetricians in government hospitals having high volume of deliveries
• No-Scalpel-Vasectomy(NSV) surgeons were more enthusiastic when CMOs monitored their performance and recognized their contributions
• When CMOs used available data to monitor the performance of community volunteers and rewarded their achievements in increasing coverage of households and the number of new family planning acceptors, their motivation increased and improved their performance over time

Guidance on Using Data to Manage Urban FP Programs

The key to effective data management for better program decision making includes:

• Determining the indicators that need to be captured, along with their source and frequency. For example, an indicator like the number of clients given different FP methods should be monitored on a monthly basis, while HR and capacity building indicators may require six-monthly monitoring
• Clearly defining indicators with the numerator and the denominator, wherever required
• Devising ELAs against which these indicators can be monitored
• Ensuring that the indicators are understood by all the staff
• Providing appropriate training to the staff including to the analysts responsible for data management

Using data for feedback: While it is important for the district health teams, facility-in-charges, and ASHA supervisors to review the available data and reports, and take corrective actions on the basis of identified gaps and weaknesses; it is equally important to communicate the gaps to the team in a constructive manner so that it boosts morale and yet provides direction for course correction. A simple way of doing this is to ‘Appreciate and Acknowledge each person right in the beginning, followed by suggested improvement (including offering any support / peer coaching that the person may require) instead of direct blaming, public shaming as it actually demotivates people.

Training staff in data usage: All the staff handling data should be informed and oriented on all the data forms, the definitions of key indicators and basic analysis of the data and indicators. Annual training / refresher training on data management should be considered and funds are available through the PIP. Master trainers can be identified at the city level. Support can be taken from NGOs to support this task.

Roles and Responsibilities towards Data Usage for Program Management

Monitoring the Usage of FP Data for Program Management

Monitoring of data usage for program management should be based on the following indicators:

Cost Elements

The following elements are required for an effective data usage and management system. Their PIP codes are provided below for easy reference. A state may already have these elements, but if not, then they should be budgeted for in the PIP:

This table is indicative and illustrates the manner in which cost elements are provisioned in a government PIP, thus giving guidance to the audience on where to look for elements related to a particular task, such as using data to effectively manage the FP program.

Sustainability

Routine HMIS provides the basic data and the staff who can conduct the data entry and basic analysis is already in place. If the available data is analyzed and made part of the routine review process where people can see the benefit of analyzing data and using that to make necessary corrections / adaptations, then the entire process of data collection, analysis and feedback will continue and be sustained.

Disclaimer: This document is based on the learnings collated from Urban Health Initiative, Health of the Urban Poor (supported by USAID) and Expanded Access and Quality (EAQ) to broaden method choice in Uttar Pradesh. This document is not prescriptive in nature but provides overall guidance of how this particular aspect was dealt with in these projects for possible adoption and adaptation.

The downloadable versions of this document are slightly modified to make it state representative for Uttar Pradesh, Madhya Pradesh and Odisha, respectively.

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