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Indicators and Calculating Coverage Indicators 07 Indicators
Indicators and Calculating Coverage Indicators 07 Indicators
Indicators and Calculating Coverage Indicators 07 Indicators
Coverage indicators
M&E Indicators
*An ITN is 1) a factory treated net that does not require any treatment, 2) a
pretreated net obtained within the past 12 months, or 3) a net that has been
soaked with insecticide within the past 12 months.
Common Indicator Metrics
Counts
– Number of providers trained
– Number of ITNs distributed
Thresholds
– Presence, absence
– Pre-determined level or standard
– Cut-off point
Characteristics of Good Indicators
Valid: accurate measure of a behavior, practice or task
Reliable: consistently measurable in the same way by different
observers
Precise: operationally defined in clear terms
Measurable: quantifiable using available tools
and methods
Timely: provides a measurement at time intervals relevant and
appropriate in terms of program goals and activities
Programmatically important: linked to a public health impact
or to achieving the objectives that are needed for impact
Characteristics of Good Indicators: Valid
Effective treatment
Population at-risk
Suspected cases of malaria
Characteristics of Good Indicators:
Measurable
Quantifiable using available tools and methods
Timeliness Considerations
– Reporting schedules
– Recall periods
– Survey schedules
– Length of time over which change can be
detected
Characteristics of Good Indicators:
Programmatically Important
Linked to a public health impact or to achieving the
objectives needed for impact
Are the following indicators programmatically important?
Decreases
Global
Compare countries
Overview world-wide situation
Number of
Indicators
National/Sub-national
Assess effectiveness of response
Increases
Reflect goals/objectives of national/
sub-national response
District or Facility
Identify progress, problems, and challenges
Indicator Matrix
Measurement:
Frequency:
Interpretation:
Data Source(s):
Strengths:
Limitations:
THIS SHEET LAST UPDATED ON: 07/18/2011
Indicator Strengths & Limitations
Indicator:
Number of ITNs sold and Indicator:
distributed Prevalence of
malaria
Indicator: parasite
Proportion of household infection
members who slept
under an ITN the previous
night
Results Framework Indicators
Rule of thumb
At least one or two indicators per key activity or result
(ideally, from different data sources)
At least one indicator for every core activity (e.g., ITN
distribution, IRS, training, BCC)
No more than 8-10 indicators per area of significant
program focus
Use a mix of data collection strategies/source
Choosing the right number of
indicators
Good indicators:
• Provide information useful for program decision-making
Numerator Denominator
• IPTp Provided to Question: What will be the
denominator?
– Town A= 200 women
Response: Number of women that
need IPTp who visited ANC clinics in
– Town B= 400 women each town
– Town C= 600 women • Number of pregnant
women:
Question: Can we say that Town C
has the highest coverage? Please
– Town A= 10,000
justify your response.
– Town B= 30,000
Answer: No. We need the denominator
for each town – Town C= 60,000
Indicators for program: Denominators
P( t ) P( 0 ) * exp(r * t )
• Where: Example:
– P(t) is the population size after 300,000 people at census
t years Growth rate = 3% (0.03),
– P(0) is the population size at What is the population after
the last census 10 years?
– r the annual population 404,958 people
growth rate
• Use the national statistics office project national and sub-national level
• Use UN population, World Bank estimates for national level
• Use the official figures and only make projections if they are not available
Defining Population at Risk
Person time
Individual 5 3/12=0.25
Individual 4 5/12=0.42
1
Individual 3 7/12=0.58
Individual 2
1 10/12=0.83
1
Individual 1 12/12=1
Jan 01 Dec 31
Mid year pop: Person year:
1+1+1=3 0.25+0.43+0.58+0.
83+1=3.08
Estimating Target Population
Answers:
Annual target population = 10,000 x 0.03 = 300
Monthly target population = 1,800/12 = 25
Challenges in Estimating Coverage from
Routine Data
• Limited knowledge of target pop/denominators
• Low timeliness & completeness of reporting
• Poor data quality
– Lack of written standard reporting procedures
– No systematic supervision on data management
• Dual reporting systems (EPI, HMIS)
• Data from private sector not often included
Assessing Reliability of Routine
Coverage Indicators
• Understand how denominators are derived
• Understand the process of collecting the information
• Look for inconsistencies and surprises
• Look for reliable data from other sources to use as a
basis for comparison
• Cross-check
Estimating Coverage
From Survey Data
Tools for Coverage Estimation
www.statcompiler.com
Challenges with Routine-based Coverage
Advantages: Disadvantages:
• Provides Denominator errors
information on more Poor quality reporting
timely basis
• Makes use of data
routinely collected
• Can be used to
detect and correct
problems in service
delivery
Challenges with Survey-based Coverage
Advantages Disadvantages
• Avoids problems with Larger standard errors at
denominators sub-national levels
• Includes community Irregular and expensive
based information
Survey timing may affect
coverage rates
Group Project
WHO, 1999. The Evolution of Diarrhoeal and Acute Respiratory Disease Control at WHO: Achievement 1980-
1995 Research, Development and Implementation (WHO/CHS/CAH/99.12).
MEASURE Evaluation is a MEASURE program project funded by
the U.S. Agency for International Development (USAID) Through
Cooperative Agreement GHA-A-00-08-00003-00 and is
implemented by the Carolina Population Center at the University
of North Carolina at Chapel Hill, in partnership with Futures Group
International, John Snow, INC., ICF Macro, Management Sciences
for Health, and Tulane University.