1. Participatory monitoring and evaluation approaches that influence decision-making: lessons from a maternal and newborn study in Eastern Uganda
- Author
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Elizabeth Ekirapa-Kiracho, Ligia Paina, Godfrey Mulekwa, Asha George, Htet Nay Lin Oo, Suzanne N Kiwanuka, David H. Peters, Dinah Nakiganda-Busiku, Rornald Muhumuza Kananura, and Ahmed Bumba
- Subjects
Community-Based Participatory Research ,Implementation research ,medicine.medical_specialty ,Knowledge management ,Maternal Health ,Decision Making ,Participatory monitoring ,Psychological intervention ,Maternal and newborn health ,Health administration ,Translational Research, Biomedical ,03 medical and health sciences ,Stakeholders ,0302 clinical medicine ,Health facility ,Pregnancy ,Stakeholder Participation ,medicine ,Humans ,Infant Health ,Maternal Health Services ,Uganda ,030212 general & internal medicine ,Health policy ,Retrospective Studies ,HB Economic Theory ,business.industry ,Research ,lcsh:Public aspects of medicine ,030503 health policy & services ,Health Policy ,Public health ,Community Participation ,Infant, Newborn ,Health services research ,lcsh:RA1-1270 ,Quality Improvement ,Participatory monitoring and evaluation ,Female ,Health Facilities ,Health Services Research ,0305 other medical science ,business ,Decision-making - Abstract
Background The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders’ decision-making in eastern Uganda. Method The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitative and quantitative M&E techniques such as key informant interviews, formal surveys and supportive supervision, as well as participatory approaches, notably participatory impact pathway analysis. Results At the design stage, the M&E approaches were useful for identifying key local problems and feasible local solutions and informing the activities that were subsequently implemented. During the implementation phase, the M&E approaches provided evidence that informed decision-making and helped identify emerging issues, such as weak implementation by some village health teams, health facility constraints such as poor use of standard guidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birth weight infants. Sharing this information with key stakeholders prompted them to take appropriate actions. For example, the sub-county leadership constructed placenta disposal pits, the district health officer provided fuel for ambulances, and health workers received refresher training and mentorship on how to care for newborns. Conclusion Diverse sources of information and perspectives can help researchers and decision-makers understand and adapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine information generating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successful implementation of complex development interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0274-9) contains supplementary material, which is available to authorized users.
- Published
- 2017