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Home Care - 5.8 Monitoring and reporting
5.8.1 Monitoring inputs and process
The issue of uneven quality of monthly data on patient numbers and team activities, provided by the HCTs to the Home Care Network Group has been described in an earlier section of this report (Section 2.6, Methodology: Limitations of the Evaluation).
It is recommended that the monthly figures for patients, visits and team activities are quality reviewed before each monthly HCNG meeting, and that the HCTs reach a common understanding with the Home Care Network Co-ordinator on the definitions of a home care visit and a home care patient, for accounting purposes.
It is recommended that the Home Care Network reviews with the HCTs the system of monitoring and reporting patient numbers and team activities.
In addition to numbers of visits and patient numbers, the monthly team reports also provide data on referrals, deaths, volunteer activities, community contacts, expenditure, etc., all of which are useful for monitoring inputs and process.
5.8.2 Monitoring impact
Apart from reviews and evaluations such as this one, there is no system in place to measure the impact of the programme on PLHA, families, communities or the health system. It is strongly recommended that the HCNG initiates a process to establish an impact monitoring system for the Home Care programme. Having a pilot monitoring system underway in Phnom Penh will provide valuable lessons in establishing a system in the Provinces, where capacity and resources may be more limited.
Decisions need to be made on:
It is beyond the scope of this report to develop specific recommendations on the answers to these questions. However, the following suggestions are offered:
The HCTs have already began a process of identifying indicators, and this will hopefully be continued during the forthcoming participatory local partner reviews in July. However, the difficulties in establishing even a simple but effective impact monitoring system should not be underestimated, and external resources and expertise in impact monitoring are likely to be required.
It is recommended that the HCNG seeks technical support to facilitate the process of establishing an impact monitoring system for the Home Care programme, including developing appropriate indicators.
The issue of uneven quality of monthly data on patient numbers and team activities, provided by the HCTs to the Home Care Network Group has been described in an earlier section of this report (Section 2.6, Methodology: Limitations of the Evaluation).
It is recommended that the monthly figures for patients, visits and team activities are quality reviewed before each monthly HCNG meeting, and that the HCTs reach a common understanding with the Home Care Network Co-ordinator on the definitions of a home care visit and a home care patient, for accounting purposes.
It is recommended that the Home Care Network reviews with the HCTs the system of monitoring and reporting patient numbers and team activities.
In addition to numbers of visits and patient numbers, the monthly team reports also provide data on referrals, deaths, volunteer activities, community contacts, expenditure, etc., all of which are useful for monitoring inputs and process.
5.8.2 Monitoring impact
Apart from reviews and evaluations such as this one, there is no system in place to measure the impact of the programme on PLHA, families, communities or the health system. It is strongly recommended that the HCNG initiates a process to establish an impact monitoring system for the Home Care programme. Having a pilot monitoring system underway in Phnom Penh will provide valuable lessons in establishing a system in the Provinces, where capacity and resources may be more limited.
Decisions need to be made on:
- what should be monitored (and why)?
- what are the most appropriate methods?
- who should conduct the monitoring?
- are any special skills required, and if so, who should help develop these skills?
- over what scale and timeframe may the different types of monitoring be appropriate?
It is beyond the scope of this report to develop specific recommendations on the answers to these questions. However, the following suggestions are offered:
- Selected Quality of Life (QoL) indicators would be most appropriate for measuring impact on PLHA and their families. Case studies could complement routine sampling of families visited by the HCTs.
- At the community level, support groups and community leaders could be involved in participatory impact monitoring activities, perhaps using PLA techniques and involving volunteers.
- At city level, the HCNG would need to liaise with hospitals and health centres to develop appropriate indicators and methods of verifying the impact of the programme.
The HCTs have already began a process of identifying indicators, and this will hopefully be continued during the forthcoming participatory local partner reviews in July. However, the difficulties in establishing even a simple but effective impact monitoring system should not be underestimated, and external resources and expertise in impact monitoring are likely to be required.
It is recommended that the HCNG seeks technical support to facilitate the process of establishing an impact monitoring system for the Home Care programme, including developing appropriate indicators.