Monitoring and Evaluation

Monitoring and evaluation (M&E) are key aspects of any project and together they serve to support informed decisions, the best use of resources, and an objective assessment of the extent to which an organization’s services and other activities have led to a desired result.[1]

To make informed decisions, health care managers need an M&E system that yields reliable and timely information about such factors as:[2]

  • The health needs of the people in their catchment area—the area from which clients are drawn to receive health services

  • The health priorities of the country, province, district, and communities the program serves

  • The quality and coverage of the health services the program offers

  • The resources the program has used and resources still available

  • Progress in the implementation of program activities and progress toward desired outputs and outcomes[3]

What is different about M&E of FP programs compared with M&E of other programs? The answer in many ways is “not much.” The fundamental M&E principles (i.e., frameworks, indicators, data sources) apply to FP programs. However, FP programs have a few specific features. First, the outcomes are relatively well-defined, focused, and measurable, unlike in some other health program areas, including wider reproductive health. There is also a long history of data collection on FP outcomes through global survey programs such as the World Fertility Survey and the DHS, among others. This means that data collection methods and indicators have been well-tested and are fairly standard now and that we have extensive documentation of global trends in these indicators going back to the 1970s and 1980s in many countries. Also, given historical population debates, there have also been several attempts to demonstrate that FP programs work, giving rise to a relatively rich literature on FP program impact evaluation and associated methods.[4]

  • Outputs for FP programs cover the different functional areas and are also similar to other programs. For example:

    • Functional area of training include people trained in FP activities, their performance, and the cost per person trained.

    • Service outputs for FP program M&E include things like service delivery points providing FP services, the quality of FP services, and the cost of increasing access and quality of FP services.

    • Service utilization outputs are closer to the population outcomes and impact and include measures of the volume and cost of services provided, such as new FP acceptors, couple-years of protection (which accounts for the length of protection from pregnancy provided by different methods), returning clients, and the cost of increasing these various service utilization outputs.

    • Intermediate outcomes and long-term outcomes and impacts for FP programs typically include the contraceptive prevalence rate, unmet need (detailed below), and fertility rates, particularly unintended fertility rates.[5]

Please also see Key Family Planning Impact Indicators and Their Definitions

Key M&E Resources:

  • Monitoring and Evaluation Toolkit (K4Health, 2011). The M&E Toolkit is a collection of resources intended for use by project managers and M&E practitioners working in public health in low- and middle-income countries. The toolkit is categorized according to the basic M&E project cycle, which many organizations use and follow.
  • Monitoring and Evaluation (M&E) Fundamentals (USAID, 2011). Course on the USAID Global Health e-Learning Center.
  • M&E TRM (USAID/CSHGP, 2007). This module of the Technical Reference Materials describes basic M&E concepts and a six-step process for developing an M&E plan linked to the project design.
  • M&E of Family Planning Programs—1 Day Module (MEASURE Evaluation). This module is designed and intended to be used as a three-hour training session that is delivered as part of a larger M&E workshop on population, health, and nutrition topics, including HIV. This training module includes a PowerPoint presentation, readings, and class exercises.


[2] Idem

[3] Idem

[4] Monitoring and Evaluation: Family Planning Programs. PowerPoint. USAID and MEASURE Evaluation.

[5] Idem