An Assessment of the Demand-Side of the Monitoring and Evaluation System of the Health Sector in Zambia

Kanyamuna Vincent^1, , Mubita Aurick², Ng’andu Emily², Mizinga Chinyama³ and Mwale Ackson²

¹Department of Monitoring and Evaluation, Ministry of National Development Planning, Lusaka, Zambia

²Department of Social Work and Sociology, University of Zambia, Lusaka, Zambia

³Department of Monitoring and Evaluation, Project Concern International, Lusaka, Zambia

Cite this paper:
Kanyamuna Vincent, Mubita Aurick, Ng’andu Emily, Mizinga Chinyama and Mwale Ackson. An Assessment of the Demand-Side of the Monitoring and Evaluation System of the Health Sector in Zambia. World Journal of Social Sciences and Humanities. 2018; 4(2):75-86. doi: 10.12691/wjssh-4-2-2

Abstract

This paper assesses the Monitoring and Evaluation (M&E) arrangements of the health sector in Zambia. This topic has been pursued with an understanding that sector M&E is an important aspect in the overall national poverty reduction agenda. The specific focus of this paper is on the demand-side of the health sector M&E system. The paper looked at the M&E arrangement in the Ministry of Health (MOH) and the quality of information being generated. For the analytical framework, the paper used the diagnostic checklist elaborated by Bedi et al., in their 2006 publication which identifies four basic elements crucial to consider when assessing the demand-side of an M&E system. These include: (i) analysis and evaluation; (ii) outputs and dissemination; (iii) integration with the budget process and parliament; and (iv) non-state actors as demand-side stakeholders. Fundamental issues brought out are that the M&E function in the health sector in Zambia has some central recognition, but it is not fully developed. It also reveals that the organisational framework to undertake M&E in the sector was in place but equally not yet fully operationalized. Equally, M&E champions exist but not adequate to make an impactful case for M&E. Possible opportunities for a stronger M&E system in the health sector identified are that: Government through the MOH was committed to ensuring that the sector enhances its M&E through various fronts such as donor community involvement through Sector Wide Approaches (SWAps) and the strengthened implementation of the Paris Declaration (PD) principles of alignment and harmonization on aid effectiveness; the link between the National Health Strategic Plan (NHSP) and the budget process through the Mid Term Expenditure Framework (MTEF) mechanism; the presence of the National Decentralization Policy which could be used to strengthen the M&E capacities in the sector especially the lower structures which are currently underdeveloped; the fact that the MOH strategic plan is developed and implemented within the framework of the National Development Plan (NDP)(currently the 7NDP 2017-2021) and coupling this with the use of the MTEF, the arrangements could be used to lobby for resources to strengthen the sector M&E function. The paper also indicates that there is need to create practical incentives for using information generated by the sector M&E system and this could be done in various ways. For instance, linking the use of M&E information to appropriate moments can be effective when well planned and executed. Recommendations for the MOH M&E improvement include; (1) the need to conduct a thorough sector M&E diagnosis; (2) to create a forum for inter-line ministry and stakeholder M&E to share experiences for learning purposes; (3) to build the M&E capacity of lower and decentralized sector structures; (4) to enhance the incentive structure for generating and using M&E information within and outside the MOH; and (5) to engage both MNDP and MOF to provide M&E backstopping.

Keywords:
monitoring evaluation M&E system health sector demand-side Zambia

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Castro, M.F. (2009). “Evaluation Capacity Development: Insider Insights: Building a Results-Based Management and Evaluation System in Colombia”, ECD Working Paper 18, World Bank, Washington, D.C.
[2]	Görgens, M. and Kusek, J. (2009). Making Monitoring and Evaluation Systems Work: A Capacity Development Toolkit, Washington DC, IBRD World Bank.
[3]	Government of the Republic of Zambia (GRZ). (2002). “Zambia Poverty Reduction Strategy Paper 2002-2004”, Ministry of Finance and National Planning, Lusaka.
[4]	Republic of Zambia. (2010). “Sixth National Development Plan (2011-2015): Sustained Economic Growth and Poverty Reduction”, Ministry of Finance and National Planning, Lusaka.
[5]	Government of the Republic of Zambia (GRZ). (2006). “Fifth National Development Plan 2006-2010: Broad based wealth and job creation through citizenry participation and technological advancement”, Ministry of Finance and National Planning, Lusaka.
[6]	Mackay K. (2006). Institutionalization of Monitoring and Evaluation Systems to Improve Public Sector Management. ECD Working Paper Series No. 15
[7]	Kanyamuna, V. 2013. Sector Monitoring and Evaluation systems in the context of poverty reduction strategies: A comparative case study of Zambia’s health and agriculture sectors. MSc – Dissertation, University of Antwerp.
[8]	Mackay K. (1999). A Diagnostic Guide and Action Framework. Evaluation Capacity Building—ECD Working Series No. 6. Washington DC: World Bank.
[9]	Kusek, J.Z. and Rist, R.C. (2004). Ten Steps to a Results-Based Monitoring and Evaluation Systems. A Handbook for Development Practitioners, Washington D.C., The World Bank.
[10]	Bedi, T., Coudouel, A., Cox, M., Goldstein, M. and Thornton, N. (2006). Beyond the Numbers. Understanding the Institutions for Monitoring Poverty Reduction Strategies, Washington, D.C., The World Bank.
[11]	Booth, D. and Lucas, H. (2002). “Good Practice in the Development of PRSP Indicators and Monitoring Systems”, ODI Working Paper 172, London, Overseas Development Institute.
[12]	Holvoet, N. and Renard, R. (2007). Monitoring and Evaluation Reform under Changing Aid Modalities: Seeking the Middle Ground in Aid-Dependent Low-Income Countries, UN University, Research Paper No. 2007/52.
[13]	UNDP. (2002). Handbook on Monitoring and Evaluating for Results, UNDP Evaluation Office, New York.
[14]	IFC/GTZ/DFID. (2008). The Monitoring and Evaluation Handbook IF C | G T Z | D F ID
[15]	OECD/DAC. (1991). OECD/DAC Principles for the Evaluation of Development Assistance, Paris, OECD/DAC.
[16]	Simister, N. (2009). Developing M&E Systems for Complex Organizations: A Methodology, Monitoring and Evaluation (M&E) Paper 3, INTRAC (www.intrac,org).
[17]	UNDP. (2002). Handbook on Monitoring and Evaluating for Results, UNDP Evaluation Office, New York.
[18]	Republic of South Africa, 2008. Basic Concepts in Monitoring and Evaluation, Public Service Commission, Pretoria, South Africa.
[19]	Government of the Republic of Zambia (GRZ). (2006). “Vision 2030: A Prosperous Middle-Income Nation by 2030”, Cabinet Office, Lusaka.
[20]	Government of the Republic of Zambia (GRZ). (2017). “Seventh National Development Plan 2017-2021: Accelerating Development Efforts towards Vision 2030 without Leaving Anyone Behind – Volume I”, Ministry of National Development Planning, Lusaka.
[21]	World Bank. (2003). Participation in Monitoring and evaluation of PRSPs. A document review of trends and approaches emerging from 21 full PRSPs. Washington, D.C., The World Bank, Social Development Department, The participation and civic engagement group.
[22]	Government of the Republic of Zambia (GRZ). (2006). “2006 Annual Fifth National Development Plan Progress Report: Broad based wealth and job creation through citizenry participation and technological advancement”, Ministry of Finance and National Planning, Lusaka.
[23]	Government of the Republic of Zambia (GRZ). (2011). “Annual Progress Report: Analytical Report for selected sectors”, Ministry of Finance, Lusaka.
[24]	Valadez, J. and Bamberger, M. (1994). “Organizational and Management Issues in Programme Evaluation”, in: Valadez J. and Bamberger M. (eds.) Monitoring and Evaluating Social Programmes in Developing Countries: a Handbook for Policymakers, Managers and Researchers, Washington D.C., The World Bank, 402-442.
[25]	Prennushi, G., G. Rubio and K. Subbarao (2001). “Monitoring and Evaluation”, World Bank PRSP Sourcebook (Draft for Comments, Apr 2001) (www.worldbank.org/poverty).
[26]	Government of the Republic of Zambia (GRZ) (2009). “Mid-Term Review of the Fifth National Development Plan 2006-2010: Broad based wealth and job creation through citizenry participation and technological advancement”, Ministry of Finance and National Planning, Lusaka.
[27]	Government of the Republic of Zambia (GRZ). (2016). “2015 Annual Progress Report for the Revised Sixth National Development Plan 2013-2016: People Centred Economic Growth and Development”, Ministry of National Development Planning, Lusaka.
[28]	Holvoet, N., Gildemyn, M. and Inberg, L. (2012). “Taking Stock of Monitoring and Evaluation Arrangements in the Context of Poverty Reduction Strategy Papers: Evidence from 20 Aid-Dependent Countries in Sub-Saharan Africa”, Development Policy Review, 30 (6): 749-772.
[29]	African Community of Practice on Managing for Development Results (AfCoP-MfDR) (AfCoP-MfDR). (2014). Putting results first in Zambia: Changing the lives of People - managing for development results country assessment
[30]	Booth, D. (2005). ‘Missing Links in the Politics of Development: Learning from the PRSP Experiment’. ODI Working Paper No. 256. London: Overseas Development Institute.
[31]	World Bank. (2005). Enabling capacity to achieve results—2005 Comprehensive Development Framework (CDF) progress report. Washington, DC: World Bank, Operations Policy and Country Services.
[32]	Republic of Zambia. (2006). “National Health Strategic Plan (2011-2015): Towards attainment of health related Millennium Development Goals and Other National Health Priorities in a clean, caring and Competent environment”, Ministry of Health, Lusaka.
[33]	Estrella, S. and Gaventa, J. 2014. Who Counts Reality? Participatory Monitoring and Evaluation: A literature Review, IDS Working Paper 70.
[34]	Hardlife, Z., and Zhou, G. 2013. Utilisation of Monitoring and Evaluation Systems by Development Agencies: The Case of UNDP in Zimbabwe, American International Journal of Contemporary Research, 3(3) 70-83.
[35]	De Renzio, P., D. Booth, A. Rogerson, and Z. Curran. (2005). ‘Incentives for Harmonization and Alignment in Aid Agencies. ODI Working Paper No. 248. London: Overseas Development Institute.
[36]	Government of the Republic of Zambia (GRZ), 2014. National Planning and Budgeting Policy: Responsive, transparent, accountable and results-oriented Development Planning and Budgeting processes, Ministry of Finance, Lusaka.
[37]	Engela, R. and Ajam, T. 2010. Implementing a Government-Wide Monitoring and Evaluation System in South Africa, ECD Working Paper series No. 21, The World Bank, Washington, D.C.
[38]	Government of the Republic of Zambia (GRZ). (2002). “The National Decentralization Policy: Towards Empowering the People”, Government Policy, Cabinet Office, Lusaka.
[39]	Chigunta, F. and Matshalaga, N. (2010). “Evaluation of the Implementation of the Paris Declaration in Zambia”, Final Report, Lusaka.
[40]	3rd High Level Forum on Aid Effectiveness. (2008). Accra Agenda for Action. Accra: 3rd High Level Forum on Aid Effectiveness.
[41]	OECD. (2005). “Paris Declaration on Aid Effectiveness”, Paris, OECD Publications.
[42]	Mackay, K. (2007). How to Build M&E Systems to Support Better Government, Washington D.C., The World Bank.
[43]	Cousins, Bradley and Leithwood, Kenneth. (1986). ‘Current Empirical Research on Evaluation Utilization’, Review of Educational Research 56 (3): 331-64.
[44]	Republic of South Africa, 2007. Policy Framework for the Government-Wide Monitoring and Evaluation System, The Presidency, Pretoria, South Africa.
[45]	Ajam, T. and Engela, R. (2010). Implementing a Government-Wide Monitoring and Evaluation System in South Africa, ECD Working Paper No. 15, World Bank, Washington, D.C.
[46]	Hauge, O. and Mackay, K. 2004. Sharing best practices and lessons learned: Monitoring and Evaluation for Results – Lessons from Uganda, Capacity Enhancement Briefs, OED, World Bank, Washington, D.C.
[47]	Hlatshwayo, A.Z. and Govender, K.K. 2015. Monitoring and Evaluation in the Public Sector: A Case Study of the Department of Rural Development and Land Reform in South Africa, Asian Journal of Economics and Empirical Research, 2(2) 91-99.
[48]	Burdescu, R., del Villar, A. Mackay, K., Rojas, F. and Saavedra, J. 2005. Institutionalising M&E systems in Latin America and Caribbean countries Prem Notes, World Bank, Washington, D.C.
[49]	Holvoet, N. and Inberg, L. (2012). Sector Monitoring and Evaluation Systems in the context of Changing Aid Modalities: The case of Uganda’s Health Sector, IOB, Antwerp.
[50]	Chabane, C. 2013. The Role of Monitoring and Evaluation in the Public Service, Republic of South Africa – The Presidency Department of Performance Monitoring and Evaluation.
[51]	Government of the Republic of Zambia (GRZ). (2014). “Report of the Final Evaluation of the Fifth National Development Plan 2006-2010”, Ministry of Finance and National Planning, Lusaka.
[52]	Republic of Zambia. (2017). ‘To improve the health status of people in Zambia in order to contribute to increased productivity and socio-economic development’, Ministry of Health, Lusaka.