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

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.

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