A detailed monitoring and evaluation platform has been established to assess progress towards the MDGs, and compare what is happening in Millennium Village Project sites, villages not receiving the intervention, and national and sub-national data sets.
Components of the MVP Monitoring and Evaluation Package
Components of the MVP package vary between sites depending on factors such as existing infrastructure, community priorities, national policy, local economic opportunities and the burden of disease. A standardized approach to document the timing, sequence and uptake of interventions is critical to defining the contents of the package, and will assist in generating hypotheses to explain observed effects on MDG-related outcomes.
A quarterly report system for performance indicators. This report system is developed after extensive consultation with the various sectors. Eighty-seven performance indicators in nine different sectors, their definitions and unit of observation, and the person responsible for reporting at each site has been developed and implemented. These are compiled at the end of each quarter and submitted to New York. An information system for recording this remotely is also being developed.
Within the health sector, vital events monitoring of all births and deaths is routinely collected through a cell-phone based system (Comm-care). This is supplemented by a Verbal Autopsy system which provides real-time information on medical and social cause of death. Furthermore, as clinical record keeping in most sites remains rudimentary, an Electronic Medical Record system (OpenMRS) has been introduced in a number of sites. This system involves a simplified electronic patient encounter form which allows for rigorous reporting on the utilization of clinic services alongside patient diagnoses and outcomes.
MVP interventions: Contribution to accelerating progress towards MDG targets
The MVP has developed many evaluation tools for assessing impact. Performance indicators provide an assessment of real-time accomplishments and outputs/outcomes. Using theories of change, they also help to assess potential impact/effectiveness of programs. Detailed social, economic and health surveys are a second critical tool being employed to assess changes in MDG-related outcomes.
At each of five evaluation rounds (year 0, 3, 5, 7, 9) over a ten year period, the project administers approximately 40,000 questionnaires, and collects 25,000 biological specimens (malaria, anaemia, neglected tropical diseases), 6,000 anthropometric measurements, and crop yield data from 500 farm plots. Data are available from villages receiving the intervention, matched comparison villages that are not, as well as regional and national data sets.
In a complex multi-sector intervention such as the MVP, systematically documenting the ‘process’ of implementation and the factors that act as barriers and facilitators to this are equally important to impact assessment in maximizing the lessons learned from the project.
This line of enquiry in conducting a Process Evaluation is qualitative and exploratory. Key informant interviews (annually) are being conducted with project recipients and community leaders, sector heads, project management, government officials and donors. These discussions will generate an assessment of program feasibility and effectiveness (did it achieve its goals), relevance (were the ‘right’ interventions undertaken), efficiency (where they undertaken in the ‘right way’), and the sustainability of various components of the MVP package. It will formally document the ‘institutional memory’ of the program, provide perspectives on contextual barriers and facilitators to effective implementation, and generate lessons for replicability and transfer to other contexts.
The MVP Study Evaluation Protocol has been externally peer reviewed and registered with the Lancet. In addition, the trial has been registered with the United States National Institutes of Health (protocol number NCT01125618).
For additional details regarding the evaluation protocol and assessment tools, click here.