Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Department of Social Policy, London School of Economic and Political Science, London, United Kingdom.
Health Res Policy Syst. 2017 Dec 28;15(Suppl 2):107. doi: 10.1186/s12961-017-0274-9.
The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda.
The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitative and quantitative M&E techniques such as key informant interviews, formal surveys and supportive supervision, as well as participatory approaches, notably participatory impact pathway analysis.
At the design stage, the M&E approaches were useful for identifying key local problems and feasible local solutions and informing the activities that were subsequently implemented. During the implementation phase, the M&E approaches provided evidence that informed decision-making and helped identify emerging issues, such as weak implementation by some village health teams, health facility constraints such as poor use of standard guidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birth weight infants. Sharing this information with key stakeholders prompted them to take appropriate actions. For example, the sub-county leadership constructed placenta disposal pits, the district health officer provided fuel for ambulances, and health workers received refresher training and mentorship on how to care for newborns.
Diverse sources of information and perspectives can help researchers and decision-makers understand and adapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine information generating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successful implementation of complex development interventions.
参与式监测和评价（M&E）方法对于指导地方决策、推动有效干预措施的实施以及解决实施过程中出现的问题至关重要。本文探讨了参与式 M&E 方法如何帮助确定关键的设计和实施问题，以及它们如何影响利益相关者在乌干达东部的决策。
本文的数据来自于对在乌干达东部三个地区实施的母婴健康项目中使用的各种 M&E 方法的回顾性反思。方法包括定性和定量的 M&E 技术，如关键知情人访谈、正式调查和支持性监督，以及参与式方法，特别是参与式影响路径分析。
在设计阶段，M&E 方法有助于确定当地的关键问题和可行的当地解决方案，并为随后实施的活动提供信息。在实施阶段，M&E 方法提供了证据，为决策提供了信息，并帮助发现了新出现的问题，如一些村级卫生团队执行不力、卫生机构的限制，如标准指南使用不善、缺乏胎盘处理坑、一些设施的救护车燃料不足、对低出生体重婴儿的护理不当等。与主要利益相关者分享这些信息促使他们采取适当的行动。例如，县以下领导层建造了胎盘处理坑，地区卫生官员为救护车提供燃料，卫生工作者接受了关于如何照顾新生儿的复习培训和指导。
多样化的信息来源和观点可以帮助研究人员和决策者理解和适应证据，以实现更有效的干预措施。因此，支持地区建立跨部门、常规的信息生成和共享平台，将来自不同部门的利益相关者聚集在一起，对于复杂发展干预措施的成功实施至关重要。
