Objectives and Indicators for MCH Programs

MCH in Developing Countries

Objectives and Indicators

Session goals

• Promote an understanding of the importance of good objectives and indicators, and their contribution to effective program management

• Provide or refine skills needed to develop MCH program objectives

Objectives and Indicators

Session objectives -- by the end of the session, participants should be able to:• Explain the terms “goal,’ “objective,” “indicator” and “target”• Describe the characteristics of objectives and indicators that are useful for program management• Write a “smart” objective for the country project and state its corresponding indicator

Why discuss MCH program objectives?• How will you know if you are successful if you don’t identify

what you want to do?• There are always limited resources• Clear objectives are often a donor requirement• Developing appropriate and useful objectives is not always

simple or intuitive

Note -- they are NOT a substitute for “doing the right thing” based on a needs assessment

Logic model flow chart - how program efforts contribute to program goals

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Terms will vary!

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Activities are any action, funded or unfunded, undertaken to achieve a program result

• Assignments, tasks, stuff we do to achieve our objectives

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Objectives can include anything clearly intended to be achieved through the program or project

• Output level objectives are those resulting from first order activities

• Impact level objectives refer to the desired long-term or ultimate result

• Outcomes -- Intermediate objectives that fall somewhere between these two

Outputs vs. Outcomes Outputs vs. Outcomes • Example:

Number of pregnant women delivering in a health facility is an output. Percentage of those delivering in a health facility who deliver a newborn without complications is an outcome.

Not how many worms the bird feeds its young,

but how well the fledgling flies (United Way of America)

Source: University of Wisconsin Extension, Program and Evaluation

Inputs Activities

Processes

Outputs

Objectives

Outcomes Results

• Output level objectives are those that result from activities -- things your program does– In most instances don’t represent population change

– Important area for program/project monitoring

• Frequently “bean counting”– Useful for program management purposes

– And -- donors may hold you accountable for the beans

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Impact and outcomes are…– Changes in the condition or behavior of a program participant or

changes in conditions that affect a participant: results

• Whether an objective is a impact or outcome depends on its level in the causality chain– Impact describes the long-term results

– Outcomes describe the immediate effects on participants

• The ability of a program to produce results (i.e., outcomes, impact, or both) depends on your resources, program duration, and many, many social, economic and cultural conditions that affect participants in the program

Causality

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Objectives should be the highest order objectives for which you can be held accountable

• They should be S M A R T :– S - simple

– M - measurable (in the program setting)

– A - appropriate (technically correct, important)

– R - realistic

– T - time-limited

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Let’s consider this objective...

The project will improve the understanding of mothers

about the importance of oral rehydration therapy and how

to correctly mix ORS.

Let’s try again….

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

• Let’s consider another objective...

The project will increase

immunization coverage to 80%

Let’s try again….

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Measures

• By…, v% coverage • By …, coverage will increase from

w% to x%• By…, coverage will increase by y%• By…, coverage will increase by z

percentage points

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Additional terms:

• Indicators…– Answer the question, “How will we measure “How will we measure

what we have achieved?”what we have achieved?”

• Target…– the specific level of achievement

What is the indicator and target for the immunization objective?

Indicator:

Target :

SelectingSelectingIndicatorsIndicators

• Who to involve in setting objectives and indicators?

– Project staff– Others familiar with relevant data– The community, partners– Published literature, project reports

• When?– Iterative - As work on program development proceeds– Check feasibility before finalizing

• It’s usually OK to revise objectives if rationale is provided

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Practicality

Are the data associated with the indicator practical? • How will you collect the data?

• Are quality data currently available?

• Can routine data can be procured on a regular and timely and economical basis?

• Will you need to conduct a survey or special studies?

All of these contribute to the program goals -- broad, long-term intended results

Inputs Activities

Processes

Outputs

Objectives

Outcomes Impact

Indicators