Participatory monitoring and evaluation approaches that influence decision-making: lessons from a maternal and newborn study in Eastern Uganda

摘要

BACKGROUND: The use of participatory monitoring and evaluation (M&E) approaches is important for guiding localdecision-making, promoting the implementation of effective interventions and addressing emerging issues in thecourse of implementation. In this article, we explore how participatory M&E approaches helped to identify key designand implementation issues and how they influenced stakeholders’ decision-making in eastern Uganda.METHOD: The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternaland newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitativeand quantitative M&E techniques such as key informant interviews, formal surveys and supportivesupervision, as well as participatory approaches, notably participatory impact pathway analysis.RESULTS: At the design stage, the M&E approaches were useful for identifying key local problems and feasiblelocal solutions and informing the activities that were subsequently implemented. During the implementationphase, the M&E approaches provided evidence that informed decision-making and helped identify emergingissues, such as weak implementation by some village health teams, health facility constraints such as poor use of standardguidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birthweight 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, andhealth workers received refresher training and mentorship on how to care for newborns.CONCLUSION: Diverse sources of information and perspectives can help researchers and decision-makers understand andadapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine informationgenerating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successfulimplementation of complex development interventions.