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Monitoring and evaluation - its importance in communicating health research

Up-to-date research that informs policy and practice is vital in the constantly evolving field of international development. Research ensures development programmes respond to the realities of people. This has been recognised by the UK Department for International Development (DFID) who recently committed to supporting research in development with £220 million by 2010.

As research becomes valued then effective communication strategies between policy makers, practitioners, researchers and communities become ever more important. For example, in the last few years key funders have started to specify that their researchers allocate at least 10% of their budgets to research dissemination.

This change encourages non-government organisations (NGOs) and researchers to communicate their research and account for its impact. Healthlink Worldwide has been supporting the effective communication of research for a number of years and in September 2006 ran a series of activities, including a two-day workshop for over 40 participants that explored how UK and international NGOs could develop their capacity in this emerging field.

The workshop, funded by DFID, was convened by the Monitoring and Evaluation communicating research group (M&E research group). This group - a loose network of like-minded organisations and individuals - was formed in 2004 to address growing concerns with monitoring and evaluation in research communication. The group’s members cover many different disciplines and include organisations such as the International Institute for the Environment and Development (IIED), Institute of Development Studies (IDS), Panos London, Healthlink Worldwide, the International Network for the Availability of Scientific Publications (INASP), the Overseas Development Institute (ODI), Wren Media and SciDev.Net.

Nicholas Ishmael Perkins, Head of Communication, Networking and Learning at Healthlink Worldwide, explains: “A divide exists between the research community and practising development organisations as well as with sectors such as the media. Often practitioners in the development field feel excluded from research, believing it has little impact on the ground. The M&E research group’s direct experience of monitoring and evaluation means we are able to turn this into an opportunity to show how monitoring and impact assessment approaches bridge this gap and can support the need to communicate research.”

The M&E research group conducted a scoping study, documented stories, and held a workshop to provide an overview of the key issues in monitoring and evaluation (M&E) of research communications. The case studies gathered, some of which are featured here, show the approaches people are using, what is special about them, and how these might be integrated into projects.

Case study 1:“Shared Care” in Burkina Faso - the challenges of implementation
Source: Ansgar Gerhardus et al

In the late 1980s ‘shared care’ was proposed by a group of researchers from the Ministry of Health. The approach was based on the idea that mothers and health workers could collaborate on the recognition, care-taking and treatment-seeking of childhood illnesses. However the approach has not been implemented; an evaluation sought to uncover the reasons.

Evaluation methods
Major stakeholders and the researcher’s agenda were identified by a document analysis, which included a review of the research proposals, published articles, minutes and reports and other project documents. Semi-structured interviews with decision makers and researchers established the environmental context at the time shared care was proposed. Focus group discussions with staff, women’s groups and mothers - who were not included in the original analysis - examined awareness of the ideas of shared care, and how practical the approach was.

Findings
The evaluation found that although researchers managed to disseminate their results to decision-makers, these were not transformed into intervention. Failure to undertake effective stakeholder analysis early on, to account for the policy context and awareness of the limited time available of key decision makers to process information were major constraints to implementation.

Made to measure – scoping paper
The workshop, which explored the subject of M&E for communicating research, was supported by a scoping paper, written by Catherine Butcher and Gil Yaron. It included a literature review, telephone discussions and case-studies, which highlighted approaches and challenges faced by practitioners in the field of research communications. The paper, designed to raise issues rather than form conclusive answers, highlighted the following key findings:

Frameworks
The most commonly used framework for M&E is the logical framework (log-frame). This framework, although well used, can present difficulties when capturing the ‘networking’ aspect of communication. Alternatives, such as mapping potential communication pathways, may offer a better way to monitor the relationship between research communications and networks particularly in smaller projects. Complex projects however, involving large numbers of stakeholders and numerous communication routes, may respond better to different approaches.

Stakeholders
Target audiences and ‘knowledge intermediaries’ such as policy makers are often only identified in the broadest terms, with little information known about their requirements. Establishing an ongoing relationship with audiences and intermediaries could enhance the uptake of information and help determine impact.

Methods and tools
A range of qualitative and quantitative M&E methods and tools are currently in use. Quantitative methods are more commonly used for ongoing monitoring, while qualitative, semi-structured interviews are popular for evaluations.

Case Study 2: World Wildlife Federation (WWF) - Evaluation of People and Plants Initiative (PPI)
PPI was a 12 year programme in selected developing countries that used applied ethnobotany (the scientific study of how plants are used in different cultures) to promote the sustainable use of plant resources. It aimed to build local capacity for community-based conservation.  Part of the programme is still running. The evaluation is unusual because it assessed long-term change. The effects of research communication of ethnobotany, including effects on local people’s livelihoods, were examined.

Purpose
The PPI and its original objectives were reviewed as part of the evaluation and lessons extracted for use by the WWF. The programme’s relationship to WWF’s partnership with DfID was examined and recommendations made for the next phase of the programme.

Approach and methods
A variety of methods were used including an evaluation of impact at the very local level. Questionnaires were sent to over 800 people and 115 responses were gathered. Semi-structured interviews and focus group discussions, which included people involved with or users of PPI, were carried out by a team of local consultants. The principal consultant and a colleague specialising in livelihood issues attended the annual meeting of PPI in the UK, and PPI publications, videos and website were consulted. 

Challenges
Establishing impact was difficult as some of the processes of the programme (for example accreditation of ‘wood certificates’ to authenticate work by wood carvers in Kenya) were not in place. In some instances effects were attributed to the programme but other influences inevitably would have played a role in communicating the research findings.

Critical factors
Five key factors for effective M&E were identified at the two-day workshop. These were:

Making space for learning
Creating spaces for learning within organisations was seen as a critical factor by participants at the workshop. This allows M&E to be seen as a learning approach rather than a ‘judgment’, which is beneficial to organisations, partners and funders. One useful approach is the ‘balanced scorecard approach’, which is set on criteria that measures an organisation or project. It is a competency framework, moving from a not-so-good position to a better position. The idea is to reach a balanced situation within the organisation and the project. As Geoff Bernard, at the Institute of Development Studies says: “It makes it normal to be not achieving everything on the spread-sheet.”

Tools for the job
 In addition, new technologies, such as network analysis software and tracking of electronic discussion groups, are creating more options for M&E. While it was noted that tools and approaches are useful learning from others, sharing case studies and best practice is key to developing better M&E, and the development of clear indicators for M&E and communicating research (and for communication for development more broadly).

Involve your stakeholders
Stakeholder involvement is a critical factor. Different groups should be identified at the beginning of projects and stakeholders should be engaged in a participatory manner throughout all M&E activities.

Choose your framework wisely
The choice of conceptual framework for research and communicating the research needs to be thought out in a holistic manner so practitioners are clear about any changes that may occur. One workshop participant commented: “There’s no shortage of theories of how communications work. There’s no shortage of how to do M&E, but there is a shortage in the intersection of these two areas.” Many of the workshop participants felt there were few viable alternatives to using the logical framework for evaluation.

Who are you talking to?
Identifying audiences for different types of communication is essential, and so to is identifying audiences for the M&E of the communication. Different strategies are required for different audiences, and the language and the format revised as necessary. Broad potential audiences include: policy makers, donor and institutional leaders, practitioner level and fellow project and programme implementers, the research community, and others such as educational bodies and beneficiaries.

Case Study 3: Lao Fisheries
This is an example of multi-level evaluation: participatory M&E undertaken by local communities as part of the adaptive learning process and a more traditional impact assessment at the end of the project.  Research communication played a critical role in the adaptive learning; improvements to management are possible only if the learning generates desired information and this disseminated and utilised.

Purposes
To ensure that interventions met the needs of local communities and to assess end of the project impact (primarily for funders and implementers).

Approach
An evaluation framework was drawn up as a flow diagram, which formed the basis for assessing learning outcomes. The diagram posed questions of whether the information generated was expected, did it get to the people who needed it, was the information used, and were the benefits worth the costs? Was the information generated what was expected?

Formal research on which management practices worked best was initially undertaken and results were then evaluated by all stakeholder groups in terms of their implications for future management. Repeated cycles of M&E allowed comparison over time. By incorporating the views of various stakeholder groups, triangulation (cross-checking of results) was possible.

Methods
A combination of quantitative and qualitative methods were used including group discussions and workshops at district level and in villages, formal meetings, self-evaluation through questionnaires and roundtable discussions. The evaluators were made up of district staff, village representatives and provincial staff.

Challenges faced
Cultural factors: local beneficiaries were concerned not to appear rude to outsiders – this suggested that evaluators from outside the area may find a bias towards success rather than failure. The evaluation was time-consuming for local people.

Conclusions
These are early days for M&E of communicating research. Following on from the workshop the M&E research group has committed to addressing some of the challenges and key factors identified. Next steps for the group include:

  1. Developing a structured peer review system for M&E initiatives
  2. Working across sectors at a country level to maximise and learn from M&E activities
  3. Developing an online resource service with a view to sharing best practice, peer review and other outputs
  4. Further developing the scoping study as a resource for both evaluators and researchers.

Other areas of interest include:

For more information contact Shampa Nath, Director of Operations, Healthlink Worldwide at nath.s@healthlink.org.uk

For further details on the case-studies please refer to the scoping study.