USAID/ZAMBIA SYSTEMS FOR BETTER HEALTH ACTIVITY MONITORING AND EVALUATION PLAN (VERSION 2) August 2016 This publication was produced for review by the United States Agency for International Development. It was prepared by Abt Associates for the USAID Systems for Better Health activity. SBH M&E Plan Contract/Project No.: Task Order No. AID611-TO-16-00001 Contract No. AID-OAA-I-14-00032 GUC Mechanism Submitted to: William Kanweka, Contracting Officer’s Representative USAID/Zambia Prepared by: Abt Associates In collaboration with: American College of Nurse-Midwives Akros Inc. BroadReach Institute for Training and Education Initiatives Inc. Imperial Health Sciences Save the Children DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government USAID Systems for Better Health ▌pg. i SBH M&E Plan Table of Contents Acronyms ...................................................................................................................................... iv 1. Introduction ......................................................................................................................... 6 1.1 Context ........................................................................................................................................................ 6 1.2 Development Hypothesis ........................................................................................................................ 7 1.3 Systems for Better Health Results Framework .................................................................................. 7 1.4 Geographic Focus .................................................................................................................................... 10 2. Guiding Principles for SBH Monitoring and Evaluation ................................................. 11 2.1 Guiding Principles .................................................................................................................................... 11 2.2 Comprehensive and Flexible Approach ............................................................................................. 11 2.3 Gender and Equity ................................................................................................................................... 12 3. Theory of Change and Implementation Logic Model .................................................... 13 3.1 SBH Theory of Change .......................................................................................................................... 13 3.2 Rationale for Indicator Selection.......................................................................................................... 15 4. Plan for SBH Monitoring and Evaluation ........................................................................ 16 4.1 SBH Research, Monitoring, and Evaluation Team ............................................................................ 16 4.2 Routine Monitoring ................................................................................................................................. 17 4.3 Data Sources, Data Collection and Management ............................................................................ 18 4.4 Data Quality Assurance ......................................................................................................................... 20 4.5 Data Flow .................................................................................................................................................. 23 4.6 Data Use, Dissemination and Reporting ............................................................................................ 24 4.7 Schedule for Performance Monitoring Tasks .................................................................................... 25 5. Research and Evaluation Plan .......................................................................................... 28 5.1 Baseline Documentation ........................................................................................................................ 28 5.2 SBH Research and Evaluation Plan ...................................................................................................... 28 5.3 Abt Research Standards ......................................................................................................................... 29 5.4 Abt Institutional Review Board and Ethical Reviews....................................................................... 30 5.5 USAID Open Data Policy ...................................................................................................................... 30 USAID Systems for Better Health ▌pg. ii SBH M&E Plan 6. RME Budget........................................................................................................................ 31 7. Indicators and Targets ...................................................................................................... 32 Annex 1: Summary of Indicator Revisions ................................................................................. 40 Annex 2: List of Target Facilities by Province and District ....................................................... 44 Annex 3: Detailed Theory of Change by Result .......................................................................... 47 Annex 4: SBH Performance Indicator Reference Sheets (PIRS) ........................................... 53 Annex 5: Data Quality Assessment Checklist and Recommended Procedures ................. 138 Annex 6: SBH RME Year 1 Work Plan ................................................................................... 142 USAID Systems for Better Health ▌pg. iii Acronyms AMEP Activity Monitoring and Evaluation Plan APAS Annual Performance Assessment System CB Capacity Building CBD Community Based Distributor CDCS Country Development Cooperation Strategy CHA Community Health Assistant CHW Community Health Worker CHV Community Health Volunteer CPR Contraceptive Prevalence Rate CTC Abt Associates’ Client Technology Center DATIM Data for Accountability, Transparency, and Impact DDL Data Development Library (USG) DHIS2 District Health Information System Version 2 DHMT District Health Management Team DQA Data quality assurance or data quality audit EHT Environmental Health Technician GMCSP Governance and Management Capacity Strengthening Plan (MOH) GRZ Government of the Republic of Zambia HF Health Facility HMIS Health Management Information System HRH Human Resources for Health HRIS Human Resources Information System MandE Abt Associates’ Monitoring and Evaluation System M&E Monitoring and Evaluation MOH Ministry of Health OR Operations Research PA Performance Assessment PEPFAR United States President’s Emergency Plan for AIDS Relief USAID Systems for Better Health ▌pg. iv PFM Public Financial Management PIRS Performance Indicator Reference Sheet PMP Performance Monitoring Plan PQA Project Quality Assurance RF Results Framework RME Research, Monitoring and Evaluation SBH Systems for Better Health Project SOP Standard Operating Procedure TOC Theory of Change TWG Technical Working Group TSS Technical Support Supervision USAID United States Agency for International Development USG United States Government USAID Systems for Better Health ▌pg. v 1. Introduction This is a revised Activity Monitoring and Evaluation Plan (AMEP) for the United States Agency for International Development’s (USAID) five-year Systems for Better Health (SBH) in Zambia activity1. See Annex 1 for an overview of changes. SBH seeks to improve health outcomes for Zambians by strengthening systems that underpin the delivery of high quality health services. The activity also seeks to increase the utilization of high impact health interventions. SBH is being implemented by Abt Associates Inc. (Abt) partnered by subcontractors that include Akros Inc., American College of Nurse-Midwives, BroadReach Institute for Training and Education, Imperial Health Sciences, Initiatives Inc., and Save the Children to implement special segments in the SBH program from October 2015 to October 2020. To achieve its goal, SBH provides technical, financial, logistical, and administrative assistance to the Government of the Republic of Zambia (GRZ) at the national, provincial, and district levels. SBH strengthen the capacity of non-governmental and community-based Box 1. Zambia Health Sector—the basics organizations (NGOs and CBOs) to foster healthy behaviors among community recipients and deliver selected health The following summary is extracted from NHSP: services in remote areas. Since 1991, Zambia’s approach to health sector organisation has focused on decentralization of planning, 1.1 Context management, and resources to the district level where health services are delivered. This approach has inevitably called for broader participation of all the key stakeholders, Zambia has made promising gains against several key health particularly the communities in the governance of the indicators in recent years, although challenges remain2. Over health sector. The MOH is responsible for the overall the past decade, Zambia has made steady reductions in child coordination and management of the health sector in mortality (MTR 2014) with under-five mortality rate declining Zambia. In order to facilitate efficient and effective coordination, the following sector coordination structures steadily from 197 per 1,000 live births (1996 Zambia