Assessment of the capacity of the monitoring and evaluation system components at Uganda Catholic Medical Bureau

Abstract

Introduction: The demand for institutionalization of monitoring and Evaluation (M&E) systems across all sectors has brought to light the notable gap in the adoption, design and correct use and functionality of the M&E system components in many institutions including medical bureaus. The generation of data and subsequent information in the M&E cycle is now a key management focus, the application of M&E information in management and core M&E functions like learning and accountability is an emerging field but still a big concern in the health sector. Aim: The purpose of this study was to assess the capacity of the M&E System components at the Uganda Catholic Medical Bureau with the view of understanding the M&E capacity, identify gaps, and recommend approaches to strengthen it in order to enhance the core management functions of accountability and learning at the bureau. Methods: A cross-sectional study design using a mixed method approach was employed using the Monitoring Evaluation Capacity Assessment Tool (MECAT) to collect data from Uganda Catholic Medical Bureau, the scores of the components the M&E system were assessed based on the four dimensions of status, Quality, financial autonomy and technical autonomy, these four-dimension areas had scores that were uploaded on a self-administered online tool on kobo collect. The study population was staff from UCMB who provided the study sample of 21 members. The data was analyzed using STATA to generate descriptive statistics to ascertain the extent of performance of the M&E system components at UCMB. Qualitative data was analyzed using NVIVO to generate themes and narrative to support the quantitative data. Results: The overall average status score of the M&E system components out of 10 was as follows: organizational structure (9.46), Human capacity for M&E (5.00), Partnerships and Governance (6.96), Organizational M&E plan (8.07), Annual Costed UCMB M&E Plan (9.29), Advocacy, Communication, and Cultural Behavior (8.57), Routine monitoring (9.11), Surveys and Surveillance (6.43), National and Subnational Databases (5.36), Supervision and Auditing (8.04), Evaluation and Research (4.64), Data demand and use (8.21). Excerpts from the qualitative There is no particular mission statement for M&E and I don’t think anybody can point it out, the overall objective of the M&E system is to support the tracking, reporting and systematically organize the relevant data that can be used in the UCMB Network, and provide a platform where our stakeholder can know what UCMB is doing, (KII,001, a senior staff in M&E) The M&E unit has no stand-alone mission or values but largely all this feed into the UCMB mission since M&E is unit within UCMB which is a department of the Uganda Episcopal conference, in addition we also have regular weekly meetings. Finally, according to the respondents; UCMB holds monthly M&E meetings. (KII,004, program management staff) UCMB has policies and procedures that guide M&E function but also has well defined partnerships with Nkozi University and George Town university which has helped them develop the capacity of the M&E function, and strengthen policies, (KII,001, a senior staff in M&E unit of UCMB). What you need to know we have never undertaken a system assessment for a while most were done by the Uganda Health System Strengthening Activity. A respondent further said; “we run many scattered projects here which have one M&E port now, but we have not reached the point of absolutely linking the plan to the overall UCMB strategy (KII,001 a senior M&E staff) Conclusion: Uganda Catholic Medical Bureau has varying levels of performance across different M&E systems components, components where the monitoring and evaluation system under performed include evaluation, database management and skills that were significantly lacking were in areas of evaluation and research. UCMB should consider routine assessment of their M&E system components, in addition UCMB should consider partnerships with teaching institutions so as to grow their skills and also learn how to lead and institutionalize the M&E system functions. UCMB must invest in training staff internally and build a critical mass of home-grown technical competence, and also mobilize resources to run all the M&E functions as a long-term solution to achieve technical and financial autonomy for sustainable M&E functions. Failure to invest in these areas will see perpetuation of the identified gaps and this will hinder the effective execution of the current M&E system components.