From the Field: the Power of "M&E"

Also posted at: http://scoutbanana.org/health-in-africa/from-the-field-the-power-of-me/

When asked what my favorite part of being in Malawi is thus far, I can answer in a heartbeat: being in the field! Although I only understand six phrases in the national language of Chichewa, the experience of interacting with real people making real things happen in their communities is inspiring. We live in a world where we're taught that intelligence is in a university degree, but anyone who has interacted with these community health workers knows that is simply not true.

Recently, I had the chance to attend a site coordinators meeting. Twelve talented female community health workers (CHWs) who have been overseeing CHW involvement at several health facilities came together for a day of training, discussion, and fellowship. After opening with a prayer and reviewing the induction of new health workers, we focused on one of the most crucial components of the organization's work: M&E.

Now, perhaps you've heard "M&E" is the buzzword of the year. "M" stands for monitoring, or measuring what a program is doing. "E" stands for evaluation, or measuring the impact of the project. The idea behind the loaded phrase "monitoring and evaluation" is that any project should be periodically and systematically examined to ensure that it is accomplishing its goals and to understand its long-term impact. It is easy to propose, for example, that training community health workers will prevent HIV. But monitoring and evaluating such a project encourages us to keep track of the project: how many people are we training? What effect is the training having? Is the knowledge translating into action? What impact does our project have on its overall goal of decreasing HIV incidence over time? In the words of a former professor, monitoring answers "Am I doing the right things?" while evaluation looks at "Am I doing the right things?"

I know it may sound like unnecessary technical jargon, but M&E is so valuable because it can drastically improve the way we approach health worldwide. Instead of just pouring resources into a random project that "sounds good," utilizing both monitoring and evaluation strategies can encourage us to critically think about how we approach these projects and how we can improve them so as to help the people we seek to serve. Of course, with any methodology come additional challenges: how do we encourage the collection of quantitative AND qualitative data? How can we begin to measure nebulous concepts such as "empowerment" and "community participation?" And these are some of the issues that I hope to contribute to over the course of the year.

Perhaps what was most exciting about the field visit was watching the commitment and engagement of the 12 women present. They were quick to identify differences between the old and newly-introduced M&E tools; they successfully summarized and tabulated required data for the past week. The workshop was not without questions or challenges, but these women who are "living positively" were eager and committed to enhancing their skills so as to improve their advisory roles. They provided hope that contrary to so many existing models – where an outsider is deemed more capable of tabulating data and measuring indicators and where HIV infection is considered a death sentence – women from these communities can be trained and utilized as valuable resources towards improving the health of themselves and those around them.

Outside the training venue.

Preparing to start the training.

The National Trainer and Regional Manager prepare for
today's meeting.

The National Trainer intently listens to issues brough up
by the coordinators.

Two site coordinators evaluate the new M&E tools while
enjoying snacks.

Coordinators examining new tools.

Coordinators listening as another colleauge speaks, as one
carries her baby on her back.

One site coordinator completes the new Tally Sheet by
summarizing client information from the week.

The National Trainer double checks the coordinators' work
to ensure comprehension.

A team of amazing women!