How to strengthen the Monitoring and Evaluation System to improve Compassionate, Respectful, and Caring services in Ethiopia: An implementation study

Abstract

Background: Monitoring and Evaluation (M&E) practices have a key role in encouraging the performance of Compassionate, Respectful and Caring (CRC) initiatives. However, during the last five years, CRC implementation was given less attention, and caused to a lack of integration and oppression. Therefore, this study aimed on assessing how to strengthen the M&E system to improve the CRC.

Methods: An implementation study with a qualitative approach was conducted in three regions of Ethiopia (Oromia, SNNP,  and Sidama) and FMOH from 01 March to 30, 2021. Twenty-six key informants were interviewed using an interview guide and analyzed using open code version 4.02. Additionally, 15 health institutions were observed. The data were coded, and thematized.

Result: The finding of this research indicated that the program didn’t have scope, structure, and M&E frame works during the strategy development. Additionally, the program’s document didn’t have standardized indicators for the M & E plat forms. Besides this, the current M&E systems and current practices different from region to region and facility to facility. The finding also revealed that there are barriers to the M&E systems of the program’s implementation. The most affecting barriers are: organizational barrier (absence of standard indicators and lack of resources), behavioral barrier ( bad behavior, poor attitudes), and technical barrier (poor knowledge and difficulty in measuring). On the other hand, the finding indicated that there are good opportunities to enhance the M&E of the CRC program, such as good government commitment, availability of systems and materials, and availability of funders.

Conclusion: The M&E platforms and practices of the CRC program were not uniform across regions and facilities. Besides, the current reporting and feedback mechanisms are also different from region to region and facility to facility. Therefore, establishing a clear structure, ownership, scope, M&E framework, and standardized indicators of the CRC program is important at the national level. Moreover, preparing working documents and guidelines is also crucial for improving the program.