Capturing In-Country Specifics and Inter-Country Diversity in a Global PMP: Approaches and lessons

The LMG Project is a global health systems strengthening project with many individual country-level projects. Unlike service delivery approaches such as immunizations, antenatal care provision, or HIV or TB treatment, health system strengthening interventions are shaped by the context of the health system itself. So, an approach in country A to build leadership capacity and skills may look very different from an approach with the same goals in country B.

As country-level projects are awarded, each has a unique Performance Monitoring Plan (PMP) that maps to their workplan and technical approach and is specific to the country context. However, we also report LMG’s results in an aggregate, global PMP, so country-level PMPs must roll up to the global report. Since country-level projects are frequently awarded to the LMG Project, we needed to rethink our PMP for several reasons:

  • The indicators did not adequately capture the range of our project work. There were some global indicators that no longer mapped to the project’s technical strategy or approach, so they were removed, while other indicators needed to be tweaked. Additionally, country buy-ins during the first two years of the project had generated work that was not adequately captured by the existing indicators, so some new ones were developed.
  • Some indicators were being interpreted differently. With a global project and over 400 staff members, each indicator needs to be specific and very clear. Through this exercise, we found that some of our indicators were being interpreted inconsistently, based on the context of the project. As such, we needed to provide more clarification about “what counts” and “what does not count.”
  • Many targets had already been surpassed, and others were unlikely to be reached. We needed to go back and check the assumptions on the basis of which targets had been set. We wanted to see which of these assumptions still held true and could hold true for the remainder of the project.

Working closely with our USAID AOR team, we reviewed project reports, consulted M&E advisors from other global projects, reviewed external resources, and developed detailed Indicator Reference Sheets (IRSs) – brief reference guides with definitions of all key terms, guidance on data collection and reporting, notes on baselines and targets, data quality concerns, and linkages between indicators and data use.

Ultimately, we created a revised PMP with 36 indicators – 23 fewer indicators than in our previous PMP. Staff feedback has been positive: the new PMP is more clear and concise than the earlier version, and the IRSs are extremely helpful with reporting. With this renewed clarity and guidance, the LMG Project not only has greater confidence in its reports, but also that the results achieved in diverse country projects and at the global level are shared.

Many other projects have probably had similar experiences. Have you ever had to align a global or country-level PMP for a health systems strengthening project? We want to hear from you!

Also in this edition:

Building Local Capacity One Indicator at a Time by Donal Harbick and Dr. Paul Waibale

Performance Management Plan Development Experience and Lessons Learned by Dr. Ataullah Saeedzai

Data for Design: Using Data to Improve the Virtual Leadership Development Program by Mariah Boyd-Boffa, Elizabeth Duncan McLean, and Dr. Reshma Trasi