Monitoring and Evaluation

Perinatal Care Project has developed a monitoring system to record all births and their outcomes within the 18 control and intervention unions for the duration of the project. The intention was to create a monitoring system that can be easily replicated, at low cost, elsewhere. The monitoring system comprises of two stages:

I. The Identification Stage
The system needs to be able to identify all women in our study area who have:

Two different approaches will be tested for identifying women fitting one of the above criteria (Figure 1). The first will utilise government outreach workers, called Family Welfare Assistants (FWAs), whose current role is to visit households in the community and systematically record births and outcomes.

Figure 1: The Monitoring System


The Monitors meet with FWAs once a month to collect the list of women.

For the purposes of monitoring the interventions in this project a reliable monitoring system needs to be in place, therefore a secondary system has been developed to ensure maximum identification. The second approach for identifying women will expand the role of TBAs. TBAs are responsible for conducting the majority of deliveries and are therefore in a good position to identify births.

Base line information was collected on all TBAs in our study area. We have selected 3 TBAs per ward, covering a population of 600 households in both the control and intervention wards. A selection committee comprising of the following members was involved in the selection process:

• Thana Health and Family Planning Officer
  
• Thana Family Planning Officer
  
• 1 Family Welfare Visitor (FWV) per Union
  
• 3 female member of the Union Council per Union
  
• Project Area Manager
  
• Field Supervisor
  

The committee considered the following criteria when making their selection:

• Location of household (each TBA needs to cover a separate area of 200 households, therefore it is best if they are evenly distributed throughout the ward)
  
• Number of deliveries they currently attend (more deliveries better)
  
• Mobility (they need to cover an area of 200 households so we need TBAs who are mobile)
  
• Acceptability within the community
  
• Well known with in the community
  
• Good health
  
• Ability to keep simple records, i.e. name and address of mother, date of delivery - Willingness to identify deliveries and meet our staff once a month
  
• Willingness to be trained
  
• Willingness to learn better practices
  

2. The Interview Stage

Women will be interviewed 6 weeks after delivery. They will be asked to complete a questionnaire covering background characteristics, the antenatal period, delivery, and post-partum. In the event of a stillbirth or neonatal death a verbal autopsy will be also completed. Where a maternal death is identified up to two months post-partum a verbal autopsy will be conducted. Verbal autopsies will be conducted with the mother herself (or close relative / friend in the case of a maternal death) as well as with the provider (if one was present). All eligible women identified will be snowballed - to see if they can identify any other women.

Field Surveillance Manager in dhaka office also checks the questionnaires then data entry operators will enter the data into the computer.


Data quality control:

Data Management: