In 2013, the Bill & Melinda Gates Foundation launched two programs to help monitor progress toward a new global goal to increase modern contraceptive use by 2020: Performance Monitoring and Accountability 2020 (PMA2020) and Track20. This evaluation of both programs is based on interviews with more than 260 stakeholders, statistical analysis of the PMA2020 survey, and analysis of stakeholder ratings of data maturity and sustainability.

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Evaluation of Two Programs Supporting Global Family Planning Data Needs

Assessing Achievements, Informing Future Directions

by Melinda Moore, Laura J. Faherty, Shira H. Fischer, Kathryn E. Bouskill, Julie DaVanzo, Claude Messan Setodji, Bill Gelfeld, Emily Hoch, Luke J. Matthews, Sarah Weilant, et al.

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Research Questions

  1. How well are the PMA2020 and Track20 programs functioning now?
  2. What changes to the design of PMA2020 surveys might improve their use?
  3. How do stakeholders view PMA2020 and Track20 (including their perceptions of the level of data maturity in program countries)?
  4. Are the two programs sustainable?

In 2013, the Bill & Melinda Gates Foundation launched two programs to help monitor progress toward a new global goal to increase modern contraceptive use by 2020. The Performance Monitoring and Accountability 2020 (PMA2020) program aimed to support annual, rapid-turnaround, nationally representative surveys of households and service delivery points in nine countries. Track20 was designed to support global standardization of key family planning indicators and country-level monitoring and capacity-building in 22 countries. This evaluation of both programs is based on interviews with more than 260 stakeholders in the United States and 15 program countries, statistical analysis of the PMA2020 survey, and analysis of stakeholder ratings of data maturity and sustainability.

Stakeholders felt that PMA2020 has successfully conducted annual, rapid-turnaround surveys with high-quality data. However, it has not fully achieved its original objectives of promoting data use, meeting local data needs, or integrating PMA2020 into country data systems. The team's statistical analysis of PMA2020 surveys identified opportunities for modifications in survey frequency, design, and content. Stakeholders felt that Track20 is on target to achieve most of its objectives. Monitoring and evaluation officers are the core of Track20 in program countries: They are highly skilled personnel, typically embedded within ministries of health, giving them ready access to decisionmakers. The RAND research team recommended that both programs promote country-driven agendas for data collection, use, and ownership; intensify focus on data use; and plan for and measure data maturity and data system sustainability. The research team also recommended a new program — Data for Action Training Activity for Family Planning (DATA-FP) — to increase country capacity for data system management.

Key Findings

PMA2020

  • PMA2020 household surveys could be fielded every 12 months instead of every six months.
  • Stakeholders would like data from the service delivery points more frequently than annually.
  • Stakeholders want more geographically granular data.

Track20

  • The program is on target to achieve most of its original objectives.
  • Monitoring and evaluation (M&E) officers are often stretched very thin, and there is a need for continued capacity-building among decisionmakers to facilitate data use.

Data Use

  • Gates Foundation staff felt that the demand for data had come from the global level, making it more difficult to integrate data needs arising at the country level.
  • Nonetheless, in-country stakeholders asserted that the data were invaluable for a variety of uses, including program planning and forecasting commodity needs.

Data Maturity

  • In-country respondents noted the inadequate capacity of some decisionmakers in their country to interpret data.
  • PMA2020 and Track20 fell into the developing level of data maturity in most countries. Data management, data analysis, organizational readiness, institutionalization, ownership, and data use can be improved.

Sustainability

  • Financial sustainability is critical for PMA2020 because of the resource intensity of launching surveys.
  • Technical sustainability ratings highlighted the need to ensure hardware and software maintenance, and interview data highlighted the need for more well-trained M&E personnel.
  • Operational sustainability is enabled by leadership buy-in and cultural acceptability and impeded when key stakeholders do not understand or use the data, policymaker needs are not met, and local communities are not consulted with regard to survey planning and implementation.
  • Data culture is enabled when data use impacts outcomes and is impeded when there are inadequate numbers of data professionals with sufficient technical capabilities.

Recommendations

Overarching Recommendations

  • Promote country-driven agendas.
  • Intensify focus on data use.
  • Plan for and measure data maturity.
  • Plan for and measure sustainability.
  • Institutionalize countries' data capacity development.

Program-Specific Recommendations for PMA2020

  • Reorient and operationalize the program to better align with program objectives.
  • Engage key partners in active data dissemination.
  • Enhance PMA2020's survey design.
  • Broaden the PMA2020 platform and seek cost efficiencies to attract co-financing.

Program-Specific Recommendations for Track20

  • Intensify focus on generating actionable data at different levels in increasingly decentralized health systems.
  • Improve and expand use of the Family Planning Estimation Tool.
  • Optimize the M&E officer model.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Background

  • Chapter Three

    Methods

  • Chapter Four

    Assessment Frameworks

  • Chapter Five

    Stakeholder Views on Family Planning Data Needs

  • Chapter Six

    PMA2020 Goals, Accomplishments, and Challenges

  • Chapter Seven

    Statistical Properties of PMA2020

  • Chapter Eight

    PMA2020 Survey Design

  • Chapter Nine

    Track20 Goals, Accomplishments, and Challenges

  • Chapter Ten

    Interactions Between PMA2020 and Track20

  • Chapter Eleven

    Data Use

  • Chapter Twelve

    Data Maturity

  • Chapter Thirteen

    Sustainability

  • Chapter Fourteen

    Conclusions and Recommendations

  • Appendix A

    Details of PMA2020 Sampling Procedures

  • Appendix B

    Indicators Collected by PMA2020, FP2020, and DHS

  • Appendix C

    Comparison of Selected Family Planning Data Sources

  • Appendix D

    Additional Background on Logic Models

  • Appendix E

    Additional Background on Data Maturity Models

  • Appendix F

    Additional Background on Sustainability Enablers

  • Appendix G

    Contextual Information on the 15 Countries Evaluated

  • Appendix H

    Additional Detail on Statistical Methods and Country-Specific Analyses

The research described in this report was conducted by RAND Health and supported by the Bill & Melinda Gates Foundation.

This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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