Addis Ababa University, College
of Health Science, School of
Public Health, Dep’t of Health
Services Management & Health
Policy, Health Economics Unit
Module Title: Health Project Management
Credit Values of the Module – 3.5 ECTS
Module Code: PHSM 672
Unit 3: Project monitoring and evaluation
1) Introduction
• In the previous units of this module you have learned about how to formulate,
design and implement different health related projects and in the remaining units
you will get detailed insight into evaluation, dissemination and project closure.
• Also you will have seen, in Units 1 and 2, how monitoring is built into the design of a
project, through the project planning matrix and the project brief.
• Monitoring should therefore take place at key points throughout your project.
Monitoring requires effective communication, and you will have learned how to
maintain communication channels in Unit 4.
• This unit will brief and equip you with the concepts and skills that will help you to
learn how to monitor progress over time and control a project. Control systems are
essential in managing a project of any size, to ensure that the project achieves its
intended outcomes.
• Monitoring and evaluation are similar activities, but have very different purposes.
We will explore monitoring in this unit and evaluation in Unit 6. To start, however,
Project monitoring and evaluation … Continued
Learning outcomes: After studying this unit you will be able to:
Knowledge and understanding
• explain the purpose of monitoring and evaluation, and recognise the essential differences
are between them
• explain and justify the role of monitoring in controlling a project.
Practical and professional skills
• monitor, and recommend adjustments to, activities, resources and plans
• compare current progress to predict future performance
• use constant monitoring to keep a project on track towards reaching its goals.
2) Project monitoring and evaluation
2.1 Introduction to project monitoring and evaluation
• Monitoring and evaluation are integral stages in the project cycle management. Monitoring
is an ongoing data collection and follow up process during project implementation, while
evaluation occurs periodically to assess the project efficiency, effectiveness and to make
judgments. The differences between monitoring and evaluation are summarised in Table 1.
Project monitoring and evaluation … Continued
Table 1 Differences between monitoring and evaluation:
Attributes Monitoring Evaluation
Frequency Continuous Episodic/periodic
Answers the question ‘What is going on?’ ‘Why do we have the results indicated
by the monitoring data?’
Method Follows trends, compares actual Compares achievements with
performance with targets counterfactual
Performed by Internal Internal and External
Uses Alerts when to take action Provides detailed information on what
types of actions to take
Focus in general Tracking performance Judgment, learning, merit
Source: Jhpiego (2014), Module 9 – Health Project Management, The Open University, Walton Hall, Milton
Project monitoring and evaluation ... Continued
• Adrien and Jobin (2008) acknowledge that contemporary discussions in the
international development arena have broadened the scope and design of
evaluation, from an earlier, narrower focus on projects or programmes to broader
assessments that encompass policy, policy coherence, and development
outcomes.
• At the same time, there has been increasing pressure to make evaluation central
to a country’s own development process and more relevant and meaningful to
the people whose lives are affected by development interventions.
• The field of evaluation is being reshaped by the evolving context of international
aid, and particularly, by the emerging recognition that effective development
assistance requires that donor agencies respect partner country leadership and
help strengthen their capacity to exercise it.
• Country-led evaluation is a relatively new concept, and one that reflects the
world’s growing recognition of the importance of a nation’s self-determination in
its own development.
Project monitoring and evaluation … Continued
• Conventional forms of evaluation, typically mandated and funded by development
agencies, are now being challenged by emerging independent forms of assessment
which put the recipient country in the driver’s seat.
• The rationale for Country-led evaluation is clear, but the question now is how to do it.
What are the obstacles to Country-led evaluation? What needs to be done to support
it?
• Adrien and Jobin (2008) present an analysis of enabling factors and barriers to
Country-led evaluation, based on the outcome of recent regional consultations in
Eastern Europe and Africa.
• Aid agencies are required to conform to stringent project reporting requirements in
order to satisfy the wide range of stake-holders. Project monitoring and evaluation
(M&E) information systems (IS), frequently a requirement for funding, are believed to
inform the reporting process (Crawford and Bryce, 2001).
• The logical framework approach (LFA) is widely used throughout the aid industry for
project design and appraisal, and although much of the literature also promotes the
use of the LFA for the purposes of M&E, it has proved inadequate (Ibid, 2001).
Project monitoring and evaluation … Continued
2.2 The role of project monitoring
• During project implementation it is very rare for any project to go exactly
according to plan. In fact it is not uncommon for a project to take on a direction
and a momentum that was completely unanticipated during planning.
• Hence, project managers have the important and difficult task of establishing
sufficient control over the project to ensure that it stays on track to achieve its
objectives.
• This is done by monitoring, which can be defined as the systematic and
continuous collection, analysis and use of information for management control
and decision making (Information Training and Agricultural Development, 1999).
• The implementation schedule, or the activity and resource schedules, provides
the basis for monitoring. One of the practical questions that arise frequently in
implementation and monitoring of a project is ‘What should be monitored and
controlled?’
Project monitoring and evaluation … Continued
• There are two forms of project monitoring that should be addressed – process and
impact monitoring. Process monitoring reviews three main aspects of a project:
1. the physical delivery of structures and services provided by the project (activities)
2. the use of structures and services by the target population (outputs)
3. the management of financial resources.
• Conversely, impact monitoring focuses on the progress of the project towards
achieving the project purpose and the impact of the project on different groups of
people.
• The process of data collection, particularly with regard to impact assessment, should
facilitate participation by a cross section of stakeholders.
2.3 Monitoring as control
• The basic success factors in monitoring progress and controlling the project include
monitoring progress against plan; holding effective review meetings; combining
responsibility with authority; and understanding the purpose of control (Turner, 2009).
Project monitoring and evaluation … Continued
• Knowing the focus of, and who is responsible for, monitoring is also essential for the
monitoring to be conducted effectively.
• To achieve control you need a plan that indicates what should happen and
information that tells you what is actually happening. By comparing the information
about actual progress against the plan, you will be able to identify any variations.
• You can control the project by taking action to correct those deviations from the
plan that can be controlled, or by revising the plan in the light of new knowledge or
environmental change. If the plan is clear about what should be achieved and when,
it is possible to monitor progress to be sure that each outcome is of the right quality
and achieved at the right time.
• The purpose of control is neither to hold meetings nor to punish people for failing to
achieve the plan. If people believe that is the purpose of control they will withhold
information.
• The purpose is to monitor progress, to compare progress to the plan and to take
necessary action to achieve the project’s goals.
Project monitoring and evaluation … Continued
• That requires people to be open and honest about progress on the project. If people
know they are reporting progress because it is time to report progress, and the
information will be used to help and support them, they will be more willing to give a
true picture of progress.
• Monitoring poses the question ‘Are we doing the project correctly?’ Its purpose is to
alert management to any problems that arise during implementation.
• Monitoring works within the existing project design, focusing on the transformation of
inputs and activities to outputs. It ensures that inputs are made available on time and
are properly utilised. If any unexpected results are observed, their causes are noted
and corrective action identified in order to bring a project back onto target.
• Monitoring focuses on tracking control parameters or key performance indicators
(KPIs), which measure progress towards achievement of the success criteria. It is not
an activity that is solely carried out by the project manager.
• If the project team is meeting regularly to review progress, monitoring becomes more
dynamic and changes to the plan can be achieved by consensus. Involving the team
not only helps to keep everyone on target – it also builds commitment.
Project monitoring and evaluation … Continued
Box 1 Checklist for regular project monitoring: the following basic issues need to be monitored regularly and
periodically:
1) Are the activities taking place as scheduled? Which activities are underway and what progress has been
made (e.g. at weekly intervals)?
2) At what rate are funds being used and costs incurred in relation to progress in implementation (e.g.
monthly)?
3) Efficiency: are the desired results/outputs being achieved (e.g. quarterly update)?
4) Effectiveness: to what extent are these results/outputs furthering the project purpose (e.g. half-year
analysis)?
5) Ownership: how are the beneficiaries responding to the project?
6) Identify possible causes of differences between actual and target performance. Were the original targets
realistic?
7) Have any unexpected outputs arisen? Should they be included in a revised logical framework (see lecture)?
8) Are the assumptions identified in the logical framework relevant or do the assumptions hold true? Have any
killer assumptions emerged? Have any new risks appeared?
9) Are there changes in the project environment? (i.e. changes of key stakeholder groups, local strategies and
policies, etc.)
10) What is the likely achievement of the project purposes?
11) Recommend corrective action that would improve the implementation of the existing project.
Project monitoring and evaluation … Continued
2.4 Steps of managerial control
• Control is the process of regulating service activities so that your performance conforms to
expected standards and goals, and ensures that the necessary corrective action is taken
whenever deviations occur.
• In health project managerial terms, control ensures that your health work is accomplished
according to agreed action plans. It is a process of ensuring that the work that you do
produces the desired results.
• Control is a continuous activity. For instance, health extension practitioners in Ethiopia
control local primary health care services and the resources used in order to minimise
mistakes, inefficiency and wastage.
• According to Information Training and Agricultural Development (1999), control is a basic
managerial function involving the following four essential steps:-
1) Identifying target performance indicators
2) Measuring performance
3) Comparing performance to the plan and forecast future results
Project monitoring and evaluation … Continued
References
1. Bill Jackson (2015), Designing Projects and Project Evaluations Using The Logical Framework Approach, Logical
Framework Approach – Guideline, ResearchGate, Accessed June 01/2020:
https://www.researchgate.net/publication/265012218_Designing_Projects_and_Project_Evaluations_Using_The_Logi
cal_Framework_Approach
2. Chapman, J. (2007) Work Breakdown Structure (WBS), Available Online and Accessed 11 July 2014 at:
http://www.hyperthot.com/pm_wbs.htm
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Management, Fourth Edition, Gower eBook, Gower Publishing Limited, Gower House, Hampshire GU11 3HR, England,
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4. Federal Democratic Republic of Ethiopia Ministry of Health (No date) Health Management, Ethics and Research:
Blended Learning Module for the Health Extension Programme, http://labspace.open.ac.uk/course/view.php?id=7320
5. Food and Agriculture Organization of the United Nations (FAO) (2001) ‘Project Cycle Management Technical Guide’,
Socio-Economic and Gender Analysis (SEAGA) Programme, United Nations.
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development results, UNICEF. Available Online and Accessed 6 th of September 2021 at:
https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.446.9357&rep=rep1&type=pdf#page=111
7. Marie-Helene Adrien and Dennis Jobin (2008) Country-Led Evaluation, In Ed., UNICEF (2008), Bridging the gap: The
role of monitoring and evaluation in evidence-based policy making, Marco Segone, Senior Regional Monitoring and
Evaluation Advisor, Available Online and Accessed May 28/2020 at:
Project monitoring and evaluation … Continued
8) Martin, V. and Dixon, K. (2006) Managing Performance and Change Block 3 Managing Projects and Change,
Sessions 1 to 3, 2nd edn. Milton Keynes, The Open University.
9) Paul Crawford and Paul Bryce, (2003). Project monitoring and evaluation: a method for enhancing the efficiency
and effectiveness of aid project implementation, International Journal of Project Management 21 (2003) 363–373
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Development), Training Action for Project Cycle Management, West Sussex, UK, Accessed May 28/2020 at:
https://caricom.org/wp-content/uploads/EC_PCM_Training_Handbook.pdf
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Development Projects, Czech University of Life Sciences, Prague, Czech Republic, Accessed May/2020 at:
http://www.dww.cz/docs/pcm_handbook_2018.pdf
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Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com, Vol. 2, Issue 2, Mar-Apr 2012,
pp.683-686
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Organizations, 3rd edn, New York, McGraw-Hill.
15) Walmsley, S. (1996) ‘Project management as a tool in implementing major organisational change: a case study’,