Tracking Our Progress: A Look into Monitoring & Evaluation at SVH

As Monitoring and Evaluation Coordinator for Sacred Valley Health, it is always a pleasure to see the ways in which our program is growing, and also to recognize the ways in which we can use the data we collect to further improve.

Since our first promotora (community health worker) training in October 2012, we have significantly refined our program model. The two biggest changes have been transitioning from a 2-year training cycle with monthly trainings to a 1-year cycle with bi-monthly trainings and changing the order of our trainings to ensure that we frontload first aid and signs of alarm for pregnant women so that promotoras can immediately get to work in their communities.

In the table below, view how program has grown and our progress so far!

Program Snapshot (March 2014 Update)
Cycle 1 Cycle 2
Start Date October 2012 September 2013
Communities 5 9
Residents Serving 680 887
Promotoras Started 11 11
Total Trainings (Hours) 16 Trainings (80 hours) 10 Trainings (50 hours)
Total General Assembly Presentations 29 9
Total Secondary Presentations 18 7

As our organization grows and evolves, it is important that our monitoring and evaluation efforts inform the decisions we make. Below are some of the ways that Sacred Valley Health assesses programming to develop action plans:

Community Health Assessments

Before SVH enters a community, we conduct household surveys on health habits, home infrastructure (toilets, running water, chimneys, etc.), and health ailments in each household and what the inhabitants view as the big health issues in their community. Then we create a community-specific action plan reflecting the ways we can address the issues the data reveals. For example, after noting the limited dietary options in some of our high altitude communities, we decided to seek partnerships to create greenhouses to increase access to more nutritious foods.

We also monitor health issues within our communities through health campaigns and ficha (patient) forms. During campaigns, visiting medical professionals conduct physical exams and make referrals when needed to our partner clinics, such as the local posta or the nonprofit clinic Kausay Wasi. This information is then compiled in reports that we share with our health campaign partners, and will soon be entered into an Electronic Medical Records system called OpenMRS, that we can then use to keep track of patient information.

A young Ollantaytambo resident has her blood pressure checked.
A young Ollantaytambo resident has her blood pressure checked.

Our promotoras are responsible for seeing patients in their communities and bringing a form (that is picture based) to provide us information on who they saw and what problem they addressed. This data is compiled in a chart to show what the conditions are (the promotoras treat lots of cuts!), and we also create charts showing how these conditions change over time. SVH’s Community Coordinators can then make suggestions on potential presentation topics and when appropriate, we can target health campaigns to address these issues. This information will also be entered in to OpenMRS.

Monitoring Promotora Progress

Community Coordinators work individually with promotoras to assess knowledge of each training topic.
Community Coordinators work individually with promotoras before and after each training to assess knowledge of the topics being covered.

Since the focal point of our organization is the training of health promoters, it is essential that we keep track of their progress on tests, presentations, and patient work. Starting this spring, Sacred Valley Health staff members came up with ways to better keep coordinators informed of the progress of their promotoras by implementing a star chart system, in which at each training health promoters are shown their progress on a certain set of indicators (test scores are not included) and receive a Gold star – Excellent, Blue star – Average/Expected, or Red star – Need to Improve.

Promotora star chart
Promotora star chart

In addition, we compile quarterly community reports that track the four indicators of promotora progress. These indicators are: training attendance, post-test grades, number of presentations each promotora has given in the community (General Assemblies and Secondary Presentations), and finally the number of patients seen. With the star charts and reports, promotoras and coordinators are able to better work together to address areas for improvement that will ensure promotora success.

Stay tuned for a future program impact assessment report. We look forward to sharing the successes of our program and future improvements we will make as we continue to work on providing healthcare access to communities throughout the Sacred Valley!

– Written by Ayo Oti

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