Publication: Influence of participatory monitoring and evaluation on decision-making in maternal and newborn health programs in Mombasa county, Kenya
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2023-10
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Mount Kenya University
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Abstract
Improving Maternal and Newborn Health (MNH) is crucial to attaining the SDGs and Kenya
Vision 2030. Both demand and supply-side issues exist in environments where maternal and
neonatal mortality is high. Participatory Monitoring and Evaluation (PM&E) systems are
critical for recognizing these difficulties, which may then be minimized to save lives.
Participatory M&E of health programs enables information collecting and sharing with
community stakeholders, service providers, and county and national decision makers. As a
result, this impacts decision-making and action by numerous stakeholders in order to achieve
community emancipation, effective administration of health systems, resource allocation based
on need, and responsibility for meeting health obligations. This study assessed the utilization
of PM&E approaches and its influence in decision making in MNH programs in Mombasa
County. The specific objectives included determining the influence of utilization of PM&E
approaches at the program initiation phase on the quality of decision making in MNH programs
in Mombasa County; assessing the influence of utilization of PM&E approaches at the program
design and planning phase on the quality of decision making in MNH programs in Mombasa
County; and evaluating the influence of utilization of PM&E approaches at the program
implementation phase on the quality of decision making in MNH programs in Mombasa
County. A descriptive cross-sectional study was conducted using mixed methods research
approach. The research was conducted at Mombasa County's 36 level 2 and 3 public health
facilities. Purposive and stratified random sampling techniques were used to select 390
participants from a target population of 2521 county and sub-county reproductive health
coordinators, nurses, community health workers, maternity patients, facility in-charges, and
members of health facility management committees. Data was gathered from 349 survey
respondents and 7 interviewees through the use of a structured questionnaire, modified Quality
of Decision-Making Orientation Scheme (QoDoS), and key informant interviews, and
descriptive and inferential statistics were used to analyze the data. At a significance level of
0.05, associations between variables were determined using the phi correlation coefficient and
binary logistic regression. The results revealed that the odds of quality decision making
occurring were higher when PM&E approaches were utilized at the initiation (φ = 0.164, OR =
1.728, p < 0.05), design and planning (φ = 0.203, OR = 2.977, p < 0.05), and implementation (φ
= 0.199, OR = 5.665, p < 0.05) phases of MNH programs than when the PM&E approaches
were not utilized. The study concludes that utilization of PM&E approaches had a significant
effect on quality of decision making in MNH programs in Mombasa County. On the basis of
the research findings, I recommend that the department of health in Mombasa County should
adopt PM&E approaches in MNH programs’ initiation, design and planning, and
implementation phases in order to benefit from rational, timely, and relevant information for
decision-making, and thus improve on delivery of MNH services.
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Improving Maternal and Newborn Health, management, inferential statistics, committees