CONTEXT OF DECISION MAKING

Session 3

Session Objectives
Explain the context of decision making Define the concept of stakeholders Explain the importance of involving stakeholders throughout the data use in decision-making cycle Introduce the Stakeholder Analysis and Engagement tools

Session Overview
Context of decision making
Stakeholders Decisions Data

Small Group Activity 3: Stakeholder Analysis and Engagement

Group Participation
How can we ensure that information is being used to make diagnoses and inform decisions?

Context of Decision Making

Data

Stakeholders

Decisions

Context of Decision Making

Data

Stakeholders

Decisions

What Is a Stakeholder?
Any person, group, or organization with a particular interest in a policy or program
Government agencies Beneficiaries Policymakers Funding agencies Providers / implementers Civil society Researchers M&E specialists

Stakeholders
Nongovernmental organizations
Professional associations Religious leaders Journalists/media Private sector/business

Data Producers vs. Data Users

Data producers think that decision makers: Value political considerations over evidence Are unprepared to measure or evaluate the consequences of their decisions Decision makers or data users think that health researchers and M&E specialists: Lack responsiveness to priorities Favor numbers / jargon over transparent communication Prefer written reports to face-to-face conversation

Importance of Knowing Your Stakeholders

View activities from different perspectives
Have different degrees of understanding

Need / want different information

Need information at different levels of complexity Have different intensities of interest Have different roles in the decision-making process

Results of Involving Stakeholders in Data Use Process

Relevance of data Ownership of data Appropriate dissemination of data Use of data

Stakeholder Analysis Matrix & Engagement Plan

Clarify who has interest in a program and what that interest is Identify who can help a program and how, and who can hurt it Help you use this information for the success of the planning effort

Stakeholder Analysis Matrix

The Stakeholder Analysis Matrix is a framework and process for:
Identifying stakeholders Defining their roles and resources Identifying dynamics among stakeholders Setting the optimum stakeholder group

Stakeholder Analysis Matrix

Name of Stakeholder organization, group or individual Stakeholder description Primary purpose, affiliation, funding Potential role in the issue or activity Level of knowledge of the issue Level of commitment Support or oppose the activity, to what extent, and why? Available resources Staff, money, technology, information, influence

Stakeholder Analysis Matrix

Program issue Proposed activity Date
Name of stakeholder organization, group, or individual

Develop plan (inc. M&E plan) to scale up PMTCT programs throughout system. Convene stakeholders to identify priorities based on available data and develop action plan. November 2006
Stakeholder description Primary purpose, affiliation, funding Potential role in the issue or activity Level of knowledge of the issue Level of commitment Support or oppose the activity, to what extent, and why? Available resources Staff, money, technology, information, influence

National AIDS Control Committee (NACC)

Involved in planning, implementation, M&E of all HIV/AIDS programs in the country; approves donor and NGO-funded HIV/AIDS programs

Facilitates the stakeholder meeting, prepares for meeting by identifying data sources and preparing an agenda

High receives reports on PMTCT activities from MCH division at MOH; Medium level of knowledge of intl guidelines and studies

Strongly supports activity but hesitant to use international data sources. NACC opposes use of the DHS and most recent international estimates, as it considers these sources to overestimate HIV prevalence

Staff available to facilitate; room and computers available for meetings at NACC headquarters

How to Involve Stakeholders

Quarterly program management meetings
Quarterly meetings to interpret RHIS data
Involvement of facility staff to interpret program data

M&E system improvement

Indicator planning and/or harmonization Data quality review meetings

Stakeholder Engagement Plan

Program issue Proposed activity Date Stakeholder organization, group, or individual Potential role in the activity Engagement strategy How will you engage this stakeholder in the activity? Follow-up strategy Plans for feedback or continued involvement

Stakeholder Engagement Plan

Program issue Proposed activity Date Develop plan (inc. M&E plan) to scale up PMTCT programs throughout system. Convene stakeholders to identify priorities based on available data and develop action plan. November 2006

Stakeholder organization, group, or individual

Potential role in the activity

Engagement strategy How will you engage this stakeholder in the activity?

Follow-up strategy Plans for feedback or continued involvement

National AIDS Control Committee (NACC)

Facilitates the stakeholder meeting, prepares for meeting by identifying data sources and preparing an agenda that allows for the sources to be discussed

The NACC is the lead in this activity. It will be important for the NACC to involve more specifically the PMTCT coordinator, clinical care coordinator, and National AIDS Program Coordinator

The NACC is responsible for following up with the prioritized stakeholders

Context of Decision Making

Data

Stakeholders

Decisions

Decision Areas
Program design and evaluation Program management and improvement Strategic planning Advocacy and policy development

Program Design and Evaluation

Design
Select messages for prevention campaigns

Evaluation
Determine if new program approaches are needed to ensure that health impact objectives are met

Program Management and Improvement

Management
Determine if the program is meeting its process objectives

Improvement
Develop new strategies to increase coverage

Strategic Planning
Identify geographic areas of highest need Determine human resource allocation

Determine which of offered services is making the greatest impact

Advocacy and Policy Development

Identifying and quantifying underserved populations Identifying focus areas for new policies

Context of Decision Making

Data

Stakeholders

Decisions

Data and Information

Census Vital events data Surveillance data Household surveys Facilities-level service statistics Financial and management information Modeling, estimates, and projections Health research

Factors Other than Data that Influence Decisions

Arbitrariness Competing Priorities
Stakeholders
Data

Political Ideology

Public Opinion
Decisions

Power Relationships

Strengthening the Decisionmaking Process

Stakeholders

Involve new counterparts

Decisions

Understand service delivery realities

Data

May require additional data

Key Messages
Every decision is made in the context of available data and stakeholders Critically assessing and involving stakeholders will facilitate data-informed decision making

Small Group Activity 3: Instructions

Break into small groups. Each group should select a decision that they make in their work settings and complete the Stakeholder Analysis Matrix around that decision. A minimum of 7 stakeholders should be identified.

Complete the Matrix across the columns for 12 stakeholders.

Select 1 stakeholder and complete the Stakeholder Engagement Plan for that stakeholder. Time for activity: 45 minutes

Group Work Report Back

Have note taker transfer your final Stakeholder Analysis Matrix onto flip chart paper Share the decision your group chose Share the priority stakeholders selected

Choose 1 stakeholder and share the entire row from the Matrix for that stakeholder
Share the Engagement Plan for the same stakeholder Time for report back: 1015 min per group

THANK YOU!
MEASURE Evaluation is a MEASURE project funded by the U.S. Agency for International Development and implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill in partnership with Futures Group International, ICF Macro, John Snow, Inc., Management Sciences for Health, and Tulane University. Views expressed in this presentation do not necessarily reflect the views of USAID or the U.S. Government. MEASURE Evaluation is the USAID Global Health Bureau's primary vehicle for supporting improvements in monitoring and evaluation in population, health and nutrition worldwide.

Visit us online at http://www.cpc.unc.edu/measure