Evaluating Capacity Building for Monitoring & Evaluation in Low- and Middle-Income Countries: A Performance Monitoring Plan

ABSTRACT Victoria Taffe: Evaluating Capacity Building for Monitoring & Evaluation in Low- and Middle-Income Countries: A Performance Monitoring Plan(Under the Direction of Lori Evarts)Background/Objectives:This paper will define and describe the benefits of monitoring and evaluation (M&E), explain capacity building for M&E in the context of global health interventions in low- and middle-income countries (LMICs), and propose a performance monitoring plan (PMP) for a case study of the capacity building provided by US-based non-governmental organization (NGO) MiracleFeet to their implementing partner (IP) in Tanzania. The paper will address the following objectives: 1. To provide a clear example of a PMP, a standard approach for outlining components of an M&E plan, to help global public health leaders think through evaluation approaches to clarify the value of capacity building for M&E2. To provide recommendations and key considerations for global public health leaders who are exploring evaluation of their own M&E capacity building efforts in LMICs3. To contribute to increased clarity and greater understanding within global health of how to assess the value of donor organizations’ capacity building provision for M&E to their in-country IPs.Methods:Before determining an evaluation approach for the PMP, it was essential to first understand the elements and activities that comprise capacity building for M&E. For the purposes of this paper, which focuses on work in global settings, this foundational knowledge was rooted mainly in the United Nations Development Programme (UNDP) Handbook on Planning, Monitoring and Evaluating for Development Results (2009). The UNDP approach to building and ensuring M&E capacity emphasizes a three-level, four-domain structure (UNDP, 2009). Another global resource was the 12 Joint United Nations Programme on HIV and AIDS (UNAIDS) component “capacity areas”, described by MEASURE Evaluation (2017) in their Monitoring and Evaluation Capacity Assessment Toolkit (MECAT) User Guide. The MEASURE Evaluation/UNAIDS model depicts rings of the organizational and human resources as part of the M&E processes as well as the necessary data tools (MEASURE Evaluation, 2017, p.2). At the core is analysis and use of data (i.e. informing decision making) (MEASURE Evaluation, 2017, p.2).Results:A PMP was developed to walk through the capacity building efforts for M&E currently being provided by the non-governmental organization MiracleFeet to their IP in Tanzania. (Several proposed capacity building activities were added to diversify the intervention for evaluation.) The PMP structure includes: ●Background/context●Description of the program/intervention (including the Conceptual Framework) ●Goals and Objectives●A Logic Model●An Indicators Matrix●A Table and Description of data sources for program monitoring●Overview of Outcome/Impact Evaluation design (time frame, sampling, strengths and limitations of evaluation design)●Overview of proposed Economic Evaluation●Overview of Stakeholder Engagement Plan●Plan for Results Dissemination and Use●Conclusions and Recommendations for global public health leaders.  Recommendations:Capacity building must begin with an assessment of the M&E knowledge and abilities of the IP organization and its staff. Additional activities support development of knowledge and abilities, all of which can be evaluated through qualitative and quantitative methods, telling a more detailed story of what’s happening on the ground. This paper provides resources that can help global health leaders organize their thinking about capacity building for M&E and how to best gauge whether their efforts are effective as a result of the activities undertaken.Conclusions:The evaluation of capacity building for M&E is necessary to ensure that an IP’s intervention activities, and the implementation approach, are as effective as possible. Increasing capacity improves organizational learning in real time from their activities through stronger data collection, reporting, and ultimate use to inform decisions; and evaluation ensures overarching organizational learning to improve and strengthen the planning and delivery of future capacity building interventions. The PMP suggests additional activities for inclusion into the current MiracleFeet approach to capacity building for M&E (the intervention). The addition of these activities could be a limitation if it overwhelms the IP and consequently negatively impacts their experience in the other activities or takes too much time away from conducting clinical protocols. Future work could expand the preliminary discussion on cost-effectiveness analysis, which can be conducted for each activity that comprises the capacity building for M&E approach.Master of Public Healt

Reelin deficiency contributes to long-term behavioral abnormalities induced by chronic adolescent exposure to Δ9-tetrahydrocannabinol in mice

Cannabis use is widespread among adolescents and has been associated with long-term negative outcomes on neurocognitive functions. However, the factors that contribute to the long-term detrimental effects of cannabis use remain poorly understood. Here, we studied how Reelin deficiency influences the behavior of mice exposed to cannabis during adolescence. Reelin is a gene implicated in the development of the brain and of psychiatric disorders. To this aim, heterozygous Reeler (HR) mice, that express reduced level of Reelin, were chronically injected during adolescence with high doses (10 mg/kg) of Δ9-tetrahydrocannabinol (THC), a major psychoactive component of cannabis. Two weeks after the last injection of THC, mice were tested with multiple behavioral assays, including working memory, social interaction, locomotor activity, anxiety-like responses, stress reactivity, and pre-pulse inhibition. Compared to wild-type (WT), HR mice treated with THC showed impaired social behaviors, elevated disinhibitory phenotypes and increased reactivity to aversive situations, in a sex-specific manner. Overall, these findings show that Reelin deficiency influences behavioral abnormalities caused by heavy consumption of THC during adolescence and suggest that elucidating Reelin signaling will improve our understanding of neurobiological mechanisms underlying behavioral traits relevant to the development of psychiatric conditions