Sustainability, Monitoring & Evaluation
The programme will ensure sustainability in three ways.
Firstly, countries will work with WHO and ITU to share their experiences across regional groupings, spreading lessons learnt to neighbouring countries. This is something that we term “PAY IT FORWARD”— the eight countries chosen will be expected to act as champions within regional political and economic groupings, diffusing mHealth models and approaches from their experience to other countries who may benefit from a similar structure or content.
Secondly, all recipient governments will co-fund country operations. Donor governments (and their taxpayers) plus other donors to the Joint Programme will receive transparent reporting on impact. Taxpayers from donor countries will be able to track, near real time, the impact of their funds on end-users in participating countries. We believe that this model will help strengthen impact measurement in health systems and particularly philanthropy.
Thirdly, the fact that the interventions are large-scale avoids post-pilot paralysis. This is when trials for mobile health solutions are successful, but fail to be further developed, leaving numerous small, stand-alone projects. By absorbing small but successful pilot projects into a bigger health system, the solutions are able to scale up their work and collect clear evidence on the beneficial impact of their intervention. This concentrates efforts to a few key good ideas, which can be properly developed and adjusted to maximize their usefulness for an entire population.
At the end of the four years WHO/ITU will go through their normative processes and ensure that the mHealth interventions scaled through this project are standardized for the world (ITU study group process/WHO guidelines process).
Monitoring and evaluation: The Joint programme is developing a robust metric for monitoring and evaluation so that it is fully, accountable and transparent to all stakeholders in terms of impact of the intervention. The focus will be solely on interventions for NCDs that are considered “best buys” on the basis of pilot or sentinel results proving effectiveness and cost-effectiveness. An impact assessment framework will be developed for participating country projects, involving outcome-based systems to monitor progress and measure impact. Individual country projects will be evaluated using mobile technology that will feed into national information systems and central monitoring across the eight countries. This will ensure that the initiative strengthens domestic monitoring systems whilst stimulating partner collaboration at all levels. In line with WHO guidelines there will also be third party evaluations of the global and country projects.