FACTORS AFFECTING UTILISATION OF MONITORING AND EVALUATION FINDINGS IN PUBLIC HEALTH FACILITIES IN IBANDA DISTRICT, UGANDA

BY

ATUHEIRE DIANA

JAN/PM&E/0358U

SUPERVISOR

1. AUPAL WILFRED

A PROPOSAL SUBMITTED TO UGANDA TECHNOLOGY AND MANAGEMENT UNIVERSITY (UTAMU) IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF MASTERS DEGREE IN MONITORING AND EVALUATION

SEPTEMBER, 2021

CHAPTER ONE

INTRODUCTION

• Introduction

The study will examine the determinants of utilization of monitoring and evaluation findings within public health facilities at level III and IV in Ibanda District. For this study technical, financial, and quality factors will be the independent variables, while utilization of monitoring and evaluation findings will be the dependent variable. The chapter will focus on the background of the study, statement of the problem, purpose of study, specific objectives of the study, research questions, research hypotheses, conceptual framework, and scope of the study, significance, justification and operational definitions of key terms in the study.

1.2 Background to the Study

1.2.1 Historical Background

Evaluation is as old as the world itself and has moved side by side the journey of human civilization (Basheka, 2016). The practices of the field of evaluation can be traced as far back as the biblical times during the known creation story extensively addressed in Genesis (1:31) where the biblical account informs us that on the fifth day of creation God saw everything he had created and everything appeared good. From the philosophical works of Socrates, Plato and Aristotle to the mathematical methodologies of Pythagoras and Euclid, the ideas of the ancient Greeks shaped many institutions and contributions to many fields including evaluation (Zanakis, Theofanides, Kontaratos and Tassios, 2003). Existing scholarly accounts inform us that the Delphic oracle of the ninth to the third centuries BC was the first central intelligence database of the ancient world, an interdisciplinary think tank of approximately 90 priests, deemed the best educated experts of antiquity (Theofanides et al., 2003. They collected and evaluated information and advised ordinary people and leaders, among them Alexander the Great. Major project management in the fourth century BC existed where evaluation and monitoring were key. Griffin (2005) notes that: “The practice of management can be traced back thousands of years.  These great pyramids, which were built in 2900B.C., are a classic example of management and co-ordination. Griffin (2005) notes that: The practice of management can be traced back thousands of years. The Egyptians used the management functions of planning, organizing and controlling when they constructed the pyramids. These great pyramids, which were built in 2900B.C, are a classic example of management and co-ordination.

In the contemporary world, the international status of M&E research remains theoretically and methodologically influenced by the American tradition. The United States (US) is regarded as the motherland of the field in terms of its trends, number of authors and their academic and professional influence, degree of professionalization, focus of academic programs, legislation and institutionalization of evaluation, development of models and approaches for evaluation, evaluation capacity building initiatives, evaluation standards and guiding principles, number and attendees of evaluation conferences and workshops, publications and their impact factor, guides and evaluation handbooks (Basheka, 2016: 4). The American Evaluation Association (AEA) for example remains the most dominant evaluation society in the world with membership that has grown from just over 3000 members in 2001 to approximately 7000 by mid-2015 (Basheka & Byamugisha, 2015:76). Other countries however, equally have noticeable developments regarding evaluation. In Europe, professionalization of evaluation has progressed to different levels across countries with Sweden, the Netherlands, Great Britain, Germany, Denmark, Norway, France and Finland currently topping the list. Recent rankings further point to impressive developments of the field in Switzerland, Japan, Spain, Italy, Israel and Africa. In 2011, the International Organization for Cooperation in Evaluation (IOCE) identified 117 evaluation associations, 96 of which were national organizations located in 78 different countries. By 2013, the number had increased to 145 (IOCE 2013:2; BaTall 2009:7).

In Africa, the oldest evaluation association was established in 1997 in Ghana, while the African Evaluation association was itself established in 1999 with the heyday period of intense professional associations reported between 2000 and 2004 (Basheka & Byamugisha, 2015). Domestic and global forces played a role in this growth. Globally, Mertens and Russon (2000:275) proclaim that the emergence of many new regional and national organizations illustrated the growing worldwide recognition of the importance of evaluation. Before 1995 there existed only five regional and/or national evaluation organizations in the world but by 2000 there were more than 30 – a 500% increase in a 5-year period. Much of this growth was occurring in developing countries, particularly in Africa (p. 275). Malefetsane, Lungepi and Tembile (2014:5) observe that in Africa, evaluation has been on the increase; a trend predicted to continue especially with political recognition of the utility of evaluation to good governance. De Kool and Van Buuren (2004:173) conceded that the rise to New Public Management (NPM) which was constructed around key philosophies that emphasized outputs and outcomes, transparency and accountability, created a demand for M&E in Africa.

In Uganda, over the past two decades, considerable efforts have been made to establish a strong and robust basis for assessing both private and public spending. In achieving this, M&E was considered as a means of Government and NGOs measuring their development interventions. M&E was therefore enshrined in the National Development Plan and institutionalized in the governance systems and processes (National Development Plan,2010/11-2014/15).The Office of the Prime Minister (OPM) was given the constitutional mandate to oversee reforms and service delivery in all Government Ministries, Departments and Agencies and established an M&E function to support this role (National M&E Policy, 2013).

A National Integrated Monitoring and Evaluation Strategy of Government programmes was developed with the aim of enhancing M&E capacity as well as ensuring that sound evidence based data and information are available to inform decision making (NIMES, 2006). Significant effort went into introducing planning, results based budgets, monitoring systems and developing the institutional capacity to design ministry strategy and plans to implement M&E arrangements to monitor results and provide a basis for performance improvement as provided for in the National Development Plan (Annual Performance Assessment Report,2013/2014).

1.2.2 Theoretical Background

The study will be based on the General Systems Theory which was developed by Bertalanffy (1934), as cited in Tama (1987). The theory provides an analytical framework which can be used to explain the factors affecting the utilization of evaluation data. According to Bertalanffy (1968), a system is an assemblage of things connected or interrelated so as to form a complex unity: a whole composed of parts and sub-parts in orderly arrangement according to some scheme or plan. The following are the features of a system. A system is basically a combination of parts, sub-parts, sub-systems. Each part may have various sub-parts. A system has mutually dependent parts, each of which may include many sub-systems. Parts and sub-parts of a system are mutually related to each other, some more, some less; some directly, some indirectly. The relationship is in the context of the whole. Any change in one part may affect other parts also. A system is an interdependent framework in which various parts are arranged (Tamas, 1987).

A system transforms inputs into outputs. This transformation is essential for the survival of the system. There are three aspects involved in this transformation process: inputs, mediator, and outputs. Inputs are taken from the environment, transformed into outputs and given back to the environment. The various inputs may be in the form of information, money, materials, human resources, etc. Outputs may be in the form of goods and services. The total relationship may be called the input–output process, and a system works as a mediator in the process (Bertalanffy 1968). In this study, it is assumed that inputs like technical, financial and the quality of M&E systems are the inputs and utilization of M&E data is the output.

1.2.3 Conceptual Background

Technical capacity refers to the extent to which the human resources in an organization are able to manage evaluations (Byamugisha, 2016). For this study, technical capacity will be measured in terms of whether staff are qualified, experienced and knowledgeable about using M&E systems.

Financial Capacity refers to the extent to which funds are available to finance and facilitate the monitoring and evaluation function in an organization (USAID, 2015). In this study therefore financial capacity will be measured in terms of whether there are adequate financial resources, whether the funds are released in a timely manner and whether the funds are accounted for. Quality of M&E systems refers to the extent to which the M&E systems and activities meet the specified requirements and standards (Mulandi, 2013:12). For this study, the qualities of M&E systems will be measured as the extent to which the M&E systems meet the methodological and quality standards.

Utilization of Monitoring and Evaluation Information refers to putting monitoring and evaluation results to use. The use of monitoring and evaluation findings for decision making and project control ensure that there is a baseline against which to undertake new measurements (Mulandi, 2013). For this study utilization of M&E data will be measured in terms of the extent to which the data is used to inform decisions, improve organizational processes and learning.

1.2.4 Contextual Background

There have been significant efforts towards the utilization of Monitoring and Evaluation findings that have been noticed characterized by the introduction of planning, results based budgets, monitoring systems and developing the institutional capacity to design and implement M&E arrangements (Annual Performance Assessment Report, 2013/2014). Similarly national efforts have been directed towards providing a basis for performance improvement as provided for in the National Development Plan (National Development Plan, 2010/11-2014/15) that the utilization of Monitoring and Evaluation findings have been valued to improve the performance of the health sector (Uganda Bureau of Statistics, 2010).

Such efforts have also been characterized by the establishment of an M&E function to support this role enshrined in the M & E national policy (National M&E Policy, 2013). Unfortunately, much as national efforts have been directed towards enhancing M&E capacity as well as ensuring that sound evidence-based data and information are available to inform decision making (The Republic of Uganda, National Integrated Monitoring and Evaluation Strategy, 2006), the use of M&E results remain questionable.  This study will therefore attempt to examine the factors affecting utilization of M&E data in Uganda’s health sector using a case study of Ibanda District.

1.3 Statement of the Problem

Findings from the M&E function ought to be used to inform decision making, planning and organizational learning (Basheka, 2016). However in the public health facilities at level III and above in Ibanda, health information is not adequately used (Ibanda District, 2017). In order to increase use of health information, the Ministry of Health has devoted significant human, technological and financial resources to the Monitoring and Evaluation function. Despite the significant investment in M&E, there is widespread concern that the utilization of evaluation findings in public health facilities in the district is low (Ibanda District, 2017).  The annual report of the District Health Officer in Ibanda District indicates that M&E data are not effectively utilized to track and measure performance so there was little/no improvement and learning from the practices. (Ibanda District, 2017).  The current study thus seeks to determine the factors affecting utilization of M&E findings within the public health facilities in Ibanda District. Without this information, utilization of evaluation findings may deteriorate further and affect the performance of the public health facilities.

1.4 Main objective

The study seeks to determine the factors affecting the utilization of M&E findings in the level III and IV public health facilities in Ibanda District.

1.5 Specific objectives

1. To determine the relationship between technical capacity on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District;
2. To assess the relationship between financial capacity on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District;

• To examine the relationship between the quality of M&E systems on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District.

1.6 Research questions

1. What is the relationship between technical skills capacity on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District?
2. What is the relationship between financial capacity on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District?

• What is the relationship between the quality of M&E systems on the utilization of M&E findings in the public level III and IV health facilities in Ibanda District?

1.7 Study hypotheses

H1. Technical skills capacity has a positive and significant effect on the utilization of M&E findings in public health facilities

H2. Financial capacity has a positive effect on the utilization of M&E findings in public health facilities

H3. The quality of M&E systems has a significant effect on the utilization of M&E findings in public health facilities

1.8 Conceptual Framework

Independent Variables (Factors)           Dependent Variable (Utilization of M&E Findings)

Source: Adopted from Kasule (2016) and modified by the researcher

The conceptual framework above shows the factors affecting the utilization of M&E data. The model assumes that utilization of M&E findings is enhanced by improved technical, financial and quality of M&E systems within organizations.

1.9 Significance of the Study

The findings this study will be vital in enabling management within the public sector in Ibanda District to understand the factors affecting utilization of M&E findings in order to come up with practical strategies that will enhance the utilization of M&E findings in the sector. The findings of this study will contribute to the body of knowledge regarding the factors affecting the utilization of M&E findings hence benefiting researchers and academicians who are interested in the topic.

1.10 Justification of the Study

It is critical that the factors that affect the utilization of M&E findings are thoroughly examined and understood by the public sector implementing Monitoring and Evaluation system. Without clear understanding of these factors, the public health sector may continue underutilizing evaluation findings. This may affect the performance of the sector and subsequent underperformance of the public health sector.

1.11 Scope of the Study

1.11.1 Content Scope

The study will examine the factors affecting the utilization of M&E findings. The study will specifically focus on the effects of technical, technological and quality factors on the utilization of M&E findings in Ibanda District.

1.11.2 Geographical scope

The study will be conducted in Ibanda District which lies in South Western Uganda. It will be conducted at public Health centers IIIs and Health Centre IVs within the district.

1.11.3 Time scope

The study will look at quarterly HIV data/reports for the financial year 2015/2016 and how it was used to inform the clinic processes or facilitated good quality data, monitoring and evaluation, or planning at the level III health centres and the general hospital.  In addition, the field study will be conducted between September and October 2017.

1.12. Definition of Key Terms and Concepts

Technological capacity refers to the capacity of the human resources/people to use M&E findings.

Technological capacity refers to the ability of the organizations to utilize technology to manage M&E activities

Quality of M&E Findings refers to the extent to which the evaluation findings meet the specified requirements and standards

Utilization of Monitoring and Evaluation Data. This will refer to the application of Monitoring and Evaluation findings in decision-making, quality improvement and learning.

CHAPTER TWO

LITERATURE REVIEW

• Introduction

This chapter presents a review of literature on the topic under investigation. The chapter presents a review of the relevant theories. It also presents empirical literature on the factors affecting the utilization of M&E findings.

• Theoretical Review

The theory which will underpin this study is General Systems Theory (GST). The General Systems Theory, which was developed by Bertalanffy (1934) as cited in Tama (1987), provides an analytical framework which can be used explain the effect of planning on performance. According to Bertalanffy (1968), a system is an assemblage of things connected or interrelated so as to form a complex unity: a whole composed of parts and sub-parts in orderly arrangement according to some scheme or plan. The following are the features of a system. A system is basically a combination of parts, sub-parts, sub-systems. Each part may have various sub-parts. A system has mutually dependent parts, each of which may include many sub-systems. Parts and sub-parts of a system are mutually related to each other, some more, some less; some directly, some indirectly. The relationship is in the context of the whole. Any change in one part may affect other parts also. A system is an interdependent framework in which various parts are arranged (Tamas, 1987).

A system transforms inputs into outputs. This transformation is essential for the survival of the system. There are three aspects involved in this transformation process: inputs, mediator, and outputs. Inputs are taken from the environment, transformed into outputs and given back to the environment. The various inputs may be in the form of information, money, materials, human resources, etc. Outputs may be in the form of goods and services. The total relationship may be called the input-output process and system works as a mediator in the process (Bertalanffy, 1968). The systems theory has been used in a number of fields like community development, (Tamas, 1987; Lazlo & Knipper, 1998). In this study, factors like technical, technological and the quality of M&E systems will be the inputs and utilization of M&E data by the public health units will be the output.

• Conceptual Review

Put a brief introduction what you intend to write in this section

2.3.1 Technical capacity

Human capital, with proper training and experience is vital for the production of M&E results. There is need to have an effective M&E human resource capacity in terms of quantity and quality, hence M&E human resource management is required in order to maintain and retain a stable M&E staff (World Bank, 2011). This is because competent employees are also a major constraint in selecting M&E systems (Koffi-Tessio, 2002). M&E being a new professional field, it faces challenges in effective delivery of results. There is therefore a great demand for skilled professionals, capacity building of M&E systems, and harmonization of training courses as well as technical advice (Gorgens and Kusek, 2009).

The UNDP (2009) handbook on planning, monitoring and evaluation for development results, emphasizes that human resource is vital for an effective monitoring and evaluation, by stating that staff working should possess the required technical expertise in the area in order to ensure high-quality monitoring and evaluation. Implementing of an effective M&E demands for the staff to undergo training as well as possess skills in research and project management, hence capacity building is critical (Nabris, 2002). In-turn numerous training manuals, handbooks and toolkits have been developed for NGO staffs working in project, in order to provide them with practical tools that will enhance result-based management by strengthening awareness in M&E (Hunter, 2009). They also give many practical examples and exercises, which are useful since they provide the staff with ways of becoming efficient, effective and have impact on the projects (Shapiro, 2011).

The M&E system cannot function without skilled people who effectively execute the M&E tasks for which they are responsible. Therefore, understanding the skills needed and the capacity of people involved in the M&E system (undertaking human capacity assessments) and addressing capacity gaps (through structured capacity development programs) is at the heart of the M&E system (Gorgens & Kusek, 2010:43). In its framework for a functional M&E system, UNAIDS (2008) notes that, not only is it necessary to have dedicated and adequate numbers of M&E staff, it is essential for this staff to have the right skills for the work. Moreover, M&E human capacity building requires a wide range of activities, including formal training, in-service training, mentorship, coaching and internships. Lastly, M&E capacity building should focus not only on the technical aspects of M&E, but also address skills in leadership, financial management, facilitation, supervision, advocacy and communication.

Building an adequate supply of human resource capacity is critical for the sustainability of the M&E system and generally is an ongoing issue. Furthermore, it needs to be recognized that “growing” evaluators requires far more technically oriented M&E training and development than can usually be obtained with one or two workshops. Both formal training and on-the-job experience are important in developing evaluators with various options for training and development opportunities which include: the public sector, the private sector, universities, professional associations, job assignment, and mentoring programs (Acevedo et al., 2010:12).

Monitoring and evaluation carried out by untrained and inexperienced people is bound to be time consuming, costly and the results generated could be impractical and irrelevant. Therefore, this will definitely impact the success of projects (Nabris, 2002:17). In assessment of CSOs in the Pacific, UNDP (2011:12) discusses some of the challenges of organizational development as having inadequate monitoring and evaluation systems. Additionally, the lack of capabilities and opportunities to train staff in technical skills in this area is clearly a factor to be considered. During the consultation processes, there was consensus among CSOs that their lack of monitoring and evaluation mechanisms and skills was a major systemic gap across the region. Furthermore, while there is no need for CSOs to possess extraordinarily complex monitoring and evaluation systems, there is certainly a need for them to possess a rudimentary knowledge of, and ability to utilize reporting, monitoring, and evaluating systems.

A study by White (2013:43) on monitoring and evaluation best practices in development INGOs, indicates that INGOs encounter a number of challenges when implementing or managing M&E activities one being insufficient M&E capacity where M&E staff usually advise more than one project at a time, and have a regional or sectoral assignment with a vast portfolio. Furthermore, taking on the M&E work of too many individual projects overextends limited M&E capacity and leads to rapid burnout of M&E staff whereby high burnout and turnover rates make recruitment of skilled M&E staff difficult, and limits the organizational expertise available to support M&E development. Mibey (2011:19) study on factors affecting implementation of monitoring and evaluation programs in kazi kwa kijana project, recommends that capacity building should be added as a major component of the project across the country (Kenya), and this calls for enhanced investment in training and human resource development in the crucial technical area of monitoring and evaluation.

2.3.2 Financial capacity

Financial Capacity refers to the extent to which funds are available to finance and facilitate the monitoring and evaluation function in an organization (USAID, 2015). In this study therefore financial capacity will be measured in terms of whether there are adequate financial resources, whether the funds are released in a timely manner and whether the funds are accounted for.

There is empirical evidence to suggest that lack of adequate financial capacity constrains M& E systems. In Ghana, a study by CLEAR (2012) found that after several years of implementing the national M&E system, significant progress had been made. However, challenges include severe financial constraints; institutional, operational and technical capacity constraints; fragmented and uncoordinated information, particularly at the sector level. To address these challenges the CLEAR report argues that the current institutional arrangements will have to be reinforced with adequate capacity to support and sustain effective monitoring and evaluation, and existing M&E mechanisms must be strengthened, harmonized and effectively coordinated.

The study by Koffi-Tessio (2002), on Efficacy and Efficiency of Monitoring-Evaluation Systems (MES) for Projects Financed by the Bank Group that was done in Burkina Faso, Mauritana, Kenya, Rwanda and Mozambique, through desk review and interviews, for projects approved between 1987 and 2000. Monitoring-Evaluation systems are not meeting their obligatory requirements because of financial constraints.

A study conducted by Gamba (2016) to determine the factors affecting the utilization of evaluation findings in malaria control projects in Uganda found that management support was low and financial resources allocated for M&E was insufficient. This greatly affected effective outcome and impact monitoring and evaluation of projects.

2.3.3 Quality of Evaluation Findings

Quality of M&E Findings refers to the extent to which the M&E systems and activities meet the specified requirements and standards (Mulandi, 2013:12). For this study, the qualities of M&E findings meet the standards and requirements.

The quality of evaluations is important to the credibility of reported results hence, it is important to incorporate data from a variety of sources to validate findings. Furthermore, while primary data are collected directly by the M&E system for M&E purpose, secondary data are those collected by other organizations for purposes different from M&E (Gebremedhin, Getachew & Amha, 2010:24). In the design of an M&E system, the objective is to collect indicator data from various sources, including the target population for monitoring project progress (Barton, 1997). The methods of data collection for M&E system include discussion/conversation with concerned individuals, community/group interviews, field visits, review of records, key informant interviews, participant observation, focus group interviews, direct observation, questionnaire, one-time surveys, panel surveys, census, and field experiments. Moreover, developing key indicators to monitor outcomes enables managers to assess the degree to which intended or promised outcomes are being achieved (Kusek & Rist, 2004).

Frequent data collection means more data points; more data points enable managers to track trends and understand intervention dynamics hence the more often measurements are taken, the less guess work there will be regarding what happened between specific measurement intervals. But, the more time that passes between measurements, the greater the chances that events and changes in the system might happen that may be missed (Gebremedhin et al., 2010). Mulandi (2013:75) concurs that to be useful, information needs to be collected at optimal moments and with a certain frequency. Moreover, unless negotiated indicators are genuinely understood by all involved and everyone’s timetable is consulted, optimal moments for collection and analysis will be difficult to identify.

According to Cornielje, Velema and Finkenflugel (2008:15), only when the monitoring system is owned by the users the system is it likely to generate valid and reliable information. However, all too often the very same users may be overwhelmed by the amount of daily work which in their view is seen as more important than collecting data and subsequently the system may become corrupted. They conclude that it is of extreme importance that the front-line workers are both involved in monitoring and evaluation and informed about the status of the services and activities they largely provide in interaction with other stakeholder and beneficiaries.

Evidence suggests that the quality of evaluations has an effect on the utilization of evaluation findings.  According to an IFAD (2008:26) annual report on results and impact, recurrent criticisms against M&E systems include: limited scope, complexity, low data quality, inadequate resources, weak institutional capacity, lack of baseline surveys and lack of use. Moreover, the most frequent criticism of M&E systems in IFAD projects relates to the type of information included in the system. Most of the IFAD projects collect and process information on the project activities. However, the average IFAD project did not provide information on results achieved at the purpose or impact level. The M&E system of the Tafilalet and Dades Rural Development project in Morocco for example only focused on financial operations and could not be used for impact assessment. In the Pakistan IFAD Country Program Evaluation, cases were reported of contradictory logical frameworks combined with arbitrary and irrelevant indicators while in Belize, two different logical frameworks were generated which increased confusion and complexity. The Ethiopia IFAD Country Program Evaluation found that project appraisal documents made limited provision for systematic baseline and subsequent beneficiaries surveys. For example in one project in Ethiopia, the baseline survey was carried out 2-3 years after projects start-up.

In a study report of an Australian NGO conducted by Spooner and Dermott (2008:45), staff reported that, as WAYS evolved over time, they were unsure about what works in the current system of monitoring and evaluation. Additionally, resources had not been dedicated to data analysis; and the data was rarely analyzed. A further problem found with data analysis was that the responsibility of doing the analysis lied with program managers, who had little time to analyze data that was not required by funding bodies. Some of the staff stated that they are required to collect information and analyze it, but that their analysis is hampered because they have minimal research skills. Finally, some staff reported that there was no feedback loop built into the current system so, while staff report on their activities to the management, they do not know what happens to the information once it is reported.

A problem in African countries, and perhaps in some other regions, is that while sector ministries collect a range of performance information, the quality of data is often poor. This is partly because the burden of data collection falls on over-worked officials at the facility level, who are asked with providing the data for other officials in district offices and the capital, but who rarely receive any feedback on how the data are actually being used, if at all. This leads to another problem: data are poor partly because they are not being used; and they are not used partly because their quality is poor therefore, in such countries there is too much data, not enough information (Mackay, 2006:7).

Obure (2008:5) in a study of RBM in Northern Ghana indicates a problem associated with post collection data management. As confessed by many field officers, the storage, processing and interpretation of data was ineffectively handled. Results from the study strongly point to a weakness in the system arising from the inability of stakeholders to handle and process data in a meaningful way. He concludes that this challenge could seriously lead to mere collection of large volumes of data which eventually might not be used in a helpful way. Data must be collected and analyzed regularly on the objectives and intermediate results. Furthermore, the PME&R system allows for three levels of information by project, activity and organization where the data for all organizations involved in a specific activity can be averaged up to the activity level, and the data for all activities can be averaged up to the project level (Booth, Ebrahim & Morin, and 2008:31).

A study by Gamba (2016:65) to establish the factors affecting the utilization of M&E results in malaria control projects in Uganda found that evaluation quality and communication of the M & E results had a significant positive effect on utilization and timeliness of the M & E activities had a significantly moderate positive effect on the utilization of M & E findings in the implementation of the MCP activities across the organizations.

2.3.4 Utilization of M&E data

Utilization of Monitoring and Evaluation data refers to putting monitoring and evaluation results to use. The use of monitoring and evaluation findings for decision making and project control ensure that there is a baseline against which to undertake new measurements (Mulandi, 2013)

2.7 Summary of empirical literature

2.8 Gaps Identified in the Literature

The review of literature indicates that organizational capacity factors, top management support and the quality of evaluation findings affect the utilization of M&E findings. Studies by CLEAR, 2012:31),  the Kenyan NGO Coordination Board (2009:17),  White (2013:10)  Mibey (2011:25) and  Nyagah (2015:47) indicate that organizational capacity has a significant effect on the utilization of M& E findings. This means that utilization of M&E findings improves with financial, technical and technological capacity of an organization. These studies however have a contextual gap in that they were conducted in organizations in other countries which may have more organizational capacity to utilize M&E findings. It remains to be seen whether organizational capacity will have the same effect on utilization of M&E findings within the health facilities in Ibanda District.

Studies by Turabi et al and Kasule (2016) Kasule indicate that top management support effects the utilization of M&E findings. This means that utilization of M&E findings improves with top management support in an organization. However it remains to be empirically seen whether top management support has any significant effect on utilization of M&E findings because earlier literature is largely anecdotal. The literature also indicates that the quality of M&E findings affects utilization of M&E findings (Mackay, 2006:7; Obure, 2008:5; Gamba (2016:65 and Booth et al., 2008:31). However it remains to be empirically seen whether top management support has any significant effect on utilization of M&E findings because earlier literature is largely anecdotal. Generally, whereas literature points out the effect of the above mentioned factors on the utilization of M&E findings; most studies are based on anecdotal observations and less on empirical findings. There is therefore need to conduct a study which will empirically document the factors affecting the utilization of M&E findings.

Where is the section for synthesis of literature review.

CHAPTER THREE

METHODOLOGY

3.1 Introduction

This chapter presents the methodology that will be adopted during the study. It describes and discusses; the research design,  sample size and selection, the data collection methods  used and their corresponding data collection instruments, data management and analysis procedure as well as steps that will be taken to ensure validity and reliability during the study and measurement of variables.

3.2 Research Design

The study will adopt a cross sectional design. The cross sectional design will be adopted because data will be collected from a cross section of respondents in the health facilities in Ibanda at a given point in time as suggested by Amin (2005).  Since the study seeks to examine the relationship between variables, a simple bivariate correlation design will be adopted to determine the relationship between organizational capacity, top management, quality of evaluations and utilization of evaluation findings.

The study will use both qualitative and quantitative approaches. The quantitative approach will be adopted because the study intends to examine the factors affecting the utilization of M&E data. Such an endeavor can best be achieved when a quantitative approach is used because it allows for collecting numeric data on observable individual behavior of samples, then subjecting these data to statistical analysis (Amin, 2005:5).

A qualitative approach will also be adopted to enable the researcher capture data that will be left out by the quantitative approach. This will be aimed at capturing more in-depth information on the topic under investigation.

3.3 Study Population

The study population is will be comprised of 150 staff within the public health facilities in Ibanda District as obtained from the District Personnel Office (2017).

3.4 Study Sample

The study sample will be comprised of 134 respondents. The sample size will be arrived at using the predetermined table for determining sample size by Krejicie and Morgan (1970) as cited in Amin (2005) see Appendix III.

Table 1: Sample Size Determination

Source: Chief Administrative Office, Ibanda District (2017)

3.5 Sampling Techniques and Procedure

A number of sampling techniques will be used to select respondents to the study namely; simple random and purposive sampling techniques. The lower level Staff will be selected using simple random sampling technique. Simple random sampling will be used because it ensures generalizability of findings and minimizes bias (Sekaran, 2003).  Purposive sampling technique will be used to select the hospital administrators. These key informants will be purposively sampled because they are believed to have technical and specialized knowledge about the topic under investigation by virtue of the offices that they hold.

3.6 Data collection Methods

A little introduction please

3.6.1 Survey Method

The study will use the questionnaire method to collect data. The questionnaire will be used because it allows for the collection of data from a big group of respondents in a short period as suggested by Mugenda and Mugenda (1999: 107). The questionnaire will also be used because it allows busy respondents fill it at their convenient time. It also allows respondents express their views and opinions without fear of being victimized (Oso & Onen, 2008:18).

3.6.2 Interview Method

The study will employ interview method. Interviews in this study will help the researcher obtain more information on the topic under investigation. This method will also be used because it will offer the researcher an opportunity to adapt questions, clarify the questions by using the appropriate language, clear doubts and establish rapport and probe for more information (Sekaran, 2003:253).

3.6.3 Document Review Method

The researcher will review documents in order to obtain recorded information that is related to the issue under investigation. This method will be used because it enables the researcher access data at his convenient time, obtain data that are thoughtful in that the informants have given attention in obtaining them and enables the researcher obtain data in the language of the respondent (Oso & Onen, 2008: 45).

3.7 Data Collection Instruments

The instruments used in this study will be questionnaire, interview guide and document review checklist.

3.7.1 Self-Administered Questionnaire

The study will employ a questionnaire as a tool of data collection. The questionnaire for staff will have 5 sections (see appendix I). Section A will deal with the demographic characteristics of the respondents, section B will focus on technical capacity, Section C will focus on financial capacity, Section D will be concerned with the quality of evaluation activities and section E will be concerned with the utilization of M&E findings.  The questionnaires will be closed ended. Closed ended questions will be developed to help respondents make quick decisions; in addition, closed ended questions will help the researcher to code the information easily for subsequent analysis and narrow down the error gap while analyzing data as observed by Sekaran (2003:231).

3.7.2 Interview Guide

An unstructured interview will be used as a tool for collecting in depth information from the key informants. The guide will have list of topical issues and questions which will be explored in the course of conducting the interviews. The guide will be drawn with the questions soliciting for the perception of the key informants regarding the factors affecting the utilization of M&E findings within the public health facilities. The interview guide will be used because it obtains in-depth data which may not be possible to obtain when using self-administered questionnaires (Mugenda & Mugenda, 1999:17; Kakoza, 1999:27).

3.7.3 Documentary Review Checklist

3.8.1 Validity

To ensure validity, the questionnaire will be developed and given to three expert judges to score the relevance of each question in providing answers to the study.  After which a content validity index C.V.I will be computed using the formula; number of items declared valid/number of items in the questionnaire. A CVI of above 0.7 will be acceptable (Amin, 2005).

3.8.2 Reliability

A pre-test will be done on 10% (12) of the respondents who will not be part of the final study as suggested by Mugenda and Mugenda (1999). Data will be coded and entered into the computer. Cronbach’s Alpha Reliability Coefficients will be generated using the statistical package for social scientists (SPSS) computer program to estimate the reliability of the questionnaire. The Cronbach’s alpha reliability coefficient of above 0.6 will be acceptable (Sekaran, 2003).

3.10 Data Analysis

3.10.1 Analysis of quantitative Data

The statistical package which will be used for analysis of data in this study is the SPSS version 16.0. Different statistical techniques will be used namely: correlation and regression analysis. The upper level of statistical significance for hypothesis testing will be at 5%. All statistical test results will be computed at 2-tailed level of significance.

Descriptive statistics namely frequency counts, percentages will be used to analyze the respondents’ demographic characteristics and the mean and standard deviation will be used to analyze the respondents’ opinions on the factors affecting the utilization of M&E data within the public health units in Ibanda District.

Data will be analyzed and correlated using Pearson Product-Moment correlation coefficient to establish the relationship between technical capacity, technological capacity, quality of M&E systems and the utilization of M&E data as suggested by Sekaran (2003), Amin (2005) and Oso and Onen (2008).

For this study, the three dimensions of technical capacity, technological capacity and quality of M&E will be regressed utilization of M&E data within the health facilities. This will be aimed at determining the effect of each of these factors on the utilization of M&E data.

3.10.2 Analysis of qualitative data

Qualitative data will be analyzed using content analysis. Responses from key informants will be grouped into recurrent issues. The recurrent issues which will emerge in relation to each guiding questions will be presented in the results, with selected direct quotations from participants offered as illustrations.

3.11 Measurement of variables

Data on the respondent’s views and opinions about the factors affecting the utilization of M&E data will be obtained using scaled variables from a self-developed questionnaire. A five point-Likert scale of 1= strongly disagree, 2= disagree, 3= not sure, 4= agree and 5= strongly agree will be used to tap respondents perception on the study variables.

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