Avoiding the Wrong Prescription: Why Country M&E Diagnostics Are Just What the Doctor Ordered

Girl walking down a rural road in Monrovia, Liberia. Photo © Dominic Chavez/World Bank
Can you imagine getting a prescription from a doctor without being diagnosed first? You would protest it as guesswork. Even the finest doctors need to review symptoms before suggesting the right approach.

Dr. Taku Chirau is Deputy Director at the The Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) at Witwatersrand University in South Africa. His role is to establish and nurture partnerships for strengthening M&E capacity in English speaking African countries. 

Can you imagine getting a prescription from a doctor without being diagnosed first? You would protest it as guesswork. Even the finest doctors need to review symptoms before suggesting the right approach.

This is also true in the field of monitoring and evaluation (M&E), where conducting an M&E situation analysis (MESA) is a prerequisite for finding the best approach for improving government performance for the delivery of services to citizens. Governments and parliaments make public policy decisions almost every day. This is usually a complex process, which can be more effective when informed by robust evidence, a key source of which can come from an effective M&E system.

The first step to an accurate diagnosis: situational analysis

The Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) has a long history of conducting country level diagnostics, using different customized tools to help governments improve their M&E systems.  Over the years, I have seen the diagnostic process evolve to one where programs are country-led and managed with CLEAR-AA support – this is a crucial evolution and informs our current collaborative approach.

Below, I’d like to share our process for helping country governments improve their evaluation capacity through the use of the MESA:

Program Inception workshop
  1. Program Inception Workshop. This workshop is convened in-country by the government agency tasked with M&E oversight (e.g., the Uganda Office of the Prime Minister). During the workshop, invited government stakeholders share information on their M&E activities and any immediate needs or goals.  CLEAR-AA shares what kind of support we can offer.  The output of that meeting is an inception meeting report prepared by CLEAR-AA. 
  2. MOU. During this phase, an MOU is signed with the government client. This can be a time-intensive process as buy-in of senior government stakeholders is secured.
  3. MESA. After the MOU is signed, a MESA is conducted, which looks at the wider ecosystem of M&E in the country (i.e., government agencies, academic institutions, civil society organizations, parliament, and VOPEs).  The MESA results are presented in a validation workshop to relevant stakeholders whose input will be used to complete the final report. 
  4. M&E Capacity Strengthening Plan. Based on recommendations in the final report of the MESA, an M&E capacity strengthening strategy and implementation plan is developed for the country client. The plan is implemented by the client, with support from CLEAR-AA.

I must note that these steps don’t always happen in this order - they are determined by country interest and windows of opportunity. Entry points for each country are different and require a variety of interventions depending on the maturity of the system. 

Finding the Right Prescription Takes Time (and other Lessons Learned)

CLEAR-AA conducted MESAs in Liberia, Uganda, Kenya, Rwanda, Ghana, Zambia, Tanzania, Lesotho, and Malawi.
CLEAR-AA conducted MESAs in Liberia, Uganda, Kenya, Rwanda, Ghana, Zambia, Tanzania, Lesotho, and Malawi.

The MESA approach holds considerable promise in providing the correct prescription for strengthening a country’s M&E system – especially when it is implemented in a collaborative and participatory manner. However, I want to be up-front that it is a challenging endeavor that requires patience, a sustainable rapport with government partners and, quite frankly, grit. Below are a few other things that CLEAR-AA has learned from years of supporting country-level diagnostics: 

Take advantage of all formal and informal relationship networks. The journey of conducting a MESA is not an easy walk in the park. Governments are bureaucratic systems and getting access and approval takes time and energy. Persistence is critical. Using networks in and outside the country to gain entry is one solution. In our work in Malawi and Lesotho, we worked with the UNICEF country offices; in Liberia, UNDP supported our efforts; and, the African Development Bank facilitated entry in Tanzania. 

Secure support of senior government officials as soon as possible. Government agency managers can change, which compromises the trust that has been established. Often, you must start again. Buy-in and ownership from senior government officials (e.g., Permanent Secretaries) is critical to pushing new managers to endorsing the value of M&E and supporting the MESA work.    

Facilitate agency collaboration from the start. Unclear institutional arrangements are a spanner in the works, resulting in fuzzy M&E roles and responsibilities between ministries, departments, and agencies. This often results in duplication of effort and turf wars that may delay the undertaking of a MESA. CLEAR-AA’s approach has been to encourage ministries, departments, and agencies to collaborate and partner in ways that are complementary. 

Be creative in addressing the data availability challenge. Unavailability of data is an enormous challenge. M&E is still in embryonic phases in African countries, and the availability of data at the individual level and institutional level is a huge constraint that hinders the MESA process. CLEAR-AA had to rely on secondary data such as national development plans, voluntary national reviews and so forth. At the individual level, several tranches of interviews had to be done with personnel to complement initially conducted interviews that left gaps.  

Secure additional funding to support MESA work. Due to the COVID-19 pandemic, African countries are undergoing austerity measures, reducing government spending – especially on programs like M&E diagnostics. Utilisation of partnerships is critical. CLEAR-AA received a grant from the Netherlands Ministry of Foreign Affairs that supported work on MESAs in Liberia, Malawi, Uganda, and Zambia.

Be ready to provide technical support at multiple stages of the process. Countries where M&E is still in nascent stages will have little or no government technical capacity to support the MESA work. Often, an outside individual expert or consultancy firm will be hired by the government to conduct the MESA. On several occasions, CLEAR-AA has provided support to the outside firm conducting the MESA – such as in countries like Malawi, Uganda and Liberia. 

In summary, undertaking a diagnosis of country M&E systems is not only a logical step before proposing any prescriptions, but also serves as an avenue to initiate engagement and build trust – or to deepen existing relationships. Understanding the country’s current M&E approaches/policies and goals for further improvement will make your suggestions for improvement more effective – and definitely not guesswork.


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