Objectives
Uttar Pradesh, being the largest Indian State (200 million population), has the largest adolescent micronutrient programme in the country. This paper describes institutionalization of real-time monitoring and feedback loop mechanism to strengthen programme coverage and quality of service, covering 49 million adolescentsâ girls and boys across the state, with 75 districts and 820 administrative blocks.
Methods
In 2013, State Health Department with UNICEF technical assistance initiated the real-time monitoring in partnership with a local reputed organization using standard formats in 45 districts, with districts being covered 8 times/year by a multi-sectoral team (covering 67% blocks). Using standard formats, feedback was provided to districts after each field visit. Five report cards were developed for each district. Following each visit, a range of activities were undertaken to implement the findings, including capacity-building, supply logistics/forecasting and streamlining review/reporting. Actions were conducted in an enabling and fact-finding mode.
Results
After one year, the following results were evident: (1) streamlined supplies of iron folic acid and deworming tablets; (2) increased accountability through joint monitoring; (3) enhanced ownership of data by districts leading to program reviews becoming timely and more action oriented. Recognizing its added-value, the initiative was expanded to all 75 districts by 2014
Conclusions
In large states, strong strategic partnerships can help enhance concurrent monitoring of programme coverage. However, this should be complemented with strengthening of key programme components. Real-time data collection, to add-value, should be coupled with efforts to support state government to take corrective actions in between concurrent monitoring visits
