Working document on health and family planning indicators : a tool for results frameworks [volume I]

Under re-engineering, the API was transformed into the "results review" (known as the R2 or R2a), a document presenting an operating unit"s logical results framework along with detailed specification of performance indicators. While some performance indicators are widely accepted, new indicators are still being established and refined. This document focuses on performance indicators used in the Africa region in the family planning and health sector. Drawing on the technical review of APIs and R2s through FY 1995 (as well as a few Results Frameworks submitted by Missions after the review was completed), this document seeks to: (1) provide an introduction to the results framework, which is a hierarchical model consisting of strategic objective, supporting intermediate results, and key performance indicators; (2) present and define key indicators; and (3) offer guidance on difficulties in collecting and interpreting data for these indicators. Three levels of indicators are presented, corresponding roughly to the three levels of a results framework. Higher-level indicators include total fertility rate, infant mortality rate, maternal mortality rate, HIV/sexually transmitted infection prevalence, and nutritional status; higher-level indicators are generally well-established. Second-level indicators (which are also frequently well-established) track people-level impacts in terms of behavior and use of services (for example, indicators for prenatal care include both neonatal tetanus immunizations and consultations during pregnancy). Lower-level indicators are often more program-specific and may best be defined by individual Missions. These indicators can be grouped in a few general categories: access to services, quality of services, sustainability, and demand.