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Outcomes are very relevant to stakeholders in order to continue, improve or stop programmes. Quality data must be gathered during all stages of implementation, so a clear monitoring framework and evaluation plan with specific indicators should be established during planning. Time and personnel resources should be planned accordingly to ensure continuous monitoring throughout the whole duration of the programme.
Monitoring aims to track performance of a programme over time with indicators that are collected on a regular basis. An initial evaluation of spectacle wear, wearing behaviour, adaptation problems etc. should ideally be carried out after just a few weeks. Periodic monitoring and auditing the referrals by screening personnel and compliance with spectacle wear after 6 months are also important.
Evaluation on the other hand, provides feedback on how the programme was implemented (process evaluation) or its impact (impact evaluation). It can be conducted at mid course or at the end of the programme, and should be undertaken by external individuals who have relevant expertise.
| Monitoring (and auditing) | Process evaluation | Impact evaluation | |
|---|---|---|---|
| Objectives | track performance of the programme over time | assess if the programme was implemented as planned and if not, why not | assess the extent to which the goals and objectives have been met, and if not, why not |
| Examples of indicators | number of children/teachers screened, screening accuracy, referrals, spectacle wear, attendance rates | satisfaction of the children, teachers, parents and other stakeholders with the processes | impact of spectacles on quality of life and visual functioning of children and teachers, impact on school attendance or academic performance, compliance on spectacle wear and follow-ups, and reasons for noncompliance |
Monitoring will allow the programme makers to identify if parts of the programme aren’t reaching the objectives and take corrective actions to adjust. Main indicators should provide information on coverage, reach, outcomes, compliance, cost-effectiveness and quality of the programme :
Given that young girls with refractive disorders carry a higher burden than boys32, all data should be collected and analysed by sex and disability. This methodology will help compare results between both sex and prevent gender inequalities and promote inclusiveness in the programme.
| Disability (Y/N) | Male | Female | Total | |||
|---|---|---|---|---|---|---|
| Output indicators (number) | ||||||
| Training | Screeners trained | |||||
| Eye care professionals (or allied health workers) orientated for detailed examination in schools where applicable | ||||||
| Screening of teachers | Teachers screened | |||||
| Teachers dispensed spectacles (near and/or distance) | ||||||
| Teachers referred | ||||||
| Health promotion | Children exposed to health education | |||||
| Parents (and/or other community members) exposed to health education | ||||||
| Parents of children dispensed spectacles exposed to health education | ||||||
| Parents of children referred exposed to health education | ||||||
| Outcome indicators (%) | ||||||
| Spectacle provision & referrals for teachers | Proportion of teachers requiring spectacles who receive them | |||||
| Proportion of teachers referred who access eye care services | ||||||
| Impact indicators | ||||||
| Number of children undergoing surgery (sight restoring or strabismus) | ||||||
| Change in quality of life / visual functioning in children wearing spectacles | ||||||
| Improvement in school performance | ||||||
| Programme indicators | ||||||
| Spectacle dispensing | Number of spectacles dispensed | |||||
| Number and % of children eligible to ready-made / ready-to-clip | ||||||
| Costing | Cost per child screened | |||||
| Cost per child needing spectacles | ||||||
| Cost per child receiving medication | ||||||
Saravanan (2023), Cost Analysis of a comprehensive School eye screening model from India
Minakaran (2020), Cost-minimisation Analysis from a Non-inferiority Trial of Ready-Made versus Custom-Made Spectacles for School Children in India
