Assessment of the monitoring and evaluation system for integrated community case management (iCCM) in Ethiopia: A comparison against global benchmark indicators

Background. Program managers require feasible, timely, reliable, and valid measures of iCCM implementation to identify problems and assess progress. The global iCCM Task Force developed benchmark indicators to guide implementers to develop or improve monitoring and evaluation (M&E) systems. Objective. To assesses Ethiopia's iCCM M&E system by determining the availability and feasibility of the iCCM benchmark indicators. Methods. We conducted a desk review of iCCM policy documents, monitoring tools, survey reports, and other relevant documents; and key informant interviews with government and implementing partners involved in iCCM scale -up and M&E. Results. Currently, Ethiopia collects data to inform most (70% [33/47]) iCCM benchmark indicators, and modest extra effort could boost this to 83% (39/47). Eight (17%) are not available given the current system. Most benchmark indicators that track coordination and policy, human resources, service delivery and referral, supervision, and quality assurance are available through the routine monitoring systems or periodic surveys. Indicators for supply chain management are less available due to limited consumption data and a weak link with treatment data. Little information is available on iCCM costs. Conclusion. Benchmark indicators can detail the status of iCCM implementation; however, some indicators may not fit country priorities, and others may be difficidt to collect. The government of Ethiopia and partners should review and prioritize the benchmark indicators to determine which should be included in the routine M&E system, especially since iCCM data are being reviewed for addition to the IIMIS. Moreover, the Health Extension Worker's reporting burden can be minimized by an integrated reporting approach.