Evidence-Informed Decision-Making

Evidence-informed decision-making means the action follows what the available records can support, including what they cannot support. It is not the same as waiting until every possible fact is known. Facilities have to act. They should not act on a story the data do not tell.

Who uses the figures

The officer-in-charge uses the monthly summary to see which clinic day was overloaded, which commodity is running low, and which report is late. The Monitoring and Evaluation officer uses the same figures to compare facilities, prepare a programme report, and ask why a number changed. Neither person should treat a single month as proof of success or failure.

State the limit before the recommendation

A sound note has three parts. First, what the record shows. Second, what it does not show. Third, the next action that fits those two statements.

Example. “The immunisation register shows pentavalent-3 dropout of 30% for children who started at this facility. The register cannot say whether the missing children were vaccinated elsewhere. This week, the immunisation team will list the 15 names and check them against the child health cards before the local government is told that coverage has fallen.”

Conclusions the data will not carry

• Attendance rose, so the quality of care improved.
• Attendance fell, so staff were negligent.
• A partner's tally is higher, so the facility register should be changed to match it.
• One mother's comment proves that the whole community cannot afford transport.
• A forecast for next month is already a result.

You may still act. If the store will not cover the doses the register says are due, order the doses. That action rests on the stock ledger and the register, not on a claim about quality of care.