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DEVELOPING
KEY PERFORMANCE INDICATORS
A TOOLKIT FOR HEALTH SECTOR MANAGERS
December 2013
This publication was produced for review by the United States Agency for International Development. It was prepared by Steve Rozner for the Health Finance and Governance Project 3The Health Finance and Governance Project
86$HG·V Health Finance and Governance (HFG) project will help to improve health in developing countries by
H[SMQGLQJ SHRSOH·V MŃŃHVV PR OHMOPO ŃMUHB IHG N\ $NP $VVRŃLMPHV POH Sroject team will work with partner countries
to increase their domestic resources for health, manage those precious resources more effectively, and make wise
purchasing decisions. As a result, this five-year, $209 million global project will increase the use of both primary
and priority health services, including HIV/AIDS, tuberculosis, malaria, and reproductive health services. Designed
to fundamentally strengthen health systems, HFG will support countries as they navigate the economic transitions
needed to achieve universal health care.December 2013
Cooperative Agreement No: AID-OAA-A-12-00080
Submitted to: Scott Stewart, AOR
Office of Health Systems
Bureau for Global Health
Recommended Citation: Rozner, Steve. December 2013. Developing and Using Key Performance IndicatorsA Toolkit for Health Sector Managers. Bethesda, MD: Health Finance & Governance Project, Abt Associates Inc..
Abt Associates Inc. | 4550 Montgomery Avenue, Suite 800 North | Bethesda, Maryland 20814 T: 301.347.5000 | F: 301.652.3916 | www.abtassociates.com Broad Branch Associates | Development Alternatives Inc. (DAI) | Futures Institute | Johns Hopkins Bloomberg School of Public Health (JHSPH) | Results for Development Institute (R4D) | RTI International | Training Resources Group, Inc. (TRG)DEVELOPING AND USING KEY
PERFORMANCE INDICATORS
A TOOLKIT FOR HEALTH SECTOR MANAGERS
DISCLAIMER
The aXPORU·V YLHRV H[SUHVVHG LQ POLV SXNOLŃMPLRQ GR QRP QHŃHVVMULO\ UHIOHŃP POH YLHRV RI POH 8QLPHG 6PMPHV
Agency for International Development (USAID) or the United States Government. iCONTENTS
Acronyms ............................................................................................ iii
Acknowledgments .......................................................................................... v
Introduction ............................................................................................. 1
What are KPIs? ............................................................................................. 3
Using KPIS in the Health Sector ................................................................... 5
Linking KPIS to Strategy ................................................................................ 7
Linking KPIS to Programs ........................................................................... 11
Characteristics of Good KPIS ...................................................................... 15
Distinguishing Causes from Results ........................................................... 17Types of Indicators ....................................................................................... 18
Setting KPI Targets ...................................................................................... 23
Using Health Information Systems to Manage KPI Data ........................ 31 Defining the Frequency of KPI Reporting ................................................ 35Interpreting KPI Data .................................................................................. 37
Conclusion ........................................................................................... 39
Annex A: Templates for Logic Models ...................................................... 41 Annex B. Special Types of Indicators ........................................................ 43Annex C. Sample KPIs ................................................................................. 47
Annex D: KPI Template .............................................................................. 51
Annex E: References .................................................................................... 55
List of Tables
Table 1. Cause and Result Indicators: A Compariso ...................................... 17 Table 2. Inputs, Outputs, Outcomes, and Efficiency Indicators:Strengths and Weaknesses .................................................................................... 19
Table 3. Input, Process, Output, Outcome, and Efficiency Indicators:Some Basic Illustrations .......................................................................................... 21
Table D.1. KPI Template ........................................................................................ 51
Table D.2. Example of Clinical KPI Using the KPI Template ........................ 52List of Figures
Figure 1. Using a Logic Model to Sharpen Focus on Strategic Plan Goals ... 8 Figure 2. Logic Model for Program Planning ..................................................... 12 iiiACRONYMS
ART Antiretroviral therapy
ARV Antiretroviral
HFG Health Finance and Governance Program (USAID)HIS Health Information System
GFMIS Government (integrated) financial management information systemsHMIS Health Management Information System
ICT Information and communications technology
KPI Key Performance Indicator
MDS Minimum data set
MOF Ministry of Finance
MOH Ministry of Health
M&E Monitoring and evaluation
PI Performance Indicator
SMART Smart, Measurable, Achievable, Relevant, Time-boundTB Tuberculosis
USAID United States Agency for International DevelopmentWHO World Health Organization
vACKNOWLEDGMENTS
This toolkit would not have been possible without the trust, patience, and cooperation of Jeremy Kanthor and the Health Finance and Governance (HFG) Program team. Special thanks also go to Fred Rosensweig, Victor Zafra, and Mark Gallagher for their illuminating suggestions and feedback. Of course, any errors, omissions, or contradictions that remain are solely the responsibility of the author 1INTRODUCTION
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