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Base de données d'évaluation

Evaluation report

2001 IRN: Evaluation of the Client Oriented Monitoring Tool (Self-Evaluation Method) in Semnan Urban Health Centers

Author: Nouraee, M.; Younessian, M.; Seddighi, J.; Maalekinejad, M.; Majdzadeh, S. R.

Executive summary


The following text is a field study of a monitoring method called "Self-evaluation". In this monitoring method, the service providers at the health center (by looking at the service quality based on client perception) evaluate their services in a group fashion. This evaluation then leads towards monitoring the services of the center, and helps to continuously improve the quality of service provision by the center.

Purpose / Objective

The objectives of the field study can be summarized in two categories:

- Finalization of the instruments and how to proceed with the "self-evaluation"
- Analyzing the effectiveness of this monitoring method


The effectiveness of the "Self-evaluation" has been assessed based on the study of applicability, learning orientation, comparing the monitoring role of this method with regular supervision and its effect on the working condition in the center, and knowledge and satisfaction of the clients. In order to assess the effectiveness of "self evaluation", the baseline data were collected from the urban health centers of Semnan district, and then, by random sampling, centers were classified into two groups of intervention "self-evaluation training" and "regular supervision". After the completion of the first session of "self evaluation", the "post intervention data" were collected from the health centers, to be compared with each other. The base for the analysis of the goals of learning orientation and applicability were the staff of the intervention centers and, for analysis of other goals, they were the difference of the data collected after the education and "self evaluation" execution intervention with the basic data.

Key Findings and Conclusions

86.5% and 100% of the staff of three intervention centers and one pilot center, respectively, stressed that they would encourage their colleagues in other centers to undergo the "self evaluation". They mentioned the monitoring role, improvement of inter-staff relations, and promotion of the incentive as strong points of "self evaluation". Meanwhile, the weak points expressed stressed the lack of co-ordination with higher levels and the possibility of discouragement in cases where the network would not respond to the referred cases.

Comparison of the monitoring role of "self evaluation" and regular supervision shows that "self evaluation" does not face the supervision problems such as superficiality and the extent of the revealed problems. Due to the manner of its execution, it can be continuous. In contrast, the average duration between two regular supervisions was four months.

"Self evaluation" has increased general job satisfaction of the staff and satisfaction from other colleagues; and has improved their attitude towards their relations with their colleagues. However, "self evaluation" has not shown a meaningful difference in the attitudes towards management and the practice of the centers.


The results obtained bear out that it is possible to adapt "self evaluation" according to the service provision conditions. It is, therefore, recommended to act on the following lines:

- Strengthening program monitoring and evaluation on other levels of the health system, by utilizing the attitude obtained from "self evaluation in urban health centers".

- Extending self-evaluation to other services of the health centers, including child care, growth monitoring, vaccination, family planning etc.

- Evolving the "self evaluation" method, for example, by using public participation and integrating it with smoothing the supervision.

- Continuation of field study in a way that complete evaluation of the variables and, especially, mid and final outcomes (such as coverage of target group, continuation of service provision and client health) would be analyzed.

- Considering "quality with a client-based attitude" in defining standards for health service programs.


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Report information





Health - Managment

Ministry of Health and Medical Education


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