Type of indicators

Input indicators

These indicators refer to the resources needed for the implementation of an activity or intervention. Policies, human resources, materials, financial resources are examples of input indicators.

Example: inputs to conduct a training course may include facilitators, training materials, funds.

Process and output indicators

Process indicators refer to indicators to measure whether planned activities took place. Examples include holding of meetings, conduct of training courses, distribution of medicines, development and testing of health education materials.

Output indicators add more details in relation to the product (“output”) of the activity, e.g. the number and categories of health providers trained in case management or communications skills, the number and type of radio spots produced and broadcast.

Example: the output of a training course on case management may be the number of medical assistants trained and, consequently, the number or proportion of them with improved knowledge and skills in case management.

Indicators should also monitor the quality of the activities conducted, based on a number of established quality criteria or standards.

Example: indicators to monitor the quality of a communication training course may include the ratio facilitator to participant, the total duration of the training, the percentage of total training time spent practising the communication skills, the number of caregivers counselled per participant, the proportion of participants trained that were followed up with skill reinforcement visits within 4 weeks of training.

These indicators are useful management tools to monitor implementation and its quality. However, they do not provide information on the results and impact of the activity.

Outcome indicators

Outcome indicators refer more specifically to the objectives of an intervention, that is its ‘results’, its outcome. These indicators refer to the reason why it was decided to conduct certain interventions in the first place. They are the result of both the “quantity” (“how many”) and quality (“how well”) of the activities implemented.

Example: the outcome of a training of health providers in the Integrated Management of Childhood Illness (IMCI) should be improved management of sick children under 5 years old, e.g. the proportion of sick children correctly managed by the trained health providers.

These indicators are usually measured through surveys. Coverage indicators measure the extent to which the target population (e.g. children under-five) has received—and therefore has been reached by—the intervention.

Examples: proportion of under-five children with suspected pneumonia treated with antibiotics, proportion of under-five children with diarrhoea given oral rehydration therapy, proportion of infants 0-5 months old who are exclusively breastfed.

These indicators, therefore, allow us to know whether the desired outcome has been generated.

It may take time before final outcomes can be measured. A number of intermediate outcome indicators should therefore be identified for all the intermediate changes that the intervention is expected to bring about and that will eventually lead to the final outcome. This helps us know whether we are progressing towards achieving the expected final outcome.

Impact indicators

Impact indicators refer to the health status of the target population: reduction in child mortality, reduction in child morbidity, improved child nutritional status.

These indicators do not show progress over relatively short periods of time. It is then the logical flow of indicators described above which enables a more regular and frequent monitoring of changes.