Monitoring and evaluation in public health has a timing problem.
The traditional M&E cycle works like this: health workers collect data on paper forms, forms are aggregated at facility level, district officers compile them into reports, national-level analysts review the reports, and eventually a summary reaches programme managers. By the time a decision-maker sees that a key indicator is underperforming, months have passed. The programme has continued in the wrong direction. The opportunity to course-correct was lost weeks ago.
Digital M&E changes this. When data is captured electronically at the point of collection, whether through a tablet, a smartphone, or an SMS-based system, it can flow in near-real-time to dashboards that programme managers, district officers, and national teams can all see simultaneously. The feedback loop compresses from months to days.
I have seen this work firsthand at WHO. The difference is not just speed. It is the quality of the questions that get asked. When data is stale, the most common question is "what happened last quarter?" When data is current, the question becomes "what is happening now, and what should we do about it?" That shift in question changes the entire character of programme management.
But digital M&E is not simply about software. The tools are the easy part. The hard part is the human system around the tools.
The first challenge is data entry discipline. A digital form that is filled in correctly produces better data than a paper form. A digital form that is rushed, skipped, or filled in by someone guessing at values produces worse data than paper, because the errors are invisible. Digital tools create a false sense of data quality unless you build in validation, range checks, and completion audits from the start.
The second challenge is interpretation capacity. Dashboards that show indicators in green and red are only as useful as the people looking at them. If district officers cannot interpret a control chart, a real-time alert is just a source of anxiety. M&E digitalisation must be accompanied by data literacy training, not optional training, but embedded capacity building that is part of how the system is deployed and maintained.
The third challenge is sustainability. Health systems are littered with digital tools that were funded by a project, worked well during the project, and were abandoned when the project ended. Sustainable digital M&E requires that the tools are owned by the ministry or programme team, that technical capacity to maintain them exists internally, and that the cost of operation is built into the recurrent budget. These are institutional design questions, not technology questions.
When these conditions are met, digital M&E is transformative. It brings the programme data into the same room as the strategy conversation. It makes underperformance visible early enough to act on. And it creates an institutional memory, a longitudinal record of what was tried, what worked, and what did not, that outlasts any individual staff member.
That is what modern M&E looks like. And that is what I am working to build.