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INPUTSAND PROCESSIt is recommended that the Home CareNetwork reviews with the HCTs the system ofmonitoring and reporting patient numbersand team activities.It is beyond the scope of this report to developspecific recommendations on the answers tothese questions. However, the following suggestionsare offered:In addition to numbers of visits and patientnumbers, the monthly team reports also providedata on referrals, deaths, volunteer activities,community contacts, expenditure, etc., all ofwhich are useful for monitoring inputs andprocess.5.8.2 Monitoring impactApart from reviews and evaluations such asthis one, there is no system in place to measurethe impact of the programme on PLHA, families,communities or the health system. It is stronglyrecommended that the HCNG initiates aprocess to establish an impact monitoring systemfor the Home Care programme. Having apilot monitoring system underway in PhnomPenh will provide valuable lessons in establishinga system in the Provinces, where capacityand resources may be more limited.Decisions need to be made on:• what should be monitored (and why)?• what are the most appropriate methods?• who should conduct the monitoring?• Selected Quality of Life (QoL) indicatorswould be most appropriate for measuringimpact on PLHA and their families.Case studies could complement routinesampling of families visited by the HCTs.• At the community level, support groupsand community leaders could be involvedin participatory impact monitoring activities,perhaps using PLA techniques andinvolving volunteers.• At city level, the HCNG would need toliaise with hospitals and health centresto develop appropriate indicators andmethods of verifying the impact of theprogramme.The HCTs have already began a processof identifying indicators, and this will hopefullybe continued during the forthcoming participatorylocal partner reviews in July. However, thedifficulties in establishing even a simple buteffective impact monitoring system should notbe underestimated, and external resources andexpertise in impact monitoring are likely to berequired.• are any special skills required, and if so,who should help develop these skills?• over what scale and timeframe maythe different types of monitoring beappropriate?It is recommended that the HCNG seekstechnical support to facilitate the process ofestablishing an impact monitoring systemfor the Home Care programme, includingdeveloping appropriate indicators.pg 55