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A diagram with "Monitoring & Evaluation" at the top, connected to three surrounding bubbles labelled monitoring, process evaluation, and impact evaluation.

Outcomes are very relevant to stakeholders in order to continue, improve or stop programmes. Quality data must be gathered during all stages of implementation, so a clear monitoring framework and evaluation plan with specific indicators should be established during planning. Time and personnel resources should be planned accordingly to ensure continuous monitoring throughout the whole duration of the programme.


Monitoring aims to track performance of a programme over time with indicators that are collected on a regular basis. An initial evaluation of spectacle wear, wearing behaviour, adaptation problems etc. should ideally be carried out after just a few weeks. Periodic monitoring and auditing the referrals by screening personnel and compliance with spectacle wear after 6 months are also important.


Evaluation on the other hand, provides feedback on how the programme was implemented (process evaluation) or its impact (impact evaluation). It can be conducted at mid course or at the end of the programme, and should be undertaken by external individuals who have relevant expertise.

Monitoring (and auditing) Process evaluation Impact evaluation
Objectives track performance of the programme over time assess if the programme was implemented as planned and if not, why not assess the extent to which the goals and objectives have been met, and if not, why not
Examples of indicators number of children/teachers screened, screening accuracy, referrals, spectacle wear, attendance rates satisfaction of the children, teachers, parents and other stakeholders with the processes impact of spectacles on quality of life and visual functioning of children and teachers, impact on school attendance or academic performance, compliance on spectacle wear and follow-ups, and reasons for noncompliance


A flowchart outlining the steps in school eye health screening M&E. It includes visual acuity screening, refraction, and outcomes & impact. It includes steps like the number of children enrolled, tested, screened, referred, prescribed spectacles, and wearing spectacles, with data disaggregated by age and gender.

Monitoring will allow the programme makers to identify if parts of the programme aren’t reaching the objectives and take corrective actions to adjust. Main indicators should provide information on coverage, reach, outcomes, compliance, cost-effectiveness and quality of the programme :

  • Number of children screened : provides information on the reach and coverage of the programme. If the number is low, we need to find out how to reach more children in the school or the community
  • Number referred / number prescribed glasses: provides information on the outcomes of the programmes; helps planning in a cost-effective manner
  • Number attending referrals / number of spectacles dispensed : provides information on the impact of the programme; if low compliance, it is necessary to investigate to identify the main causes of non-compliance in the region
  • Number correctly referred (true positives) : indicates the effectiveness of the screening
  • Number of children missed (false negatives) : can be calculated by rechecking a sample, 10%, of the children who passed the screening; indicates the quality of screening.

Given that young girls with refractive disorders carry a higher burden than boys32, all data should be collected and analysed by sex and disability. This methodology will help compare results between both sex and prevent gender inequalities and promote inclusiveness in the programme.

Disability (Y/N) Male Female Total
Output indicators (number)
Training Screeners trained
Eye care professionals (or allied health workers) orientated for detailed examination in schools where applicable
Screening of teachers Teachers screened
Teachers dispensed spectacles (near and/or distance)
Teachers referred
Health promotion Children exposed to health education
Parents (and/or other community members) exposed to health education
Parents of children dispensed spectacles exposed to health education
Parents of children referred exposed to health education
Outcome indicators (%)
Spectacle provision & referrals for teachers Proportion of teachers requiring spectacles who receive them
Proportion of teachers referred who access eye care services
Impact indicators
Number of children undergoing surgery (sight restoring or strabismus)
Change in quality of life / visual functioning in children wearing spectacles
Improvement in school performance
Programme indicators
Spectacle dispensing Number of spectacles dispensed
Number and % of children eligible to ready-made / ready-to-clip
Costing Cost per child screened
Cost per child needing spectacles
Cost per child receiving medication