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Case Study
Use of Blogs as a Tool for Monitoring and Evaluation – A
case report from Health Department
Dr.J.Mariano Anto Bruno Mascarenhas1, Thiru.P.W.C.Davidar I.A.S.2,

Abstract
Work undertaken at periphery is being Monitored and Evaluated at the Central Office by various
means. Use of a “Group Blog” for monitoring of the work was tried by Tamil Nadu Health Systems
Project. The implementation went smoothly and the user acceptance was immediate and full and
the end users were very comfortable with this system. We report this case to serve as an eye
opener that “Hi end”, “advanced” and “latest" Technology need not be used just because it is
available and the minimum technology needed for a project can still give the desired or may be
even better result (because of the comfort level of the end user.)

Keywords
Blog, Monitoring, Evaluation, M&E, User Acceptance, Time Lag, Photo
For Correspondence
Dr.J.Mariano Anto Bruno Mascarenhas

Introduction
Tamil Nadu Health System Project is a World Bank Funded Project for improving the Quality of Care in
Secondary Care Hospitals. Project work undertaken across the state in various districts has to be
continuously monitored and evaluated for timely implementation of the project. In addition to depending
on the report by routine mail telling in words “completed” / “ongoing” / “started”, the project decided to
monitor the actual scenario by looking at photos taken at the work site.

Conventional Method of (M&E)

In the Conventional method of monitoring with photographs, for a work being undertaken (for example)
at Kanyakumari District, a photo is taken. The negative is then developed, photograph printed and is send
by Courier / Post and it reaches Chennai. There are quite a few disadvantages with this method like
ª Time Lag
– Time needed for Developing and Printing
– Time needed for sending the photos from Periphery to Chennai
ª High Cost involved
– Cost involved in Film, Processing
– Courier Charges
ª Difficulties in monitoring

1
Coordinator –Management Information System, Tamil Nadu Health System Project, Department of Health
and Family Welfare, Government of Tamil Nadu at the Time of this case report and Post Graduate in Neuro
Surgery, Institute of Neurology, Madras Medical College and Government General Hospital, Chennai at
Present. bruno@targetpg.com Address for Communication : “Annai Vailankanni”, 2/604, 12th Street (East), P
& T Colony Extn, 3rd Mile, Thoothukudi - 628008
2
Project Director, Tamil Nadu Health System Project & Special Secretary to Government, Department of
Health and Family Welfare, Government of Tamil Nadu at the time of this case report and Secretary to
Government of Tamil Nadu, Information Technology Department at Present secyit@tn.nic.in
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– Additional Copies needed to be sent to all the personnel involved
– Difficulty in Filing and Retrieving
– How to arrange
ƒ Whether district wise
• Finding the works undertaken in the current week is difficult
ƒ Or Date Wise
• Finding the progress of the work in a hospital over two months is difficult

Using E Governance for Monitoring and Evaluation

So it was decided to use a form of electronic system that does not depend on Developing and processing
of the films, does not depend on Post /Courier, does not need additional copies and makes life simple
while accessing the data using a various of parameters. The traditional softwares were usually a Server –
Client Model, and software of those model has inherent shortcomings like Problems with Updating each
Client Software and the system can be sued from particular systems only.

A Web Based System system, on the other hand, can be used from any computer that has Net
Connectivity, can be accessed from Any where with a computer connected to Internet and data can be
uploaded from anywhere with a computer connected to Internet

Options for Web Based Monitoring Interface

There are 4 Options Available
1. Development of a new custom made software from scratch
2. Use any “photo sharing” software already available and “modify” it to suit Tamil Nadu Health
System Project ’s needs
3. Use a Blog and Modify the Template to suit the purpose
4. Ask the persons to just send the photographs by Mail marking copies to all concerned

Case Report
We created a group blog, with administrative control with the Project Management Unit and stakeholders
in periphery as blog users and modified the template to suit our pattern. The advantage with this system
was many. There was no need to develop negatives, there was no need to print, no need to post/courier
the copies, no need of Multiple Copies and more over the access was in real time. Any one from the
Officer Manning the Particular Programme at the Project Management Unit / Project Director / Health
Secretay etc see the images in real time
The Next big Advantage was Categorization. Photos can be accessed by name of Builiding (eg Maternity
Ward), Name of the Hospital (eg Annavasal), name of the District (eg Theni), Week / Month the photo
was taken (eg 19th March to 25th March)

Since The software is web based and does not need any installation at the Client End All the data are also
stored in the server. The Photos and other Data can be viewed and assessed from the following
URL http://civil.tnhsp.net/from any computer with Internet facility and a browser.

And this does not need a dedicated server. Can be hosted on Web Hosting Servers at a cost of about Rs
5000 – 10000 per year (depending on the number of photos) or can be hosted at NIC Servers

The project took very little time from conception of the idea to actual implementation and can be seen
from the timeline below

9th March 2007 The Need for a Monitoring and Evaluation Tool was discussed
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th
12 March 2007 A prototype was developed and tested in Chennai
13th March 2007 Added the list of Hospitals in the Civil Works Software
15th March 2007 Moved the civil works monitoring software to civil.tnhsp.net
16th March 2007 User Manual Prepared
20th March 2007 One day Hands on training given to End Users
23rd March 2007 First Round of Photos received from Theni and Kanyakumari

Time From “Discussing the need for a software” to “final implementation” took only 2 weeks.
The project is running successfully from March 2007 till today at http://civil.tnhsp.net

Discussion
Comparing Various Options
The Pros and Cons of the various options are listed below
Option Pros Cons
Custom Made Software Tailor Made and so suits the purpose to Time Lag
the maximum ª Time to Get Administrative
Sanction
ª Time to get Financial
Sanction
ª Time to call for tender
ª Time to Finalise Contract
ª Time to Prepare SRS
ª Time to Pilot
ª Time to Debug
ª Time for implementation
ª Time for the Users to get
used to the interface
Work Flow has to be defined
Newer Bugs
Modification of Photo Quicker and with less bugs as compared to Users have to learn the interface
sharing software previous
Group Blog Minimum Time and Minimum debugging To be labeled as a “lazy”
while implementation approach
To post in a Blog = Write a Mail
E Mail Least Learning Time and most easy Categorization and Retrieval is
Learning Curve for the End Users difficult

Advantages of Group Blog

Minimum Learning Curve for the User
In the Training it was stressed that posting to a blog is similar to sending a email
E Mail Our Software
Login Login
Compose New Photo
Subject Subject
Text Details
Attachment Upload Photo
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Send Post

Familiarity for those already blogging

No need to learn new commands or shortcuts
Users can use their old user name and Passwords (if they already have one) – No need to remember one
more user name

Lessons Learnt
1. For any software implementation, user acceptance is more important than the choice of
technology
2. The lesser number of keystrokes and mouse clicks you give to the end user, the more will be the
acceptance
3. Familiar interfaces and Graphical User Interfaces (GUI) are more acceptable than a entirely new
interface
4. Lesser the number of error messages or interruption, more chance for users to adapt to the system
5. Web based software is better than client server based
6. Use of Local Language Interface increases user acceptance

Moral for Software Implementation

Latest and “Hi end” Technology need not be used just because they are available
KISS – Keep it Short and Simple
Use Local Language

Suggested Use of this method

This method is most suited for small projects which may not have the time or budget or both for a custom
made software, especially when implementation has to be started immediately. Also suited for emergencies
(Tsunami Relief, Flood Relief) and temporary programmes (Pulse Polio, Chikungunya)

Acknowledgement :
The authors thankfully acknowledge the contribution of Staff involved in photographing and sending the
photos for having made this project a success

References:
1. http://en.wikipedia.org/wiki/Blog
2. http://en.wikipedia.org/wiki/Collaborative_blog

Source of Support :
Tamil Nadu Health System Project is a world bank aided Project

Conflict of Interest :
Nil