Key point

A useful indicator is valid, clearly defined, feasible to collect, sensitive to meaningful change, and connected to a decision.

Start with the result

Write the program result before writing the indicator. “Improve childhood immunization coverage” is an objective. “Percentage of children aged 12-23 months who received three doses of pentavalent vaccine” is an indicator.

Indicators may describe inputs, activities, outputs, outcomes, or impact. A balanced framework usually needs several levels, but not every available measure belongs on the routine dashboard.

Define every component

ComponentQuestion to answer
NameWhat exactly is measured?
NumeratorWhich people, events, or units count?
DenominatorWhat is the eligible population or total opportunity?
Data sourceWhich register, survey, system, or record supplies the data?
FrequencyHow often is it calculated and reviewed?
DisaggregationWhich groups or locations must be compared?
ResponsibilityWho collects, validates, analyzes, and acts?

Worked example

Indicator: Percentage of suspected disease alerts verified within 24 hours.

  • Numerator: Suspected alerts verified within 24 hours during the reporting period.
  • Denominator: All suspected alerts received during the reporting period.
  • Formula: Numerator divided by denominator, multiplied by 100.
  • Source: Alert log and verification record.
  • Frequency: Weekly calculation, monthly review.
  • Disaggregation: District, alert source, and disease category.

Set baselines and targets carefully

The baseline should use the same definition and data source planned for future reporting. Targets should reflect expected program contribution, resources, implementation time, historical performance, external conditions, and equity goals. Avoid setting targets only because they are easy to communicate.

Check indicator quality

  • Validity: Does it measure the intended result?
  • Reliability: Would different trained staff calculate it consistently?
  • Feasibility: Can the required data be collected at acceptable cost?
  • Timeliness: Is the result available before the decision is needed?
  • Disaggregation: Can inequities or implementation gaps be detected?
  • Actionability: Is there a defined response when performance changes?

Common mistakes

  • Using vague terms such as “adequate,” “timely,” or “quality” without thresholds.
  • Changing numerator or denominator definitions between reporting periods.
  • Counting services delivered without checking whether clients were eligible.
  • Collecting too many indicators and reviewing too few.
  • Setting a target without documenting the baseline and assumptions.

References

UNAIDS. An Introduction to Indicators. Monitoring and Evaluation Fundamentals.

World Health Organization. Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies. 2010.