Performance Improvement Review Package (PIR)



To provide organizations with the tools and guidance necessary to help them monitor and improve the quality and performance of integrated programs.


The Performance Improvement Review (PIR) package measures actual program performance against established performance indicators. The review is a rapid, biannual, self-assessment process that enables organizations to obtain comprehensive pictures of their current programs, identify strengths and weaknesses, and make competent decisions to improve the management of and services offered by the programs. PIR collects qualitative data on five categories of program performance: management and organization, supply system, sustainability, quality of service and community commitment. Qualitative data are complemented with quantitative data to ensure a balance between quality and results. PIR includes a four-step process for conducting performance reviews. The four steps are: planning, collecting data, analyzing data, and preparing a performance improvement plan to guide monitoring. Examples, worksheets and detailed instructions are provided to guide users through the process. The package can be used for internal program reviews, to guide workshops of performance reviews or a reference tool for quality assurance.

Developed by:

Initiatives Inc with support and funding from the Family Planning Service Expansion Technical Support (SEATS) project, in August 2000.

Intended Users:

The PIR Package is designed specifically for health and community development NGO managers and program officers. However, anyone seeking guidance for monitoring the quality of the delivery of reproductive health services, or other services offered at the community level, will find the PIR Package is a useful reference.


The PIR Package was field-tested with four different NGO managed integrated family planning projects in India, Zambia, and Zimbabwe between 1996-1999. Two of these organizations used the process on a biannual basis for a period of two full years. PIR was also adapted for use in national clinics offering services in Jordan, for NGOs implementing integrated community health programs in Zambia, and to a forest co-management project in Guinea. For these programs, new instruments have been developed and/or existing instruments adapted.


PIR gives managers and staff a clearer sense of program performance and the knowledge they need to define actions to improve their program. As a quality assurance tool, PIR guides organizations through the steps of collecting information about their programs, analyzing data, identifying strengths and weaknesses, creating concrete performance improvement plans and monitoring the implementation of actions. As a participatory process that necessitates the involvement of all program partners, PIR also helps strengthen partnerships. Performance improvement reviews can be conducted in a few days, making semi annual reviews possible. Periodic reviews enable organizations to follow up on issues and actions in order to assure that their programs are moving forward in the right direction. PIR also enables organizations to put together a graphic picture of program performance and development over time. The success of the PIR process is measured by its ability to involve staff in self-assessment, problem solving and improvement monitoring as a continuous, sustainable, self directed activity. Furthermore, the methodology can be adapted to other programs such as community-based environmental initiatives.


The process requires the organization/manager to engage in thoughtful review and consideration of the content to maximize its benefits. While the methodology is useful for a variety of programs, the instruments and other tools may need to be adapted to suit the context/and or needs of other programs. NGO managers with little or no experience in program assessment need assistance in using the tool initially. Managers with experience in monitoring and quality assurance will find the tool accessible from the start. The tool is only as effective as the people who use it. In order for PIR to be effective, organizations have to be willing to take an honest look at their programs and put in the effort necessary to implement action plans.

Recommendation for Users:

The PIR process has been successfully adapted to a variety of programs for both NGO community-based activities and clinic-based programs. The methodology has also proved useful for programs outside of public health. Recently, the PIR methodology was adapted to a forest co-management program in Guinea.

Reports and Publications:

PIR was based on the steps and guidance provided in the handbook Integrating Reproductive Health into NGO Programs: Volume 1: Family Planning. The package includes guidance and worksheets for each step.

Bjerregaard, Donna. Performance Improvement Review for Quality Assurance. Reproductive Health Integration Issues. Initiatives, Inc. Volume 2, Number 3: November 1999.


PIR is available in English in electronic (PDF) or hard copy.


Melissa Chalmers
Initiatives, Inc.
376 Boylston Street, Suite 4C
Boston, MA 02116 USA
Phone: 617-262-0293