Monitoring and Evaluation Unit was established in July 2005 with a core mandate of coordinating Performance Contracting (PCs), ensuring that progress reports reflect the actual situation and organizing for evaluations. The Unit has enabled learning in the organization and has ensured that MTRH remains faithful to its mission of providing accessible specialized quality health care services and teaching facilities through research, training, capacity building, innovation and participation in National Health Planning.
Monitoring and evaluation (M&E) defined, is a systematic way of learning from past experience and using the lessons learned to improve service delivery, planning and allocating resources, and demonstrating results as part of accountability to stakeholders by selection of alternatives for future action.
Departmental Vision
To be the leading department in the provision of Monitoring and Evaluation functions at MTRH and beyond
Departmental Mision
To provide timely information to facilitate evidence-based decision making in order to enable the provision of accessible specialized quality health care services and teaching facilities through research, training, capacity building, innovation and participation in National Health Planning.

QUALITY OBJECTIVES FOR MONITORING AND EVALUATION UNIT

1. To involve all departments, sections, Units and all Agents in the Hospital in the process of developing and executing their yearly Performance Contracts according to the institutional and Government of Kenya guidelines by generating quarterly feedback reports.

1. To support development of Monitoring and Evaluation staff by ensuring each member of the department attends at least six relevant CPD’s by the end of the financial year.

3.   To meet statutory/institutional requirements deadlines in the preparation of performance reports to the Ministry of Medical Services within 30 days after the end of each quarter
The functions of Monitoring and Evaluation is carried out through existing structures – the Board of Management, Performance Contracts Steering Committee, and regularly scheduled  Divisional and Departmental meetings where reports are expected on performance. The purpose of quarterly and annual reports is to validate performance, determine deviations and reasons then re-plan based on the available resources.
At the Board level, management submit quarterly financial and narrative reports. All reports to the Board emanates from the Divisions through Senior Management, after having been discussed by the respective departments. These reports are based on respective signed Performance Contracts.
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1. Receiving of monthly performance Reports from the agents before the 5th day of every month.

2. Consultation on performance contracting from Monday to Friday

3. Preparing a quarterly feedback reports to Agents at the end of each Quarter,

4. Preparation of Performance Report to the Ministry of Medical Services at the end of each quarter

5. Facilitate the process of developing Performance Contracts, Monitoring the implementation of the PCs and Evaluations the performs quarterly and annually

Performance Contracting
Performance Contracting is an effective and promising means of improving the performance of public enterprises as well as government departments. Essentially, a Performance Contract is an agreement between a government and a public agency which establishes general goals for the agency, sets targets for measuring performance and provides incentives for achieving these targets. They include a variety of incentive-based mechanisms for controlling public agencies—controlling the outcome rather than the process.
Performance Contract is defined as a freely negotiated performance agreement between a Principal and an Agent that clearly specifies their mutual performance obligations, intentions and responsibilities. It belongs to a branch of management science referred to as Management Control Systems.
It involves the setting of verifiable performance indicators (Targets) which are freely negotiated between the Principal and Agent at the beginning of a contract period (1st July – 31st June).These Performance Indicators are monitored on monthly basis and evaluated quarterly through Monitoring and Evaluation procedures.
During the 2009/2010 financial year individual staff were brought on board and were involved in Performance Contracting as they signed Performance Contracts with their respective Departmental Heads.