Reproductive health service delivery organizations in developing countries are increasingly engaging in advocacy for social change.

This paper examines this trend and lays out the related monitoring and evaluation (M&E) challenges. It argues that M&E strategies can demonstrate accountability and deliver results to stakeholders—both upwards to donors and downwards to the individuals providers serve. Building on the strengths of existing services and advocacy M&E practices enables providers and advocates to “shake the M&E tree” and harvest fruit that already is ripe for picking.

The paper looks at reproductive health civil society organizations (CSOs, or nongovernmental organizations) engaging in advocacy for social change, discusses their M&E practices and challenges, and posits M&E strategies that combine both services and advocacy. IIt also poses some priorities for an integrated M&E approach to services and advocacy, illustrated with the approach of an Ethiopian CSO.