Background As the third most disaster prone nation in the world, the Republic of the Philippines is subjected to the relentless threat of disasters which have the potential to devastate the economy and impede development. To minimize the morbidity and mortality associated with disasters, health departments in the Philippines must ensure that disaster response practices are continually improved and lessons from previous events are learned. As part of the UNICEF-funded evidence-based planning for resilient health systems initiative (rEBaP) in the Philippines, we were commissioned to develop a robust monitoring and evaluation (M&E) framework for disaster response, to guide this process in local government units (LGUs).

Objectives We aim to identify the underlying theories that explain why some local authorities report success while others failure. Our objectives are to: (1) Document existing interventions for M&E of disaster response and recovery activities conducted by local health authorities; (2) Examine the contextual factors influencing how and why M&E models produce their respective outcomes; (3) Analyze the decision generating mechanism local health authorities use to engage with monitoring and evaluation: and (4) Develop an explanatory framework that synthesizes the findings of the review, attempting to understand why some M&E models produce positive outcomes while others do not.

Methods We have conducted a Rapid Realist Review (RRR) to systematically analyze and synthesize the existing disaster literature to identify the context-mechanism-outcome (CMO) configurations which may affect the outcomes of M&E activities.

Result Our findings suggest that the contextual factors of organizational culture, resources and capacity and governance and regulation have significant influence over how M&E is conducted.

Conclusion The findings provide insights into how and why health departments chose to act in response to the constraining or enabling contextual factors.