The format of a survey data collection results in an oversimplification of monitoring and improvement systems. The surveys were designed to collect a census of current monitoring activities. However, the actual complexity of these systems is difficult if not impossible to summarize through a questionnaire. This complexity is for the reason for including in-depth site visits in the evaluation design. The interactive dynamic of site visits is better suited for teasing out what states are doing when they monitor, what they monitor, and what they do with the results.