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Tracking Contextual Factors in Large-scale, 'real-life' Evaluations of Child Survival Programs in Africa
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| Presenter(s):
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| Elizabeth Hazel, Johns Hopkins University, ehazel@jhsph.edu
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| Jennifer Callaghan, Johns Hopkins University, jcallagh@jhsph.edu
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| Kate Gilroy, Johns Hopkins University, kgilroy@jhsph.edu
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| Abstract:
Large-scale evaluations of child survival programs in low and middle-income countries occur in complex, dynamic environments. Tracking contextual factors is integral to the overall evaluation process and in combination with program implementation documentation, it provides valuable insight for interpretation of evaluation results and is vital for the internal and external validity. Evaluators need information on contextual factors such as demographic patterns, socio-economic factors and the presence of other child survival initiatives to design a sound evaluation and to identify potential confounders and effect modifiers for analysis and interpretation. We describe methodological guidelines for documenting contextual factors, with an emphasis on child health program mapping exercises to track efforts external to the evaluated program. The value and challenges of documenting contextual factors prospectively is demonstrated through case studies from Ghana and Malawi.
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Understanding and Evaluating Scale-Up: Research and Programmatic Challenges
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| Presenter(s):
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| Rebecka Lundgren, Georgetown University, lungrer@georgetown.edu
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| Susan Igras, Georgetown University, smi6@georgetown.edu
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| Ruth Simmons, University of Michigan, rsimmons@umich.edu
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| Abstract:
Many international health programs aim to achieve national level scale up, yet serious gaps exist in understanding the processes by which innovations are scaled up and sustained, and hence, in evaluating programs with scale up goals. A five-year prospective study of the process and outcomes of scaling up a family planning innovation, the Standard Days Method, is underway in Mali, India, Madagascar, Guatemala and Rwanda, drawing upon ExpandNet/WHO's scale up model, which guides scaling up processes and grounds development of a feasible yet rigorous methodology to evaluate results of scaling up programs. First year research findings suggest that periodic systems assessments help maintain accountability and build systems evaluation skills of stakeholders. Analysis of different program elements of scale up led to clearer definition of outcome indicators as well as values such as informed choice that should not be lost as scale up progresses. Program and research lessons learned will be discussed as well as methodological issues.
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Multi-Country Evaluations of Health Care Collaboratives: The Challenges and Opportunities
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| Presenter(s):
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| Mary Gutmann, EnCompass LLC, mgutmann@encompassworld.com
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| Tessie Catsambas, EnCompass LLC, tcatsambas@encompassworld.com
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| Abstract:
As part of a multi-country evaluation of health care improvement collaboratives in low-to middle income countries, EnCompass used a developmental approach to evaluating 35 collaboratives in 14 countries over three continents. Each collaborative focused on one or more health care topics including maternal and newborn health, pediatric hospital improvement, HIV/AIDS, tuberculosis, malaria, and family planning. The contextual diversity of the different countries and health care systems posed a major challenge to the design of an evaluation framework to document best practices and evaluate the results of health care collaboratives in developing countries. The paper describes a participatory, developmental evaluation approach to using context to inform the crafting of evaluation questions, testing hypotheses and identifying new lines of inquiry and exploration. Incorporating context allowed the evaluation to capture system dynamics, interdependencies, and emergent interconnections that increased the validity and generalizability of findings across different models of health care collaboratives.
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