Challenges of Programs Evaluation of Health Interventions in Developing Countries

by Wynn, Barbara; Nelson, Martha I.; Dutta, Arindam

• ISBN13: 9780833038524
• ISBN10: 0833038524
• Format: Paperback
• Copyright: 2005-11-01
• Publisher: RAND Corporation

Summary

Examines various approaches, methodogies, and issues related to evaluation of the impact of health programs in developing countries and ways to make program evaluation more rigorous.

Table of Contents

Preface	iii
Figures	ix
Tables	xi
Summary	xiii
Acknowledgments	xxi
Acronyms	xxiii
Introduction	1	(12)
Purpose of the Study	1	(1)
Program Evaluation in Developing Countries	2	(1)
Vaccination Campaigns	3	(5)
Malaria	4	(1)
Tuberculosis	5	(2)
Hiv/aids	7	(1)
Challenges Facing Program Evaluation	8	(2)
Study Approach and Methods	10	(1)
Organization of This Report	11	(2)
A Conceptual Framework for Evaluating Health Projects in Developing Countries	13	(12)
Traditional Framework for Program Evaluation	13	(3)
Scaling Evaluation Intensity to Potential Impact	16	(2)
Using a Logical Framework to Stage an Evaluation	18	(3)
Stage One	19	(1)
Stage Two	19	(1)
Stage Three	20	(1)
System Impact Assessments	21	(4)
Methodological Challenges in Evaluating the Impact of Health Projects in Developing Countries	25	(18)
Attribution Issues	26	(7)
Internal and External Validity	27	(1)
Unobserved Heterogeneity	27	(1)
Randomized Control Trials	28	(2)
Cluster-Randomized Trials	30	(1)
Quasi-Experimental Designs	31	(1)
Pre-Post Regression Analysis	32	(1)
Measurement Issues	33	(10)
What to Measure	33	(2)
How to Measure	35	(3)
Data Limitations	38	(1)
Use of Surrogate Markers	39	(2)
Multidisciplinary Measures	41	(2)
Current Status of Program Evaluation in Developing Countries	43	(16)
Summary of Findings from the Review of HIV/AIDS Program Evaluations	44	(3)
Summary of Findings from the Review of TB Program Evaluations	47	(7)
Discussion of Findings from HIV/AIDS and TB Program-Evaluation Reviews	54	(1)
The Progresa Program: A Case for Impact Evaluation	55	(4)
Research and Other Actions to Promote Impact Assessment	59	(16)
Actions to Increase Support for Impact Evaluations	61	(4)
Developing Priorities for Impact Assessments	61	(1)
Building a Case for Impact Evaluation	62	(1)
Encouraging Multidisciplinary Evaluation Designs	63	(1)
Creating Funding Incentives	64	(1)
Actions to Improve Evaluative Capacity	65	(3)
Facilitate Use of Evaluation Methodologies	65	(1)
Increase Independent Evaluator Technical Capacity	66	(1)
Increase Local Evaluation Capacity	66	(1)
Disseminate Research Findings	67	(1)
Actions to Improve Evaluation Methodologies	68	(3)
APPENDIX
HIV/AIDS Data Sources	71	(4)
Bibliography	75