1 / 20

Program Evaluation: a potential platform for cross site analyses

Program Evaluation: a potential platform for cross site analyses. Louise C. Ivers, MD, MPH and Joia S. Mukherjee, MD, MPH Partners In Health, Division of Global Health Equity, Brigham and Women’s Hospital, Harvard Medical School. Context: Reason for Program Evaluation.

hazina
Download Presentation

Program Evaluation: a potential platform for cross site analyses

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Program Evaluation: a potential platform for cross site analyses Louise C. Ivers, MD, MPH and Joia S. Mukherjee, MD, MPH Partners In Health, Division of Global Health Equity, Brigham and Women’s Hospital, Harvard Medical School

  2. Context: Reason for Program Evaluation GHI spending may not be distributed evenly throughout countries Sub-recipients / partners at district, local or grassroots level are involved Program-level evaluation gives opportunity to examine variability in impact that may not otherwise be seen at a macro level

  3. Program Evaluation: Aims Evaluate performance of local health system impact of GHI on HS Impact of HS on GHI Facility level evaluation Community level evaluation

  4. Methods Quantitative data at program level Comparative analysis Historical control Projected targets Qualitative data via ethnographic surveys and focus groups with patients and providers

  5. Performance of Health System Scale Scope Distribution Quality/safety of services System capabilities (response to emerging and changing challenges)

  6. Process: Human Resources Number Distribution / per population served Skill level Skill mix Accreditation

  7. Outcomes Targeted disease/health outcomes GHI specific Non-targeted health outcomes Child Health DTP3 Diarrheal illness (2 weeks) Under 5 malnutrition (diagnosis and treatment) Maternal Health Births assisted by skilled worker Family planning uptake

  8. Outcomes: Patient-focused lens Quality of services Diversity of services Health literacy Fairness

  9. Delivery / access / linkages Attendance at antenatal clinic Attendance at primary care clinics Number of children weighed Existence of functional referral systems Community  health clinic  secondary/tertiary  community

  10. Lascahobas, Haiti: Attribution of Financing

  11. Lascahobas, Haiti:Work force, 2002 vs. 2007

  12. Lascahobas, Haiti:Health Service Utilization, 2002 vs. 2007

  13. Care Targets • MOH targets for primary health care utilization: 10% of population per month, 1.2 visits per capita per annum • WHO targets for ANC: 4% of total population is pregnant in a given year • Global TB report TB incident and prevalence • UNAIDS and country reports for HIV prevalence

  14. Lascahobas, Haiti:Is it stronger?

  15. Using the Yard Stick • Disease specific: HIV detection, ART enrollment, TB case detection and treatment, pMTCT • Total number : general visits, ANC, family planning uptake, immunization • Health personnel: numbers and cadres • Drugs: % of full “essential drug package” • Diagnostics: number of diseases “diagnosable”

  16. Rusumo, Rwanda: 2006 vs. 2007

  17. Rusumo, Rwanda:Is it stronger?

  18. Further Challenges • Outcomes • Temporal changes—strengthening, integraton • Evaluating quality of services • Evaluating counterfactual—clinics that have not had the benefits of GHI monies OR the GHI monies were used only vertically

  19. Next steps: • Developing a data abstraction tool Aug 28, 2009 • Evaluation of 2-3 PIH supported MOH clinics in Haiti, Rwanda, Malawi, Lesotho and one counterfactual in each Jan 1, 2009 • Visits to 4-5 other countries to analyze a clinics with tool Mar 1, 2009 • Analyze and interpret and write May 1, 2009

More Related