Challenges in Program Evaluation of Health Interventions in Developing Countries

Challenges in Program Evaluation of Health Interventions in Developing Countries

Barbara O. Wynn
Arindam Dutta
Martha I. Nelson
Copyright Date: 2005
Edition: 1
Published by: RAND Corporation
Pages: 114
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  • Book Info
    Challenges in Program Evaluation of Health Interventions in Developing Countries
    Book Description:

    Health interventions that are effective in developed countries may not be as effective in developing countries given the differing social, economic, cultural, and infrastructure factors that may affect a program's implementation and outcomes. This monograph is intended to promote an understanding of why program evaluation is a critical component of any health intervention and to stimulate discussion on ways to make evaluation of health interventions in developing countries more rigorous.

    eISBN: 978-0-8330-4818-9
    Subjects: Health Sciences, Political Science

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-viii)
  4. Figures
    (pp. ix-x)
  5. Tables
    (pp. xi-xii)
  6. Summary
    (pp. xiii-xx)
  7. Acknowledgments
    (pp. xxi-xxii)
  8. Acronyms
    (pp. xxiii-xxiv)
  9. CHAPTER ONE Introduction
    (pp. 1-12)

    A recent editorial in theJournal of the American Medical Associationnoted that the effectiveness of many health interventions in developing countries has not been proven. The editorial called for increased international support and collaboration to provide the infrastructure to evaluate global health interventions and move toward evidence-based global health (Buekens, 2004). Interventions that are effective in developed countries may not be effective in developing countries that have differing social, economic, cultural, and infrastructure factors that may affect how a project is implemented and the project’s outcomes. Rigorous program evaluation of interventions in various resource-limited settings is needed to determine...

  10. CHAPTER TWO A Conceptual Framework for Evaluating Health Projects in Developing Countries
    (pp. 13-24)

    Program evaluation across all fields and disciplines is intended to (1) judge the effectiveness and worth of programs in order to maintain an ethical standard of accountability and (2) direct future program design so that resources are efficiently targeted to the most effective interventions and the groups that would benefit the most from those interventions. To accomplish these objectives, evaluation should take place throughout the various stages of an intervention, starting in the project-design phase with a baseline assessment and consideration of historical trends, and ending with an assessment of ultimate outcomes. At any given stage of the intervention, the...

  11. CHAPTER THREE Methodological Challenges in Evaluating the Impact of Health Projects in Developing Countries
    (pp. 25-42)

    This chapter primarily addresses the design of impact evaluations—the conscious and planned incorporation of evaluation needs into program design and implementation—so that both measurement and attribution of effects are more precise. The degree to which impact evaluations are useful and informative to decisionmakers depends on three factors: (1) the quality of the evaluation data and the precision with which the data are collected, (2) the magnitude of the effects, and (3) how much precision in measuring the effects is actually required for decisionmaking (the direction and magnitude of the effect may be more important than the preciseness of...

  12. CHAPTER FOUR Current Status of Program Evaluation in Developing Countries
    (pp. 43-58)

    Some notable high-quality evaluations demonstrate the value of rigorous impact assessments, such as the evaluation of Mexico’s PROGRESA national nutritional program, described later in this chapter. However, our review of the literature and selected evaluations indicates that despite the acknowledged benefits of randomized studies, the great majority of evaluations continue to use standard regression methodologies.

    For the most part, there is a considerable gap between best practices in program evaluation and actual practices in evaluative strategies. For example, the literature contains many analyses and reviews that address the methodological issues associated with cluster-randomized studies. Despite discussion in the literature of...

  13. CHAPTER FIVE Research and Other Actions to Promote Impact Assessment
    (pp. 59-70)

    The Bill and Melinda Gates Foundation, the World Health Organization, and, increasingly, other global funding organizations such as the World Bank, are vigorously improving the designs of program evaluations to maximize their utility beyond merely serving as an internal management tool to become a global resource for directing evidence-based national and international health policies. For example, the Bill and Melinda Gates Foundation recently sponsored three randomized tuberculosis treatment pilot programs. The World Bank is now funding expansion of the PROGRESA program (see Chapter Four) throughout Mexico and currently is promoting randomized designs to evaluate HIV education programs in Kenya.


  14. APPENDIX HIV/AIDS Data Sources
    (pp. 71-74)
  15. Bibliography
    (pp. 75-89)