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NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the Bill & Melinda Gates Foundation, the Doris Duke Charitable Foundation, the Wellcome Trust, and the William and Flora Hewlett Foundation. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
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Suggested citation: IOM (Institute of Medicine). 2014. Evaluation design for complex global initiatives: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE FOR THE WORKSHOP ON
EVALUATING LARGE-SCALE, COMPLEX,
MULTI-NATIONAL GLOBAL HEALTH INITIATIVES1
ANN KURTH (Chair), New York University, New York, NY
GEORGE ALLEYNE, Pan American Health Organization, Washington, DC
KARA HANSON, London School of Hygiene & Tropical Medicine, London, United Kingdom
DOROTHY MUROKI, FHI 360, Nairobi, Kenya
JONATHON SIMON, Boston University, Boston, MA
MARTIN VAESSEN, ICF International, Rockville, MD
IOM Staff
BRIDGET B. KELLY, Project Co-Director
KIMBERLY A. SCOTT, Project Co-Director
KATE MECK, Associate Program Officer
CHARLEE ALEXANDER, Senior Program Assistant (from November 2013)
JULIE WILTSHIRE, Financial Officer
PATRICK W. KELLEY, Senior Board Director, Board on Global Health
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
RICHARD BERK, University of Pennsylvania
ANN KURTH, New York University
DOROTHY MUROKI, FHI 360,
SANJEEV SRIDHARAN, University of Toronto
HOWARD WHITE, International Initiative for Impact Evaluation (3ie)
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Enriqueta Bond, President Emeritus, Burroughs Wellcome Fund. Appointed by the Institute of Medicine, she was responsible for
making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
Acknowledgments
The planning committee and project staff deeply appreciate many valuable contributions from individuals who assisted us with this project. First, we offer our profound thanks to all of the presenters and discussants at the workshop, who gave so generously of their time and expertise. These individuals are listed in full in the workshop agenda in Appendix B. We are also grateful to the many participants who attended the workshop both in person and via the live webcast. The engagement of all those in attendance was robust and vital to the success of the event. We are also particularly appreciative of the thoughtful and creative contributions of Mary Ellen Kelly and James Kelly, who applied their many years of experience to help generate the fictional initiative used for the hypothetical design exercise at the workshop.
In addition, we thank the sponsors of this project for their support: the Bill & Melinda Gates Foundation, the Doris Duke Charitable Foundation, the Wellcome Trust, and the William and Flora Hewlett Foundation. We are also grateful to the Wellcome Trust for hosting the workshop, with a special thanks to Zoe Storey, Danielle Taplin, and all of the staff there for their gracious assistance in support of every aspect of the event. We also extend many thanks to Anthony Mavrogiannis and the staff at Kentlands Travel for supporting the travel needs and requirements of this project. We appreciate LeAnn Locher’s creative work in designing the report cover. Finally, we convey our gratitude for the hard work of the many staff of the Institute of Medicine and the National Academies who supported the project at every stage, from its inception to the workshop to the final production of this workshop summary report.
Contents
1 INTRODUCTION AND OVERVIEW OF THE WORKSHOP
Organization of the Workshop Report
2 OVERVIEW FRAMEWORK FOR COMPLEX EVALUATIONS
The BetterEvaluation Initiative Rainbow Framework
Reflections from the Experience of the Evaluation of the U.S. President’s Malaria Initiative
Evaluation at the United Nations
An Evaluation Funder’s Perspective on Where Problems Arise
Lessons Learned from the Global Fund to Fight AIDS, Tuberculosis, and Malaria
Comparing Evaluations of Selected Global Initiatives
Other Topics Raised in Discussion
4 DEVELOPING THE EVALUATION DESIGN AND SELECTING METHODS
Affordable Medicines Facility–Malaria Assessment
The Search for Good Practice in Complex Evaluations
Other Topics Raised in Discussion
5 MAPPING DATA SOURCES AND GATHERING AND ASSESSING DATA
Data Mapping in the IOM Evaluation of PEPFAR
Data Issues in the Global Fund Evaluation
Data Approach and Challenges in the Affordable Medicines Facility–Malaria Evaluation
President’s Malaria Initiative Evaluation
Developing a Large-Scale Data Infrastructure
Other Topics Raised in Discussion
6 APPLYING QUALITATIVE METHODS TO EVALUATION ON A LARGE SCALE
Rigor and Credibility in Qualitative Design
The Value of Qualitative Methods
Other Topics Raised in Discussion
7 APPLYING QUANTITATIVE METHODS TO EVALUATION ON A LARGE SCALE
Mathematical Modeling as a Tool for Program Evaluation
Extended Cost-Effectiveness Analysis
Other Topics Raised in Discussion
8 ANALYSIS THROUGH TRIANGULATION AND SYNTHESIS TO INTERPRET DATA IN A MIXED METHODS EVALUATION
Triangulation in the Global Environmental Facility
Developing a Deeper and Wider Understanding of Results
Lessons from the IOM’s PEPFAR Evaluation
Other Topics Raised in Discussion
9 EVOLVING METHODS IN EVALUATION SCIENCE
Use of Realist Methods to Evaluate Complex Interventions and Systems
Innovative Designs for Complex Questions
Comparative Systems Analysis: Methodological Challenges and Lessons from Education Research
Other Topics Raised in Discussion
10 LESSONS FROM LARGE-SCALE PROGRAM EVALUATION ON A NOT-QUITE-AS-LARGE SCALE
Saving Mothers, Giving Life Strategic Implementation Evaluation
Avahan—Reducing the Spread of HIV in India
EQUIP—Expanded Quality Management Using Information Power
Other Topics Raised in Discussion
11 USING EVALUATION FINDINGS AND COMMUNICATING KEY MESSAGES
The U.S. President’s Malaria Initiative
The South African Perspective on Influencing Policy and Performance
Communicating Results from the PEPFAR Evaluation
Other Topics Raised in Discussion
12 ENVISIONING A FUTURE FOR EVALUATION
Building an Ecology of Evidence
Capacity Building for Future Evaluators
D EVALUATION INFORMATION SUMMARY FOR CORE EXAMPLE INITIATIVES
