Design Considerations for Evaluating the Impact of PEPFAR Workshop Summary (2008) / Chapter Skim
Currently Skimming:
1 Introduction to Impact Evaluation for PEPFAR
1 Introduction to Impact Evaluation for PEPFAR
Pages 23-36
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 23... ...
Meaning and Uses of Impact Evaluation Defining Impact Evaluation Workshop moderator Ruth Levine of the Center for Global Development proposed a definition of impact evaluation as a measurement of net change in outcomes attributable to a specific program using a methodology that is robust, available, feasible, and appropriate, both to the question under investigation and to the specific context. In the context of PEPFAR, she noted, impact evaluation can provide insights about the outcomes from specific interventions, types of approaches, or different methodologies.
|
From page 24... ...
All impact evaluations must be based on a conceptual model of causation and intervention, observed speaker Nils Daulaire of the Global Health Council, but cultural-, political-, and location-specific factors and shifting influences make causality in the world of HIV/AIDS highly nonlinear. Innovative thinking may therefore be required when designing an impact evaluation for such a system.
|
From page 25... ...
Some consideration for how the impact evaluation's results will be packaged, disseminated, and used at these multiple levels is important in evaluation design, added Pacqué-Margolis. Speaker Jonathan Mwiindi of the Kijabe HIV/AIDS Relief Program in Kenya commented that decision makers at different levels may have different evaluation needs; sometimes the results and indicators of donors will benefit the donor but will be of little use to local operations.
|
From page 26... ...
Programmatic decision making in partner countries. Impact evaluation also has value for decision makers at the level of partner countries. Speaker Binagwaho outlined the following benefits of evaluation results at the country level: • To improve performance • To continue and expand good initiatives • To improve planning, monitoring, and evaluation • To provide examples of implementation practices where available opportunities and resources have been optimally used
|
From page 27... ...
PEPFAR's Evaluative Approach PEPFAR's Approach to Strategic Information Speaker Tom Kenyon, principal deputy U.S. Global AIDS Coordinator and chief medical officer of the Office of the U.S.
|
From page 28... ...
PEPFAR's 5-year performance targets for the 15 focus countries include • Prevention of 7 million new HIV infections • Treatment of 2 million HIV-infected people • Care for 10 million people infected with and affected by HIV/AIDS, including orphans and vulnerable children These targets -- generated using limited HIV incidence and prevalence data available in 2003 -- represented at the time of PEPFAR authorization about half of those eligible for treatment, half of those in need of care, and half of the new infections, said speaker Tom Kenyon of the Office of the U.S. Global AIDS Coor dinator.
|
From page 29... ...
1-1 • Supporting local leadership and ownership of HIV/AIDS response by encouraging countries to develop one national plan, one coordinating mechanism, and one monitoring and evaluation plan • Building capacity of indigenous partners, including infrastructure and human capacity, through support of an annual implementers meetings • Using local health infrastructure and community structures • Implementing the program according to national guidelines • Monitoring using internationally agreed-upon indicators • Funding programs based on results Kenyon presented PEPFAR's FY 2006 achievements, stating that 83 percent of partners were local organizations supporting 15,000 project sites: • Antiretroviral treatment for 822,000 people; treatment programs projected to save 3.4 million life years by 2009 One national plan, one coordinating mechanism, and one monitoring and evaluation plan are known as "the three ones."
|
From page 30... ...
PEPFAR's strategic information reporting was fed by an annual planning and reporting cycle for target setting, program implementation, funding tracking, and results. Development of an Evaluation Framework At the initiation of PEPFAR, evaluation planners established an "ideal" national strategic information system that would be informed by different surveillance approaches.
|
From page 31... ...
Future M&E frameworks for PEPFAR may be informed by the development and strengthening of a number of new tools, including a UNAIDS methodology for helping countries define their own evaluation targets, health provider reporting systems, surveillance studies, population surveys, HIV testing tools, and supply chain management tools. A Global Fund impact study also will be available soon to provide information on disease rates, mortality, morbidity, and health systems within countries.
|
From page 32... ...
This structure includes a formalized, annual PHE priority-setting process to identify the most important questions for advancing PEPFAR impact. With oversight by a PHE subcommittee, PHE teams -- drawn from PEPFAR headquarters, field offices, and partners -- provide technical assistance for developing projects, establish common protocols (that is, guidelines for studies involving human subjects)
|
From page 33... ...
Involving implementers in evaluation design, implementation, and sharing of results is intended to contribute to ensuring independence and transparency of the evaluation. Products of PHE Although PHE does not extend to basic or investigational clinical research activities, it will result in the production of studies of program activities, characteristics, outcomes, and impact, which can in turn be used to determine program effectiveness, compare program models, and answer operational questions for implementation.
|
From page 34... ...
BOX 1-2 Main Recommendations from IOM Evaluation of PEPFAR Address long-term factors • Emphasize prevention • Empower women • Build workforce capacity • Expand knowledge base Improve harmonization • Improve coordination • Support the World Health Organization prequalification process • Remove budget allocations Expand, improve, integrate services • Data-driven prevention • Adequate medications for treatment • Community-based, family-centered care • Target for orphans and vulnerable children • Attention to marginalized populations
|
From page 35... ...
drug prequalification process and removing specific budget allocations for prevention, treatment, and care. Expansion, Improvement, and Integration of Services The committee recommended the expansion, improvement, and integration of prevention, treatment, and care services, with emphasis on evidencedriven prevention interventions, an adequate supply of medications for treatment, and care based on a family-centered, community-based model.
|
From page 36... ...
. Among those indicators developed to track change in public health capacity, measures for monitoring the health care workforce are particularly important in light of the depletion of that workforce by the disease itself, the flux of health care workers to developed countries, and the sequestration of the health care workforce to vertical health programs.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.