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Webinar on Guide to Statistical Methods for Program Impact Evaluation

How Do We Know if a Program Made a Difference? A Guide to Statistical Methods for Program Impact EvaluationMEASURE Evaluation hosted two one-hour webinars Thursday, September 25, at 10:00am and 11:30am EDT. The webinars focused on the How Do We Know if a Program Made a Difference? A Guide to Statistical Methods for Program Impact Evaluation manual. Peter M. Lance, MEASURE Evaluation Research Associate and an author of the manual, led the presentation and discussion.

Listen to the webinar recording from 10:00am or the recording from 11:30am, view the presentation slides, and download the manual. We invite you to use the comment section below to share your thoughts and ask questions about the guide and the topics it covers.

HIV and Malaria as Major Causes of Maternal Mortality in Mozambique

Acknowledging HIV and Malaria as Major Causes of Maternal Mortality in Mozambique

Objective: To review national data on HIV and malaria as causes of maternal death and to determine the importance of looking at maternal mortality at a subnational level in Mozambique.

Methods: Three national data surveys were used to document HIV and malaria as causes of maternal mortality and to assess HIV and malaria prevention services for pregnant women. Data were collected between 2007 and 2011, and included population-level verbal autopsy data and household survey data.

Results: Verbal autopsy data indicated that 18.2% of maternal deaths were due to HIV and 23.1% were due to malaria. Only 19.6% of recently pregnant women received at least two doses of sulfadoxine-pyrimethamine for intermittent preventive treatment, and only 42.3% of pregnant women were sleeping under an insecticide-treated net. Only 37.5% of recently pregnant women had been counseled, tested, and received an HIV test result. Coverage of prevention services varied substantially by province.

Conclusion: Triangulation of information on cause of death and coverage of interventions can enable appropriate targeting of maternal health interventions. Such information could also help countries in Sub-Saharan Africa to recognize and take action against malaria and HIV in an effort to decrease maternal mortality.

Access the report.

Survey Tools for Orphans & Vulnerable Children Programs: Results and Lessons Learned from the 2013 Pilot Tests in Zambia & Nigeria

Child, Caregiver & Household Well-being Survey Tools for Orphans & Vulnerable Children Programs: Results and Lessons Learned from the 2013 Pilot Tests in Zambia & NigeriaChild, Caregiver & Household Well-being Survey Tools for Orphans & Vulnerable Children Programs: Results and Lessons Learned from the 2013 Pilot Tests in Zambia & Nigeria

MEASURE Evaluation has produced a set of questionnaires for measuring quantitative child outcomes and caregiver/household outcomes, developed with the support of the PEPFAR Orphans and Vulnerable Children Technical Working Group.

The questionnaires include a number of verifiable questions (e.g., weight, documented immunizations). However, some questions may be open to interpretation for both the respondent and the data collector. Furthermore, some of the sections include questions that may be duplicative (e.g., income and expenditure, or items of a psychosocial well-being assessment scale).  Others contain questions that ask respondents to recall their state of well-being up to one month prior to survey.

To finalize the questionnaires for public use, we pilot-tested them in Zambia and Nigeria in 2013. Findings from the pilot test informed revisions of the questionnaires. This report presents the methodology and findings of the pilot test, as well as the nature of the revisions to questions and procedures after pilot testing.

Access the report.

Explaining Inequity in the Use of Institutional Delivery Services in Selected Countries

Wealth-related disparities in the use of reproductive health services remain a substantial problem in many low- and middle-income countries. Very few studies have attempted to explain such inequalities through decomposition of the contributions made by various individual- and household-level factors.

This study aims to: (1) assess the degree of wealth-related inequality and inequity in the use of institutional delivery services in selected low- and middle-income countries, and (2) to explain wealth-related inequity through decomposition by the contributions made by various components, including health insurance coverage. Data come from Demographic and Health Surveys in three countries: Ghana, Rwanda, and the Philippines. Concentration indices are used to calculate inequality and horizontal inequity in service utilization. Multivariate methods are used to decompose inequity.

Findings indicate a moderate to high degree of inequity in institutional delivery service use in all study countries.

Access the study.

Seeing the World as a Network – Jen Chapman

Jen Chapman and her daughters on Canada DayJen Chapman is MEASURE Evaluation’s Senior Technical Specialist for Community-based Information Systems (in Phase III her title was senior OVC advisor). She is based at the Futures Group offices in Washington, DC. She started at MEASURE Evaluation in late 2007, initially working in Nigeria and Rwanda. She spent much time in Nigeria and she met her husband, Ben, there. In Rwanda, she led a behavioral surveillance study of men who have sex with men, which led to significant changes for the HIV strategy in that country, including use in a bill to decriminalize homosexuality.

Jen was born in Canada, but the beauty of Vancouver couldn’t hold her down. By the time she was 25, she had visited 60 countries. Among them there were the Philippines, where she volunteered with a children’s organization; Thailand, where she taught English; and England, where she studied international human rights law, then switched to health promotion for a master’s degree and PhD at the University of London.

In this photo, you see Jen and her daughters Sadie (2) and Zaria (6 months). Jen says that she has slowed down in her globe-trotting. But she also says that Sadie took 35 flights with her in her first year. Looks like Sadie is primed to follow in her mother’s footsteps.

Triangle Global Health Consortium Conference Keynote Address

Guest Post by Dr. Lisa Parker, Monitoring and Evaluation Technical Advisor for MEASURE Evaluation

On September 14th, representatives from over 18 institutional members of the Triangle Global Health Consortium joined together at the Friday Center in Chapel Hill, NC to hear Dr. Deborah L. Birx, the new U.S. Global AIDS Coordinator, present on delivering an AIDS-free generation. This was the keynote address for the 1st annual Triangle Global Health Consortium conference. The theme of the conference was Innovation in Global Health:  Bridging the innovation gap between research and implementation.

Dr. Birx began with a brief history of the epidemic and described the impact of PEPFAR programs on new HIV infections, life expectancy, and infections diverted. She then spoke about the importance of focusing programs to effectively control the epidemic and the need to do: The Right Thing, in the Right Place, at the Right Time.

The Right Thing: In order to do the right thing she described the need to prioritize activities based on high impact core interventions, for example focusing on combination prevention activities that include prevention through condom use, Anti-Retroviral Treatment, and Prevention of Mother to Child Transmission.

The Right Place: She then noted the importance of determining the geographic prioritization for services and presented important service and mapping data that could aid in improving the matching of programs and disease burden. She also described key remaining disparities and the importance of leaving no groups behind such as sex workers, pediatric HIV patients, and Men who have sex with Men and focused specifically on the disparity in HIV prevalence between young men and women.

The Right Time: Dr. Birx also used data to show that an increasing HIV/AIDS epidemic is not financially sustainable and thus stressed the importance of acting now to prevent new infections in the most vulnerable and high prevalence areas in order to ensure more cost effective delivery of services, ensuring a longer term more sustainable strategy.

Indeed, Dr. Birx’s talk highlighted the theme of the conference by using HIV/AIDS as a concrete example of the importance of bridging the research and implementation gap.

Reading: Valuing Health Systems

valuing-health-systemsValuing Health Systems: A framework for low and middle income countries
Collins, Charles and Andrew Green. New Delhi: Sage Publications, 2014.

In developing and middle-income countries, reforms of health care financing, governance, management and planning over the years too often have failed to result in real improvements in the health of the people, Collins and Green contend. They suggest that longer-term perspectives and consequent actions, reflecting the input of a wider array of system stakeholders, are far more likely to bring about the real change that health systems need.

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