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Sharing Expertise on World Health Day: Impact Evaluations of Public Health Interventions

by on April 7, 2015

In an era of shrinking resources and increasingly complex development environments, governments and donor agencies need to determine the effect of investments in health and health systems on health outcomes. Impact evaluations are one way to obtain information essential for health program planning and to guide resource allocation.

Findings from large-scale impact evaluations can be instrumental for decision making, yet they are not without challenges and costs. On World Health Day, the MEASURE Evaluation project presents a working paper detailing experiences and lessons learned from impact evaluations conducted in nine countries. The working paper draws on practical experiences to illustrate real world challenges in large-scale impact evaluations of public health programs, showcasing some of the solutions employed to design and conduct such studies, especially those with a focus on HIV/AIDS programs.

Impact Evaluations of Large-Scale Public Health Interventions: Experiences from the Field shares field experiences from ten evaluation studies undertaken by MEASURE Evaluation from 2003 to 2014. The series of case studies highlights design and implementation challenges that required creative solutions, and provides an analysis of common and reoccurring themes across the studies that yield valuable lessons for groups implementing impact evaluations. Examples of these cross-cutting themes include:

  • Challenges with identification and selection of program beneficiaries
  • Random assignment in complex environments
  • Identification of a robust comparison or control group for estimating the counterfactual
  • Heterogeneity of program impacts
  • Timing of baseline data collection
  • Absence of baseline data and a counterfactual

Field experiences from the MEASURE Evaluation project demonstrate the need for transparency and collaboration among key partners involved in impact evaluations, the need to balance technical requirements with programmatic priorities, and the importance of flexibility and the ability to adapt designs in order to answer the most salient evaluation questions. Evaluators, implementers, and funders that seek to conduct robust evaluations of health interventions will benefit from lessons learned by MEASURE Evaluation. Such knowledge is relevant for all interested in applying evidence-based research techniques, whose use contributes to greater accountability in health systems.

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