There has been much discussion in recent years about developing and harmonizing indicators. Many of these discussions have taken place in the context of US government efforts to restructure foreign assistance and reauthorize PEPFAR, calls for harmonization and standardization among donor-required assessment tools, and the introduction of large extra-governmental actors, such as the Global Fund for AIDS, TB & Malaria and the Gates Foundation into the complicated global health milieu. Yet, developing a common set of measurable indicators is only one step in the process of better understanding global health. We need to move from outputs to outcomes to impact. It is important to measure not only what is being/has been done and delivered but to also assess the changes that these induced and the factors that have influenced them (measuring outcomes and demonstrating impact).
Measuring Results. On a population level, a better understanding of global health patterns and trends requires standard and common measures. The goal is to develop asset of measures that can be compared between countries, which may include both program outputs and health outcomes. These measures maybe fairly simple and can be translated from one program, language or culture to another. However, they also tend to focus on program outputs rather than on health outcomes - more work is needed to move toward measures of program results.
Measuring Behavior. To make progress in addressing problems on the ground, a better understanding of the complex nature of health issues is needed. This requires establishing new or adapting existing tools that assess behavior-based constructs in a more comprehensive manner. In addition to measuring health outcomes, successful programs need to assess risk factors and social determinants. For example, determining the impact of depressive symptoms on maternal health or health-seeking behavior warrants more than a single question - a number of instruments used in the US and other industrialized countries (e.g., the CESD) could potentially be adapted for use in developing countries. Measurement of these more complex constructs could provide richer data and suggest ways to improve services.
Presentations: Scaling-up Sustainably. With a variety of state and non-state actors involved in global health delivery, a challenge lies in the integration of a disease-specific program with the public health sector. With great unmet need, implementers and donors are assessing how best to scale and sustain their services. New measures are required to capture how best to integrate, manage and operate programs at scale. Dr. Rebecca Weintraub of GHD will review findings from the following studies: WHO Maximizing Positive Synergies Project, Critical interactions between Global Fund-supported programs and health systems and Sustaining Delivery at Scale supported by the Bill and Melinda Gates Foundation.
Strategic Frameworks in Program Assessment. Frameworks to assess programs benefit from a consultative development process that involves stakeholders, creating room for collective ownership and collaboration with partners in evaluating common results. Jane Kengeya-Kayondo will present a framework for systematic assessment of TDR's performance, its strategic relevance and contribution to global health. The framework is a potential approach for measuring the results and changes that can be attributed to research and scientific capacity development providing the basis for continuous improvement. Discussion will include the key principles followed, lessons learned, and the challenges faced.
Breakout Sessions: Complex Measures in Women's Health
In this exercise, participants will work through how to measure constructs that are multifaceted and often not adequately assessed in program evaluation processes. This exercise will enable participants to step beyond the numbers and the disease-specific silos and to move toward understand the people and the life circumstances that influence health-seeking behaviors.
