Abstract

Although Africa has made significant progress in public health over the past several decades, it still faces a very high burden of disease compared to the rest of the world. This overwhelming disease burden is further aggravated by a lack of adequate financial and human resources for health, inequitable distribution of health services, and other social, economic and political factors. Given these constraints, it has become critical for African countries to ensure that health interventions are selected based on evidence and implemented efficiently and effectively to ensure desired outcomes and impact. This has led to an increasing appreciation for monitoring and evaluation as an integral element of programme planning, implementation and scale-up. The importance of M&E within the health sector was recently reflected in the fact that the health evaluation strand was the largest at AfrEA’s 7th Biennial International Conference, held over 3 days in March 2014 in Yaoundé, Cameroon. The health strand, which had nine sub-themes, was sponsored, managed, and supported by the USAID-funded AfricanStrategies for Health (ASH) project. This review summarises the health strand presentations, and panel and roundtable discussions. The evaluations featured in the strand were diverse interms of health area focus, evaluation methodology, language and authors’ affiliation. More than 21 African countries from all regions of sub-Saharan Africa were represented. Among thekey recurrent messages highlighted during the conference were the importance of: data use for planning and improving health programmes, data quality, well-functioning M&E systems and identifying and sharing best/good practices.

Highlights

  • Over the past decade, increasing calls for accountability and evidence-based programming in the social sectors has led governments, donors, and international and national organisations to intensify their focus on monitoring and evaluation

  • The most recent African Evaluation Association (AfrEA) 7th Biennial International Conference, held over 3 days in March 2014 in Yaoundé, Cameroon, brought together more than 500 participants from over 70 countries representing a wide range of representatives from governments, universities, non-governmental organisations, national evaluation associations, individuals, and donors such as the World Bank, the African Development Bank, United Nations Children’s Fund (UNICEF), the Bill and Melinda Gates Foundation, and US Agency for International Development (USAID)

  • Sub-Saharan Africa accounts for almost 71% of the people living with HIV worldwide with approximately 1 in 20 adults in the region living with HIV (WHO n.d.)

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Summary

Introduction

Over the past decade, increasing calls for accountability and evidence-based programming in the social sectors has led governments, donors, and international and national organisations to intensify their focus on monitoring and evaluation. The presenter described MEASURE’s approach to strengthening individual and organisational M&E capacity using routine data quality assessments at facility level and Community Trace and Verify (CTV) – a supervisory tool developed by MEASURE to be used at the household level for verifying services received during visits to households served by the program and identifying M&E challenges in community-based HIV programmes. The approach involved six steps: (1) Establishing the cause-effect issue to be addressed; (2) Developing the postulated theory of change and risks to it, including rival explanations; (3) Gathering existing evidence on the theory of change; (4) Assembling and assessing the contribution claim, and challenges to it; (5) Seeking out additional evidence; and (6) Revising and strengthening the contribution story This evaluation found that performancebased financing (PBF) contributed to intended improvements in health service delivery by increasing motivation and performance of health professionals despite the prevalence of doi:10.4102/aej.v3i2.170. Host government participation in USAID evaluations to facilitate buy-in and use of evaluation results for future programming

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