Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Upcoming SlideShare
Compare Shipping Rates with ShipGooder.com. Save Time and Money
Next
Download to read offline and view in fullscreen.

0

Share

Download to read offline

Operations Research In MCH Programs: Measurement Challenges

Download to read offline

Operations Research In MCH Programs: Measurement Challenges - How MCHIP is working to Support PVOs

Jennifer Luna, MCHIP

CORE Group Spring Meeting, April 28, 2010

Related Books

Free with a 30 day trial from Scribd

See all

Related Audiobooks

Free with a 30 day trial from Scribd

See all
  • Be the first to like this

Operations Research In MCH Programs: Measurement Challenges

  1. 1. Operations Research In MCH Programs: Measurement Challenges How MCHIP is working to Support PVOs CORE Spring Meeting, April 28, 2010 Wednesday 11:00-12:30
  2. 2. CSHGP history of implementing community oriented programs since 1985 <ul><li>Tradition of collecting rigorous information </li></ul><ul><ul><li>Since 1991 Grantees implemented baseline and final KPC surveys </li></ul></ul><ul><ul><li>Health Facility Assessments </li></ul></ul><ul><ul><li>Sustainability Assessments </li></ul></ul><ul><ul><li>Complemented by qualitative information </li></ul></ul>
  3. 3. <ul><li>Traditional baseline and final information is rigorous enough for judging: </li></ul><ul><ul><li>If projects met targets </li></ul></ul><ul><ul><li>If the health situation improved in the project area after project implementation was completed </li></ul></ul><ul><ul><li>If quality of services improved </li></ul></ul><ul><ul><li>Calculating estimated lives saved from interventions implemented </li></ul></ul>
  4. 4. Questions remaining: <ul><li>International community not always convinced that this is enough evidence to recommend scaling up </li></ul><ul><ul><li>(i.e. WHO, Universities, National Governments, other Donor organizations) </li></ul></ul><ul><li>Those of us implementing community oriented programs may not have enough evidence </li></ul><ul><ul><li>to compare effectiveness of different approaches </li></ul></ul><ul><ul><li>to recommend one approach as a best practice </li></ul></ul><ul><ul><ul><li>i.e. Is the Care Group model as traditionally implemented the best approach for scaling up or could it be adjusted to facilitate scaling up? </li></ul></ul></ul>
  5. 5. Solution: Innovation Grants <ul><li>New category started 2008 (2 rounds of grants) </li></ul><ul><li>Emphasis on including OR </li></ul><ul><ul><li>Purpose to contribute to the evidence base for community oriented programming </li></ul></ul><ul><li>Opportunity for grantees to include strong research designs as part of their projects </li></ul><ul><ul><li>Grantees have flexibility to: </li></ul></ul><ul><ul><ul><li>Propose a variety of interventions/approaches to study </li></ul></ul></ul><ul><ul><ul><li>Define research questions/ hypotheses </li></ul></ul></ul><ul><ul><ul><li>Develop appropriate study designs </li></ul></ul></ul><ul><li>Builds on the strong history of collecting rigorous baseline and final information </li></ul>
  6. 6. Role of MCHIP <ul><li>Work with grantees to ensure that: </li></ul><ul><ul><li>Studies are focused and can be practically implemented within a CSHGP project </li></ul></ul><ul><ul><li>Research designs are logical for the questions being asked </li></ul></ul><ul><li>Facilitate exchange of information/ experience among innovation grantees </li></ul><ul><li>Recently held OR workshop for grantees </li></ul><ul><li>Develop guidance </li></ul><ul><li>Support USAID in communicating about the studies </li></ul>
  7. 7. Challenge: Cookie cutter approach to evidence building not appropriate <ul><li>Grantees flexibility to propose a variety of interventions/approaches </li></ul><ul><li>Community oriented programs usually work at multiple levels to achieve success; It is important to explain these mechanisms: </li></ul><ul><ul><li>Community organization; community management of health; referral between community and facility level health providers; new relationships between health care providers </li></ul></ul><ul><li>Some interventions/approaches have been implemented many times (some evidence of success); others are new (no evidence); others are in the middle </li></ul><ul><ul><li>Requires different study designs </li></ul></ul>
  8. 8. Continuum
  9. 9. Study Designs <ul><li>Emphasis on formative </li></ul><ul><ul><li>One study arm, no comparison group </li></ul></ul><ul><li>Combination formative and summative </li></ul><ul><ul><li>Quasi-experimental; comparison group </li></ul></ul><ul><ul><li>Quasi-experimental; 2 different intervention groups </li></ul></ul><ul><ul><li>Cluster randomized trial </li></ul></ul>
  10. 10. Overview of OR Studies <ul><li>Topics include: </li></ul><ul><ul><li>MNC; CCM; Telemedicine; Nutrition </li></ul></ul><ul><ul><li>Working with illiterate/low literate women </li></ul></ul><ul><ul><li>Male involvement </li></ul></ul><ul><ul><li>Public-private (civil society) partnership </li></ul></ul><ul><ul><li>Community based vs. Facility based interventions </li></ul></ul><ul><ul><li>Less expensive Care Group model </li></ul></ul><ul><ul><li>Community financial support for health workers </li></ul></ul>
  11. 11. Overview of OR Studies <ul><li>Baitadi district of Nepal </li></ul><ul><li>Innovation of combining homestead food production (HFP) + essential nutrition actions (ENA) </li></ul><ul><li>Determine whether it can significantly improve child nutrition (anthropometry and anemia status) </li></ul><ul><li>Well documented interventions by HKI </li></ul><ul><li>Summative </li></ul><ul><li>Cluster-randomized, pre/post design comparing treatment and control areas </li></ul>
  12. 12. Overview of OR Studies <ul><li>Chitral district </li></ul><ul><li>Innovation: community financing scheme to support trained community midwives (CMWs) </li></ul><ul><li>Determine whether CMWs can earn enough to sustain work; communities can pay enough; quality maintained </li></ul><ul><li>New intervention (formative and summative) </li></ul><ul><li>Quasi-experimental </li></ul>
  13. 13. Concern Worldwide – Mabayi District, Burundi
  14. 14. Concern Worldwide <ul><li>Determine if health outcomes of adapted model similar to traditional </li></ul><ul><li>Quasi-experimental </li></ul><ul><ul><li>2 study arms: traditional Care Group, adapted Care Group </li></ul></ul>

Operations Research In MCH Programs: Measurement Challenges - How MCHIP is working to Support PVOs Jennifer Luna, MCHIP CORE Group Spring Meeting, April 28, 2010

Views

Total views

1,010

On Slideshare

0

From embeds

0

Number of embeds

4

Actions

Downloads

11

Shares

0

Comments

0

Likes

0

×