This document summarizes a presentation on operations research given by Dr. Florence Nyangara. The presentation covered 3 case studies from Benin, Honduras, and Nepal that tested different approaches to improving community health programs. The case studies examined the impact of paying and training community health workers in Benin, integrating health services in Honduras, and using a cross-sector nutrition model in Nepal. The goal of operations research is to generate evidence that can inform practices, policies, and guidelines to improve health programming.

1. Bringing Operations Research to Life
Florence Nyangara, PhD.
(ICF/MCHIP)
CORE Spring Meeting,
May 2nd, 2012
Wilmington, DE

2. Session Outline
§ Background
§ Presentation of 3-Case Studies -:
Benin, Honduras, and Nepal
§ Summary -: key take home messages

3. Objectives of OR Session
 Understand how to start, implement,
and use OR results
 Feel empowered to go start applying OR
to resolving your own program problems

4. Growing Interest on OR
 Need for knowledge to scale-up high impact interventions
 Need for information to guide key program decisions, e.g.
How much it will cost to implement an intervention?
 Need to test innovative programming approaches – to
inform practice, policy, operational guidelines, etc
 Need to arrive at “best practices” through comparisons

5. Operations Research
Operations = Program Activities
Research = Capturing what is happening in a
systematic manner
Goal: Information Use (publishing alone is not
enough) - to improve programming i.e.
change practice, guidelines, policies, etc

6. USAID Response: CSHGP/OR Support
 23 OR studies across 21 countries (2008-2011)
 FY Cohorts: 2008; 2009; 2010; and 2011
Local Relevance:
•Health indicators,
•Evidence of national priorities
Global Relevance:
•Problem occurs in many countries and programs
•Persistent problems over the years (e.g. Mal-Nutrition)

7. Partnerships for OR
OR focuses on national, regional or local community priority health issues
(23 health challenges identified in 21 countries)
Partner Academic Other local partners Other international
community & institutions (Government, partners
community • North (9) USAID/Mission, public health (INGOs, UNICEF, UNFPA,
committees • South (8) partners, CBOs, Private WFP, WHO)
sector)
• Access to the • Research • Administrative and • Collaboration
community expertise in key infrastructure capacities • Leveraging resources
• Relationships areas • Community engagement • Global dissemination of
with the partner and partnerships evidence
community (i.e., experience in
community- • Training
based • Communication
participatory • Dissemination
research and
public health • Evaluation
practice) • Use of evidence
USAID/CSHGP & MCHIP Provide Program Oversight and OR Technical Support

8. CSHGP Tests Innovative, Scalable Solutions through Operations
Research (23)
mHealth: (Indonesia,
Timor-Leste,
Afghanistan) Community Care
Groups for MNCH Health System Integration
for Continuum of MN Care
Introduction
demand and access
(Burundi, Rwanda) (Nepal, Ecuador, Honduras,
Scale-up
Zambia)
Integration of MCH &
FP (Malawi) Community-based Health Information Systems
(Sierra Leone, Guatemala, Indonesia, Ghana)
CHWs performance & sustainability (Pakistan, Benin, Malawi)
Cross-sectoral synergies
(Nepal, Rwanda)
CCM – Acceptability, delivery, policy
(S. Sudan, Burundi, Nepal, Rwanda)
Male Involvement in Public-private partnerships
MN (Nicaragua) to improve health equity
(Honduras, Bangladesh)

9. CSHGP Innovation Grantees: Case Studies
 CHS Benin 2010 Cohort:
Tests impact of CHW payment and quality improvement
 Intervention and comparison groups
 CFI Honduras 2009 Cohort:
Tests impact of integration (UCOs) on utilization, client costs.
 Before and after comparisons
 HKI Nepal 2008 Cohort:
Tests an integrated cross-sector nutrition model
 RCT (Randomized)

10. Case Studies Presentation Format
 “How you get started”-- - CHS/Benin Project (Marthe
Akogbeto/Sara Riese)
• Questions
 Implementation -- CFI/Honduras (Alfonso Rosales)
• Questions
 Dissemination/Use -- HKI/Nepal (Jennifer Nielsen)
• Questions
 General Q&A -: questions, comments
 Conclusion -: key take home messages