The document discusses the evaluation of PEPFAR conducted by the Institute of Medicine, focusing on the use of case-based approaches to assess its performance and health impact. It highlights the evaluation design, data sources, and methods used, emphasizing the importance of triangulation for thorough analysis. Key takeaways include the adaptability of case-based methods and the need for informed, intentional approaches in evaluation context.

1. Lessons from the 2013 IOM
Evaluation of PEPFAR:
Use of Case-Based
Approaches
Bridget Kelly

2. Evaluation of PEPFAR - Congressional Charge
U.S. Congress mandated
that the Institute of
Medicine assess and
evaluate the
“performance” and “impact
on health” of PEPFAR.

3. Evaluation Design:
Fit for Purpose and Feasibility
• Retrospective
• Hybrid Design
• Mixed Methods
• Nested, in-depth case-based
approaches

4. Data Sources for PEPFAR Evaluation

5. Nested Case-Based Approaches
• Country selection process
• By topic
• By individual country
• By subsets of countries (aggregated
data)

6. Tools for Case-Based Approaches
Chronologies/Histories (Country briefs; Timelines for
context, guidance, activities)
Time trends (PEPFAR data, partner data, global data)
Document review (Guidance documents, operational plans
by HQ and country, published literature)
Interviews (semi-structured)
Iterative group discussions for analyses and
interpretation (across whole and subsets of evaluation
team)
Triangulation among data sources and analyses
(interview/document/programmatic/clinical/financial)

7. Case-Based Evaluation Planning

8. 88
Analysis and Interpretation

9. What did we learn from use of case-
based approaches?
Appropriate and relevant for learning about and
within complexity
Expands and enriches the tools available
beyond indicators and metrics
Lends credibility through techniques to help
understand “how” and “why” questions.
Triangulation is critical for analysis and
interpretation

10. Takeaways
• No need to be intimidated
• No need to be apologetic
• What is a “case”?
• More than you might think
• What does “best practice” mean in
this context?
• Fit-for-purpose
• Informed and intentional
• Well-documented

11. Full report available:
www.iom.edu/pepfar2
For Evaluation
Approach and Methods:
Chapter 2
Appendix C