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The evaluation of comprehensive sexuality education programmes: a focus on the gender and empowerment outcomes.
New York, New York, UNFPA, 2015. 64 p.Repeated evaluations have demonstrated that comprehensive sexuality education does not foster earlier sexual debut or unsafe sexual activity. By contrast, programmes that teach only abstinence have not proved to be effective. Additionally, recent research demonstrates that gender norms are a “gateway factor” for a range of adolescent health outcomes. Comprehensive sexuality education curricula that emphasize critical thinking about gender and power – the empowerment approach – are far more effective than conventional “gender-blind” programmes at reducing rates of sexually transmitted infections (STIs) and unintended early pregnancy. These studies also indicate that young people who adopt more egalitarian attitudes about gender roles, compared to their peers, are more likely to delay sexual debut, use condoms and practise contraception. They are also less likely to be in relationships characterized by violence. This report, The Evaluation of Comprehensive Sexuality Education Programmes: A Focus on the Gender and Empowerment Outcomes, represents an important milestone in our understanding of advances in the field of comprehensive sexuality education evaluation. It offers an extensive review and analysis of a wide range of evaluation studies of different comprehensive sexuality education programmes, at different stages of development and from different contexts and setting across the globe. It enriches our knowledge of new methodologies, available questionnaires and instruments that can be applied in future assessments and evaluations, most particularly to measure the gender empowerment outcome of comprehensive sexuality education programmes. It addresses the adaptation of the methodology to various contexts and age-specific groups of young people and children. This report is co-sponsored by UNFPA, the United Nations Educational, Scientific and Cultural Organization, the World Health Organization and the International Planned Parenthood Federation.
New York, Evaluation Office, United Nations Population Fund [UNFPA], 2014 Nov. 145 p.Purpose: The purpose of the evaluation is to assess the performance of UNFPA in the field of family planning during the period covered by the Strategic Plan 2008-2013 and to provide learning to inform the implementation of the current UNFPA Family Planning Strategy Choices not Chance (2012-2020). The evaluation will also inform other relevant programmes such as the Global Programme for Reproductive Health Commodity Security (GPRHCS) (2013-2020) and the Preventing HIV and Unintended Pregnancies Strategic Framework (2011-2015). Finally, the evaluation results will feed into the mid-term review of UNFPA current Strategic Plan 2014-2017. Objectives: The primary objectives of the evaluation are to: 1. Assess how the framework as set out in UNFPA Strategic Plan (and revised development results framework (DRF)) 2008-2013 and further specified in the Reproductive Rights and Sexual and Reproductive Health Framework (2008-2011)as well as in the GPRHCS (2007-2012) and the Preventing HIV and Unintended Pregnancies Strategic Framework (2011-2015), has guided the programming and implementation of UNFPA interventions in the field of family planning; 2. Facilitate learning and capture good practices from UNFPA experience across a range of key programmatic interventions in the field of family planning during the 2008-2013 period to inform the implementation of both outcome 1 of UNFPA current Strategic Plan and the Choices not Chance 2012-2020 Strategy; inform the GPRHCS (2013-2020) and the Preventing HIV and Unintended Pregnancies Strategic Framework (2011-2015) as well as future programming of interventions in the field of family planning. (excerpt)
Washington, D.C., World Bank, 2011.  p.This book offers an accessible introduction to the topic of impact evaluation and its practice in development. Although the book is geared principally toward development practitioners and policy makers, we trust that it will be a valuable resource for students and others interested in impact evaluation. Prospective impact evaluations assess whether or not a program has achieved its intended results or test alternative strategies for achieving those results. We consider that more and better impact evaluations will help strengthen the evidence base for development policies and programs around the world. Our hope is that if governments and development practitioners can make policy decisions based on evidence -- including evidence generated through impact evaluation -- development resources will be spent more effectively to reduce poverty and improve people's lives. The three parts in this handbook provide a nontechnical introduction to impact evaluations, discussing what to evaluate and why in part 1; how to evaluate in part 2; and how to implement an evaluation in part 3. These elements are the basic tools needed to successfully carry out an impact evaluation. The approach to impact evaluation in this book is largely intuitive, and we attempt to minimize technical notation. We provide the reader with a core set of impact evaluation tools -- the concepts and methods that underpin any impact evaluation -- and discuss their application to real-world development operations. The methods are drawn directly from applied research in the social sciences and share many commonalities with research methods used in the natural sciences. In this sense, impact evaluation brings the empirical research tools widely used in economics and other social sciences together with the operational and political-economy realities of policy implementation and development practice. (Excerpt)
Washington, D.C., World Bank, 2004.  p.This report’s central message is that well-designed evaluations, conducted at the right time and developed in close consultation with intended users, can be a highly cost-effective way to improve the performance of development interventions. It includes eight case studies of evaluations that were utilized for improving programs and increasing effectiveness.
Decentralising HIV M&E in Africa. Country experiences and implementation options in building and sustaining sub-national HIV M&E systems, in the context of local government reforms and decentralised HIV responses.
Washington, D.C., World Bank, Global HIV / AIDS Program, 2007 Aug. 10 p. (HIV / AIDS M&E -- Getting Results)In operationalising the 3rd of the Three Ones - One HIV M&E system, a growing number of countries in Africa are opting to decentralise their national HIV monitoring and evaluation (M&E) systems. This decentralization is primarily driven by other decentralisation processes happening within government, and by the fact that the HIV response itself is changing towards less centralized intervention and increased community ownership. Decentralisation of national HIV M&E systems is an arduous and resource intensive process, but experience has shown that it is essential to decentralise M&E functions as HIV services are rolled out. This note summarizes the experience of countries that are decentralizing their national HIV M&E systems and describes how it can be done. It defines decentralization, discusses the rationale and benefits of decentralizing the HIV response, and key factors to take into account when doing so. Decentralizing the HIV M&E system is linked to decentralizing the HIV response. The note describes how each of the 12 components of a HIV M&E system can be decentralized, with country examples. (author's)
[Geneva, Switzerland], International Labour Organisation [ILO], Understanding Children's Work, 2003 Oct 1. 6 p.A good practice can be defined as anything that works in some way in combating child labour, whether fully or in part, and that may have implications for practice at any level elsewhere. The following are implicit in this definition: A good practice can represent any type of practice, small or large: It can represent a practice at any level. E.g. good practices can range from broad policy-level activities to practices at the grassroots level in the field. It need not represent an overall project or programme. Even if a project overall has not been successful, there still good be good practices that it developed or applied. It could be a very specific "nitty-gritty" process or activity, e.g. a strategy for incorporating questions related to child labour in other household surveys, a means of getting teachers in a rural setting to incorporate child labour considerations into the curriculum, a technique that was successful in getting an employer association on board, an effective communications strategy, an approach that led to the adoption of Convention 182, an innovative legal clause in implementing legislation … It could also represent something that only emerges after comparison across multiple settings, which may be more useful at the policy level than with nitty-gritty programme implementation considerations at the grassroots. (excerpt)
Fulfilling reproductive rights for women affected by HIV / AIDS. A tool for monitoring progress toward three Millennium Development Goals. Updated version.
Chapel Hill, North Carolina, Ipas, 2006 Aug. 20 p.In 2004, more than 25 national and international organizations presented a statement to the secretariat of the United Nations (UN) Commission on the Status of Women that highlighted relatively neglected areas in the reproductive health of women affected by HIV/AIDS. In collaboration with the International Community of Women Living with HIV/AIDS (ICW), the Center for Health and Gender Equity (CHANGE) and the Pacific Institute for Women's Health, Ipas used that statement and a literature review to develop this practical tool to help nongovernmental organizations (NGOs) address those neglected areas of reproductive health. Since the Millennium Development Goals (MDGs) have become a common framework for assessing progress in development, the tool links those areas of reproductive health to three of the MDGs related to empowering women, improving maternal health and combating HIV/AIDS. This document is an updated version of the original resource published in 2004. Changes were made after the eight partner NGOs listed below piloted the benchmarks in 11 developing countries. (excerpt)
Johannesburg, South Africa, University of the Witwatersrand, Reproductive Health and HIV Research Unit, 2006 Oct. 58 p.A systematic review of the literature was conducted, for evidence on whether a policy of providing a wide range of contraceptive methods, as opposed to the provision of a limited range, improves health outcomes such as contraceptive uptake, acceptability, adherence, continuation and satisfaction; reduction of unintended pregnancy; and improved maternal health and wellbeing. Studies of all designs, reviews, reports, policy documents, commentaries, opinion papers and position papers were included in a search of MEDLINE (via Pubmed, Ovid MEDLINE and Old Ovid MEDLINE), All EBM Reviews, POPLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS and Psyc Info. A total of 6977 citations were identified. Of these, 3586 were duplicates, leaving 3391 titles/abstracts for screening. After more sensitive review by three authors (AG, JS, NM), 231 citations were included in the review. Two authors (AG, JS) independently extracted data from full reports or papers of all included studies. In a few instances, the full text could not be accessed and the study was assessed on the abstract only. Not unsurprisingly, this systematic review has failed to find large quantities of high quality evidence that increasing choice has a direct impact on the contraceptive outcomes of interest. The best evidence retrieved is summarised in Table 1. (excerpt)
Arlington, Virginia, Management Sciences for Health [MSH], Rational Pharmaceutical Management Plus, 2005 Oct 27. 19 p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACH-068; USAID Cooperative Agreement No. HRN-A-00-00-00016-00)Many national TB programs continue to encounter problems in providing quality TB medicines to patients when they need them. While lack of financial resources may be one constraint for procuring all TB medicines needed, national programs experience a host of other problems in pharmaceutical management. Strong pharmaceutical management is one of the key pillars to effective tuberculosis (TB) control; without appropriate selection, effective procurement, distribution, stock management and rational use of TB medicines and related supplies, individuals will not be cured of the disease and countries will not reach global targets. Management Sciences for Health's Rational Pharmaceutical Management Plus (RPM Plus) program funded by USAID in collaboration with Stop TB Partnership's Global TB Drug Facility (GDF) housed at World Health Organization (WHO) Geneva conducted a workshop at the 36th International UNION World Congress on Tuberculosis and Lung Health on October 19th 2005 at Paris, France. This is the fourth year MSH and GDF have collaborated in such an event at the UNION congress due to popular demand by national TB programmes and their partners. (excerpt)
Valiadation of a new clinical case definition for paediatric HIV infection, Bloemfontein, South Africa [letter]
Journal of Tropical Pediatrics. 2005 Dec; 51(6):387.In 2003 a study was published, evaluating the WHO clinical case definition for paediatric HIV infection in Bloemfontein, South Africa. It was found that the WHO case definition could only detect 14.5 per cent of children who were in fact symptomatic and HIV positive on age-appropriate serology testing. Following logistic regression analysis, a new case definition was proposed, namely that HIV is suspected in a child who has at least two of the following four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. This new case definition had a sensitivity of 63.2 per cent and a specificity of 96.0 per cent. (excerpt)
Habitat Debate. 2002 Dec; 8(4): p..Violence against women, be it threats, intimidation, harassment, sexual attacks or rape, considerably inhibits women’s mobility within the city. Women are targets of violence due to their vulnerability, and this vulnerability perpetuates their position in society. This means that in large cities, most women restrict their movements or activities because they feel unsafe. This daily experience of insecurity makes them infinitely qualified to detect problems and offer solutions. One of the ways in which women can feel safer and fully benefit from the services and resources cities have to offer is to actively go about changing their environment together with municipal authorities and other community institutions and groups. A Women’s Safety Audit is a tool that enables a critical evaluation of the urban environment. This tool was initiated in Canada following the recommendations of a report in 1989 on violence against women and has been further developed by UN-HABITAT’s Safer Cities programme. (excerpt)
Joint ILO / WHO guidelines on health services and HIV / AIDS. Tripartite Meeting of Experts to Develop Joint ILO / WHO Guidelines on Health Services and HIV / AIDS.
Geneva, Switzerland, ILO, 2005.  p. (TMEHS/2005/8)These guidelines are the product of collaboration between the International Labour Organization and the World Health Organization. In view of their complementary mandates, their long-standing and close cooperation in the area of occupational health, and their more recent partnership as co-sponsors of UNAIDS, the ILO and the WHO decided to join forces in order to assist health services in building their capacities to provide their workers with a safe, healthy and decent working environment, as the most effective way both to reduce transmission of HIV and other blood-borne pathogens and to improve the delivery of care to patients. This is essential when health service workers have not only to deliver normal health-care services but also to provide HIV/AIDS services and manage the long-term administration and monitoring of anti-retroviral treatments (ART) at a time when, in many countries, they are themselves decimated by the epidemic. (excerpt)
Washington, D.C., Population Reference Bureau [PRB], 2005 Apr. 5 p.Among the development challenges that the international community hopes to tackle in the next decade, reducing the death and suffering associated with pregnancy and childbirth in the world's poorest communities remains one of the most daunting. Despite heightened attention to the issue in the last two decades, progress in reducing these deaths (the number of which is particularly difficult to estimate) has so far eluded governments. But the international community has renewed its commitment to the issue by setting a 2015 deadline for a significant worldwide reduction in pregnancy-related deaths and for improving maternal health globally. Progress toward this and other UN Millennium Development Goals (MDGs) set by world leaders in 2000 will be weighed at a high-level session of the UN General Assembly in New York in September 2005. Discussions are expected to include a focus on ways of measuring the problem and on the most effective strategies for reducing maternal mortality. (excerpt)
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2002.  p.A 100% condom use programme (100% CUP), targeting female sex workers in entertainment establishments, is important in prevention and control of STIs, including HIV. Monitoring and evaluation to measure the progress of the programme is one of its essential components, and requires appropriate indicators. An indicator is a way in which to quantify or measure the magnitude of progress toward something one is trying to achieve in a programme, whether it is a process, an outcome or an impact. Indicators are just that - they simply give an indication of magnitude or direction of change over time. They cannot tell managers much about why the changes have or have not taken place. While a single indicator cannot measure everything, knowing the magnitude and direction of change in achieving a programme objective is critical information for a manager. A good indicator for monitoring and evaluation needs to be: relevant to the programme; feasible to collect and analyse; easy to interpret; and able to measure change over time. Identifying an indicator to be followed in a 100% CUP also demands attention to how that indicator will be defined, the source of the information needed for it, and the timeframe for its collection and analysis. (excerpt)
Measuring the level of effort in the national and international response to HIV / AIDS: The AIDS Programme Effort Index (API). Summary report.
Geneva, Switzerland, UNAIDS, . 24 p.UNAIDS, USAID and the POLICY Project have developed the AIDS Programme Effort Index (API) to measure programme effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that programme effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programmes scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programmes received relatively high rating in all categories except care. The results presented here will be supplemented later in 2001 with a new component on human rights. (excerpt)
BMJ. British Medical Journal. 2004; 329:1036-1039.Imagine a new drug that reduces the absolute risk of treatment failure by three quarters—a rare situation in the West but a reality in countries where malaria is endemic, and where adding artesunate to existing drugs has this effect on cure. In middle and low income countries, life threatening infectious diseases are everywhere: new drugs can therefore have large effects on outcomes, and even modest benefits from new interventions can have a dramatic impact on health overall. In addition, wasting resources on ineffective interventions results in technical inefficiencies and substantial opportunity costs in countries least able to afford them; the Global Fund’s purchase of ineffective drugs is a recent example. Since 1990 there has been a massive collective effort, largely fuelled by the Cochrane Collaboration, for people from middle and low income countries to “get it together”—to work collectively to bring research evidence into systematic reviews and to consider ways to ensure the findings are used in clinical practice. We all want to put research into practice, but in the past the emphasis was implementing results from single studies. Now it is widely accepted that we need to “globalise the evidence, and localise the decision”—that is, set the results from a single study in the context of other relevant research. However, these syntheses of the evidence must then be actively managed to ensure change: they require dissemination, policies and systems that enable change, and influential people motivated to stimulate change. This article highlights some of our experiences and personal observations of preparing reviews and implementing change. (excerpt)
Emerging Infectious Diseases. 2004 Nov; 10(11):1979-1983.The mechanisms, techniques, and data sources used to monitor and evaluate global AIDS prevention and treatment services may vary according to gender. The Joint United Nations Programme on HIV/AIDS has been charged with tracking the response to the pandemic by using a set of indicators developed as part of the Declaration of Commitment endorsed at the U.N. General Assembly Special Session on AIDS in 2001. Statistics on prevalence and incidence indicate that the pandemic has increasingly affected women during the past decade. Women’s biologic, cultural, economic, and social status can increase their likelihood of becoming infected with HIV. Since 2000, global financial resources have increased to allow expansion of both prevention and treatment services through a number of new initiatives, such as the Global Fund to Fight AIDS, TB and Malaria; the U.S. President’s Emergency Plan for AIDS Relief; and the World Bank MAP program. Programs should be monitored and evaluated to ensure these investments are used to maximum effect. Different types of data should be included when assessing the status of the HIV/AIDS epidemic and effectiveness of the response. Each of these “data streams” provides information to enhance program planning and implementation. (excerpt)
“Three Ones” key principles . “Coordination of National Responses to HIV / AIDS”. Guiding principles for national authorities and their partners.
Geneva, Switzerland, UNAIDS, 2004. 4 p.The HIV/AIDS pandemic is a genuine global emergency taking the lives of eight thousand people a day and threatening the lives of tens of millions more as the infection continues to spread around the world. New but still limited resources to respond to the needs of people living with HIV and AIDS and those at risk of infection will be utilized most efficiently if there is maximum coordination within the international community. To leverage resources and have the maximum impact on the global response to AIDS, all parties should strive to target their programmes on the priority needs of affected countries strive, seeking to avoid duplication of effort. (excerpt)
Geneva, Switzerland, UNAIDS, 2004. 5 p.This document is the report of a consultation process undertaken by UNAIDS with key donor partners in order to build a common ground around the “Three Ones” and leading up to the meeting of donors and national partners in Washington on 25th April 2004. The document is not a negotiated text, but seeks to capture convergence on some key concepts relevant to effective donor support for the country level AIDS response. There is a marked shift in the global response to the crisis of AIDS; a new acknowledgement of urgency and stronger and more consistent demand for action. As the number of funding and implementing partners increases, there is also an urgent need to deal with the risk of duplication, overlap and fragmentation of the response, particularly where the capacity to co-ordinate is weak. Donor governments and other external partners have a major role in ensuring that their funding and support policies enable a nationally owned and led AIDS response. The “Three Ones” principles for coordination can only serve to enhance effectiveness, speed and sustainable results to the extent there is active support from donor partners. (excerpt)
Geneva, Switzerland, UNAIDS, . 2 p.The AIDS epidemic is a complex global crisis, which continues to worsen. At the same time, the world is responding more effectively than ever before. National responses are broader and stronger, and have improved access to financial resources and commodities. We, bilateral and multilateral donor agencies meeting with national leaders combating the spread of AIDS, reaffirm our broad and sustained commitment to supporting national AIDS responses. We endorse the “Three Ones” or key principles for concerted AIDS action at country level, with a view toward achieving the most effective and efficient use of available resources and ensuring rapid action and result-based management. These principles – detailed in the conference papers – are: One agreed HIV/AIDS Action Framework that provides the basis for coordinating the work of all partners. One National AIDS Coordinating Authority, with a broad based multi-sectoral mandate. One agreed country level Monitoring and Evaluation System. (excerpt)
An evaluation of infant growth. A summary of analyses performed in preparation for the WHO Expert Committee on Physical Status: the Use and Interpretation of Anthropometry.
Geneva, Switzerland, WHO, Nutrition Unit, 1994.  p. (WHO/NUT/94.8)In preparation for the WHO Expert Committee meeting on Physical status: the use and interpretation of anthropometry, a Working Group on Infant Growth was established to assess the growth patterns of infants following current WHO feeding recommendations, and the relevance of such patterns to the development of growth reference data. This document presents the full report of the analyses carried out, which were the basis for the Working Group's recommendations to the Expert Committee. The information is being made available to the scientific community to encourage and support further research on the questions raised by the Expert Committee after its evaluation of present knowledge about infant-growth assessment. In providing this information, the Working Group seeks to improve the nutritional management of infants and children by motivating the development of new scientific information that will fill gaps in knowledge and resolve a number of crucial issues raised by the Group's analyses. (author's)
Geneva, Switzerland, WHO, 1999.  p. (WHO/NHD/99.2)WHO, in close cooperation with Wellstart International, its collaborating centre on breastfeeding, began responding to this demand in 1997 by developing a set of monitoring/reassessment tools. Many partners were involved in its preparation (see acknowledgments), and UNICEF's office for the European Region was especially supportive of the process. The tools were field-tested in Brazil, Egypt, Nicaragua and Poland, which provided valuable feedback for finalizing the tools and enabled participating countries to launch or further develop their own BFHI monitoring and reassessment process. The tools are designed to foster involvement of hospital management and staff in problem identification and planning for sustaining or improving implementation of the Ten Steps. This strategy should contribute to long-term sustainability of BFHI and help ensure its credibility. The monitoring and reassessment tools are: Prototypes that can be adapted to meet country needs. Based on the "global criteria" for assessment of the "Ten steps to successful breastfeeding". Easy to use for assessors familiar with the BFHI assessment process and easy to teach to new assessors. Flexible, so that tools can be added or deleted and a system devised for use either internally by a hospital for on-going self-monitoring, or externally for periodic monitoring and reassessment. Easy to use in a short time, if desired. For example, the monitoring or reassessment process can be completed in just one day. (excerpt)
Development in Practice. 2004 Jun; 14(4):569-573.Monitoring and evaluation (M&E) are needed by all development interventions in order to document their output and outcomes. Once a set of goals has been established in response to a development ‘problem’, a corresponding set of indicators (i.e. variables or information) will also be identified in order to review progress towards those goals. In Africa, the so-called ‘expert’ evaluators—those who see M&E as their professional calling—have dominated the process of selecting social indicators. Unfortunately, this domination has given rise to sporadic and unreliable social data for M&E purposes facing every agency involved in development work in Africa. Zimbabwe is no exception. This Practical Note tells the story of UNICEF Zimbabwe’s search for relevant and reliable indicators based on solid data. The guiding philosophy in this effort is the belief that local communities themselves are among the many agencies involved in implementing development programmes—in the sense that they always seek ways of tackling whatever problems they face. These communities must therefore be active participants in the process of selecting indicators. The paper will first discuss the difficulty in establishing relevant data and indicators in the context of Zimbabwe, a task which is now an urgent priority given the dual problems of HIV/ AIDS and a declining economy. It is generally believed that these two problems have been responsible for the reversal of social gains made immediately after independence—hence the need to know exactly what is going on. The paper will then highlight recent attempts by UNICEF Zimbabwe—together with its partners—to establish good and reliable information sources so that not only can it monitor and evaluate the various impacts of its programmes but also the social environment of children. In part, the pressure for community-generated indicators has also been driven by the shift in UNICEF’s approach to its work—an approach underpinned by human rights principles. The final part of the paper discusses the challenges that UNICEF and its partners have faced and continue to struggle with. It draws some lessons learned and points to what more could be done to improve the qualities of social indicators. (excerpt)
Geneva, Switzerland, WHO, 2004. 60 p.By tracking the past course of the HIV/AIDS epidemic, warning of possible future spread and measuring changes in infection and behaviour over time, second- generation surveillance is designed to produce information that is useful in planning and evaluating HIV/AIDS prevention and care activities over time. This objective has been met in many countries, where useful, high-quality data are now available. Nevertheless, a gap remains between the collection of useful data and the actual use of these data to reduce people's exposure to HIV infection and to improve the lives of those infected. More effort has been put into improving the quality of data collection than into ensuring the appropriate use of data. Collecting high-quality data is an important prerequisite to using them well, but why are available data not used better? One reason is that surveillance systems are often fragmented. This means that many departments or groups are responsible for various aspects of data collection. Each considers its job done after it has held its own "dissemination workshop". No single entity is responsible for compiling all the data, analysing them and presenting them as a cohesive whole. Further, very few countries budget adequately for analysing, presenting and using data, either the financial or human resources. When financial resources are allocated, people often underestimate the skills and time required to use data well. Many surveillance officials responding to an informal WHO/UNAIDS survey gave one final reason: they simply do not know how to use the data. This is hardly surprising: most people responsible for surveillance systems are physicians and public health professionals who are good at interpreting trends in disease but who have limited training in the different ways HIV surveillance data can be used to improve programming, measure the success of prevention, lobby for policy change and engage affected communities in the response. This publication aims to provide guidance in these areas. It discusses the three major areas of data use: programme planning, programme monitoring and evaluation and advocacy, giving examples of how data can be used effectively in these contexts. The publication concentrates on the mechanics of using data: not just what can be done with data but how it can be done. How can data be packaged for different audiences? Who should be involved in dissemination? What makes a good press release? What steps are required to produce a national report? Practical guidance is given on how to develop interesting and persuasive presentations and how to present data effectively. Suggestions are made for bringing together programme planning and advocacy. Different countries have different epidemics, different surveillance systems and different data use needs. It is hoped, however, that all countries can find some general principles that will provide pointers on how to improve performance in areas of data use relevant to them. (excerpt)
Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries.
Bulletin of the World Health Organization. 2004 Feb; 82(2):106-114.To gain insight into similarities and differences in patient evaluations of quality of primary care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (for example, responsiveness) of these countries. Patient evaluations were derived from a series of Quote (QUality of care Through patients’ Eyes) instruments designed to measure the quality of primary care. Various research groups provided a total sample of 5133 patients from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Portugal, United Kingdom, and Ukraine. Intra-class correlations of 10 Quote items were calculated to measure differences between countries. The world health report 2000 — Health systems: improving performance performance measures in the same countries were correlated with mean Quote scores. Intra–class correlation coefficients ranged from low to very high, which indicated little variation between countries in some respects (for example, primary care providers have a good understanding of patients’ problems in all countries) and large variation in other respects (for example, with respect to prescription of medication and communication between primary care providers). Most correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (0.86) was between the primary care provider’s understanding of patients’ problems and responsiveness according to WHO. Patient evaluations of the quality of primary care showed large differences across countries and related positively to WHO’s performance measures of health care systems. (author's)