21/4/2008 Evaluation of control measures 1. 21/4/2008 Evaluation of control measures 2 Family and...

21/4/200821/4/2008 Evaluation of control measures Evaluation of control measures 11


Family and Community Medicine DepartmentFamily and Community Medicine Department


EvaluationEvaluation of disease control programs is a part of disease control programs is a part

of a of a cycliccyclic process which includes: planning process which includes: planning

and implementation.and implementation.

PLANNINGPLANNING

EVALUATIONEVALUATION IMPLEMENTATIONIMPLEMENTATION


1.1. Make a “community diagnosis”. Make a “community diagnosis”.

Use morbidity and mortality data to indicate Use morbidity and mortality data to indicate frequency and severity of the disease and frequency and severity of the disease and identify high-risk groups.identify high-risk groups.

2. Select appropriate control measures, 2. Select appropriate control measures, depending on: depending on:

availability and cost of resources.availability and cost of resources.

Planning


3. Define program goals (objectives):3. Define program goals (objectives): What is to be done?What is to be done?

How much?How much?

Who is the target population?Who is the target population?

When will the goals be accomplished?When will the goals be accomplished?

Where?Where?

e.g. to immunize against measles at least 90% of the e.g. to immunize against measles at least 90% of the

children aged under 2 attending a certain health children aged under 2 attending a certain health

center during a period of 3 years.center during a period of 3 years.


ImplementationImplementation

Organization of a program to meet these goals Organization of a program to meet these goals

with maximum efficiency and use of resources:with maximum efficiency and use of resources:

-- ManpowerManpower

-- MoneyMoney

-- MaterialsMaterials


Programme evaluation

Programme evaluation is a management tool. Programme evaluation is a management tool. It is a time-bound exercise that attempts to assess It is a time-bound exercise that attempts to assess

systematically and objectively the relevance, systematically and objectively the relevance, performance and success of ongoing and performance and success of ongoing and completed programmes and projects.completed programmes and projects.

to improve current activities and promote better to improve current activities and promote better planning by careful selection of alternatives for planning by careful selection of alternatives for future actionfuture action


EXISTING CONTROL PROGRAMMESEXISTING CONTROL PROGRAMMES

National TB control programmeNational TB control programme National AIDS control programmeNational AIDS control programme Nutritional SurveillanceNutritional Surveillance National Diabetes control programmeNational Diabetes control programme National Polio surveillance programme National Polio surveillance programme Reproductive child health programmeReproductive child health programme


Monitoring and evaluationMonitoring and evaluation

Both are essential management tools which help to Both are essential management tools which help to

ensure that health activities are implemented as ensure that health activities are implemented as

planned and to assess whether desired results are planned and to assess whether desired results are

being achieved.being achieved.

Evaluation is not a substitute for monitoring nor is Evaluation is not a substitute for monitoring nor is

monitoring a substitute for evaluation. monitoring a substitute for evaluation.

Both use the same steps.Both use the same steps.


MONITORINGMONITORING

A process of measuring, recording, collecting and A process of measuring, recording, collecting and

analyzing data on actual implementation of the analyzing data on actual implementation of the

programme and communicating it to the programme and communicating it to the

programme managers so that programme managers so that

any deviation from the planned operations are any deviation from the planned operations are

detected, diagnosis for causes of deviation is detected, diagnosis for causes of deviation is

carried out and suitable corrective actions are carried out and suitable corrective actions are

taken.taken.


EvaluationEvaluation Evaluation is a Evaluation is a periodicperiodic, in-depth analysis of , in-depth analysis of

programme performance.programme performance.

It relies on data generated through monitoring It relies on data generated through monitoring

activities as well as information obtained from other activities as well as information obtained from other

sources (e.g., studies, research, in-depth sources (e.g., studies, research, in-depth

interviews, focus group discussions, surveys etc.). interviews, focus group discussions, surveys etc.).

Evaluations are often (but not always) conducted Evaluations are often (but not always) conducted

with the assistance of external evaluators.with the assistance of external evaluators.


MonitoringMonitoring::

1. To provide concurrent feedback on the 1. To provide concurrent feedback on the progress of activities progress of activities

2.To identify the problems in their implementation2.To identify the problems in their implementation

3.To take corrective action3.To take corrective action

EvaluationEvaluation: :

To assess whether the desired results of a To assess whether the desired results of a programme have been achieved if not how it programme have been achieved if not how it should be redesignedshould be redesigned

AimsAims


Basic steps of Evaluation:Basic steps of Evaluation:

Establishing standards, criteria, indicatorsEstablishing standards, criteria, indicators

Planning and methodologyPlanning and methodology

Collecting dataCollecting data

Analyzing the dataAnalyzing the data

Taking actionTaking action

Re-evaluationRe-evaluation


ComponentsComponents of Evaluation process of Evaluation process

1.1. Specify the particular subjectsSpecify the particular subjects

2.2. Information supportInformation support

3.3. Verify relevanceVerify relevance

4.4. Assess adequacyAssess adequacy

5.5. Review progressReview progress

6.6. Assess efficiencyAssess efficiency

7.7. Assess effectivenessAssess effectiveness

8.8. And assess impactAnd assess impact


ComponentsComponents RelevanceRelevance-refers to whether the program or -refers to whether the program or

service is needed.service is needed. ProgressProgress -refers to the tracking of the -refers to the tracking of the

activitiesactivities EfficiencyEfficiency -refers to whether the program results -refers to whether the program results

could be obtained less expensively.could be obtained less expensively. EffectivenessEffectiveness -refers to whether the program -refers to whether the program

results meet predetermined objectives.results meet predetermined objectives. ImpactImpact -refers to the long-term outcomes of the -refers to the long-term outcomes of the

program.program.


EffectivenessEffectiveness

An assessment of programme effectiveness focuses on the An assessment of programme effectiveness focuses on the

extent to which the outputs have been or will be achieved extent to which the outputs have been or will be achieved

and whether the programme is likely to contribute to the and whether the programme is likely to contribute to the

stated outcomes and impact. stated outcomes and impact.

If not, the evaluation will identify whether the results should If not, the evaluation will identify whether the results should

be modified (in case of a mid-term evaluation) or the be modified (in case of a mid-term evaluation) or the

programme be extended (in case of a final evaluation) in programme be extended (in case of a final evaluation) in

order to enable achievement of stated results.order to enable achievement of stated results.


EfficiencyEfficiency It assesses the results obtained in relation to the

expenditure incurred and resources used by the programme

during a given period of time.

The analysis focuses on the relationship between• the quantity, quality, and timeliness of inputs, including personnel,

consultants, travel, training, equipment and miscellaneous costs,

and

• the quantity, quality, and timeliness of the outputs produced and

delivered.

It examines whether the resources were spent as

economically as possible.


EXISTING CONTROL PROGRAMMESEXISTING CONTROL PROGRAMMES

National TB control programmeNational TB control programme National AIDS control programmeNational AIDS control programme Nutritional SurveillanceNutritional Surveillance National Diabetes control programmeNational Diabetes control programme National Polio surveillance programme National Polio surveillance programme Reproductive child health programmeReproductive child health programme


Goal & objectives of NationalGoal & objectives of NationalAIDS Control ProgrammeAIDS Control Programme

Prevention of HIV infectionPrevention of HIV infection Decrease the morbidity and mortality associated Decrease the morbidity and mortality associated

with HIV infectionwith HIV infection To minimize the socio- economic impacts To minimize the socio- economic impacts

resulting from HIV infectionresulting from HIV infection

Phase-IIPhase-II To reduce the spread of HIV infectionTo reduce the spread of HIV infection To strengthen India’s capacity to respond to To strengthen India’s capacity to respond to

HIV/AIDS on a long term basisHIV/AIDS on a long term basis


Medium term objectivesMedium term objectives

To establish effective surveillance in all states to monitor To establish effective surveillance in all states to monitor the epidemicthe epidemic

To ensure a high level of awareness of HIV/AIDS and its To ensure a high level of awareness of HIV/AIDS and its application in the populationapplication in the population

To promote the use of condoms for safe sexTo promote the use of condoms for safe sex Target intervention to high risk groupTarget intervention to high risk group To ensure safety of bloodTo ensure safety of blood To develop the services required for providing support to To develop the services required for providing support to

HIV infected persons, AIDS patients & their associateHIV infected persons, AIDS patients & their associate


Programme strategyProgramme strategy

Social mobilizationSocial mobilization Blood safetyBlood safety Condom promotionCondom promotion Control of STDControl of STD Clinical managementClinical management Care & SupportCare & Support SurveillanceSurveillance


Monitoring of family health awareness campaignMonitoring of family health awareness campaign

Monitoring for availability and distribution of materials for Monitoring for availability and distribution of materials for

awareness programme awareness programme

Ensuring the availability of condomsEnsuring the availability of condoms

Ensuring availability of drugs for opportunistic infections in Ensuring availability of drugs for opportunistic infections in

the hospitalthe hospital

Ensuring the availability of Anti retroviral drugsEnsuring the availability of Anti retroviral drugs

STD/HIV/AIDS surveillanceSTD/HIV/AIDS surveillance

Monitoring of Blood banksMonitoring of Blood banks

Monitoring & EvaluationMonitoring & Evaluation

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21/4/2008 Evaluation of control measures 1. 21/4/2008 Evaluation of control measures 2 Family and...

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