Assignment:
Global Health Care: Implementation and Evaluation
Veronica Range
Assessing the same body of evidence yields different conclusions regarding strength of evidence depending on which framework is used, some of which were extreme (with the same evidence base assessed as "strong" in one framework and "low quality" in another framework). All frameworks focus on efficacy and/or effectiveness with most attention going to the allocation method of study participants to the intervention (randomization versus other method) in assessing study quality. Many fail to consider implementation issues, and none explicitly assessed costs or sustainability at the community or scale level. Incorporating insights from the frameworks for implementation criteria helped to address some of these gaps, yet our pilot test of 10 implementation reporting criteria on nine published studies showed great variability both within and across studies.
Existing frameworks for the assessment of public health evidence do not deliver key pieces of information to inform best practices for community and large-scale global health programs, with the lack of information about implementation and sustainability being an important identified gap. In a pilot study, our application of existing criteria for the reporting of implementation information shows great variability within and across published global health intervention studies. Implementation will vary greatly from intervention to intervention in terms of duration how long the intervention lasts, frequency how many times in a given period activities occur, and intensity (how much material is covered and how much time is spent during each activity.
During all phases of your intervention, monitoring the implementation process is essential. Intervention monitoring will let you see if activities are occurring according to your plan. At the end of your intervention, you must do a final (or summative) evaluation to determine how well you achieved your goals and objectives. You'll assess how well you reached your intended participants and whether the outcomes you obtained were what you planned. You'll also compare the costs of the program with the benefits of the program.