Evaluate Together

Health outcomes

Before you enter into the details of specific health indicators, it is important to step back and look at the big picture. What health outcomes did the project aim to achieve? What were the goals and objectives?

Then try to formulate a few key questions that will enable your evaluation to determine whether you have achieved these goals and objectives; the simpler and clearer the questions, the better. If your goal was relatively narrow, this exercise will be easier than if it was broad, as illustrated in the following example:

Focus Goal
Narrow Goal: Reduce teen pregnancy in participating communities Key question: Has teen pregnancy been reduced during the project period of the last two years (as a result of our project’s efforts?3)
 
Broad Goal: Improve the health and survival of children under five years old in participating communities. Key questions: Are more children under five surviving? Are children under five years old healthier now than they were when we initiated the project (as a result of our efforts)?3 Note: In this case, the team would need to define what is meant by “healthier”.

It is not within the scope of this manual to review how to select health outcome indicators. But if you have done the previous phases well, you will already have established these indicators and will have been monitoring those that can be monitored on a regular basis throughout the action phase.

Evaluations can provide the opportunity and resources to collect and analyze information on those indicators that are more difficult to monitor on a regular basis. Outcomes are often compared to those of the baseline. Several resources (see the Resource Guide at the end of this manual) catalogue the current recommended indicators in a range of health topics. Additionally, there are usually local resources on recommended health indicators available through public health institutions (Ministry or Department of Health), donor organizations, international cooperating agencies, and NGOs that you may want to consider. Keep in mind that indicators are constantly changing as the field evolves and that experts in the field may have difficulty agreeing on them.

Evaluation planners need to carefully select indicators based on agreed-upon criteria such as:

  • The relative value of the information to participants and other stakeholders(e.g., to justify the investment in the project, to improve program quality, to advance the field through lessons learned, etc).

  • The availability of comparable indicators from baseline assessments.

  • The feasibility of gathering the data (cost, ease or difficulty of data collection, time available, skills of evaluation team members).

Many evaluators set out to assess whether a project did what the designers said it would do. Participatory project evaluation does this too, but evaluators may also need to look beyond what participants initially planned to do to determine whether project teams and participants altered their plans if they realized that a strategy was not working.

Social change: community capacity outcomes
Outcomes affecting underlying contributing factors to health problems and conditions
Setting Priorities