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Operations Research, Monitoring & Evaluation

Improving CHW Program Functionality, Performance and Engagement: Operations Research Results from Zambia

Developed for the USAID Health Care Improvement Project (HCI). Initiatives Inc., 2012.

Community health workers (CHWs) are making a substantial contribution to health service delivery the world over. They contribute to filling significant health human resources gaps and they are critical to achieving the Millennium Development Goals (MDGs). Many programs and countries have begun the large-scale deployment of community health workers to improve access to essential health services. Experience shows, however, that while crucial, community health worker programs are often fraught with significant human resources challenges. The USAID-funded Health Care Improvement Project (HCI) developed the Community Health Worker Assessment and Improvement Matrix (CHW AIM) to help assess and strengthen CHW program functionality. HCI conducted operations research in Zambia to test CHW AIM’s effectiveness as an improvement tool and to determine if associations exist among CHW program functionality, CHW performance and CHW engagement. This Research and Evaluation Report – Improving CHW Program Functionality, Performance and Engagement: Operations Research Results from Zambia – presents the findings of the CHW AIM operations research activity.


See also: Health Care Improvement Project

Final Evaluation of USAID/Senegal Community Health Program (CHP)

For the United States Agency for International Development by Eliot T. Putnam, Jr., Cheikh Toure and Souleymane Barry, Initiatives Inc., 2011.

Initiatives’ Lessons Learned / Final Evaluation Report on the USAID-funded Community Health Program (CHP) addressed the necessity of learning from the experience to date and informing program expansion. In particular the evaluation team focused on the quality and range of health services offered to communities, referral and follow-up systems, community awareness, socio-cultural barriers to accessing services, and sustainability.  


Lessons Learned From the Bénin HIV/AIDS Prevention Program (BHAPP):  Final Evaluation of BHAPP, as Implemented by Africare in Collaboration with JHPIEGO (2002 – 2006)

For the United States Agency for International Development by Dr. Léon K. Kessou and Eliot T. Putnam, Jr., Initiatives Inc., 2006.

Report presents findings and recommendations.


Rwanda Human Resources Assessment for HIV/AIDS Service Scale-Up

Prepared for the Quality Assurance Project by Rebecca Furth, Robert Gass, and Jean Kagubare, Initiatives Inc., 2005-06.

This series of reports emerged from a nine-month study of the human resources and HIV/AIDS situation in Rwanda. The purpose of the study was to assist the Government of Rwanda to determine how many staff, or what types and at what costs would be required to meet HIV/AIDS service delivery goals. The study documents include a Summary Report, containing highlights of study findings and recommendations; Phase 1 Report, documenting the national human resources situation; Phase 2 Report, detailing findings of sample site data collection at 20 different facilities across Rwanda; and Phase 3 Report, presenting analysis of staffing requirements and scenarios for HIV/AIDS scale-up.

Zambia Performance-Based Incentives Final Study

Prepared for the Quality Assurance Project by Rebecca Furth, Initiatives Inc., 2005.

This report documents findings from a 15-month pilot study of the effects of financial and non-financial awards on staff motivation and health facility performance. The study was built around clearly documented and shared health facility performance standards that included HMIS indicators, client satisfaction, health center cleanliness, and rational prescription of antibiotics in addition to process standards such as the development of performance plans and definition of clear actions to address problems. It was conducted in two districts in Zambia, one testing out trophies as non-financial incentives and the other providing cash awards for both high performance and improvement. Study results indicate that non-financial awards are more motivating for staff and influential on facility performance than financial awards, in part because they are not nearly as controversial and financial awards.


Mid-Term Evaluation Report: Save the Children's Capacity Building for Quality HIV/AIDS Services (Umoyo Network)

For the United States Agency for International Development by Eliot Putnam, Jean Meyer Capps, and Ann Van Briesen-Lewis, Initiatives Inc., 2005.

Report presents findings and recommendations.


RH/FP NGO Strategy Evaluation: Report of Findings and Recommendations

For the United States Agency for International Development by Maria Mamlouk, Betty Ravenholt, David Schrier, and Franklin Vasquez, Initiatives Inc., 2004.

Report presents findings and recommendations for USAID/Santo Domingo's reproductive health/family planning NGO program strategy.


Zambia HIV/AIDS Workforce Study: Preparing for Scale-Up 

Developed for the Central Board of Health in Zambia under the USAID-funded Quality Assurance Project by Jenny Huddart, Rebecca Furth, Joyce V. Lyons, Initiatives Inc., 2004.

Anticipating massive scale-up of its HIV Voluntary Counseling and Testing (VCT), Prevention of Mother-to Child Transmission (P-MTCT), and Anti-Retroviral Therapy (ART) services with a Global Fund award, the Central Board of Health in Zambia commissioned a study of the human resource implications of its intended national expansion of current HIV/AIDS services. The research was carried out by Initiatives through the Quality Assurance Project.

The study collected data at 16 government, NGO, and private sites across Zambia that currently provide VCT, P-MTCT, and ART services, to determine the staffing and cost implications of scale-up. The study's approach and results will be of particular interest to individuals, programs, and countries concerned with the human resource implications of scaling up HIV/AIDS services.


The Health Sector Human Resource Crisis in Africa: An Issues Paper

Initial draft prepared for the Academy for Educational Development by Jenny Huddart, Initiatives Inc., 2002-2003.

This issues paper was prepared under the USAID-funded Support for Analysis and Research in Africa (SARA) project to discuss the human resources crisis in sub-Saharan Africa. The paper, initially drafted by Initiatives’ Vice President Jenny Huddart, was used as a background document for the meeting organized by the World Bank and WHO/AFRO on “Building Strategic Partnerships in Education in Health in Africa” held in Addis Ababa, Ethiopia in January/February 2002.

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