ArticleBulletin of the World Health Organization2011
Evaluating large-scale health programmes at a district level in resource-limited countries.
Article in Bulletin of the World Health Organization, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Methodological considerations for evaluating scale-up programmes in healthcare: a methods review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Review
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- A qualitative study of the dissemination and diffusion of innovations: bottom up experiences of senior managers in three health districts in South Africa.International journal for equity in health · 2019Article
- Methodological Considerations for Use of Routine Health Information System Data to Evaluate Malaria Program Impact in an Era of Declining Malaria Transmission.The American journal of tropical medicine and hygiene · 2017Review
- A Qualitative Study of Provider Perceptions of Influences on Uptake of Pediatric Hospital Guidelines in Lao PDR.The American journal of tropical medicine and hygiene · 2017Article
- Article
- A framework for assessing outcomes from newborn screening: on the road to measuring its promise.Molecular genetics and metabolism · 2016Article
- Transforming Global Health by Improving the Science of Scale-Up.PLoS biology · 2016Article
- Framework for Selecting Best Practices in Public Health: A Systematic Literature Review.Journal of public health research · 2015Review
- Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India.Implementation science : IS · 2015Article
- Development of a technical assistance framework for building organizational capacity of health programs in resource-limited settings.BMC health services research · 2014Article
- Evaluation of capacity-building program of district health managers in India: a contextualized theoretical framework.Frontiers in public health · 2014Article
- Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives.Global health action · 2013Article
- mHealth series: New ideas for mHealth data collection implementation in low- and middle-income countries.Journal of global health · 2013Article
- Removal of user fees no guarantee of universal health coverage: observations from Burkina Faso.Bulletin of the World Health Organization · 2013Article
- PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries.PLoS medicine · 2012Article
- The Evidence Base for the Maternal, Infant, and Early Childhood Home Visiting Program Constructs.Public health reports (Washington, D.C. : 1974)Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent experience in evaluating large-scale global health programmes has highlighted the need to consider contextual differences between sites implementing the same intervention. Traditional randomized controlled trials are ill-suited for this purpose, as they are designed to identify whether an intervention works, not how, when and why it works. In this paper we review several evaluation designs that attempt to account for contextual factors that contribute to intervention effectiveness. Using these designs as a base, we propose a set of principles that may help to capture information on context. Finally, we propose a tool, called a driver diagram, traditionally used in implementation that would allow evaluators to systematically monitor changing dynamics in project implementation and identify contextual variation across sites. We describe an implementation-related example from South Africa to underline the strengths of the tool. If used across multiple sites and multiple projects, the resulting driver diagrams could be pooled together to form a generalized theory for how, when and why a widely-used intervention works. Mechanisms similar to the driver diagram are urgently needed to complement existing evaluations of large-scale implementation efforts.
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