Background: Typically the effectivness of health interventions is measured using only the efficacy of the health intervention. This approach assumes all programmatic elements for the health intervention are in place, effective, and that the community has access to the intervention. These assumptions overestimate actual program effectiveness and fail to identify potentially addressable barriers. Method: We developed a method to estimate more realistically the effectiveness of public health interventions. Four core components of the intervention were assessed using a questionnaire: the efficacy of the intervention, the human resources (quality of recruitment, training, continuing education), the infrastructure (supplies, salary, transportation and supervision) and community support for the health intervention (access and demand). Using a standard scoring system developed for this purpose, we quantified the extent to which these components effected program performance. Results: In Afghanistan, the overall effectiveness of an NGO maternal outreach program was calculated at 21%. This estimate was derived using an efficacy of 40% for the strategy (based on literature) and from summary weighted scores for three key program components: human resources and training 0.50, infrastructure 0.38, and community support 0.75. Conclusions: Experience confirms the need to assess program effectiveness with data on human resources, infrastructure, and community support as well as efficacy. In Afghanistan, the infrastructure elements were the most damaging to the overall program and the low overall score was consistent with ultimate program performance. We recommend conducting further field trials of the assessment tool to validate the scoring system and further refine this method of program evaluation.
Learning Objectives: 1. List the core components of program effectiveness for decision analysis 2. Calculate, using the worksheet, the probability of a program to perform effectively 3. List two subcomponents within the core components that effect program effectiveness. 4. List at least one data source for each core component of program effectivenss
Keywords: Evaluation, Public Health Service
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Centers for Disease Control and Prevention
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.