Online Program

Prioritizing scarce resources for program improvement: Portfolio evaluation results in South Africa

Monday, November 4, 2013

Susan J. Griffey, DrPH, BSN, FNP, Public Health Research group, Social & Scientific Systems, Inc, Silver Spring, MD
Mary Pat Selvaggio, MPH, Research and Health, Khulisa Management Services, Johannesburg, South Africa
Doug Franke, CPA, BBA, SustainabilitySolutionsAfrica, Gardenview 2047, South Africa
Edna Berhane, MPH, MIA, Health, Khulisa Management Services, Johannesburg, South Africa
Introduction: In the present economic climate, funders and organizations alike need results on program interventions to allocate scarce resources to more fruitful efforts – relevant in South Africa (SA) where USG-funded programs have also been transitioning to direct country ownership. Methods: Since mid-2012, we've streamlined the Performance Assessment (PA) research initially presented at APHA-2011, with 1-day data collection at an organization's HQ and at 2 sites. We assess 3 programmatic dimensions (fiscal management (FM), systems strengthening (SS), and 1 or more technical program areas [TPA]), each with several sub-areas. We've conducted 26 of 60 planned PAs across a variety of organizations at differing budget levels. Results/Applicability: Findings from the 26 PAs thus far (to be updated for all 60) demonstrate that, not surprisingly, FM is the strongest dimension (2.75/3.00) since much is aligned with USG contractual requirements. The SS dimension is also strong (2.66/3.00), demonstrating the results of USG investments over the past several years in providing receiver organizations with strong SS support from experienced organizations. More varied were results from site observations where health services are being provided directly (2.50-2.83/3.00). Overall, sites were weaker meeting requirements such as policies and procedures for a TPA such as HIV Counselling and Testing. Detailed results for the dimensions and the sub-areas in each will be presented and described related to actual or potential investments made in quality improvement. The results from this streamlined methodology have already enabled USG/SA program managers to understand the potential funding implications as program transitions to country ownership continue. This PA research approach has widespread applicability for managers with multiple programs of any budget level – large or small - to rapidly identify deficient areas in programs to ensure evidence-based targeting for program improvement and thus quality delivery of health services.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe the results of the streamlined Performance Assessment (PA) applied in South Africa. Identify and rank the results by the dimension assessed and describe potential implications for evidence-based program improvement recommendations.

Keyword(s): Quality Improvement, Performance Measurement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I co-developed the Performance Assessment methodology and have provided much of the quality control during the assessments. I am also an experienced evaluator of government and other programs and portfolios.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.