TY - JOUR
T1 - Critical evaluation of international health programs
T2 - Reframing global health and evaluation
AU - Chi, Chunhuei
AU - Tuepker, Anaïs
AU - Schoon, Rebecca
AU - Mondaca, Alicia Núñez
N1 - Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.
PY - 2018/4
Y1 - 2018/4
N2 - Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of “participation,” is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the “who” and “how” of programming decisions; midstream evaluation focusing on the “who” and “how” of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research.
AB - Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of “participation,” is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the “who” and “how” of programming decisions; midstream evaluation focusing on the “who” and “how” of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research.
KW - Community ownership
KW - Evaluation framework
KW - Global health
KW - International health programs
KW - Upstream and midstream evaluation
UR - http://www.scopus.com/inward/record.url?scp=85059796954&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059796954&partnerID=8YFLogxK
U2 - 10.1002/hpm.2483
DO - 10.1002/hpm.2483
M3 - Article
C2 - 29314258
AN - SCOPUS:85059796954
SN - 0749-6753
VL - 33
SP - 511
EP - 523
JO - International Journal of Health Planning and Management
JF - International Journal of Health Planning and Management
IS - 2
ER -