21/4/2008 Evaluation of control measures 1

21/4/2008 Evaluation of control measures 2 Family and Community Medicine Department

21/4/2008 Evaluation of control measures 3 Evaluation of disease control programs is a part of a cyclic process which includes: planning and implementation. PLANNING PLANNING EVALUATIONIMPLEMENTATION EVALUATIONIMPLEMENTATION

21/4/2008 Evaluation of control measures 4 1.Make a “community diagnosis”. Use morbidity and mortality data to indicate frequency and severity of the disease and identify high-risk groups. 2. Select appropriate control measures, depending on: availability and cost of resources. Plannin g

21/4/2008 Evaluation of control measures 5 3. Define program goals (objectives): What is to be done? What is to be done? How much? How much? Who is the target population? Who is the target population? When will the goals be accomplished? When will the goals be accomplished? Where? Where? e.g. to immunize against measles at least 90% of the children aged under 2 attending a certain health center during a period of 3 years. e.g. to immunize against measles at least 90% of the children aged under 2 attending a certain health center during a period of 3 years.

21/4/2008 Evaluation of control measures 6 Implementation Organization of a program to meet these goals with maximum efficiency and use of resources: Organization of a program to meet these goals with maximum efficiency and use of resources: -Manpower -Money -Money -Materials

21/4/2008 Evaluation of control measures 7 Programme evaluation Programme evaluation is a management tool. Programme evaluation is a management tool. It is a time-bound exercise that attempts to assess systematically and objectively the relevance, performance and success of ongoing and completed programmes and projects. It is a time-bound exercise that attempts to assess systematically and objectively the relevance, performance and success of ongoing and completed programmes and projects. to improve current activities and promote better planning by careful selection of alternatives for future action to improve current activities and promote better planning by careful selection of alternatives for future action

21/4/2008 Evaluation of control measures 8 EXISTING CONTROL PROGRAMMES National TB control programme National TB control programme National AIDS control programme National AIDS control programme Nutritional Surveillance Nutritional Surveillance National Diabetes control programme National Diabetes control programme National Polio surveillance programme National Polio surveillance programme Reproductive child health programme Reproductive child health programme

21/4/2008 Evaluation of control measures 9 Monitoring and evaluation Both are essential management tools which help to ensure that health activities are implemented as planned and to assess whether desired results are being achieved. Both are essential management tools which help to ensure that health activities are implemented as planned and to assess whether desired results are being achieved. Evaluation is not a substitute for monitoring nor is monitoring a substitute for evaluation. Evaluation is not a substitute for monitoring nor is monitoring a substitute for evaluation. Both use the same steps. Both use the same steps.

21/4/2008 Evaluation of control measures 10 MONITORING A process of measuring, recording, collecting and analyzing data on actual implementation of the programme and communicating it to the programme managers so that A process of measuring, recording, collecting and analyzing data on actual implementation of the programme and communicating it to the programme managers so that any deviation from the planned operations are detected, diagnosis for causes of deviation is carried out and suitable corrective actions are taken.

21/4/2008 Evaluation of control measures 11 Evaluation Evaluation is a periodic, in-depth analysis of programme performance. Evaluation is a periodic, in-depth analysis of programme performance. It relies on data generated through monitoring activities as well as information obtained from other sources (e.g., studies, research, in-depth interviews, focus group discussions, surveys etc.). It relies on data generated through monitoring activities as well as information obtained from other sources (e.g., studies, research, in-depth interviews, focus group discussions, surveys etc.). Evaluations are often (but not always) conducted with the assistance of external evaluators. Evaluations are often (but not always) conducted with the assistance of external evaluators.

21/4/2008 Evaluation of control measures 12 Monitoring: Monitoring: 1. To provide concurrent feedback on the progress of activities 1. To provide concurrent feedback on the progress of activities 2.To identify the problems in their implementation 2.To identify the problems in their implementation 3.To take corrective action 3.To take corrective action Evaluation: Evaluation: To assess whether the desired results of a programme have been achieved if not how it should be redesigned To assess whether the desired results of a programme have been achieved if not how it should be redesigned Aims

21/4/2008 Evaluation of control measures 13 Basic steps of Evaluation: Establishing standards, criteria, indicators Establishing standards, criteria, indicators Planning and methodology Planning and methodology Collecting data Collecting data Analyzing the data Analyzing the data Taking action Taking action Re-evaluation Re-evaluation

21/4/2008 Evaluation of control measures 14 Components of Evaluation process 1.Specify the particular subjects 2. Information support 3. Verify relevance 4. Assess adequacy 5. Review progress 6. Assess efficiency 7. Assess effectiveness 8. And assess impact

21/4/2008 Evaluation of control measures 15 Components Relevance-refers to whether the program or service is needed. Relevance-refers to whether the program or service is needed. Progress -refers to the tracking of the activities Progress -refers to the tracking of the activities Efficiency -refers to whether the program results could be obtained less expensively. Efficiency -refers to whether the program results could be obtained less expensively. Effectiveness -refers to whether the program results meet predetermined objectives. Effectiveness -refers to whether the program results meet predetermined objectives. Impact -refers to the long-term outcomes of the program. Impact -refers to the long-term outcomes of the program.

21/4/2008 Evaluation of control measures 16 Effectiveness An assessment of programme effectiveness focuses on the extent to which the outputs have been or will be achieved and whether the programme is likely to contribute to the stated outcomes and impact. An assessment of programme effectiveness focuses on the extent to which the outputs have been or will be achieved and whether the programme is likely to contribute to the stated outcomes and impact. If not, the evaluation will identify whether the results should be modified (in case of a mid-term evaluation) or the programme be extended (in case of a final evaluation) in order to enable achievement of stated results. If not, the evaluation will identify whether the results should be modified (in case of a mid-term evaluation) or the programme be extended (in case of a final evaluation) in order to enable achievement of stated results.

21/4/2008 Evaluation of control measures 17 Efficiency It assesses the results obtained in relation to the expenditure incurred and resources used by the programme during a given period of time. The analysis focuses on the relationship between the quantity, quality, and timeliness of inputs, including personnel, consultants, travel, training, equipment and miscellaneous costs, and the quantity, quality, and timeliness of the outputs produced and delivered. It examines whether the resources were spent as economically as possible.

21/4/2008 Evaluation of control measures 18 EXISTING CONTROL PROGRAMMES National TB control programme National TB control programme National AIDS control programme National AIDS control programme Nutritional Surveillance Nutritional Surveillance National Diabetes control programme National Diabetes control programme National Polio surveillance programme National Polio surveillance programme Reproductive child health programme Reproductive child health programme

21/4/2008 Evaluation of control measures 19 Goal & objectives of National AIDS Control Programme Prevention of HIV infection Prevention of HIV infection Decrease the morbidity and mortality associated with HIV infection Decrease the morbidity and mortality associated with HIV infection To minimize the socio- economic impacts resulting from HIV infection To minimize the socio- economic impacts resulting from HIV infectionPhase-II To reduce the spread of HIV infection To reduce the spread of HIV infection To strengthen India’s capacity to respond to HIV/AIDS on a long term basis To strengthen India’s capacity to respond to HIV/AIDS on a long term basis

21/4/2008 Evaluation of control measures 20 Medium term objectives To establish effective surveillance in all states to monitor the epidemic To establish effective surveillance in all states to monitor the epidemic To ensure a high level of awareness of HIV/AIDS and its application in the population To ensure a high level of awareness of HIV/AIDS and its application in the population To promote the use of condoms for safe sex To promote the use of condoms for safe sex Target intervention to high risk group Target intervention to high risk group To ensure safety of blood To ensure safety of blood To develop the services required for providing support to HIV infected persons, AIDS patients & their associate To develop the services required for providing support to HIV infected persons, AIDS patients & their associate

21/4/2008 Evaluation of control measures 21 Programme strategy Social mobilization Social mobilization Blood safety Blood safety Condom promotion Condom promotion Control of STD Control of STD Clinical management Clinical management Care & Support Care & Support Surveillance Surveillance

21/4/2008 Evaluation of control measures 22 Monitoring of family health awareness campaign Monitoring of family health awareness campaign Monitoring for availability and distribution of materials for awareness programme Monitoring for availability and distribution of materials for awareness programme Ensuring the availability of condoms Ensuring the availability of condoms Ensuring availability of drugs for opportunistic infections in the hospital Ensuring availability of drugs for opportunistic infections in the hospital Ensuring the availability of Anti retroviral drugs Ensuring the availability of Anti retroviral drugs STD/HIV/AIDS surveillance STD/HIV/AIDS surveillance Monitoring of Blood banks Monitoring of Blood banks Monitoring & Evaluation