Health systems and HIV treatment in sub-Saharan Africa: matching intervention and programme evaluation strategies.

Sexually Transmitted Infections
Till BärnighausenSalal Humair

Abstract

International donors financing the delivery of antiretroviral treatment in developing countries have recently emphasised their commitment to rigorous evaluation of antiretroviral treatment impact on population health. At the same time frame, but for different reasons, they have announced that they will shift funding from vertically structured (ie, disease-specific) interventions to horizontally structured interventions (ie, staff, systems and infrastructure that can deliver care for many diseases). The authors analyse likely effects of the latter shift on the feasibility of impact evaluation. The authors examine the effect of the shift in intervention strategy on (1) outcome measurement, (2) cost measurement, (3) study-design options and the (4) technical and (5) political feasibility of programme evaluation. As intervention structure changes from vertical to horizontal, outcome and cost measurements are likely to become more difficult (because the number of relevant outcomes and costs increases and the sources holding data on these measures become more diverse); study-design options become more limited (because it is often impossible to identify a rigorously defined counterfactual in horizontal interventions); the technical fe...Continue Reading

Citations

May 8, 2013·BMC Health Services Research·Heidi W Reynolds, Elizabeth G Sutherland
Dec 2, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Rebecca HopeTill Bärnighausen
Aug 12, 2016·Current HIV/AIDS Reports·Elizabeth MarumMary Grace Alwano

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