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Table 1 Steps in designing a delivery system evaluation

From: Methods for evaluating delivery systems for scaling-up malaria control intervention

 

Examples

Comments

Determine the purpose of the evaluation

- To evaluate a new delivery system for ITNs

- To evaluate a new delivery system for IPTc

- To assess the delivery of IPTp through ANC

Evaluation of a new delivery system for an existing intervention requires a pre-post survey with attribution of nets by source. A process analysis is required to assess the outputs at each intermediate step in the causal chain of delivery

Select the evaluation method

- cross sectional pre-post survey with attribution of outcomes by source of intervention

- cross sectional post intervention survey with attribution of outcomes by source of intervention

- cross sectional post only survey with no control

For evaluation of a new delivery system for an existing intervention a pre-post survey with attribution of outcomes by source would provide causality for proximal indicators and plausibility inference for distal indicators.

Define the outcome indicators

- the proportion of children under 5years using an ITN

- the proportion of children under 5 years taking a full course of IPT

- the proportion of pregnant women who attend ANC receiving at least 2 doses of IPT

The primary outcome indicator may be a distal or proximal indicator

Define the pathway of delivery

- include several proximal and more than one distal steps

- includes several proximal and one distal steps

- the evaluation terminates at proximal steps

The number of steps varies with interventions and with delivery systems.Many pathways are linearNot all pathways are linear

Characterise the contextual factors

- malaria transmission levels

- structure of the health system

- socio-demographics of the population

Disaggregate outcomes by contextual factorsDescribe contextual factors