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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