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Table 4 Core components of the impact evaluation and operational research

From: Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

  Focus Data source Analysis
Impact Evaluation Impact and effective coverage Oversampling DHS 2010 and 2015 Difference in differences in key population health indicators between 2010 and 2015, comparing the intervention area with rural comparison districts
  Service utilization and coverage, facility and community health worker levels Routine HMIS from hospital, health centers and community health worker program Change in service utilization and coverage in intervention areas in comparison to other rural districts
  Cause of death in children under five Verbal autopsy through MOH program Changes in the cause of death in children over the intervention period
  Contextual factors DHS, National Resource Database, environmental records Analysis of impact of contextual factors on district-level differences, including environmental factors, epidemics, humanitarian crises, sanitation, equity measures, women's education, HIV prevalence, Government of Rwanda records of partner contributions and engagement
Economic and Costing Analysis Costing Costing data collected by project Economic and costing assessment of the health system in the intervention area including the costs per capita of PHIT intervention; total costs per capita of the health systems in the two intervention districts; and financial contributions made by government, partners and patients to the local health systems
Component Evaluation Health facility support Health facility survey, HMIS, MESH data Impact of intervention on strengthening across WHO building blocks, explore relationship with quality and volume of care delivered
  MESH External observation of care delivery, qualitative evaluation of district and health center staff Effectiveness of MESH in improving quality of care focusing on children under-five, acceptability of and satisfaction with MESH
  Strengthened CHW systems Community HMIS data, household register Analysis of change in CHW-delivered services in intervention area and comparison areas
  Operational research Project specific Includes assessment of PHIT intervention on family-planning uptake, human resource retention, nutritional status in children