What IE is not and is not Male Circumcision Impact Evaluation Meeting Johannesburg, South Africa January 18-23, 2010 Nancy Padian UC Berkeley.

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What IE is not and is not Male Circumcision Impact Evaluation Meeting Johannesburg, South Africa January 18-23, 2010 Nancy Padian UC Berkeley

Traditional randomized “eficacy” controlled trials (RCTs) Targets individuals or communities evaluator directly controls implementation Intensive in terms of cost, training Implementation is perfect Does not consider adherence, migration or other factors that might have diluted the effect Efficacy/ highest internal validity (not real world) 3/5/2016

How is IE different from M&E? M&E: Evaluating how a program is implemented –Is the program being implemented as designed? –Could the operations be more efficient? –Are the benefits getting to those intended? –Costing and accounting –Monitoring trends –Are indicators moving in the right direction? –No ability for intervention attribution IE: Estimating the effect of the program

M&E: monitoring & process evaluation Descriptiveanalysis Causalanalysis What was the effect of the program on outcomes? How would outcomes change under alternative program designs? Is the program cost-effective? Is program being implemented efficiently? Is program targeting the right population? Are outcomes moving in the right direction?  Impact Evaluation:

Monitoring and Evaluation Results Pyramid Source: UNAIDS, The World Bank. Monitoring and Evaluation Operations Manual NUMBER OF PROJECTS LEVELS OF EVALUATION EFFORTS ALLMOSTSOMEFEW MONITORINGEVALUATION INPUTS OUTPUTS OUTCOMES IMPACT

Monitoring and Evaluation Results Pyramid Source: UNAIDS, The World Bank. Monitoring and Evaluation Operations Manual NUMBER OF PROJECTS POTENTIAL FOR RESULTS ATTRIBUTION ALLMOSTSOMEFEW MONITORINGEVALUATION INPUTS OUTPUTS OUTCOMES IMPACT Resources (fixed or mobile) Staff Funds Supplies Training No. of procedures Condom availability Trained staff Service quality Short-term and intermediate effects: Behavior change STIs Long-term effects: HIV/AIDS Mortality Economic impact

Is MC being delivered as planned? Does outreach to women increase uptake? What are the trends in HIV prevalence? Does MC affect prevention behavior? What is a precise estimate of MC effectiveness?  M&E  IE  M&E  IE