Health Research Program
**Nicodemus Marcus and Beati Mboya

While standard evaluation methods have been common practice for many years, imagine if you could evaluate and modify a project in real-time in order to maximize results? Developmental Evaluation does just that. At this year’s East Africa Share Fair in Entebbe, Uganda, Developmental Evaluation generated a fair amount of interest and curiosity. 

Participants raised several questions about Developmental Evaluation throughout the session and at multiple knowledge cafés focusing on Developmental Evaluation of health projects.

  • What is Developmental Evaluation and how does it differ from other program evaluation approaches?
  • When is Developmental Evaluation appropriate in building evidence to inform program planning and management decisions within health care programs and organizations?
  • How to advocate for developmental evaluations while taking the context into account?
  • What are the experiences of those who have used Developmental Evaluation in their projects or program?

To address these questions, let’s take a look at USAID’s work using Developmental Evaluation in Tanzania. USAID is assisting the Government of Tanzania (GoT) to promote the process of integrating and improving the quality of primary health care. The project is called Boresha Afya (“Improve Health”), and it supports the integration of an array of service areas, including HIV/AIDS, tuberculosis, malaria case management, and maternal and child health.

While integrated health care stands to greatly improve the health of Tanzanians, particularly women and children, existing data on the implementation and effectiveness of such programs is limited. Moreover, complex and dynamic interventions like Boresha Afya merit a research approach that allows for rapid learning and adaptation to effectively contribute towards achieving project objectives. Developmental Evaluation is an implementation research methodology that supports real-time collaborative learning and adaptive management efforts among implementing partners and GoT stakeholders. USAID is expected to leverage program learning to improve health service quality, utilization, and efficiency, and the scale-up of integrated health care delivery in Tanzania.

Key features of a developmental evaluation
Source: CIRCLE image

For the first time, the Developmental Evaluation team of USAID’s Coordinating Implementation Research to Communicate Learning and Evidence (CIRCLE) team is studying integration within the MNCH platform with a specific focus on child health, antenatal care (ANC) and post-natal care (PNC) services. Boresha Afya partners implement and provide technical assistance around integrated MNCH services at facilities and through community-level outreach that target pregnant women, mothers, and male partners making the ANC and PNC integration platform a priority.

Expected Results  

USAID will provide feedback in real-time to enable timely decisions and corrective or supportive actions to achieve intended outcomes, address unanticipated results, and identify new areas of opportunity. The project’s embedded evaluators will actively work alongside stakeholders to strengthen their ownership of adaptive practices and meaningful use of evaluation findings consistent with USAID’s collaboration, learning, and adaptation guidelines.

Developmental Evaluation process

The team will also track recommendations, actions, and partner learning over time to strengthen ownership of adaptive management practices among partners. Subsequent evaluation plans will build on the emerging experience as well as emerging priority areas and questions resulting from the participatory results-sharing and action-planning workshops.

The concept of Developmental Evaluation was well received among participants at the Share Fair in particular because the use of Developmental Evaluation for the Boresha Afya project highlights valuable lessons which could benefit the evaluation community, particularly health program managers.

**Beati Mboya is Chief of Party for the CIRCLE Project in Tanzania
**Nicodemus Marcus is the Knowledge Management Advisor for CIRCLE in Tanzania.

Ashwin Budden Developmental Evaluation Expert Consultant for the CIRCLE Project contributed to this report. 

Stay tuned for an in-depth look at Developmental Evaluation in our upcoming blogs.