The Boresha Afya project supports integrated primary health care in three geographical areas in Tanzania. USAID is conducting a Developmental Evaluation of the Boresha Afya project to support learning, innovation, and adaptive management efforts among implementing partners and Government of Tanzania stakeholders.
What is a Developmental Evaluation?
Developmental Evaluation (DE) is an adaptive and learning-focused approach to program evaluation that incorporates many elements of implementation research. It diverges from many of the assumptions and methods of formative and summative evaluation. DE emerged out of the realization that traditional evaluations offer little leeway from predefined measurement frameworks and external accountability reporting. These can fall short of delivering actionable guidance for program implementers.
Principles of DE:
- Adopts systems-thinking;
- Illuminates cause-effect relationships and unintended outcomes;
- Supports learning and innovation through continuous collaboration with program stakeholders;
- Applies methods with flexibility and rigor to address the needs of intended users;
- Provides real-time feedback to enable timely decision-making; and
- Engenders ownership and use of evaluation information by users.
About Boresha Afya DE:
The delivery of integrated health care is a priority for the Government of Tanzania (GoT) to improve access to quality and efficient health services. USAID assists this effort under the Boresha Afya project, which supports integrated primary health care in three geographical areas: Lake/Western Zones, North/Central Zones, and Southern Zone. The USAID Coordinating Implementation Research to Communicate Learning and Evidence (CIRCLE) project is conducting a DE of the Boresha Afya project to support learning, innovation, and adaptive management efforts among implementing partners and GoT stakeholders.
The DE has four interrelated objectives which are aligned with USAID Health Research Program’s approach to implementation research.
- To evaluate on an ongoing basis, with USAID Tanzania and Implementing Partners , factors that promote, and challenges that arise from, integrated service delivery focusing on quality, utilization and efficiency;
- To assess the fidelity of implementation, including feasibility, acceptability and sustainability of the integration approach;
- To provide timely and regular feedback and recommendations to implementing partners, based on the findings; to promote course shifts in implementation; and to strengthen integrated and client-centered healthcare with a view to improving health outcomes; and
- To promote optimal learning and improvement among key stakeholders from the project zones, including implementing partners, GoT, USAID Tanzania, service providers and managers.
DE involves a collaborative partnership between “embedded evaluators” and implementing partners. The embedded evaluators employ a variety of data collection methods and engagement tactics to gather insights on implementation processes and emerging results from the program sites. Findings and insights are shared with implementing partners on a continuous basis in order to make course corrections towards greater efficiency and quality of integrated services to reach the maximum number of clients in need of those services and enhance the impact of USAID assistance.
The DE is currently under implementation in 12 districts in the three zones. . Each of these districts has a high disease burden (including HIV prevalence) and a strong implementing partner presence.
Learn more about steps to conduct a developmental evaluation and its key features.