Sara Bennett1, Sachiko Ozawa2, Daniela Rodriguez2, Amy Paul3, Kriti Singh4, Suneeta Singh4. 1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, USA. Electronic address: sbennett@jhu.edu. 2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, USA. 3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, USA. 4. Amaltas Consulting Pvt Ltd., C-20 Hauz-Khas, New Delhi 110016, India.
Abstract
PURPOSE: In low and middle-income countries, programs funded and implemented by international donors frequently transition to local funding and management, yet such processes are rarely evaluated. We reflect upon experience evaluating the transition of a large scale HIV/AIDS prevention program in India, known as Avahan, in order to draw lessons about transition evaluation approaches and implementation challenges. RESULTS: In terms of conceptualizing the transition theory, the evaluation team identified tensions between the idea of institutionalizing key features of the Avahan program, and ensuring program flexibility to promote sustainability. The transition was planned in three rounds allowing for adaptations to transition intervention and program design during the transition period. The assessment team found it important to track these changes in order to understand which strategies and contextual features supported transition. A mixed methods evaluation was employed, combining semi-structured surveys of transitioning entities (conducted pre and post transition), with longitudinal case studies. Qualitative data helped explain quantitative findings. Measures of transition readiness appeared robust, but we were uncertain of the robustness of institutionalization measures. Finally, challenges to the implementation of such an evaluation are discussed. CONCLUSIONS: Given the scarceness of transition evaluations, the lessons from this evaluation may have widespread relevance.
PURPOSE: In low and middle-income countries, programs funded and implemented by international donors frequently transition to local funding and management, yet such processes are rarely evaluated. We reflect upon experience evaluating the transition of a large scale HIV/AIDS prevention program in India, known as Avahan, in order to draw lessons about transition evaluation approaches and implementation challenges. RESULTS: In terms of conceptualizing the transition theory, the evaluation team identified tensions between the idea of institutionalizing key features of the Avahan program, and ensuring program flexibility to promote sustainability. The transition was planned in three rounds allowing for adaptations to transition intervention and program design during the transition period. The assessment team found it important to track these changes in order to understand which strategies and contextual features supported transition. A mixed methods evaluation was employed, combining semi-structured surveys of transitioning entities (conducted pre and post transition), with longitudinal case studies. Qualitative data helped explain quantitative findings. Measures of transition readiness appeared robust, but we were uncertain of the robustness of institutionalization measures. Finally, challenges to the implementation of such an evaluation are discussed. CONCLUSIONS: Given the scarceness of transition evaluations, the lessons from this evaluation may have widespread relevance.
Authors: Jess Alan Wilhelm; Mary Qiu; Ligia Paina; Elizabeth Colantuoni; Moses Mukuru; Freddie Ssengooba; Sara Bennett Journal: PLoS One Date: 2019-10-09 Impact factor: 3.240
Authors: Ilene S Speizer; David K Guilkey; Veronica Escamilla; Peter M Lance; Lisa M Calhoun; Osifo T Ojogun; David Fasiku Journal: PLoS One Date: 2019-09-26 Impact factor: 3.240
Authors: Henry Zakumumpa; Ligia Paina; Jess Wilhelm; Freddie Ssengooba; Eric Ssegujja; Moses Mukuru; Sara Bennett Journal: BMC Health Serv Res Date: 2021-04-01 Impact factor: 2.655