EVAL-HEALTH is an collaborative research project which has two main goals:
For each project goal, different objectives have been set with the final aim of providing the European Commission and developing countries with
EVAL-HEALTH is a 46 month project with 9 participants from Europe and developing
countries. The consortium also receives technical support from external experts in areas
of public health research, monitoring and evaluation and developmental aid.
Research work has been organized into five Work Packages (WP), covering the two project components. The following figure shows the interrelation between the 5 project work-packages:
How to better assess the impact of research projects in the area of international public
health and health systems is an important issue for the European Commission, mainly to
understand how far EC funding is contributing to global health challenges. Based on the
analysis of the exiting literature on methodologies to measure the impact of health
research and the work carried out by relevant research funders and development
agencies to monitor and evaluate research projects, EVAL-HEALTH will develop a
methodology for identifying and assessing the impacts of EC funded public health
research projects with participation of low and middle income countries. This
methodology named as Impact Oriented Monitoring (IOM), as it will use an online
survey as the main tool for identifying and capturing impacts throughout the project life
There is a growing recognition of the importance of evidence-informed health policy and planning decisions. Work has been done on analysing the role of evidence in health policies in general. However, there is limited published knowledge on what forms evidence, characteristics of different types of evidence, its roles in health policy processes in different contexts, and perceptions of robust evidence by different policy actors. EVAL-HEALTH contributes to filling the above gap through analysing the role of evidence in health policy development within and across the two developing countries. The study is conducted in one Asian (India) and one African (Nigeria) country. Three case studies are used in each country, representing areas of health services (HIV/AIDS, MCH, NCDs) and a component of the health system (Human Resources).
EVAL-HEALTH as commented before has two research components, each working towards their own specific objectives. The preliminary results achieved for each component are described below:
A unified methodology was developed for this qualitative studywhich was used to
collect and analyse data in each country, followed by cross-country comparative
analysis. Data collection methods included in-depth interviews with key policy actors
(such as policymakers, academia, civil society and health managers) and review of
documents relevant to each policy. Framework approach was used to analyse data. In
each country the role of evidence was explored in three specific policies: an area of
international prominence (HIV/AIDS in India and maternal, neonatal and child health in
Nigeria), a neglected area (tobacco control in India and oral health in Nigeria), and a
health systems component (social health activists programme in India and human
resource policy in Nigeria). The cross-country analysis was performed using the country
Preliminary (as of the end of October 2013) results show that all health policies and strategies studied are perceived by the policy actors to be evidence-informed. In Nigeria mostly formal types of evidence (such as published academic articles and results of surveys) claimed to be used in policy development whereas in India the respondents also identified informal types (such as personal experiences) as informing policy development. In terms of the use of evidence at different stages of policy and strategy development, the agenda-setting stage (i.e. when the issue is formally recognised on a policy agenda) was claimed to use wider variety of evidence types in both countries and policy approval was identified as an important milestone in policy processes, demarcating the start of policy implementation. In contrast with India, situational analysis was identified as an explicit stage of policy development in Nigeria. In both countries policymakers prefer evidence which is locally-produced and thus contextspecific, of sufficient scale and representative of the whole country, rigorous and available. In India the reputation of policy actors producing evidence was particularly emphasised as a reflection of credibility of evidence whereas in Nigeria the issue of accessibility of evidence was identified as an important consideration.
It is planned that the cross-country analysis will be completed by early 2014. The above findings, though preliminary, appear to reflect contextual differences between India and Nigeria: e.g. a more prominent role of international agencies in Nigeria, who often rely on formal assessments, and a more advanced role of civil society in India, which is likely to disseminate informal evidence through advocacy work. Future efforts to enhance the role of evidence in policy and strategy development require thorough understanding of local contexts, relative roles and influences of policy actors and clear understanding of evidence preferences by policymakers and other influential actors.
The longer-term benefits of studying the evidence base of health policy-making are twofold. Firstly, the study will inform better practices of evidence/knowledge communication from the EC-funded research into policy and practice in developing countries. Secondly, the study should help strengthening evidence-informed nature of health policies within the study countries and beyond