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Male Circumcision Impact Evaluation Meeting

This meeting in Johannesburg, South Africa on January 18-23, 2010 discussed the differences between Monitoring and Evaluation (M&E) and Impact Evaluation (IE) in the context of male circumcision programs. The meeting explored the types of questions and methods used in M&E and IE, as well as the different levels of evaluation efforts. It also highlighted the potential for results attribution in both M&E and IE.

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Male Circumcision Impact Evaluation Meeting

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  1. What IE is not and is notMale Circumcision Impact Evaluation MeetingJohannesburg, South AfricaJanuary 18-23, 2010 Nancy Padian UC Berkeley

  2. 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. 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

  4. Question types and methods • M&E: monitoring & process evaluation • Is program being implemented efficiently? • Is program targeting the right population? • Are outcomes moving in the right direction? Descriptive analysis • Impact Evaluation: • What was the effect of the program on outcomes? • How would outcomes change under alternative program designs? • Is the program cost-effective? Causal analysis

  5. Monitoring and Evaluation Results Pyramid MONITORING EVALUATION INPUTS OUTPUTS OUTCOMES IMPACT ALL MOST SOME FEW NUMBER OF PROJECTS LEVELS OF EVALUATION EFFORTS Source: UNAIDS, The World Bank. Monitoring and Evaluation Operations Manual. 2002

  6. Monitoring and Evaluation Results Pyramid MONITORING EVALUATION INPUTS OUTPUTS OUTCOMES IMPACT ALL MOST SOME FEW NUMBER OF PROJECTS • 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 POTENTIAL FOR RESULTS ATTRIBUTION Source: UNAIDS, The World Bank. Monitoring and Evaluation Operations Manual. 2002

  7. When to use M&E and when IE? • M&E • 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? • IE • M&E • IE • IE

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