Evaluating a large health education programme: The Sure Start Project in Uttar Pradesh
March 5, 2010
Speaker: Dr. Arnab Acharya
Impact evaluations of health programmes are key in terms of their policy relevance and impact. There, however, needs to be emphasis on mapping out the causal chain between inputs and outputs and its eventual impact. These were some of the questions raised at the Delhi Seminar series on "Evaluating Large Health Education Program: The Sure Start Project in Uttar Pradesh".
Presenting at the seminar, Dr. Arnab Acharya, Sr. Lecturer, London School of Hygiene and Tropical Medicine, elaborated on the challenges in designing, planning and conducting the evaluation of the ‘Sure Start Project’ - a large health education program in Uttar Pradesh. “The programme design is simple but the analysis is not. If we succeed in Uttar Pradesh, we will succeed elsewhere,” he said.
The Sure Start Project is designed to enhance pregnancy and neo-natal health in 7 districts of the state of Uttar Pradesh. It is aimed at supplementing the efforts for the National Rural Health Mission (NRHM) and if successful, will be scaled up nationally. A baseline survey was carried out on the pregnancy behaviour of 17,000 women for a pregnancy that occurred in 2007 and was completed at least a month before the survey. To conduct such an evaluation, the main challenges include: the difficulties in using the difference in difference approach in the case of rare occurrences such as death, and the fact that the project will not have the same subject being pregnant at the end of project, 2010-11.
Vikram Rajan, Health Systems Specialist, World Bank pointed out that this was a key project particularly since there is a paucity of rigorous impact evaluations in this sector. “The programme is important in terms of policy relevance and policy impact, particularly since Uttar Pradesh is the biggest contributor in India to Neonatal Mortality Rate”, he said.
Ralf Radermacher, Director, Micro Insurance Academy raised the issue of spillover effects and contamination resulting from the geographical distance between beneficiaries and non-beneficiaries.
Among other points discussed at the seminar, were questions concerning the structure of incentives provided to ground level staff, like Accredited Social Health Activists (ASHA), who are involved in implementing health measures.
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