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Appendix D
Glossary
Source
Responsibility for the use of resources and the (UNAIDS MERG,
Accountability
decisions made, as well as the obligation to 2010, p. 2)
demonstrate that work has been done in compliance
with agreed-upon rules and standards and to report
fairly and accurately on performance results vis-à-vis
mandated roles and/or plans.
Actions taken or work performed through which (UNAIDS MERG,
Activities
inputs such as funds, technical assistance, and other 2010, p. 2)
types of resources are mobilized to produce specific
outputs.
The extent to which countries or people can bear the Adapted from
Affordability
cost of programs or services. (Merriam-Webster,
2010)
The ascription of a causal link between observed (UNAIDS MERG,
Attribution
changes and a specific intervention. 2010, p. 2)
A systematic process for evaluating the products, Adapted from
Benchmarking
services and work processes of organizations that are (Spendolini, 1992,
recognized as representing best practices for the p. 2 )
purpose of organizational improvement.
A methodological approach that describes a situation, (UNAIDS MERG,
Case study
individual, or the like and that typically incorporates 2010, p. 2)
data-gathering activities (e.g., interviews,
observations, questionnaires) at selected sites or
programs/projects. Case studies are characterized by
purposive selection of sites or small samples; the
163
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164 STRATEGIC APPROACH TO THE EVALUATION OF U.S. GLOBAL HIV/AIDS PROGRAMS
expectation of generalizability is less than that in
many other forms of research. The findings are used to
report to stakeholders, make recommendations for
program/project improvement, and share lessons
learned.
A series of statements that link the causes of a (Belausteguigoitia,
Causal Chain
problem with its effects (i.e., a causal chain maps the 2004, p. 2)
relations between inputs, activities, outputs, outcomes
and impact).
When HIV actively multiplies, it infects and kills CD4 (CDC, 2008, p. 13)
CD4 Count
T cells, a specific type of white blood cell, that are the
immune system’s key infection fighters. The effects of
HIV are measured by the decline in the number of
CD4 cells. The CD4 count is the number of CD4 cells
in the blood and reflects the state of the immune
system. The normal count in a healthy adult is
between 600 and 1,200 cells/mm3.
The extent to which donors implement, where (High-level Forum,
Coordination &
feasible, common arrangements at country level for 2005, p. 6)
Harmonization
planning, funding (e.g., joint financial arrangements),
disbursement, monitoring, evaluating and reporting to
government on donor activities and aid flows."
A summary measure of linear association between two (Woodward, 2005,
Correlational
quantitative variables. The correlation coefficient p. 456–457)
analysis
takes the value-1 for perfectly negatively correlated
data. For perfectly positively correlated data it takes
the value unity. The nearer to zero is the correlation
coefficient, the less linear the association there is
between the two variables.
A measure of how economically resources/inputs (DAC Network on
Cost-
(funds, expertise, time, etc.) are converted to results. Development
effectiveness/
Evaluation, 2002,
Efficiency
p. 21)
The ability of government, the private sector, and civil Partially adapted
Country
society to “plan, manage, implement, and account for from
Capacity
results of policies and programs.” (High-level Forum,
2005, p. 5)
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165
APPENDIX D
A situation in which “partner countries exercise Partially adapted
Country
effective leadership over their development policies from
Ownership
and strategies, and coordinate development actions.” (High-level Forum,
Partner countries expect donors to respect country 2005, p. 3; Accra
priorities and to invest in country human resources Agenda for Action,
and institutions with the goal of improving or 2008)
maximizing the use of the country’s systems to deliver
aid for more rapid effectiveness with developmental
aid “[…] to achieve their own economic, social, and
environmental goals.” As a part of country ownership,
partner countries will be more transparent and
accountable to donors, their governing bodies, and
their citizens by translating their actions into positive
impacts on the lives of their citizens and populations.
The extent to which a program/intervention is being (UNAIDS MERG,
Coverage
implemented in the right places (geographic coverage) 2010, p. 2)
and is reaching its intended target population
(individual coverage).
An intensive literature search, review and synthesis of (Association of
Document
all relevant documents concerning the program being Qualitative
review
evaluated. In the case of HIV programs, documents to Research, 2010a;
be considered may typically include national Operario, 2008,
epidemiological reports, official government or other p. 13)
state-level public health and human rights policy
reports, non-governmental organization reports, and
any other academic or scientific papers related.
Findings are usually integrated into the overall
findings of the study and/or used to help design a main
project.
The extent to which a program/intervention has (UNAIDS MERG,
Effectiveness
achieved its objectives under normal conditions in a 2010, p. 2)
real-life setting.
Results or changes from the program such as changes (Taylor-Powell and
Effects
in knowledge, awareness, skills, attitudes, opinions, Henert, 2008)
aspirations, motivation, behavior, practice, decision
making, policies, social action, condition, or status.
Effects may be intended and/or unintended: positive
and negative. Effects fall along a continuum from
proximal (immediate; initial; short-term) to distal
effects (ultimate; long-term), often synonymous with
impact.
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166 STRATEGIC APPROACH TO THE EVALUATION OF U.S. GLOBAL HIV/AIDS PROGRAMS
The extent to which an intervention produces the (UNAIDS MERG,
Efficacy
expected results under ideal conditions in a controlled 2010, p. 3)
environment.
A measure of how, economically, inputs (resources (UNAIDS MERG,
Efficiency
such as funds, expertise, time) are converted into 2010, p. 3)
results.
The study of the magnitude, distribution and (UNAIDS MERG,
Epidemiology
determinants of health-related conditions in specific 2010, p. 3)
populations, and the application of the results to
control health problems.
The rigorous, scientifically-based collection of (UNAIDS MERG,
Evaluation
information about program/intervention activities, 2010, p. 3)
characteristics, and outcomes that determine the merit
or worth of the program/intervention. Evaluation
studies provide credible information for use in
improving programs/interventions, identifying lessons
learned, and informing decisions about future resource
allocation.
A survey of a representative sample of facilities that (UNAIDS MERG,
Facility Survey
generally aims to assess the readiness of all elements 2010, p. 3)
required to provide services and other aspects of
quality of care (e.g., basic infrastructure, drugs,
equipment, test kits, client registers, and trained staff).
The units of observation are facilities of various types
and levels in the same health system. The content of
the survey may vary but typically includes a facility
inventory and, sometimes, health worker interviews,
client exit interviews, and client-provider
observations.
The stage of a research project in which data is (Association of
Field Work
collected, whether in the form of interviews, group Qualitative
discussions, observations, or materials for cultural Research, 2010b)
analysis.
Qualitative methodology used to obtain information (McKenzie, 2005,
Focus Group
about the feelings, opinions, perceptions, insights, p. 76)
beliefs, misconceptions, attitudes and receptivity of a
group of people concerning an idea or an issue. They
include only 8–12 participants relatively homogeneous
though unfamiliar to each other. They share in a
guided discussion which is informal and last
approximately 2 hours.
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167
APPENDIX D
The extent to which findings can be assumed to be (UNAIDS MERG,
Generalizability
true for the entire target population, not just the 2010, p. 3)
sample of the population under study.
Note: To ensure generalizability, the sampling
procedure and the data collected need to meet certain
methodological standards.
A computer mapping and analysis technology (O’Carroll, 2003,
Geographic
consisting of hardware, software, and data allowing p. 432)
Information
large quantities of information to be viewed and
System (GIS)
analyzed in a geographic context. It has nearly all of
the features of a database management system, with a
major enhancement. Every item of information in a
GIS is tied to a geographic location.
“Health workers are all people engaged in actions (WHO, 2007, p.
Health
whose primary intent is to protect and improve health. 16; IOM, 2008,
Workforce
A country’s health workforce consists broadly of p. 2)
Strengthening
health service providers and health management and
support workers. This includes private as well as
public sector health workers; unpaid and paid workers;
lay and professional cadres. Countries have enormous
variation in the level, skill and gender-mix in their
health workforce. Overall, there is a strong positive
correlation between health workforce density and
service coverage and health outcomes.” Strengthening
“involves the improvement in a range of capacities
including training, supervision and job satisfaction.”
A data system, usually computerized, that routinely (UNAIDS MERG,
Health
collects and reports information about the delivery and 2010, p. 3)
Information
cost of health services, and patient demographics and
Systems
health status.
All organizations, people and actions whose primary Partially adapted
Health System
intent is to promote, restore or maintain health. WHO from (WHO, 2007,
divided health systems into six operational “building pp. v & 2)
blocks” action framework: services, workforce,
information, commodities and technologies, financing,
and leadership and governance.
Proportion of children that are alive and free of HIV- Adapted from
HIV-Free Infant
infection, which can be measured at 18 months of age. (Stringer et al.,
Survival
The denominator of this outcome measure consists of 2008)
the number of children born within the past two years,
estimated through the survey component of the
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168 STRATEGIC APPROACH TO THE EVALUATION OF U.S. GLOBAL HIV/AIDS PROGRAMS
Demographic and Health Survey. The numerator is
based on the same figure, minus the number of
children found to be HIV-infected [determined via
HIV antibody and deoxyribonucleic acid polymerase
chain reaction testing] and the number of children
reported to have died (derived via survey
methodology).
The long-term, cumulative effect of (UNAIDS MERG,
Impact
programs/interventions over time on what they 2010, p. 3)
ultimately aim to change, such as a change in HIV
infection, AIDS-related morbidity and mortality.
Note: Impacts at a population-level are rarely
attributable to a single program/intervention, but a
specific program/intervention may, together with other
programs/interventions, contribute to impacts on a
population.
A type of evaluation that assesses the rise and fall of (UNAIDS MERG,
Impact
impacts, such as disease prevalence and incidence, as 2010, p. 3)
Evaluation
a function of HIV programs/interventions. Impacts on
a population seldom can be attributed to a single
program/intervention; therefore, an evaluation of
impacts on a population generally entails a rigorous
design that assesses the combined effects of a number
of programs/interventions for at-risk populations.
The number of new cases of a disease that occur in a (UNAIDS MERG,
Incidence
specified population during a specified time period. 2010, p. 4)
A quantitative or qualitative variable that provides a (UNAIDS MERG,
Indicator
valid and reliable way to measure achievement, assess 2010, p. 4)
performance, or reflect changes connected to an
intervention. Note: Single indicators are limited in
their utility for understanding program effects (i.e.,
what is working or is not working, and why?).
Indicator data should be collected and interpreted as
part of a set of indicators. Indicator sets alone cannot
determine the effectiveness of a program or collection
of programs; for this, good evaluation designs are
necessary.
The financial, human, and material resources used in a (UNAIDS MERG,
Inputs
program/intervention. 2010, p. 4)
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169
APPENDIX D
A specific activity or set of activities intended to bring (UNAIDS MERG,
Intervention
about change in some aspect(s) of the status of the 2010, p. 4)
target population (e.g., HIV risk reduction, improving
the quality of service delivery).
Management tool used to improve the design of (UNAIDS MERG,
Logic
interventions. It involves identifying strategic 2010, p. 4)
Framework
elements (inputs, outputs, activities, outcomes,
impact) and their causal relationships, indicators, and
the assumptions of risks that may influence success
and failure. It thus facilitates planning, execution, and
monitoring and evaluation of an intervention.
A multi-year implementation strategy for the (UNAIDS MERG,
M&E
collection, analysis and use of data needed for 2010, p. 4)
(Monitoring and
program/project management and accountability
Evaluation)
purposes. The plan describes the data needs linked to a
Strategy
specific program/project; the M&E activities that need
to be undertaken to satisfy the data needs and the
specific data collection procedures and tools; the
standardized indicators that need to be collected for
routine monitoring and regular reporting; the
components of the M&E system that need to be
implemented and the roles and responsibilities of
different organizations/individuals in their
implementation; how data will used for
program/project management and accountability
purposes. The plan indicates resource requirement
estimates and outlines a strategy for resource
mobilization.
Note: A national HIV M&E plan is a multi-sectoral,
3–5 year implementation strategy which is developed
and regularly updated with the participation of a wide
variety of stakeholders from national, sub-national,
and service delivery levels.
Mathematical analysis that describes the association (Woodward, 2005,
Modeling
between exposure, outcome and confounders. p. 427)
Numerous models have been developed and their use
depends on a certain set of assumptions. It is generally
use when it is necessary to control for many
confounding variables.
Routine tracking and reporting of priority information (UNAIDS MERG,
Monitoring
about a program/project, its inputs and intended 2010, p. 4)
outputs, outcomes and impacts.
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170 STRATEGIC APPROACH TO THE EVALUATION OF U.S. GLOBAL HIV/AIDS PROGRAMS
For service delivery programs, the “systematic and (Adapted from
Operational
objective assessment of the availability, accessibility, UNAIDS MERG,
Research
quality, and/or sustainability of services designed to 2010, p. 5)
improve service delivery. It assesses only factors that
are under the control of program/project managers,
such as improving the quality of services, increasing
training and supervision of staff members, and adding
new service components.”
Protozoan, bacterial, fungal, and viral infections that (Adapted from
Opportunistic
are more frequent or more severe because of CDC, 2008, pp.
Infection
immunosuppression in people with HIV infection or 13–14)
AIDS. When the CD4 count of an adult falls below
200 cells/mm3, the risk of opportunistic infection is
high.
Short-term and medium-term effect of an (UNAIDS MERG,
Outcome
intervention’s outputs, such as change in knowledge, 2010, p. 5)
attitudes, beliefs, behaviours.
The results of program/intervention activities; the (UNAIDS MERG,
Outputs
direct products or deliverables of program/intervention 2010, p. 5)
activities, such as the number of HIV counseling
sessions completed, the number of people served, the
number of condoms distributed.
A set of procedures used by planners/evaluators to try (McKenzie, 2005,
Pilot Test
out various processes during program development on p. 123)
a small group of subjects prior to actual
implementation.
A type of survey which is statistically representative (UNAIDS MERG,
Population-
of the target population, such as the AIDS Indicator 2010, p. 5)
based Survey
Survey and the Demographic and Health Survey.
The total number of persons living with a specific (UNAIDS MERG,
Prevalence
disease or condition at a given time. 2010, p. 5)
An overarching national or sub-national response to a (UNAIDS MERG,
Program
disease. A program generally includes a set of 2010, p. 5)
interventions marshaled to attain specific global,
regional, country, or sub-national objectives; involves
multiple activities that may cut across sectors, themes
and/or geographic areas.
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171
APPENDIX D
“A study that intends to control a health problem or (UNAIDS MERG,
Program
improve a public health program or service. The 2010, p. 6)
Evaluation
intended benefits of the program are primarily or
exclusively for the study participants or the study
participants’ community (i.e., the population from
which the study participants were sampled); data
collected are needed to assess and/or improve the
program or service, and/or the health of the study
participants or the study participants’ community.
Knowledge that is generated does not typically extend
beyond the population or program from which data are
collected.” Also referred to as summative evaluation.
Data collected using qualitative methods, such as in- (Adapted from
Qualitative Data
depth, open-ended interviews, direct observation, and UNAIDS MERG,
analysis of written documents. Qualitative data can 2010, p. 6; Patton,
provide an understanding of social situations and 2002, p. 4, 5)
interactions, as well as people’s values, perceptions,
motivations, and reactions. Qualitative data are
generally expressed in narrative form, pictures or
objects (i.e., not numerically). When using mixed
methods, “findings may be presented either alone or in
combination with quantitative data.” There are many
different theoretical perspectives for qualitative
inquiry, but they all attempt to describe or explain
phenomena.
Include individual and group approaches to data (Sankar et al.,
Qualitative
collection. They feature in-depth and extended 2006, p.s55)
Interview
discussions guided by an interviewer. They vary in the
Methods
degree of structure involved. On one end of the
continuum are semi-structured interviews using
predefined questions that allow open-ended responses.
Open-ended interviews are less structured and use a
list of discussion topics to cover in each interview.
Least structured are the informal interviews.
Data collected using quantitative methods, such as (UNAIDS MERG,
Quantitative
surveys. Quantitative data are measured on a 2010, p. 6)
Data
numerical scale, can be analyzed using statistical
methods, and can be displayed using tables, charts,
histograms and graphs. The aim of a quantitative study
is to classify features, count them, and construct
statistical models in an attempt to explain what is
observed.
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172 STRATEGIC APPROACH TO THE EVALUATION OF U.S. GLOBAL HIV/AIDS PROGRAMS
Study in which comparisons are made between Epidemiology
Quasi-
nonequivalent groups that are not randomly assigned GORDIS
Experimental
to intervention and control groups.
Study
Study where subjects are allocated to intervention and (Woodward, 2005,
Randomized
control groups according to some chance mechanism. p. 343)
Controlled Trial
A study which intends to generate or contribute to (UNAIDS MERG,
Research
generalizable knowledge to improve public health 2010, p. 6)
practice, i.e., the study intends to generate new
information that has relevance beyond the population
or program from which data are collected. Research
typically attempts to make statements about how the
different variables under study, in controlled
circumstances, affect one another at a given point in
time.
The outputs, outcomes, or impacts (intended or (UNAIDS MERG,
Results
unintended, positive and/or negative) of an 2010, p. 6)
intervention.
A person, group, or entity that has a direct or indirect (UNAIDS MERG,
Stakeholder
role and interest in the goals or objectives and 2010, p. 7)
implementation of a program/intervention and/or its
evaluation.
A type of evaluation conducted at the end of an (UNAIDS MERG,
Summative
intervention (or a phase of that intervention) to 2010, p. 7)
Evaluation
determine the extent to which anticipated outcomes
were produced. It is designed to provide information
about the merit or worth of the intervention.
The ongoing, systematic collection, analysis, (Adapted from
Surveillance
interpretation, and dissemination of data regarding a UNAIDS MERG,
specific disease or behavior for use in public health 2010, p. 7)
action to reduce morbidity and mortality and to
improve health. These kinds of surveillance data can
help predict future trends and target needed prevention
and treatment programs.
The continuation of benefits from a development (DAC Network on
Sustainability
intervention after major development assistance has Development
been completed. Evaluation, 2002,
p. 36)
“A collation of all empirical evidence that fits pre- (Adapted from
Systematic
specified eligibility criteria to answer a specific Liberati, et al.,
Literature
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173
APPENDIX D
research question. It uses explicit, systematic methods 2009, p. 2)
Review
that are selected with a view to minimizing bias, thus
providing reliable findings from which conclusions
can be drawn and decisions made. The key
characteristics of a systematic review are: (a) a clearly
stated set of objectives with an explicit, reproducible
methodology; (b) a systematic search that attempts to
identify all studies that would meet the eligibility
criteria; (c) an assessment of the validity of the
findings of the included studies, for example through
the assessment of risk of bias; and (d) systematic
presentation, and synthesis, of the characteristics and
findings of the included studies.” These methods can
be applied to various types of literature for research.
Statistical techniques used for analyzing data over Adapted from
Trend Analysis
time. The primary step is to plot the observed numbers (Rosenberg, 1997)
or rates of interest by study period, followed by
further inspection of the data which provides the basis
for subsequent analysis including data transformation
and smoothing, and more complex statistical
procedures (regression analysis, time series analysis).
The analysis of data from three or more sources (Adapted from
Triangulation
obtained by different methods. Findings can be UNAIDS MERG,
corroborated, and the weakness or bias of any of the 2010, p. 7, Patton,
methods or data sources can be compensated for by 2002, p. 247.)
the strengths of another, thereby increasing the
validity and reliability of the results. Data
triangulation, investigator triangulation, and theory
triangulation are three other types of this analytic
technique. While ideal, the technique can be
expensive—“a study’s limited budget and time will
affect the amount of triangulation that is practical.”
The extent to which a measurement or test accurately (UNAIDS MERG,
Validity
measures what is intended to be measured. 2010, p. 7)
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