potential best practices for scale-up (OGAC, 2005b, 2006a,b). In the words of OGAC staff, TEs were “studies that provide[d] rapid answers to specific, measurable, and focused questions about health program implementation to improve services and identify best practices” (Bouey and Padian, 2011, p. 4). The allowable scope and study methods of TEs were influenced by “legislative sensitivities on use of PEPFAR funds for research” (Bouey and Padian, 2011, p. 4). Randomization was not allowed and study methods mainly included quasi-experimental designs using natural controls or pre- and post-test results with a comparison or control group (Bouey and Padian, 2011; OGAC, 2005b).

Study priorities for TEs were mainly country driven, with most proposals submitted through COPs; these proposals were reviewed and selected by a TE sub-committee, which included representatives from USG agencies involved in PEPFAR. Additionally, this subcommittee, in coordination with a Scientific Steering Committee and implementing agencies, developed the priorities for centrally funded studies, developed proposal selection criteria, and oversaw selected studies (OGAC, 2005b, 2006a). There was little control from HQ level (OGAC) over TEs (Bouey and Padian, 2011; OGAC, 2011e). Studies were funded either through central funds or country-level budgets (OGAC, 2005b).

TEs that were funded in 2005 and 2006 aimed to address questions concerning the efficacy of programs in the areas of prevention, care, treatment, and service delivery for HIV/AIDS (OGAC, 2006b). Specifically, these studies assessed the following areas: abstinence/be faithful, condoms and other prevention, PMTCT, treatment (antiretroviral [ARV] drugs and services), palliative care (for basic health care and support and for TB/HIV), OVC, counseling and testing, and strategic information. The countries that received funding for targeted evaluations in 2005 and 2006 were Guyana, Haiti, Kenya, Mozambique, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. A few multi-country studies were also funded (IOM, 2011).

In 2007 the scope of the targeted evaluations expanded from studies focused on questions about individual program implementation to include studies designed to answer questions concerning efficacy and best practices with the goal of producing generalizable results that could contribute to program sustainability. Randomized trials were still not allowed (Bouey and Padian, 2011). In this round, TEs were no longer centrally funded, evaluation priorities were driven by TWGs at the country level, and proposals were submitted and funded solely through the COP and country budgets (OGAC, 2006c, 2011e). According to one interviewee, TWGs and implementing partners developed the research agendas based on gaps that they saw in the field (NCV-3-USG). Proposals were still reviewed and selected by the targeted evaluation subcommittee, which also continued to oversee



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