Evaluation plan for pilot Primary Health Care Development Program - the subcomponent of World Bank assisted Primary Health Care Development Project

Abstract

The government of Republic of Armenia intends to implement the Primary Health Care Development Project with assistance of World Bank (see Annex A). The overall Project consist of three main subcomponents aiming to establish a strong and developed Primary Health Care system. One of subcomponents, Primary Health Care Development Program (PHCDP), aims to develop high quality performance in PHC through wide ranging support of PHC teams, including the maintenance and rehabilitation of facilities, provision of equipment, medical supplies, first aid drugs, computers, etc. In the first year, it is planned to select 10 facilities from two marzes for piloting of PHCDP, and to continue the program later in other 9 marzes if program evaluation shows a positive result. The objective of the paper is to propose an evaluation plan for the first phase. Although every facility will have its own set objectives, several general indicators and objectives will be common for all target PHC teams and maybe evaluated by the common delineated evaluation plan. Five objectives detailed below will be evaluated by the proposed evaluation plan. Considering all 5 set bjectives as very important and necessary for evaluation of program, the purpose of this paper is to give detailed description of evaluation plan for objective 1, which pertains to the PHC facility as the place of first contact between the medical services and patients. In order to assess the impact of the program, it is proposed to use the pre- post- quasi- experimental method. The data about target and control PHC facilities’ activity will be gathered before and after program implementation, during the same calendar month, with interval of 1 year between them and the corresponding proportions will be calculated. According to objective 1, the net gain in target population proportions shall be 20% or more compared with the net gain in control population. Questionnaire shall be used as a main tool to gather the necessary data; the source of data will a community survey. The systematic sampling method or cluster sampling will be used for choosing the sampling elements. Analysis of the program will be based on estimation of both statistical significance (hypothesis testing) and practical significance (confidence intervals) of collected data and comprise of 3 stages: 1)analysis of pre-data - comparison between TP (Target Population - population served by facility where the program is implemented) and CP (Control Population - population served by facility where the program is not implemented); 2) analysis of TP data - comparison between pre- and post- data; 3) analysis of TP and CP pre- and post- data - comparison between changes of TP and CP after program implementation. The budget and management issues are described in order to have the picture of all steps and expenses of the program evaluation.