Methods for evaluating effects of health reforms

Abstract

This document, written for government planners and nongovernment consultants who deal with health policy, offers simple, low-cost ways to evaluate health sector reforms through direct measurements of the effects of changes on health system objectives and considers the usefulness of various methods in different situations. The evaluation methods offered can be rapidly implemented by local evaluators and are repeatable on a regular basis. The evaluations rely on existing data generated through routine information systems. The goal is to help analysts evaluate reforms relative to broad economic and public health objectives, including allocative and technical efficiency (quality and client satisfaction), equity in access to health services and in financing health services, and financial sustainability. Both direct and indirect impacts of reforms on these indicators should be measured. The methodology can also be used to analyze specific measures or elements of the broader indicators. The introductory section of the manual describes the context of health sector reform and the purpose and scope of the manual. Chapter 2 presents the following basic approaches to evaluation: descriptive analysis, methods for making a more convincing evaluation, caveats to apply to generalizations reached from the findings, and conceptual steps. After a concluding chapter, the extensive annex describes indicators relevant to health sector objectives and provides guidance on the interpretation of these indicators as well as data sources.