Brief overview of the Evaluation of PEPFAR mandated by the U.S. Congress and conducted by the Institute of Medicine. Discusses evaluation approach using case-based research, specifically nested in-depth case-based approaches, tools for case-based approaches, lessons learned, and takeaways. (Bridget Kelly, IOM)

1. Lessons from the 2013 IOM Evaluation of PEPFAR: Use of Case-Based Approaches Bridget Kelly

2. Evaluation of PEPFAR - Congressional Charge
U.S. Congress mandated that the Institute of Medicine assess and evaluate the “performance” and “impact on health” of PEPFAR.

3. Evaluation Design: Fit for Purpose and Feasibility
•Retrospective
•Hybrid Design
•Mixed Methods
•Nested, in-depth case-based approaches

4. Data Sources for PEPFAR Evaluation

5. Nested Case-Based Approaches
•Country selection process
•By topic
•By individual country
•By subsets of countries (aggregated data)

6. Tools for Case-Based Approaches
Chronologies/Histories (Country briefs; Timelines for context, guidance, activities)
Time trends (PEPFAR data, partner data, global data)
Document review (Guidance documents, operational plans by HQ and country, published literature)
Interviews (semi-structured)
Iterative group discussions for analyses and interpretation (across whole and subsets of evaluation team)
Triangulation among data sources and analyses (interview/document/programmatic/clinical/financial)

7. Case-Based Evaluation Planning

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Analysis and Interpretation

9. What did we learn from use of case- based approaches?
Appropriate and relevant for learning about and within complexity Expands and enriches the tools available beyond indicators and metrics Lends credibility through techniques to help understand “how” and “why” questions. Triangulation is critical for analysis and interpretation

10. Takeaways
•No need to be intimidated
•No need to be apologetic
•What is a “case”?
•More than you might think
•What does “best practice” mean in this context?
•Fit-for-purpose
•Informed and intentional
•Well-documented

11. Full report available:
www.iom.edu/pepfar2
For Evaluation Approach and Methods: Chapter 2 Appendix C