Improving measurement through Operations Research Peter Winch, Johns Hopkins Bloomberg School of Public Health CORE Group Spring Meeting, April 28, 2010

1. Improving measurement through Operations Research Peter Winch [email_address] Department of International Health, Johns Hopkins Bloomberg School of Public Health and Technical Advisor on Operations Research, MCHIP Project

8. Figure 2 from Odek et al. 2009

9. We invest great effort in measurement of indicators on the far right of this model

10. We invest relatively little effort in measurement of the variables in this box

14. Community mobilization, empowerment and social capital are constructs

16. What is a construct?

20. Example of additive indices: Measuring community mobilization

21. Community Action Cycle in community mobilization

22. Measuring community mobilization and the action cycle 1. Exposure to the process, engagement in the Community Action Cycle 2. Changes in individual awareness of problems, self-efficacy, commitment to change 3. Actions taken after being mobilized

29. Continuum of care for health services (Kerber et al. Lancet 2007)

32. Example of sociometric questionnaire ID Name How many times a week to you talk to ____? How many times per month do you seek advice from ____? 001 Person #1 002 Person #2 003 Person #3 004 Person #4

34. Sociometric questionnaire: Full matrix P1 P2 P3 P4 P1 5 4 10 P2 5 0 1 P3 2 0 2 P4 10 1 3

35. Sociometric questionnaire: Symmetrized lower-half matrix P1 P2 P3 P4 P1 P2 5 P3 3 0 P4 10 1 2.5

39. Health facility referral matrix Facility 1 Facility 2 Facility 3 Facility 4 Facility 1 Facility 2 20 Facility 3 5 3 Facility 4 0 0 5

43. Multidimensional scaling 1 3 2 4 20 5 3 5