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Data for Impact: Lessons Learned in Using
the Ripple Effects Mapping Method
February 20, 2020
• Introduction to ripple effects mapping (REM)
• Tanzania’s REM experience
• Botswana’s REM experience
• Lessons learned
Webinar structure
What is the REM mapping method?
• Ripples are tiny waves generated when someone
drops a stone into water.
• REM is a participatory method to understand the
different effects (or ripples) a complex program
has on a community or beneficiary.
• REM engages program stakeholders to discuss
and visually map these ripples.
Introduction
REM’s origins
Developed by the University of
Minnesota, the Evaluation
Studies Institute (MESI) was
established to conduct an
impact analysis of the Horizons
program; an 18-month
community-based program in
the US delivered to strengthen
leadership to reduce poverty.
Introduction (2)
Why REM?
• Well-suited for complex evaluations
• Engages participants and stakeholders and
creates positive energy for further action
• Ground truths a program theory of change
• Can uncover unanticipated consequences
• Part of a larger evaluation toolkit
REM in evaluation
What does REM require?
• A combination of facilitation and evaluation skills
Facilitation
 Engaging in
meaningful
discussion
 Creating open
communication
 Organizing time
Evaluation
 Group interviewing
 Rapid qualitative
data analysis
 Developing thematic
categories
 Identifying causal
pathways
Rippleeffects
mapping
REM in evaluation
Process overview
Conducting REM
1. Appreciative inquiry interviews
2. Group reflection and mapping
Peer-to-peer interviews
• Participants divide into pairs for peer-to-peer interviews
and ask a set of standard questions
• As a facilitator, ensure participants:
 Use a standard set of questions to elicit program outcomes
 Do not deviate from the interview (except to ask
follow-up questions)
 Use active listening skills
 Take notes
Conducting REM: Appreciate Inquiry interviews
Group reflection
• The facilitator should ask each pair to offer one story
(only one at a time so everyone has an opportunity
to share)
• Facilitator should probe participants:
 Then what happened?
 Who was involved?
 What skill, approach, or tool, if any, was involved?
 What are people doing differently?
 How have relationships changed as a result?
Conducting REM: Group reflection
and mapping
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Program
Effect
Effect
Effect
Effect
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Conducting REM: Mapping
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Then what
happened?
Group reflection—after collective mapping
• Ask the group to reflect on the map
as a whole
• Open participatory discussion
Conducting REM: Preliminary analysis
This presentation was produced with the support of the United States
Agency for International Development (USAID) under the terms of the
Data for Impact (D4I) associate award 7200AA18LA00008, which is
implemented by the Carolina Population Center at the University of
North Carolina at Chapel Hill, in partnership with Palladium
International, LLC; ICF Macro, Inc.; John Snow, Inc.; and Tulane
University. The views expressed in this publication do not necessarily
reflect the views of USAID or the United States government.
www.data4impactproject.org
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Lessons Learned in Using the
Ripple Effects Mapping Method:
Tanzania and Botswana Case Studies
Tanzania’s Ripple Effects Mapping
(REM) experience
Evaluation question
What are the perceptions of program
implementers, community members, and other
stakeholders on performance and influence of the
Public Service Systems Strengthening project (PS3)
on uptake of health services, finance, and human
resources, and community engagement and
governance?
How and why REM?
REM was just one method
used in the qualitative
component:
 Solicit outcomes of the
local government authority
(LGA) councilor trainings only
 More participatory method than a focus
group discussion and we thought the
visual component would help to elicit
more interaction, jog memories, etc.
Structure of REMs
Focus on PS3 priority regions (Eastern Lake,
Central, Eastern Southern Highlands)
for sampling
 Six local governing areas—1 REM per LGA
• Participants: local government councilors;
8 per LGA
• Selected based on participation in PS3
trainings and to represent range of local
vulnerabilities (e.g., higher income ward vs.
lower income; urban vs. rural, etc.)
 Three facilitators
• Main facilitator
• Mapper
• Notetaker/quote recorder
Training
1. Reviewed content of LGA councilor training
and example statements the program
had collected from LGA councilors
about training experience
2. Reviewed field guide to REM mapping
3. PowerPoint training session
4. Demonstration with MEASURE
Evaluation staff acting as
facilitator and mapper
Demonstration: Let’s practice!
We will practice each step, using a model
“program” – Your Bachelor’s Program
1. Informed consent and introduction
2. Ground rules
3. Appreciative inquiry (AI) interviews
 Tell a story about how you have used the skills/
knowledge you gained during your Bachelor’s
degree program
 What new or deepened collaborations with others
have you made as a result of your Bachelor’s training?
 What unexpected things have happened as a result
of your Bachelor’s training?
Training (2)
4. Mock session with the facilitators
practicing and other researchers playing
roles of LGA councilor participants
 Assigned acting roles to researchers
(e.g., rural area councilor who is very quiet,
urban area councilor who is gregarious and
opinionated and talks over others, etc.)
 Went through entire process from AI to
mapping and reflection
5. Pilot with LGA councilors in the field
Implementation: AI excerpt
1. Interview each other; share your experiences with
PS3 training and mentoring using these questions:
 Tell me a story about how you have used the
information and/or tools received through PS3
councilor training and mentoring.
 What is an achievement or success you had based
on your experience with/learning through PS3
training and mentoring—what made it possible?
What did this achievement lead to?
 What new or deepened collaborations with
others (individuals, community organizations,
government, etc.) have you made as a result of
these efforts? What did these connections lead to?
Implementation: Mapping excerpt
1. Ask each pair to offer one story, then ripple it out
(draw out some of the details)
 Probing questions can include:
• Then what happened?
• What skill, approach,
or tool from Government
of Tanzania/PS3 training,
if any, was involved?
• What are people
doing differently?
• How have relationships changed as a result?
Implementation: Reflections excerpt
Discussion of the map
 Ask the group to identify the
most significant change(s)
on the map.
 What other effects or impacts would you
like there to be? What do you wish would
happen? (Are there things from your
action plan that have not yet happened
that you think are important?)
 What should we do next?
Implementation: Reflections excerpt
Analysis
 Mapping data was entered into
MindManager software
 Identified additional connections;
commonalities
 Compared with themes from other
qualitative methods
Botswana’s REM experience
Evaluation objective
 To qualitatively examine how factors at the
personal, family, school, community, and
service delivery levels influence the education,
economic, and health trajectories and related
outcomes of OVC
Structure of REMs
 Total of 4 REM groups
• 2 HIV-negative
• 2 HIV-positive (participants part of youth
support group)
• ~ 8 participants per group
• Youth ages 16–19 years old
• Received USG services
for orphans and vulnerable
children (OVC)
 Two facilitators
• Main facilitator
• Mapper
Training
 The two facilitators reviewed
a training PowerPoint and the
field guide to REM mapping
 A mock REM group was
conducted with data collectors
• Data collectors played role
as youth beneficiaries
 A pilot REM was conducted in the
capital city
Appreciative inquiry
Conversations between pairs of
participants (audio-recorded):
 Tell me a story about how you have
used the information you received,
or skills learned through the project.
 Has the project helped maintain or improve
your health?
 Discuss an achievement or a success you
had based on your learning from the
project — what made it possible?
Mapping
 In the pilot REM group, the participants were
distracted by the live mapping
• The mapper moved to the side of the room and
mapped the conversation and then brought it back
to the group to react to at the end of the session
 Some youth were hesitant to share stories initially
due to the sensitivity of the information being shared
• Facilitators ensured confidentiality
• Youth came up with creative pseudonyms
 Challenging to document the intricacies and
intersections between the different sector areas
in “real time”
Reflections
 Facilitators presented the map back to
participants at the end and explored
whether the beneficiaries thought the map:
• Was a true reflection of their discussion; and/or
• Had any gaps
 Participants used the time to reflect on what
was the most significant change identified
on the map
 More concrete questions (e.g., most significant
change) were easier to grasp than questions
about “what was interesting” about the map
Analysis
 The “live” maps were photographed and
validated after listening to audio transcripts
of the session
• Additional details were added and vague
concepts clarified
 These maps were then replicated in Xmind
mapping software
 The maps and written transcripts were
reviewed to identify:
• Emerging themes,
• Perceived results of the project, and
• The perceived impact of those results
REM map
REM map in Xmind
Illustration
Section of illustration
Advantages of REM
 Post-data collection analysis time is
reduced compared with the analysis time
of typical FGDs.
 The map is a useful tool to instigate further
discussion and details during the REM
session and afterwards.
 Final maps create a sense of pride and
accomplishment among respondents.
Lessons learned
Facilitation
 Facilitators should be experienced
and well-trained in group facilitation
and management.
 Mappers should be well-versed in the
program components and theory of
change, and need analytical skills
to distill key aspects and examples
for the evaluation.
Lessons learned
Specific example
of increased self-
confidence related
to studies/school
Improved school
performance
Another specific
example of increased
self-confidence related
to studies/school
Facilitation
Lessons learned
Training: Practice, practice, practice
 Practice session with facilitators-in-
training acting as participants using
a real, common experience they share.
 Mock REM session of the study topic,
with facilitators-in-training playing
various study participant roles.
 Conduct 1–2 pilots to ensure facilitator
and mapper are well prepared.
Training
 Clarify relationship between
facilitator, mapper, and notetaker
• For example, facilitator checks
if mapper is capturing outcomes;
mapper seeks clarity when necessary;
notetaker documents key quotes, etc.
 Ask REM trainees to give examples of possible
stories from program beneficiaries to practice
mapping; encourage facilitators to probe
for details
 Clarify that outcomes, not activities or stories,
should be mapped
Lessons learned
Lessons learned
Tailoring
 How will the population
see the concept
of mapping?
 Adults versus youth
 May need to ask
questions differently
 Youth may not understand some
concepts the same way as adults
Lessons learned
Tailoring (cont.)
 Complex programs may need
to divide into categories
of discussion
 Tanzania was just one topic—governance
and citizen engagement and single
intervention
 Botswana was three different topic areas
and layered interventions; had to divide
up questions
Lessons learned
Implementation
 Budget time to introduce and explain the
purpose and process to groups unfamiliar
with participatory research
 Clarify that you want as many details as possible
 Outcomes further than outputs on the
causal chain
 Concrete examples
 Facilitators probe for those examples
• Participant: “We learned how to manage finances.”
• Facilitator: “Ok, so then what?”
• Participant: “I developed a budget and needed
less guidance than I normally do.”
Lessons learned
Implementation (cont.)
 Audio recorders can work, depending on space
 Botswana—worked well
 Tanzania—spaces were expected to be small
and noisy; did not use
 When not using an audio recorder, hold a
quality check team meeting right after session
• Clarify notes
• Check all quotes
• Make sure map captures all relevant
outcomes and ripples
Conclusions
 REM is an engaging and interactive
method visualize outcomes that may not
be captured otherwise.
 Maps can be used to compare an
intervention’s a priori theory of change
to participants’ lived experiences.
 REM can be used alone or in combination
with other evaluation methods.
 REM can help further the effects of
an intervention.
Contributors
Tanzania
MEASURE Evaluation
 Jessica Fehringer
 Brittany Iskarpatyoti
Health and Development
International Consultants
(HDIC)
 Mathew Senga
 Egidius Kamanyi
Botswana
MEASURE Evaluation
 Lisa Parker
 Mahua Mandal
 Abby Cannon
 Elizabeth Millar
Research 4 Results
 Iris Halldorsdottir
 Sedilame Bagane
Graphic Harvest
 Sonja Niederhumer
Resources
A Field Guide to Ripple Effects Mapping
https://conservancy.umn.edu/handle/11299/190639
Experiences and Lessons Learned: Implementing the Ripple
Effects Mapping Method
https://www.measureevaluation.org/resources/publications
/fs-20-423
Evaluation of Services for Orphans and Vulnerable Youth in
Botswana
https://www.measureevaluation.org/resources/evaluation-
of-services-for-orphans-and-vulnerable-youth-in-botswana
Midline Evaluation of the Tanzania Public Sector System
Strengthening Program – Final Report
https://www.measureevaluation.org/resources/publications
/tre-19-26
This presentation was produced with the support of the United
States Agency for International Development (USAID) under
the terms of MEASURE Evaluation cooperative agreement
AID-OAA-L-14-00004. MEASURE Evaluation is implemented by
the Carolina Population Center, University of North Carolina
at Chapel Hill in partnership with ICF International; John Snow,
Inc.; Management Sciences for Health; Palladium; and Tulane
University. Views expressed are not necessarily those of USAID
or the United States government.
www.measureevaluation.org

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Data for Impact: Lessons Learned in Using the Ripple Effects Mapping Method

  • 1. Data for Impact: Lessons Learned in Using the Ripple Effects Mapping Method February 20, 2020
  • 2. • Introduction to ripple effects mapping (REM) • Tanzania’s REM experience • Botswana’s REM experience • Lessons learned Webinar structure
  • 3. What is the REM mapping method? • Ripples are tiny waves generated when someone drops a stone into water. • REM is a participatory method to understand the different effects (or ripples) a complex program has on a community or beneficiary. • REM engages program stakeholders to discuss and visually map these ripples. Introduction
  • 4. REM’s origins Developed by the University of Minnesota, the Evaluation Studies Institute (MESI) was established to conduct an impact analysis of the Horizons program; an 18-month community-based program in the US delivered to strengthen leadership to reduce poverty. Introduction (2)
  • 5. Why REM? • Well-suited for complex evaluations • Engages participants and stakeholders and creates positive energy for further action • Ground truths a program theory of change • Can uncover unanticipated consequences • Part of a larger evaluation toolkit REM in evaluation
  • 6. What does REM require? • A combination of facilitation and evaluation skills Facilitation  Engaging in meaningful discussion  Creating open communication  Organizing time Evaluation  Group interviewing  Rapid qualitative data analysis  Developing thematic categories  Identifying causal pathways Rippleeffects mapping REM in evaluation
  • 7. Process overview Conducting REM 1. Appreciative inquiry interviews 2. Group reflection and mapping
  • 8. Peer-to-peer interviews • Participants divide into pairs for peer-to-peer interviews and ask a set of standard questions • As a facilitator, ensure participants:  Use a standard set of questions to elicit program outcomes  Do not deviate from the interview (except to ask follow-up questions)  Use active listening skills  Take notes Conducting REM: Appreciate Inquiry interviews
  • 9. Group reflection • The facilitator should ask each pair to offer one story (only one at a time so everyone has an opportunity to share) • Facilitator should probe participants:  Then what happened?  Who was involved?  What skill, approach, or tool, if any, was involved?  What are people doing differently?  How have relationships changed as a result? Conducting REM: Group reflection and mapping
  • 10. Then what happened? Then what happened? Then what happened? Then what happened? Program Effect Effect Effect Effect Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Conducting REM: Mapping Then what happened? Then what happened? Then what happened? Then what happened? Then what happened? Then what happened?
  • 11. Group reflection—after collective mapping • Ask the group to reflect on the map as a whole • Open participatory discussion Conducting REM: Preliminary analysis
  • 12. This presentation was produced with the support of the United States Agency for International Development (USAID) under the terms of the Data for Impact (D4I) associate award 7200AA18LA00008, which is implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill, in partnership with Palladium International, LLC; ICF Macro, Inc.; John Snow, Inc.; and Tulane University. The views expressed in this publication do not necessarily reflect the views of USAID or the United States government. www.data4impactproject.org
  • 13. Headline goes here Headline goes here Headline goes here Author Name and Degree Here MEASURE Evaluation Your organization here Date for presentation if necessary Name of meeting Lessons Learned in Using the Ripple Effects Mapping Method: Tanzania and Botswana Case Studies
  • 14. Tanzania’s Ripple Effects Mapping (REM) experience
  • 15. Evaluation question What are the perceptions of program implementers, community members, and other stakeholders on performance and influence of the Public Service Systems Strengthening project (PS3) on uptake of health services, finance, and human resources, and community engagement and governance?
  • 16. How and why REM? REM was just one method used in the qualitative component:  Solicit outcomes of the local government authority (LGA) councilor trainings only  More participatory method than a focus group discussion and we thought the visual component would help to elicit more interaction, jog memories, etc.
  • 17. Structure of REMs Focus on PS3 priority regions (Eastern Lake, Central, Eastern Southern Highlands) for sampling  Six local governing areas—1 REM per LGA • Participants: local government councilors; 8 per LGA • Selected based on participation in PS3 trainings and to represent range of local vulnerabilities (e.g., higher income ward vs. lower income; urban vs. rural, etc.)  Three facilitators • Main facilitator • Mapper • Notetaker/quote recorder
  • 18. Training 1. Reviewed content of LGA councilor training and example statements the program had collected from LGA councilors about training experience 2. Reviewed field guide to REM mapping 3. PowerPoint training session 4. Demonstration with MEASURE Evaluation staff acting as facilitator and mapper
  • 19. Demonstration: Let’s practice! We will practice each step, using a model “program” – Your Bachelor’s Program 1. Informed consent and introduction 2. Ground rules 3. Appreciative inquiry (AI) interviews  Tell a story about how you have used the skills/ knowledge you gained during your Bachelor’s degree program  What new or deepened collaborations with others have you made as a result of your Bachelor’s training?  What unexpected things have happened as a result of your Bachelor’s training?
  • 20. Training (2) 4. Mock session with the facilitators practicing and other researchers playing roles of LGA councilor participants  Assigned acting roles to researchers (e.g., rural area councilor who is very quiet, urban area councilor who is gregarious and opinionated and talks over others, etc.)  Went through entire process from AI to mapping and reflection 5. Pilot with LGA councilors in the field
  • 21. Implementation: AI excerpt 1. Interview each other; share your experiences with PS3 training and mentoring using these questions:  Tell me a story about how you have used the information and/or tools received through PS3 councilor training and mentoring.  What is an achievement or success you had based on your experience with/learning through PS3 training and mentoring—what made it possible? What did this achievement lead to?  What new or deepened collaborations with others (individuals, community organizations, government, etc.) have you made as a result of these efforts? What did these connections lead to?
  • 22. Implementation: Mapping excerpt 1. Ask each pair to offer one story, then ripple it out (draw out some of the details)  Probing questions can include: • Then what happened? • What skill, approach, or tool from Government of Tanzania/PS3 training, if any, was involved? • What are people doing differently? • How have relationships changed as a result?
  • 24. Discussion of the map  Ask the group to identify the most significant change(s) on the map.  What other effects or impacts would you like there to be? What do you wish would happen? (Are there things from your action plan that have not yet happened that you think are important?)  What should we do next? Implementation: Reflections excerpt
  • 25. Analysis  Mapping data was entered into MindManager software  Identified additional connections; commonalities  Compared with themes from other qualitative methods
  • 27. Evaluation objective  To qualitatively examine how factors at the personal, family, school, community, and service delivery levels influence the education, economic, and health trajectories and related outcomes of OVC
  • 28. Structure of REMs  Total of 4 REM groups • 2 HIV-negative • 2 HIV-positive (participants part of youth support group) • ~ 8 participants per group • Youth ages 16–19 years old • Received USG services for orphans and vulnerable children (OVC)  Two facilitators • Main facilitator • Mapper
  • 29. Training  The two facilitators reviewed a training PowerPoint and the field guide to REM mapping  A mock REM group was conducted with data collectors • Data collectors played role as youth beneficiaries  A pilot REM was conducted in the capital city
  • 30. Appreciative inquiry Conversations between pairs of participants (audio-recorded):  Tell me a story about how you have used the information you received, or skills learned through the project.  Has the project helped maintain or improve your health?  Discuss an achievement or a success you had based on your learning from the project — what made it possible?
  • 31. Mapping  In the pilot REM group, the participants were distracted by the live mapping • The mapper moved to the side of the room and mapped the conversation and then brought it back to the group to react to at the end of the session  Some youth were hesitant to share stories initially due to the sensitivity of the information being shared • Facilitators ensured confidentiality • Youth came up with creative pseudonyms  Challenging to document the intricacies and intersections between the different sector areas in “real time”
  • 32. Reflections  Facilitators presented the map back to participants at the end and explored whether the beneficiaries thought the map: • Was a true reflection of their discussion; and/or • Had any gaps  Participants used the time to reflect on what was the most significant change identified on the map  More concrete questions (e.g., most significant change) were easier to grasp than questions about “what was interesting” about the map
  • 33. Analysis  The “live” maps were photographed and validated after listening to audio transcripts of the session • Additional details were added and vague concepts clarified  These maps were then replicated in Xmind mapping software  The maps and written transcripts were reviewed to identify: • Emerging themes, • Perceived results of the project, and • The perceived impact of those results
  • 35. REM map in Xmind
  • 38. Advantages of REM  Post-data collection analysis time is reduced compared with the analysis time of typical FGDs.  The map is a useful tool to instigate further discussion and details during the REM session and afterwards.  Final maps create a sense of pride and accomplishment among respondents.
  • 39. Lessons learned Facilitation  Facilitators should be experienced and well-trained in group facilitation and management.  Mappers should be well-versed in the program components and theory of change, and need analytical skills to distill key aspects and examples for the evaluation.
  • 40. Lessons learned Specific example of increased self- confidence related to studies/school Improved school performance Another specific example of increased self-confidence related to studies/school Facilitation
  • 41. Lessons learned Training: Practice, practice, practice  Practice session with facilitators-in- training acting as participants using a real, common experience they share.  Mock REM session of the study topic, with facilitators-in-training playing various study participant roles.  Conduct 1–2 pilots to ensure facilitator and mapper are well prepared.
  • 42. Training  Clarify relationship between facilitator, mapper, and notetaker • For example, facilitator checks if mapper is capturing outcomes; mapper seeks clarity when necessary; notetaker documents key quotes, etc.  Ask REM trainees to give examples of possible stories from program beneficiaries to practice mapping; encourage facilitators to probe for details  Clarify that outcomes, not activities or stories, should be mapped Lessons learned
  • 43. Lessons learned Tailoring  How will the population see the concept of mapping?  Adults versus youth  May need to ask questions differently  Youth may not understand some concepts the same way as adults
  • 44. Lessons learned Tailoring (cont.)  Complex programs may need to divide into categories of discussion  Tanzania was just one topic—governance and citizen engagement and single intervention  Botswana was three different topic areas and layered interventions; had to divide up questions
  • 45. Lessons learned Implementation  Budget time to introduce and explain the purpose and process to groups unfamiliar with participatory research  Clarify that you want as many details as possible  Outcomes further than outputs on the causal chain  Concrete examples  Facilitators probe for those examples • Participant: “We learned how to manage finances.” • Facilitator: “Ok, so then what?” • Participant: “I developed a budget and needed less guidance than I normally do.”
  • 46. Lessons learned Implementation (cont.)  Audio recorders can work, depending on space  Botswana—worked well  Tanzania—spaces were expected to be small and noisy; did not use  When not using an audio recorder, hold a quality check team meeting right after session • Clarify notes • Check all quotes • Make sure map captures all relevant outcomes and ripples
  • 47. Conclusions  REM is an engaging and interactive method visualize outcomes that may not be captured otherwise.  Maps can be used to compare an intervention’s a priori theory of change to participants’ lived experiences.  REM can be used alone or in combination with other evaluation methods.  REM can help further the effects of an intervention.
  • 48. Contributors Tanzania MEASURE Evaluation  Jessica Fehringer  Brittany Iskarpatyoti Health and Development International Consultants (HDIC)  Mathew Senga  Egidius Kamanyi Botswana MEASURE Evaluation  Lisa Parker  Mahua Mandal  Abby Cannon  Elizabeth Millar Research 4 Results  Iris Halldorsdottir  Sedilame Bagane Graphic Harvest  Sonja Niederhumer
  • 49.
  • 50. Resources A Field Guide to Ripple Effects Mapping https://conservancy.umn.edu/handle/11299/190639 Experiences and Lessons Learned: Implementing the Ripple Effects Mapping Method https://www.measureevaluation.org/resources/publications /fs-20-423 Evaluation of Services for Orphans and Vulnerable Youth in Botswana https://www.measureevaluation.org/resources/evaluation- of-services-for-orphans-and-vulnerable-youth-in-botswana Midline Evaluation of the Tanzania Public Sector System Strengthening Program – Final Report https://www.measureevaluation.org/resources/publications /tre-19-26
  • 51. This presentation was produced with the support of the United States Agency for International Development (USAID) under the terms of MEASURE Evaluation cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is implemented by the Carolina Population Center, University of North Carolina at Chapel Hill in partnership with ICF International; John Snow, Inc.; Management Sciences for Health; Palladium; and Tulane University. Views expressed are not necessarily those of USAID or the United States government. www.measureevaluation.org