Overview

The global community has collaboratively taken responsibility for advancing health for all and codified this commitment in the Millennium Development Goals. The global effort has enabled standardization of approaches, including the agreement that evidence-based decision making is a norm for health policy, practice, and programs. The U.S. Agency for International Development (USAID) is likewise committed to evidence-based, innovative, efficacious, effective and sustainable global health programs. Evidence based decision making is critical to informing and guiding programming in global health intervention, global health policies, and programs. However, many current evidence evaluation frameworks have evolved from the clinical model where physician decision making is determined by rigorous systematic review of data derived from randomized clinical trials (RCTs) which emphasize efficacy for the individual patient. Evidence requirements for global health programs are complex, and include three streams: efficacy at the individual level, effectiveness at the population level, and sustainability at the host country level. A standardized approach to evaluation of evidence will strengthen and support global health strategies, programs, and practice optimizing limited resources for maximal health impact. The Global Health Evidence Evaluation Framework project is aimed at developing an evidence framework for the purposes of informing efficacious, effective, sustainable global health programs at the community and scale level. This project represents collaboration between the project team and an interdisciplinary group of experts, called the Technical Expert Panel, or TEP. Each key step of the project requires both preparatory work on the part of the project team and then consideration and discussion by the TEP, with synthesis of the TEP discussion and decisions then made by the project team. Preliminary Key Questions were: What is the role of context in the effectiveness and scalability of global health interventions/programs at the community and population level? What descriptions of elements of study design and execution are necessary to reach conclusions about effectiveness? What descriptions of elements of implementation are necessary to reach conclusions about scalability and sustainability? The six steps of the project are to: 1. Assemble an interdisciplinary panel of experts. 2. Select a set of exemplar interventions or programs. Note exemplar means characteristic of its kind. These exemplars are needed because they provide the real world examples to use when developing and testing frameworks and criteria. 3. Perform a focused literature review on the exemplar interventions, to elucidate what is currently being reported regarding evaluations of the exemplar interventions and to identify gaps in the evidence. 4. Perform an assessment of strengths and limitations of existing frameworks for assessing global health interventions. 5. Identify and/or develop of criteria to meet identified needs or gaps in existing frameworks. 6. Pilot test the draft criteria.

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