Lessons Learned From Implementing Prospective, Multicountry Mixed-Methods Evaluations for Gavi and the Global Fund.

Area of Science:

• Global Health
• Program Evaluation
• Mixed Methods Research

Background:

• Global health programs are increasingly complex, necessitating comprehensive evaluations.
• Gavi and the Global Fund commissioned prospective mixed-methods evaluations to assess their investments.
• This study synthesizes lessons from over seven years of implementing these evaluations.

Purpose of the Study:

• To describe lessons learned from implementing complex prospective mixed-methods evaluations in global health.
• To provide practical and conceptual considerations for designing and executing such evaluations.
• To inform future global health initiatives on effective evaluation strategies.

Main Methods:

• A synthesis of lessons learned from two case studies: Gavi and the Global Fund evaluations.
• Utilized a prospective mixed-methods approach over a seven-year period (2013-2020).
• Grounded lesson identification in the Centers for Disease Control and Prevention Framework for Evaluation in Public Health.

Main Results:

• Identified five key lessons learned, building on existing evaluation best practices.
• Lesson 1: Importance of an inception phase for stakeholder engagement and relevant design.
• Lesson 2: Aligning evaluation embedding with program implementation.
• Lesson 3: Monitoring and adapting evaluations to programmatic and contextual changes.
• Lesson 4: Necessity of mixed-methods expertise and tools for evaluators.
• Lesson 5: Contextualizing recommendations and communicating evidence strength.

Conclusions:

• Complex global health initiatives should embed evaluations to understand program mechanisms.
• Lessons learned can inform the design and implementation of future evaluations.
• Effective evaluation requires adaptability, stakeholder involvement, and clear communication of findings.