Effective public health programmes call for dedicated methods that offer comprehensive and practical solutions to challenging situations.
By Dr. Ilham Zaidi
Young, enthusiastic, budding public health professionals often enquire about the ways to ensure optimal results from a delivery programme. “What are the best strengthening exercises for our health systems?” they ask.
Although there are multiple theories, I follow a simple process that has stood me in good stead. It’s a basic five-step process that has stayed with all my students, whether or not they choose to continue working in the field of public health.
Here are the steps:
#1 Monitor
I consider monitoring to be the most important aspect of any public health programme. It can build or collapse the outcomes. Monitoring is usually done while carrying out a programme shoulder to shoulder. It is the key to effective implementation.
Monitoring is required not just to know if the implementation is generalised and up to the mark, but also to better understand the concept and process development of the team. Remember, if it isn’t monitored effectively, it is as good as having no programme at all!
#2 Evaluate
It is important to see the impact of the programme in a standardised way in order to understand the change it has brought. Evaluation helps quantify the programme benefits so that the policymakers and other stakeholders can be further convinced that this programme needs to be renewed/extended, or even expanded. The evaluation will comprehend if the trends have stayed unchanged or have reduced/increased and to what extent.
The process is usually carried out as per the anticipated growth curve, and can be yearly, quarterly, monthly, or even weekly, especially in the current scenario of COVID-19, where the case trends are changing almost every day. Evaluation is carried out in specific determined intervals along with the programme or can also be done after the programme (usually in limited duration programmes).
#3 Research
Once we know if the programme has brought about positive change, we need to know what exactly we did for this positive change. What more can be done? How can it be further improved? If the trends are unchanged or worsened, we need to identify what went wrong. What can be done to improve the results?
We have to generate a genie to answer these questions so that we can learn from our experiences and move ahead with our learnings from the programme. Yes, you guessed it right, that genie is called research in our community. It’s done hand in hand with evaluation; sometimes it is followed by an evaluation process.
#4 Improvise
This step entails improvisation from the findings of our research. It tells us what exactly we did right so that we can focus on the right steps and approaches to further strengthen the programme. This can help others learn and use our findings for similar programmes in other regions or different programmes in the same region.
If we have not achieved our target goals, we learn and try to avoid the mistakes from our experiences so that we at least don’t repeat the mistakes. The idea is to make new mistakes or no mistakes at all. In the case of new mistakes, we call our genie again and it is so kind that it helps us identify our mistakes every time we call it. These mistakes can be as small as not identifying the right group of beneficiaries. Perhaps, the programme can work better in a different location, just 100 meters ahead in the colony of underprivileged or vulnerable communities.
#5 Repeat
And finally the last step of our approach – repeating the process all over again. Starting from the monitoring of the programme, then evaluation, followed by research and improvisation of the findings, only to be further repeated.
(The author is a Senior Consultant at Eqkuiaccess Foundation. He has formerly served as the Regional Manager for the e-VIN project at UNDP)
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