Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative
Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative
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DOI：
10.1097/01.aids.0000343760.70078.89
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发表时间：
2008-12-01
期刊：
影响因子：
3.8
通讯作者：
Moore, James
中科院分区：
文献类型：
--
作者：
Chandrasekaran, Padma;Dallabetta, Gina;Moore, James
背景：缩小艾滋病毒预防差距以预防艾滋病毒感染需要在全球范围内快速开展大规模国家规划。评估此类计划具有挑战性和复杂性，需要明确的评估目的和与试点和小型计划所采用的证据方法有本质不同的方法。 目标：本文描述了印度艾滋病倡议 Avahan 实施阶段的评估设计，该计划是由比尔和梅琳达·盖茨基金会资助的大型艾滋病毒预防计划。 Avahan 于 2003 年 12 月启动，有一个为期 10 年的章程，通过在印度 6 个邦的 83 个地区实施针对核心群体和桥梁群体的艾滋病毒预防计划，将该计划移交给印度政府，并传播计划学习成果，以影响印度的流行病及其应对措施。 方法：该基金会委托外部流程来设计 Avahan 的评估框架。一个独立的咨询小组负责监督和指导该框架执行过程中的路线修正。 结果：Avahan 的评估框架包括：对干预地区子集的核心、桥梁和家庭生物行为调查数据的趋势和综合分析、所有干预地区的分母估计和项目监测以及政府的产前监测（所有地区每个地区两个站点）；定制传播动力学模型，以估计避免的感染（部分地区）；成本效益研究（部分地区）。此外，还有其他知识建设和质量监测活动。结论：规模化计划需要细致入微的评估，而不是一小组单一的成果衡量标准，通过收集不同级别地理范围的数据来近似计划规模，综合多种数据和方法以得出综合情况，并能够应对持续的环境和计划演变。 (C) 2008 年威科健康 |利平科特·威廉姆斯·威尔金斯
Background: Closing the HIV prevention gap to prevent HIV infections requires rapid, worldwide rollout of large-scale national programmes. Evaluating such programmes is challenging and complex, requiring clarity of evaluation purpose and evidential approaches substantively different to those employed for pilots and small programmes.Objectives: This paper describes the evaluation design for the implementation phase of Avahan, the India AIDS initiative, a large HIV prevention programme funded by the Bill and Melinda Gates Foundation. Avahan, which began in December 2003, has a 10-year charter to impact the Indian epidemic and its response by implementing an HIV prevention programme targeting core and bridge groups in 83 districts of six Indian states, transferring the programme to the Government of India, and disseminating programme learning.Methods: The foundation commissioned an external process to design Avahan's evaluation framework. An independent advisory group oversees and guides course corrections in the execution of this framework.Results: Avahan's evaluation framework comprises: trend and synthetic analysis of data from core, bridge and household biobehavioural surveys in a subset of intervention districts, denominator estimates and programme monitoring from all intervention districts, and government's antenatal surveillance (two sites per district in all districts); bespoke transmission dynamics modelling to estimate infections averted (subset of districts); cost effectiveness studies (subset of districts). In addition, there are other knowledge-building and quality-monitoring activities.Conclusion: Rather than a small set of monofocal Outcome measures, scaled programmes require nuanced evaluations that approximate programmatic scale by collecting data with different levels of geographical scope, synthesize multiple data and methods to arrive at a composite picture, and can cope with continuous environmental and programme evolution. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins