Demand-Driven Evaluations for Decisions (3DE) Initiative

Clients: Zambian Ministry of Health, DFID
Partner: Clinton Health Access Initiative (CHAI)
Location: Zambia
Sector: Health
IDinsight services: Policy design support, impact evaluations, scale-up support

The Problem

Despite the existence of demonstrated solutions to many of the world’s health needs, the global poor frequently go without basic healthcare. Ministries of Health often know what clinical interventions are necessary and have funding to deliver needed services, but lack evidence on the most effective and efficient strategies to deliver those services to hard to reach populations. Large-scale, multi-year impact evaluations answer many critical questions, but often fail to address MoH managers’ operational needs by examining questions without immediate operational relevance and producing findings on a timeframe that is out of sync with shorter-term decision-making deadlines. As a result, large portions of the budgets committed to global health each year are not spent as effectively as they could be.

Evidence Needs

Demand Driven Evaluations for Decisions (3DE) is an innovative partnership between IDinsight and the Clinton Health Access Initiative (CHAI) that seeks to fill the evidence gap in Ministry of Health policy using rigorous impact evaluations. 3DE works in three phases. First, key MoH policymakers are engaged to determine priority policymaking areas where rigorous evidence is needed to inform a specific decision. Second, a rigorous impact evaluation is designed and carried out according to the Ministry’s decision-making timeline. Third, the results from the evaluation are used to inform program scale-up or MoH policy change. Examples of 3DE questions are the impact of “Mama kits” on institutional delivery rates, and the impact of integrating Early Infant Diagnosis (EID) of HIV with the Expanded Program on Immunization (EPI) on diagnosis of HIV and immunization rates among infants.

IDinsight Service

Over three years, IDinsight, in partnership with CHAI, designed and ran eight impact evaluations requested by the Ministries of Health of Uganda and Zambia. IDinsight worked closely with MoH policymakers and CHAI staff to help scale up successful interventions (or adjust or abandon unsuccessful interventions) or implement national policy changes as a result of the evidence.