The evaluation plan will examine 1) the services provided, 2) the process of
implementation of services, and 3) the impact of services in the targeted population through evaluation questions. The intended outcome of the evaluation is to determine the effectiveness or ineffectiveness of the center’s services in meeting the program objectives; to highlight barriers and areas for improvements; and, to determine the impact of the medical center on the target population needs. Tumaini Medical Centre’s stakeholders may subsequently use this assessment to appropriately allocate additional funding and support and to identify and
minimize barriers in efforts to maximize and strengthen the center’s services and impact to the community. Though this evaluation is formative, stakeholders should prepare a summative evaluation by appraising services and outcomes in terms of dollar costs and values.
Evaluation Questions
The primary goal of the Tumaini Medical Centre is to improve health of PLWHIV in Marsabit County, Kenya by increasing access to comprehensive care (testing & counseling) and treatment, increasing the effectiveness of clinic services at the Medical Centre, and maximizing
access to affordable medical services for the general population. The evaluation questions presented here focus on these goals and the program objectives identified in previous sections.
Topic: Services Provided
Short-term objectives:
Within one year, Tumaini Medical Centre staff will increase the number of
community members that have been tested and are aware of HIV status in Marsabit. Within one year, Tumaini Medical Centre staff will reduce opportunistic infections of
TB in patient population at the Medical Centre by 50%.
Within one year, Tumaini Medical Centre staff will increase the reported use of condoms in the catchment area by at least 30%.
Table 9. Services Provided Evaluation Planning Table
Evaluation Question Evaluation Method (s) Participants
Were community outreach and medical campaign effective in the community? Were health talks culturally sensitive?
Open-ended interviews, clinic enrollment review
Community members/Leaders, Clinic staff
According to clinic patients, were
counseling sessions culturally appropriate in sexual health knowledge and self- efficacy?
Focus group discussions, clinic surveys, open-ended interviews
Clinic patients, Clinic staff
Could clinic patients understand what they were told in counseling sessions?
Clinic surveys, open-ended interviews
Clinic patients, Clinic staff, CHWs, FH administrative staff Are voluntary testing options (TB, HIV)
integrated in initial counseling sessions?
Focus group discussions, clinic surveys, medical records review
Clinic patients, Clinic staff
Topic: Service Implementation
Short-term objectives:
Within one year, Tumaini Medical Centre staff will improve immunity of HIV /AIDS clients (inclusive of pediatrics) through enrolment of positively tested individuals on ARTs.
Within one year, Tumaini Medical Centre will improve symptom management and psychological health of HIV/AIDS clients after Highly Active Anti-Retroviral Therapy (HAART)initiation.
Table 10. Services Implementation Evaluation Planning Table
Evaluation Question Evaluation Method Participants
Were CHWs trained in delivery of ART series according national guidelines?
Document review (training logs, training material), open-ended interviews
CHWS, Clinic staff, FH administrative staff
Does Tumaini Medical Centre follow a standardized training protocol? How is the process updated/regulated?
Document review (training logs, training material), open-ended interviews
Clinic staff, FH administrative staff
How many patients that were enrolled 6 months ago returned for follow-up CD4 count testing?
Clinic registers and medical records review, clinic surveys, open-ended interviews
Clinic staff, Clinic patients, CHWs
What barriers exist that prevented patients from continuing care? How were these overcome?
Focus group discussions, medical records review, open-ended interviews
Clinic staff, FH Administrative staff
Were Tumaini Medical Centre’sefforts to ensure follow-up care effective or ineffective? In what ways can follow-up care be improved?
Focus group discussions, clinic surveys, open-ended interviews
Clinic staff, FH Administrative staff
Topic: Program Impact
Long-term objectives:
Within five years, Tumaini Medical Centre will observe measurable changes in HIV knowledge and stigma among community members in Marsabit.
Within five years, Tumaini Medical Centre will observe measurable improvements in health seeking behavior (initiation of treatment/care and/or counseling; request for assistance in disclosure; and/or compliance to follow-up clinic/counseling visits at the medical centre) among PLWHIV in Marsabit.
Table 11. Program Impact Evaluation Planning Table
Evaluation Question Evaluation Method Participants
How have clinic patients’ perceptions of knowledge and lifestyle change, or lack of change, altered over the duration of treatment at the medical center? As a result of increased involvement of community leaders?
Focus group discussions, open-ended interviews, surveys
Community
Members/Leaders, CHWs, Clinic patients, Clinic staff
What were baseline factors or potential confounders that may have contributed to HIV transmission? Has health seeking behavior and/or sexual health knowledge changed in the community?
Focus group discussions, open-ended interviews, surveys
Community
Members/Leaders, CHWs, Clinic Staff, FH Administrative Staff, Stakeholders
What other factors and potential confounders may have contributed to community knowledge?
Focus group discussions, open-ended interviews
Community
Members/Leaders, CHWs, Clinic Staff
How can Tumaini Medical Centre
measure the effect or lack of effect of the program on the health of the
community?
Document review (monthly, quarterly reports), document review of
epidemiological data, open-ended interviews
Clinic Staff, FH Administrative Staff, Stakeholders