Health evaluations in Africa – A review of the health strand held at the 7th Biennial Conference of the African Evaluation Association

Founded in 1999, AfrEA supports its mission through its biennial international conference, which brings together representatives from governments, universities, non-governmental organisations, national evaluation associations, individuals, and donors to share evaluation findings and methodologies, and to discuss evaluative approaches and priorities. The 7th Biennial International Conference of AfrEA, held in March 2014 in Yaoundé, Cameroon, featured a health evaluation strand sponsored, managed, and supported by the USAID-funded African Strategies for Health (ASH) project. The health strand had nine sub-themes, delivered through various methods, and was attended by over 500 participants from more than 70 countries. The conference highlighted the importance of data use for planning and improving health programmes, data quality, well-functioning monitoring and evaluation (M&E) systems, and identifying and sharing best/good practices. African countries face a high burden of disease compared to the rest of the world, with a lack of adequate financial and human resources for health, inequitable distribution of health services, and other social, economic, and political factors exacerbating the situation. Given these constraints, it is critical for African countries to ensure that health interventions are selected based on evidence and implemented in the most effective and efficient way possible to ensure desired outcomes and impact. The implementation of life-saving health interventions is challenging, particularly those that require individuals and communities to change their behaviour, and what works in one context is not guaranteed to work in a different context. The health strand featured 48 evaluations conducted in 21 African countries, with most submissions in English and several in French. Authors of abstracts selected for presentation received technical support and guidance from the ASH project in producing their final papers. The focus of one session was on JHPIEGO's experience in implementing M&E standards across its health programmes in Africa and elsewhere, based on UNAID's M&E Standards and AfrEA's evaluation guiding principles. The implementation of standards-based M&E increased the attention paid to M&E at various stages of the project/programme cycle and helped to facilitate dialogue between M&E and programme and finance personnel, contributing to an increase in the quality and use of M&E data, which led to improved quality of care and services. The conference highlighted the importance of M&E in improving the implementation of health programmes and informing policy making in developing countries. The past decade has seen a growing appreciation of M&E as a way to improve implementation of health programmes and for informing policy making in developing countries. The conference also highlighted the need for better understanding of effective implementation approaches in different social, cultural, economic, and political contexts, and once found, this understanding and learning must link back to health policy and practices.