Multiple and mixed methods in formative evaluation : is more better? reflections from a South African study
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
ENGLISH SUMMARY : Background:
Formative programme evaluations assess intervention implementation processes, and are seen widely
as a way of unlocking the 'black box'
of any programme in order to explore and understand why a programme
functions as it does. However, few critical assessments of the methods used in such evaluations are available, and there are especially few that reflect on how well the evaluation achieved its objectives. This paper describes a formative evaluation of a community-based lay health worker programme for TB and HIV/AIDS clients across three low-income communities in South Africa. It assesses each of the methods used in relation to the evaluation objectives, and offers suggestions on ways of optimising the use of multiple, mixed-methods within formative evaluations of complex health system interventions.
Methods: The evaluation's qualitative methods comprised interviews, focus groups, observations and diary keeping. Quantitative methods included a time-and-motion study of the lay health workers' scope of practice and a client survey. The authors conceptualised and conducted the evaluation, and through iterative discussions, assessed the methods used and their results.
Results: Overall, the evaluation highlighted programme issues and insights beyond the reach of traditional single methods evaluations. The strengths of the multiple, mixed-methods in this evaluation included a detailed description and nuanced understanding of the programme and its implementation, and triangulation of the perspectives and experiences of clients, lay health workers, and programme managers. However, the use of multiple methods needs to be carefully planned and implemented as this approach can overstretch the logistic and analytic resources of an evaluation.
Conclusions: For complex interventions, formative evaluation designs including multiple qualitative and quantitative methods hold distinct advantages over single method evaluations. However, their value is not in the number of methods used, but in how each method matches the evaluation questions and the scientific integrity with which the methods are selected and implementented.
Description
CITATION: Odendaal, W., Atkins, S. & Lewin, S. 2016. Multiple and mixed methods in formative evaluation : is more better? reflections from a South African study. BMC Medical Research Methodology, 16:173, doi:10.1186/s12874-016-0273-5.
The original publication is available at https://bmcmedresmethodol.biomedcentral.com
The original publication is available at https://bmcmedresmethodol.biomedcentral.com
Keywords
Community health services -- Cape Town (South Africa), Volunteer workers in community health services -- Cape Town (South Africa), Formative evaluation, Complex interventions
Citation
Odendaal, W., Atkins, S. & Lewin, S. 2016. Multiple and mixed methods in formative evaluation : is more better? reflections from a South African study. BMC Medical Research Methodology, 16:173, doi:10.1186/s12874-016-0273-5