Our experts are well-versed in designing and conducting research, evaluation and cost-effectiveness studies in health, agriculture, and food security. Our monitoring experience includes Site Improvement through Monitoring System (SIMS) of PEPFAR programs, as well as traditional project monitoring. We care about the utilization of our MERL results so that they are translated into action to increase the uptake of our recommendations. We disseminate our data-driven insights and tell a story through our stakeholder’s voice. This is achieved by availing ourselves of a variety of communication channels, ranging from 1:1 mentoring with our local partners to convening large conferences with high-level officials to peer-reviewed publications.

Effaced affiliates are well-versed in study design and developing sampling strategies for quasi-experimental evaluations and randomized controlled research studies. Our experts are adept in multivariate analyses (i.e., linear, logistic, and Poisson regressions, and other methods), designing sampling strategies for household and facility-based surveys, analyzing longitudinal and time-series data. Effaced is capable of conducting a host of health financing study designs and analyses including cost-effectiveness, cost-benefit, willingness-to-pay, value-for-money, and political economy analyses. Our affiliates apply rigorous qualitative research methods for stand-alone research and evaluation or to complement robust quantitative methods.

We design simple, yet statistically strong study designs for the gamut of evaluations, i.e., process, performance, and impact. We are equally comfortable with applied research and implementation science.  Unless clients prefer otherwise, we put forth mixed-methods study designs to ensure we capture the rich qualitative information that helps us understand the “why” behind the quantitative results. We carefully match the method to the study population and the type of information we wish to glean. We aim to unveil nuanced stories with empirical evidence and compelling qualitative data in order to fuel programmatic discussions. These discussions highlight any needs for mid-course corrections, and consider future programming and policy-making.

When Effaced is working with local partners who are preparing to become prime recipients of USAID funding, we conduct a situational analysis of their current ability and likelihood they would be successful. Effaced developed a Prime Readiness Assessment that allows for a systematic assessment of an organization’s status. The  prime readiness criteria ascertain institutional systems, resources, policies, guidance, and practices vis-a-vis the USAID NUPAS (Non-US Organization Pre-Award Survey). These and more nuanced variables such as management style and organizational culture, all feed into the Prime Readiness Assessment. This tool rates ten metrics on a four point scale with clear definitions delineated  for each ranking. The Tool is coupled with feedback from the international primes working with the sub-awardees, USAID perspectives, and other primary stakeholders. Together, our mixed methods assessment allows us to shortlist sub-awardees and focus our capacity development on them for a more efficient use of everyone’s time and resources.

There is widespread agreement that development programs need to be sustainable. However, how people define sustainability can be oblique/murky at times.

Effaced borrows an analytical framework developed by Annette when she was evaluating the sustainability of USAID programs and projects. She needed a systematic way to distill data and information by clearly defining the variables that comprise sustainability. The Sustainability Measurement Framework makes it much easier to engage in a meaningful discussion and objectively evaluate its achievement. Key determinants that contribute to sustainability include (1) policy, strategies, and plans, (2) finance,  (3) accountability, (4) institutional support, (5) technical choices, (6) human dimension, and (7) external threats and enabling environments. The subsequent analysis is based on the assumption that there are both proximate and distal determinants that influence results and that they may operate within the support of mediating factors.

A very common evaluation question for health projects was whether the quality of care has improved. Through the eyes of a clinician, this is a colossal question. To begin to tackle all the factors that affect healthcare quality, Annette developed the Quality of Care Measurement Index for a USAID evaluation of an integrated health project in the Democratic Republic of Congo. She did this by examining both the supply and demand of health services.

The model identifies three proximate determinants that lead to the appropriate care and treatment of illnesses. The first proximate determinant, structural inputs of the health facility, are defined as availability of commodities and infection control measures are in situ.

The second proximate determinant in this Index is personnel.The variables selected to measure the capacity and availability of personnel include those directly related to the staff, Another category of variables under personnel include the tools of supportive supervision, such as availability and access to quality information and access to motivated staff. 

The third proximate determinant, health-seeking behaviors, rely on the health information received by the community or clients that relate to changes in their cognitive and psycho-social attributes such as knowledge, attitude and practices which influence client decision-making that drive their behaviors.  Thus, this Index incorporates  myriad variables that influence the perception of quality of care received by facility clients; whether staff are adequate to meet the volume of patients in a facility, overall satisfaction with the care received, and recent contact or exposure to a health provider. This cluster of factors influences a client’s overall viewpoint as to whether she will receive quality care and therefore, influence her health-seeking behaviors.