In an era of financial constraint, USAID (and therefore its partners) is increasingly being asked to invest in “high impact” areas/activities and, ultimately, to get better bang for every taxpayer buck spent. This is not just a USAID phenomenon. The new Global AIDS Coordinator, Ambassador Deborah Birx, declared that PEPFAR will have to do more with less, and “we will deliver the right things, in the right places, at the right times.”

Health programming has always been somewhat results-oriented, but most recently, development partners and countries have been focusing on achieving the Millennium Development goals. These are actually pretty straightforward to measure – maternal and child mortality rates, decreases in prevalence of infectious diseases, such as HIV/AIDS, TB and malaria, etc. But what about all of the activities that have to happen BEFORE we can achieve those targets? How can we evaluate whether our interventions are “high impact” along the way?

The short answers are, “it depends” and “it’s complicated.” There is no “one size fits all” approach to evaluation. Each activity or intervention being evaluated requires a special “package” or approach.

While we all understand the strengths and limitations of using only quantitative data to paint a three-dimensional picture, meaningful qualitative data can be difficult to gather. Indeed, this branch of research requires special expertise….Even more challenging, however, is applying a mixed method approach, which inherently implies a tailored “package.” Using the right mix of methodologies in the right places is what can reveal the meaningful results of, for instance, health systems strengthening and behavior change activities.

USAID has embraced the value of mixed method evaluation in its Evaluation Policy, stating, “Given the nature of development activities, both qualitative and quantitative methods yield valuable findings, and a combination of both often is optimal.” (p. 4)

There is a saying that “what can be measured gets done.” In Situ employs tailored packages of mixed methods to give a more holistic picture of health program results. By changing the definition of “what can be measured”, we can ensure that our limited resources are used for what really needs to get done.

Is your company/organization feeling the pressure in this era of financial constraint? What strategies and methodologies are you using to meet the tougher challenges we face?