The word “evidence” gets tossed around a lot these days. What do we mean by it exactly?
Imagine that you have a life-threatening disease. Your doctor recommends an intervention ( a drug or surgery) for it. What’s the first thing you want to know about it?
How well does it work?
In other words, what are the chances that after taking this drug or undergoing this surgery, I will get better?
For most drugs or interventions these days, doctors are able to answer that question quite well thanks to rigorous research. They will be even able to tell us, in some cases, how well the treatment works for people similar to you (in the same age group, of the same sex, or with the same additional diseases).
In public and global health, where we are working with communities and populations instead of individual patients, many interventions have rigorous research behind them that let us know how well it works, and even in some cases, how well it works for people in a particular context.
That is usually what we mean by “evidence”, the proof that something works or doesn’t work.
Unfortunately, the use of evidence in public and global health tends to be weaker than in healthcare and clinical settings, especially in some domains like community health. While many actors such as WHO, academia, and research think tanks work really hard to collect, analyse and compile evidence on whether public or global health interventions work, many gaps still remain.
What we have seen at Alanda is that it can be hard for implementing organizations such as NGOs to strengthen their use of evidence, because they have so many other competing priorities and they are so focused on the how.
That’s why at Alanda, we’ve come up with a framework to support our partner organizations to strengthen their use of evidence. We call this our 3 E’s framework. We help our partner organizations to strengthen three aspects:
- evidence-based,
- evidence-generating and
- evidence sharing
Evidence-Based
We’ll start with what we imply by being evidence-based.
Being evidence-based is the first thing that comes to mind when talking about evidence: Making sure any intervention we implement is based on evidence, in other words, that it has been proved to work.
For example, iIf an organization aims to improve health in a community through community programs, this could be done through house-to-house visits from community health workers, through improving access to safe water and sanitation, improving community-based surveillance of potential outbreaks, or a combination of these.
Not all these interventions have the same track record. Some have better evidence of generating true improvements in health for people in the community, and of course, tweaks based on cultural aspects and specific needs of the community also need to be considered.
HOW ALANDA SUPPORTS EVIDENCE BASE
We support our partner organizations to:
- Ensure that their programs and interventions are based on the best available evidence by carrying out literature reviews and assessments,
- Figure out which interventions have the strongest evidence of creating the desired change, in different contexts.
- Understand and take into account the quality of the evidence available, as not all studies are created equal, and some give us stronger proof that a certain intervention works than other types of studies.
Evidence-Generating
Sometimes there might not be enough evidence available on whether an intervention works, or whether it works in a certain context or for a group of people. And sometimes an organization wants to test a new, innovative intervention that has not been tested before.
For example, they might want to test if home visits by a community healthcare worker to pregnant women increase the chances that pregnant women will choose to give birth in a clinic or hospital.
In these cases, it is key to ensure that organization sets up a strong evidence-generating system to ensure that at the end of the intervention, it’s possible to determine whether it worked or not.
Unfortunately, we see organizations trying out interesting interventions that could help save lives and improve health, but without the right setup to strictly measure results. Without this setup, it’s hard to generate the evidence needed to prove the intervention’s worth.
HOW ALANDA SUPPORTS EVIDENCE GENERATION
We support organizations to set up the intervention in such a way that it will allow us to MEASURE if it works. This involves supporting them to:
- Figure out the best way to measure the impact of the intervention (in our examples the home visits), for example, whether you compare the same groups before and after receiving the intervention (a measure of what percentage of women before and after the intervention give birth in clinics or hospitals) or whether it is possible and ethical to compare a group that receives the intervention versus a similar population group that does not.
- Set up a strong monitoring and evaluation framework, including data collection tools and indicators, as well as a team who has been trained and feels confident to gather the data.
- Carry out a baseline and an endline study to collect outcome and impact level data, which will support the programme monitoring data collected throughout the intervention.
- Undertake an evaluation at the end of the project or programme to analyse all data collected, determine whether the intervention worked and gather lessons learned.
Evidence Sharing
While in academic research in global health, most studies and results will get published in journals and shared in conferences, this is not always the case with results from interventions carried out by non-governmental organizations and civil society organizations saving lives and improving health on the ground.
This is understandable, as these hands-on implementing organizations, are usually very busy with their programs and have an expertise that is skewed towards operational problem-solving rather than research and publishing.
But it is also a missed opportunity, as many organizations are implementing interesting interventions and learning important lessons that the rest of us working in global health would benefit from knowing.
HOW ALANDA SUPPORTS EVIDENCE SHARING.
At Alanda, we help organizations share their data and results with the world so that their hard work can contribute to our global evidence base. We do this by helping them to:
- Organize, analyze and present their results in a compelling and rigorous manner, whether that is a video, a press release, a conference abstract, a slideshow, or a manuscript for a peer-reviewed journal.
- Find the right forums to share the data, whether these are conferences, academic journals, science communication platforms, or other scientific data repositories.
If you would like to know more about how Alanda can support your organization or project in any of these three areas, send us an email at projects@alandahealth.com.
Let’s improve the use of evidence together.
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