Table 4 Core components of the impact evaluation and operational research
| Â | Focus | Data source | Analysis |
|---|---|---|---|
Impact Evaluation | Impact and effective coverage | Oversampling DHS 2010 and 2015 | Difference in differences in key population health indicators between 2010 and 2015, comparing the intervention area with rural comparison districts |
| Â | Service utilization and coverage, facility and community health worker levels | Routine HMIS from hospital, health centers and community health worker program | Change in service utilization and coverage in intervention areas in comparison to other rural districts |
| Â | Cause of death in children under five | Verbal autopsy through MOH program | Changes in the cause of death in children over the intervention period |
| Â | Contextual factors | DHS, National Resource Database, environmental records | Analysis of impact of contextual factors on district-level differences, including environmental factors, epidemics, humanitarian crises, sanitation, equity measures, women's education, HIV prevalence, Government of Rwanda records of partner contributions and engagement |
Economic and Costing Analysis | Costing | Costing data collected by project | Economic and costing assessment of the health system in the intervention area including the costs per capita of PHIT intervention; total costs per capita of the health systems in the two intervention districts; and financial contributions made by government, partners and patients to the local health systems |
Component Evaluation | Health facility support | Health facility survey, HMIS, MESH data | Impact of intervention on strengthening across WHO building blocks, explore relationship with quality and volume of care delivered |
| Â | MESH | External observation of care delivery, qualitative evaluation of district and health center staff | Effectiveness of MESH in improving quality of care focusing on children under-five, acceptability of and satisfaction with MESH |
| Â | Strengthened CHW systems | Community HMIS data, household register | Analysis of change in CHW-delivered services in intervention area and comparison areas |
| Â | Operational research | Project specific | Includes assessment of PHIT intervention on family-planning uptake, human resource retention, nutritional status in children |