Advocating for Adolescent Reproductive Health in Sub-Saharan Africa[PDF]

Also available in French in [PDF] format.

There are many ways to evaluate the effectiveness of an advocacy effort, from simple tracking systems to rigorous research conducted by outside professionals. The type of evaluation should be chosen by the goals and objectives and by the resources available. If the goal is modest in scale, such as making reproductive health information and services available to young people at a local health center, then process and outcome evaluations will be most appropriate. Alternately, if the goal is much more ambitious, such as to decrease national pregnancy and STD rates among adolescents, then process, outcome, and impact evaluations will all be necessary.

Process Evaluation

A process evaluation is the least expensive and most simple type of evaluation to conduct. It examines whether activities are reaching the intended audience, are occurring as planned, and are adequately funded. Quantitative data from a process evaluation show the number of activities conducted, such as the number of media interviews or meetings with opinion leaders that take place. Qualitative data can capture the mood of a meeting or a policy maker's degree of satisfaction with information received from the campaign.

A process evaluation addresses such questions as:

• How many opinion leaders received information?
• How many pieces of educational material were distributed to the public?
• How many presentations or meetings have been held with opinion leaders?
• How many favorable articles or programs about adolescent reproductive health appeared in the media?
• How many members does the network have?

Collecting this information is important to determine whether the network is on track in pursuing its activities, but it is also important not to become too preoccupied by the process. While advocates may be able to point to the number of trainings conducted and materials distributed, remember that the goal is to improve adolescents' access to information and services by affecting policies.

Outcome Evaluation

Outcome evaluation measures the network's intermediate impact. For example, if a goal is to ensure access to reproductive health information and services to any young person who requests them, the objectives may relate to affecting policies regarding the operation of health clinics or schools. Results from an outcome evaluation will indicate progress toward meeting those objectives.

Outcome evaluation assesses such questions as:

• Has awareness of adolescent reproductive health issues among opinion leaders increased?
• How many more opinion leaders publicly support the goal?
• Did the target organization's policies change as a result of the activities?
• Was there a measured increase in the public's support of these policies?

Impact Evaluation

Impact evaluation examines progress made toward the long range goals. Often these goals relate to affecting health indicators or policies on a national or regional level. Impact evaluation is the most expensive type of evaluation and is used to examine only the most ambitious advocacy efforts. An impact evaluation may take place three to five years after advocacy activities.

Impact evaluation addresses such questions as:

• Was there a change in the incidence of unintended adolescent pregnancy?
• Were STD rates among young people lowered?
• Was there an increase in adolescent use of contraceptive methods?
• Do more adolescents receive reproductive health information and services?

Any evaluation should be practical and sensitive to resource or labor limitations. If outside experience is needed, help may be found at a local college or university. The social sciences, psychology, education and public health departments may have professors or students who can help with the project. Often, graduate students are eager for experience and will work for lower fees than those charged by professional evaluators. Or, they may be permitted to use the data for theses or dissertations in exchange for their work. Conversely, the increased credibility of a professional evaluation may offset the additional expense of hiring a known, respected evaluator.

Using Evaluation Results

While evaluating an advocacy campaign can be time consuming, the results of a well executed evaluation are usually very useful. Results showing that a campaign has been effective in achieving its goals or objectives can motivate network members and funders. Successfully persuading a ministry of education to require family life education in all secondary schools may result in an increase in healthy sexual behaviors among these youth. While it is not possible to attribute the increase in healthy behaviors directly and solely to the policy change, the network's success in affecting the ministry's policy can be cited as a possible contributing factor.

At times, it is difficult to attribute changes in policies or programs directly to the network. Such changes may take place due to a general change in attitudes or because of another campaign or advocacy effort. In order to accurately assess the impact of the campaign, it is important to be aware of similar efforts in the target area which may affect policy makers or program planners. It is easy to assess the outcome when specific language used by the network is incorporated into policy documents or if key leaders are using this language. When government or other organizations cite the network' documents in support of policies and programs, this is further indication of the effectiveness of efforts.

Evaluation results also can be used to identify the most and least effective components of the campaign. Advocates must reformulate strategies when evaluation data indicate a lack of progress. Likewise, as an advocacy campaign matures and accomplishes its goals and objectives, new goals and objectives should be developed that target changes in other indicators of adolescent reproductive and sexual health.