Research and Evaluation

Rapid diagnostic tests for malaria (background) about the size of a pencil are especially useful in remote areas that lack more sophisticated testing equipment. Before implementation, however, URC research determined that community health workers could successfully use the test— which requires a finger prick, mixing blood and chemicals, and timing—with little training and a carefully designed job aid. Photo by Dr. Steve Harvey, Johns Hopkins University.

URC takes pride in its use of data-driven approaches to achieving results and improving health outcomes through research and evaluation (R&E). We embed research into our programs to find realistic solutions to documented implementation problems. We conduct comprehensive evaluation to build implementation strategies based on previous experiences and known challenges, to modify specific plans and identify best practices for expansion, and to determine changes occurring as a result of our programs. Evidence generated by R&E is also used to:

Develop innovations for increasing demand for services and improving health care;
Cost-effectively scale up evidence-based guidelines and best practices;
Motivate health workers, mobilizing their intelligence, energy, creativity, and commitment to achieve the best of which they are capable;
Advocate persuasively for policy change; and
Provide context-specific recommendations that will achieve public health results.

We design targeted research to help answer key operational questions, such as how to improve the use of insecticide-impregnated bed nets to prevent malaria and how to set standards for programs for vulnerable children and families infected or affected by HIV/AIDS. URC worked with the World Health Organization (WHO) and the Foundation for Innovative New Diagnostics to evaluate the effectiveness of a job aid to help trained community health workers retain their skills and maintain their performance in using rapid diagnostic tests for malaria. Through operations research, we have identified indicators of quality to help The United States President’s Plan for AIDS relief (PEPFAR) monitor and evaluate HIV programs.

URC manages two USAID-funded projects with significant R&E elements—the Health Care Improvement Project (HCI) and the Translating Research into Action (TRAction) Project. HCI supports a focused program of R&E related to the spread and institutionalization of best practices and improvement methods. HCI’s R&E work assesses the outcomes from applying quality improvement (QI) methods, improves the efficiency of QI interventions, adapts QI methods to community-level services, enhances QI team performance, and documents the cost-effectiveness and cost implications of QI interventions. USAID recognized HCI for having one of the best evaluation reports undertaken by a USAID-funded project. The winning report evaluated the results of 27 HCI-managed health care improvement interventions in low- and middle-income countries.

The TRAction Project funds studies to develop, test, and compare approaches to more effectively deliver health interventions, increase utilization, achieve coverage, and scale-up evidence-based interventions for priority health problems. Through implementation research, the project addresses “know-do” gaps: the delays between discovery of effective ways to combat the causes of poor health and the application of these proven interventions on a wide scale. TRAction research aims to close these “know-do” gaps so that each country’s Millennium Development Goals can be met in the targeted timeframes. TRAction emphasizes local ownership and partnerships in order to scale up equitable and sustainable efforts to “do what works.”

In an article published by the online Malaria Journal, URC researchers examined whether community health workers could successfully use rapid diagnostic tests for malaria by following a URC-developed job aid, shown here. The research found that the job aid improved performance over using the manufacturer’s instructions alone.

URC also strengthens routine program monitoring systems so that managers and providers can use data to evaluate programs and identify achievements and areas where more progress is needed. In Ghana, our Promoting Malaria Prevention and Treatment (ProMPT) Project assists the National Malaria Control Program to strengthen the health system response to malaria by bringing together Health Information Officers and supervisors in regular data quality review meetings. The project also sponsors the National Malaria Surveillance Monitoring and Evaluation Group as a forum for partner sharing and planning.

Bridging the Gap between Knowledge and Practice

URC seeks to ensure that our studies as well as our projects provide multiple opportunities for learning. We promote wider awareness of findings and lessons learned through a variety of channels, including publications, meetings, conference presentations, the internet, briefings, and peer reviewed journals.

With several highly trained researchers on staff, many affiliated with world-renowned research institutions, URC has published articles in numerous peer-reviewed journals, including the International Journal for Quality in Health Care, International Journal of Gynecology and Obstetrics, Implementation Science, European Biopharmaceutical Review, Patient Education and Counseling, Journal of Health, Population and Nutrition, BMC International Health and Human Rights, AIDS Care, Malaria Journal, and the Bulletin of the World Health Organization.

To read our peer-reviewed journal articles and evaluation reports, please visit the Resources section of our website.

Current Projects

Building Human Resource Capacity to Support Prevention, Care, and Treatment: Strategic Information and Other HIV/AIDS Programs
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2008 to present

Essential Obstetric and Newborn Care (EONC) Networks Project in Cotopaxi, Ecuador
Funded By: US Agency for International Development
Project Duration: 2009 to present

Implementation Support for Non-Communicable Diseases and Injuries
Funded By: Millennium Challenge Corporation
Project Duration: 2009 to present

South Africa Tuberculosis Program
Funded By: US Agency for International Development
Project Duration: 2009 to present

Maternal and Newborn Health in Ethiopia Partnership (MaNHEP)
Funded By: Subaward from Emory University with funding from the Bill & Melinda Gates Foundation
Project Duration: 2009 to present

Global Fund Consulting Services
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2007 to present

Translating Research into Action (TRAction) Project
Funded By: US Agency for International Development
Project Duration: 2009 to present

Technical Assistance and Support Contract 3: Global Health (TASC3 Global Health)
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Afghanistan
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Ecuador
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Ethiopia
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Guatemala
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Honduras
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Global
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Nicaragua
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Niger
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Tanzania
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Uganda
Funded By: US Agency for International Development
Project Duration: 2007 to present

Underage Drinking Prevention Education Initiatives (UADPEI)
Funded By: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
Project Duration: 2009 to present

PrevenSIDA
Funded By: United States Agency for International Development
Project Duration: 2010-present

Developing Strategies in the Central America and Panama Region to Strengthen Reponses to the HIV Epidemic
Funded By: Centers for Disease Control and Prevention (CDC)
Project Duration: 2010 to present

TB CARE II
Funded By: United States Agency for International Development (USAID)
Project Duration: 2010 to present

Impact Evaluation Services
Funded By: Millennium Challenge Corporation
Project Duration: 2005 to present

USAID Primary Health Care Project in Iraq (PHCPI)
Funded By: US Agency for International Development (USAID)
Project Duration: 2011 to present

Partnership for the Community Management of Child Health (Prise-C)
Funded By: US Agency for International Development (USAID)
Project Duration: 2010 to present

USAID Health Care Improvement Project (HCI) | Malawi
Funded By: The President’s Emergency Plan for AIDS Relief through the US Agency for International Development
Project Duration: 2011 to present

Control and Prevention of Malaria (CAP-Malaria) Project
Funded By: US Agency for International Development Regional Development Mission for Asia (USAID RDMA)
Project Duration: 2011 to present

Georgia Tuberculosis Prevention Project (TPP)
Funded By: US Agency for International Development (USAID)
Project Duration: 2011 to present

USAID Health Care Improvement Project (HCI) | Georgia
Funded By: US Agency for International Development (USAID)
Project Duration: 2011 to present

Nutri-Salud: Community Nutrition and Health Project
Funded By: US Agency for International Development
Project Duration: 2012 to present

Past Projects

Data Quality Audit (DQA) Framework
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2008-2010

USAID Health Care Improvement Project (HCI) | Russia
Funded By: US Agency for International Development (USAID)
Project Duration: 2007-2012

Infant and Young Child Nutrition (IYCN)
Funded By: US Agency for International Development
Project Duration: 2006-2011

Integrated Infectious Disease Capacity Building Evaluation (IDCAP)
Funded By: Accordia Global Health Foundation
Project Duration: 2008-2012

Management of Community Action Grants in Angola
Funded By: The World Bank
Project Duration: 2000

Multi-Sector Alliance Program (Alianzas II)
Funded By: US Agency for International Development through RTI International
Project Duration: 2010 to 2012

Rehabilitation of the Infrastructure of the Ministry of Health: Component on Investment in Health Education
Funded By: Inter-American Development Bank and the Ministry of Health of Argentina
Project Duration: 1995

Asia Family Planning Operations Research Project
Funded By: US Agency for International Development, Office of Population
Project Duration: 1985-1991

Quality Improvement Initiatives at the Acid Survivors Foundation
Funded By: US Agency for International Development
Project Duration: 2007-2008

Nongovernmental Organization Service Delivery Program in Bangladesh
Funded By: US Agency for International Development/Bangladesh
Project Duration: 2002-2006

Chile Child Survival Project Evaluation
Funded By: US Agency for International Development/Chile
Project Duration: 1993-1994

Creating a Reference Standard to Determine Central Line Associated Bloodstream Infection Rates (CLABSI)
Funded By: US Centers for Disease Control and Prevention (CDC)
Project Duration: 2009 to 2010

Egypt Cost Recovery for Health Project
Funded By: US Agency for International Development/Egypt
Project Duration: 1995-1998

The Maram Project: Healthier Palestinian Families
Funded By: US Agency for International Development
Project Duration: 2002-2004

Diagnostic Test Cost Analysis for the Developing World
Funded By: The Bill and Melinda Gates Foundation
Project Duration: 2007–2009

Partnerships for Health Reform Project and Partners for Health Reformplus
Funded By: US Agency for International Development
Project Duration: 1995–2005

Primary Health Care Operations Research Project (PRICOR) I and II
Funded By: US Agency for International Development
Project Duration: 1981–1991

Research, Information Sharing, and Facilitation
Funded By: US Department of Labor
Project Duration: 2004–2009

Water and Sanitation for Health
Funded By: US Agency for International Development
Project Duration: 1988–1994

Quality in Health (Calidad en Salud)
Funded By: US Agency for International Development
Project Duration: 1999-2009

Indonesia Management Information System Consultancy
Funded By: The World Bank
Project Duration: 1994-1996

Quality Assurance Project (QAP) I, II, and III
Funded By: US Agency for International Development
Project Duration: 1990-2008

Development of Harmonized Minimum Standards for the Prevention, Treatment and Management of Tuberculosis in the SADC Region
Funded By: Southern African Development Community
Project Duration: 2009-2010

Feasibility and Pilot Efficacy of Flash-Heated Breast Milk for Reduction of Maternal-to-Child Transmission of HIV in Tanzania
Funded By: The Thrasher Foundation and the National Institutes for Health
Project Duration: 2007-2009

Uganda: REDUCE II
Funded By: Academy for Educational Development
Project Duration: 2000-2001

Campaign for Our Children Media Initiative
Funded By: Maryland Governor’s Council on Adolescent Pregnancy
Project Duration: 1997

Occupational Analysis, Evaluation, Job Reclassification, and Career Development Consultation
Funded By: Cook County, Illinois Hospitals Governing Commission
Project Duration: 1970s

Communication Support for the National Eye Institute Information and Education Program
Funded By: US National Institutes of Health, National Eye Institute
Project Duration: 1988-1993

Evaluation of Family Planning Programs
Funded By: US Department of Health and Human Services
Project Duration: 1980-1985

Programmatic and Fiscal Audit of the Fulton County Department of Health and Wellness
Funded By: Fulton County, Georgia, Department of Health and Wellness
Project Duration: 1998

Maryland Department of Transportation Human Resources Services
Funded By: State of Maryland Department of Transportation
Project Duration: 1994-1997

Quality Assurance Evaluation of the Peace Corps Medical Support System
Funded By: The US Peace Corps Office of Medical Service
Project Duration: 1991-1995

Philadelphia Police Examination
Funded By: City of Philadelphia, PA
Project Duration: 1993-1997

Research and Development of Instructional Technology, Performance Management, and Workforce Productivity
Funded By: US Office of Personnel Management
Project Duration: 1984-1990

National Research Utilization Project
Funded By: US Department of Justice, National Institute of Justice
Project Duration: 1976-1985

Technical Assistance and Support Contract 2 (TASC2): Global Health
Funded By: United States Agency for International Development
Project Duration: 2004–2009

Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey, Phase II (HAI)
Funded By: US Centers for Disease Control and Prevention (CDC)
Project Duration: 2010-2011

Food and Technical Assistance (FANTA) II
Funded By: United States Agency for International Development
Project Duration: 2010 to 2011

Technical Assistance and Support Contract (TASC2) Tuberculosis
Funded By: United States Agency for International Development (USAID)
Project Duration: 2004–2009

TB Program Evaluation in Benin
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2011-2012