March 2001 Insights Health Issue #1

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Quick decision? Fast-track data for health policy

The prevalence of NCDs is rising rapidly in low and middle income countries. Health systems are already overburdened and the challenge of planning NCD health services in this environment is great. What tools are available to health planners to guide the effective use of resources?

Rapid Evaluation Methods could help policy-makers and planners assess current health systems and identify areas for change. Similar methods (under a variety of names) have been used to evaluate services for drug abuse, HIV/AIDS, TB, and maternal and child health. They are not designed for research but enable the rapid collection of health service data.

Researchers at the Universities of Newcastle Upon Tyne (UK), Yaoundé (Cameroon) and Muhimibili (Tanzania) and the Ministry of Health of Mauritius have developed and tested methods for assessing the level and quality of NCD treatment. They have focused on diabetes, high blood pressure, asthma and epilepsy. The table summarises the different approaches used.

The methods are designed to assess five areas:

1. national and regional NCD service provision and treatment policy
2. current clinical practice and quality of care
3. patients' experience of the service
4. knowledge and attitudes of staff and patients about NCDs
5. adequacy of facilities, equipment and drug supply.

The researchers found that:

• With a dedicated team of three to six data collectors, a useful rapid assessment can be completed within two to four weeks for a population of up to 100,000 or so.

• A report can be produced for health policy-makers and planners, forming the basis for the development of interventions.

• Successful evaluations require careful planning and close collaboration and full co-operation with local health authorities.

The team are currently preparing a guide, complete with data collection tools, on the use of these methods for assessing NCD care.

Nigel Unwin and Terry Aspray
University of Newcastle
Departments of Diabetes and Epidemiology & Public Health
Medical School
Newcastle
NE2 4HH
UK
T: +44 (0)191 222 5407
F: +44 (0)191 222 0723
N.C.Unwin@newcastle.ac.uk

See also:
Rapid assessment procedures: qualitative methodologies for planning and evaluation of health related programmes, INFDC, Boston, by N. Scrimshaw and S. Scrimshaw (1992)
The rapid assessment and response guide on injecting drug use, WHO Programme on Substance Abuse, Geneva, edited by G. Stimson, C. Fitch and T. Rhodes (1998)
Assessing the quality of service, Aga Khan Foundation USA, Washington DC, in Primary health care management advancement programme 6, edited by J. Sharples (1993)
Rapid evaluation method guidelines for maternal and child health, Family planning and other health services, WHO, Geneva (1993)