Evaluation of Malawi's Emergency Human Resources Programme

Management Sciences for Health
Overall Approach
The MSH/MSC team developed a comprehensive evaluation framework to address each
research theme (Annex C) as follows.
For Part I, Evaluation of EHRP Implementation, a set of research questions was developed
for each element, and detailed methodologies for collecting both quantitative and
qualitative data were developed. Primary sources were used to calculate costs and gauge
the extent to which each element achieved its purpose. This data was supplemented by
qualitative information in the form of focus group discussions and key informant
interviews. Additionally, a Human Resource Management (HRM) Study, previously
carried out in Ethiopia, Uganda, Kenya and Tanzania in partnership with AMREF, was
replicated in Malawi to determine the extent to which Element 4 (Building HRM Capacity
through technical assistance) achieved its purpose. 25
For Part II; Cost, Sustainability, Impact and Cost Effectiveness; the impact of the EHRP
as a whole was assessed using Health Management Information System (HMIS) data to
determine changing levels of utilisation of health services. The total costs of the EHRP
were summarised, and an analysis of indirect costs was conducted, such as changing levels
of the MOH’s contribution to total health expenditure. The feasibility of conducting a
cost-effectiveness analysis was also assessed.
In Part III, Recommendations, the MSH/MSC team conducted an analysis of the EHRP
using the Human Resources for Health Action Framework 26 as a guide. The previous data
and analysis from Parts I and II were incorporated into this analysis. In addition, input
from health and education managers at all levels, and key informant interviews with
decision makers informed the recommendations. Throughout the process, the MSH/MSC
team reviewed the literature and many reports from other commentators and reviewers of
the EHRP.
Figure 1 on the following page presents a visual framework of the research approach.
25 MSH/AMREF: “Competency Gaps in Human Resource Management in the Health Sector, An
Exploratory Study of Ethiopia, Kenya, Tanzania, and Uganda”, Final Report, Management Sciences for
Health, July, 2009
26 Human Resources for Health Action Framework, Global Health Workforce Alliance
EHRP Evaluation Final Report Page 14