Rethinking an integrated approach to health outcomes measurement: Lessons from the evaluation of a program focused on highly mobile populations and vulnerable children in the Dominican Republic

Abstract Information: Outcomes of programs focused on at-risk and vulnerable mobile populations are challenging to measure. Participants frequently drop out or are lost to follow up, thus complicating outcomes measurement that tracks progress beginning at baseline. This presentation will focus on an approach taken by Pact in the Dominican Republic to measure the outcomes of program participants that drop out and then re-register. The program provides health, education, protection, and economic strengthening services using a family centered case management approach. Haitian migrants and their descendants in the DR are disproportionately affected by HIV. Yet, lack of legal documentation status limits their access to health and social services, complicating program implementation and measurement especially given the mobile nature of the population. Using a participatory approach working with community case workers, Pact developed the Comprehensive Outcomes Assessment Tool (COAT) in collaboration with DR organizations, the funder USAID, and representatives of the target population. The tool covers an initial assessment, HIV risk screening, a service needs assessment, and tracking of service outcomes all the way to “graduation” of families from program support. Understanding the highly mobile nature of the population, the tool allows for re-registration of returning/lost to follow-up clients and graduated families that regress back to vulnerable levels. Participants will learn about how the tool was developed, administered, and used to measure outcomes. Speakers will share lessons learned, including how designing such a case management outcome measurement tool required facilitating partnerships with the public and private sectors for services delivery.