What is Triangulation?

“Short-hand term” for synthesis and integrated analysis of data from multiple sources for program decision making

A powerful tool that can be used to:• Demonstrate program impact and areas of improvement• Direct new programs and policy changes

Why Use Triangulation?Countries invest time and resources into collecting data and Strategic Information (SI):

• Patient tracking data: PMTCT & ARV program data• Surveillance data: ANC sentinel surveys, DHS+, incidence testing• Birth and deaths: Vital statistics• Research studies: Quantitative & qualitative

However:• Too much data• Information goes up but rarely comes back• Data rarely examined side-by-side• Analysis of data used for program planning and improvement, and

policy-making is often overlooked

CommunicatingResults

Triangulation Process

Planning Triangulation

Conducting Triangulation

Triangulation Part 1: Planning

Which part of the process?

What steps are involved?

Planning for Triangulation

•Identify key questions•Ensure question is answerable/ actionable

•Identify sources & gather background information•Refine research question (as needed)

Conducting Triangulation

•Gather data/reports•Observations from individual data sets•Note trends across data sets & develop hypotheses

•Check hypotheses & identify additional data to be captured•Summarize findings & draw conclusions

Communicating Triangulation

•Present results and recommendations•Outline next steps based on findings

Triangulation Part 1: Planning

Which part of the process?

What steps are involved?

Planning for Triangulation

•Identify key questions•Ensure question is answerable/ actionable

•Identify sources & gather background information•Refine research question (as needed)

Conducting Triangulation

•Gather data/reports•Observations from individual data sets•Note trends across data sets & develop hypotheses

•Check hypotheses & identify additional data to be captured•Summarize findings & draw conclusions

Communicating Triangulation

•Present results and recommendations•Outline next steps based on findings

Stakeholder Involvement

•Interest from country

•Meet with stakeholders

•Develop In-country Working Team

Question Identification

•Identify key questions of interest

•Identify data sources

•Refine research question(s)

Triangulation Part 2: Conducting

Which part of the process?

What steps are involved?

Planning for Triangulation

•Identify key questions•Ensure question is answerable/ actionable

•Identify sources & gather background information•Refine research question (as needed)

Conducting Triangulation

•Gather data/reports•Observations from individual data sets•Note trends across data sets & develop hypotheses

•Check hypotheses & identify additional data to be captured•Summarize findings & draw conclusions

Communicating Triangulation

•Present results and recommendations•Outline next steps based on findings

Data Collection

•Point person to work in-country to gather data

•Collect all data possible

Hypothesis Development

•Make observations within data sets and across data sets

•Note trends

•Develop hypotheses to answer key questions

Hypothesis Checking

•Note evidence that supports or refutes

•Identify and gather more data, as needed

•Choose promising hypotheses

Triangulation Part 3: Communicating

Which part of the process?

What steps are involved?

Planning for Triangulation

•Identify key questions•Ensure question is answerable/ actionable

•Identify sources & gather background information•Refine research question (as needed)

Conducting Triangulation

•Gather data/reports•Observations from individual data sets•Note trends across data sets & develop hypotheses

•Check hypotheses & identify additional data to be captured•Summarize findings & draw conclusions

Communicating Triangulation

•Present results and recommendations•Outline next steps based on findings

Summation of Findings

•Develop report of methods and findings

Next Steps

•Identify any existing data to fill gaps

•Identify research needed to fill gaps

Application

•Recommend policy &/or program changes

Final Question(s)

Key Questions

16 9 2

Botswana example:Narrowing Key Questions

Important Actionable

Data Available Method Appropriate Feasible

Key Questions

Triangulation at IGH: What We Do

Conduct triangulation analyses• Generate report of findings, recommendations and next steps eg:

• Botswana Case Study: http://www.who.int/entity/hiv/pub/casestudies/evaluation/en/index.html

• Malawi Analysis and Case Study (under review)

Build capacity through in-country collaboration• Joint analyses between UCSF and in-country partners

• Practicum-based training using country data and country analyses

• On-going mentoring with local collaborators to assure a transfer of skills and capacity

www.igh.org

Capacity Building ActivitiesTotal Triangulation Analysis and Training duration is four to six months

• Initial Stakeholder meeting Stakeholders introduced to methodology. Group collaboratively defines area of study

and question for triangulation analysis Task-Force of national technical representatives created to guide triangulation

• Capture of Data Twinning with local collaborating researcher for in-country data-collation work

• Analysis Joint analysis with local collaborating researchers (long distance, in-country, or in San

Francisco depending on capacity, budget, and schedule) Ongoing consultation and review by Task-Force

• Training Workshop For Task-Force members and selected technical personnel from national and provincial

offices Emphasis on practicum-based approach using own-country data. Participants

independently recreate & refine triangulation analyses

• Final Stakeholder Meeting Presentation of findings to collaborators, informed by ideas and feedback of training

workshop, jointly led by local collaborating researchers