A country assessment guide for implementing hypertension and secondary prevention programmes

This toolkit describes the main suggested steps for rolling out national WHF roadmaps.

The main steps are:

1. Epidemiological analysis including quantitative indicators. Data should be considered at local, regional and national level.

1.1 Rapid review (published and grey literature)

1.2 Data collection from secondary sources

2. Assessment of the health care system and policies including how is organized, description of common patients pathways and identification of barriers and facilitators to accessing services from the perspective of the patient, health care professional, and policy maker.

2.1 Rapid review (published and grey literature)

2.2 Data collection from secondary sources

2.3 Semi structure interviews

3. Policy dialogues with multiple stakeholders where the problem, the specific barriers and potential solutions are discussed and a bundle of appropriate strategies are selected according to the context.

3.1 Selecting the stakeholders who will participate in the policy dialogues

3.2 Prepare reading material for participants

3.3 Conduct Policy Dialogues

4. Produce a concrete plan report including recommendations of which of the potential solutions proposed are more relevant and feasible for the specific context in which they will be implemented.

   

1 EPIDEMIOLOGICAL ANALYSIS INCLUDING QUANTITATIVE INDICATORS.

The first stage consists of conducting an epidemiological analysis that will be conducted at the country level but if possible it should include regional and local level disaggregation. It should include a rapid review (published and grey literature) and data collection from secondary sources.

Table 1 Indicators to be collected

INDICATORS TO BE COLLECTED

Patients with known cardiovascular diseases

• Prevalence of cardiovascular diseases • Mortality due to cardiovascular diseases • Burden of CVD disease • Proportion of patients with known cardiovascular disease receiving at least

three priority interventions

Hypertension • Prevalence of hypertension • Mortality due to hypertension • Burden due to hypertension • Proportion of patients with hypertension awareness, treatment and control

Tobacco

• Prevalence of tobacco • Mortality due to tobacco • Burden due to tobacco

When possible the indicators should be reported for the last 10 years and with specific estimates by gender and age groups  

   

2 ASSESSMENT OF THE HEALTH CARE SYSTEM AND POLICIES This assessment will describe the functioning of the health system and policy for the specific place where the roadmap will take place and will help identify the local barriers to implementation of priority interventions suggested in the WHF roadmap.

Rapid reviews Include grey and published literature.

The search strategy should combine the terms of interest (cardiovascular disease/hypertension/raised blood pressure/smoking/) and the name of the corresponding country. The WHF would provide guidance on how to conduct this search and will also provide international published data that might contain national relevant data. For the grey literature review it is recommended to contact key personnel from Ministry of Health and other relevant governmental offices.

Secondary sources

Data collected by the Ministry of Health, insurers and public health institutes are likely to contain useful data. These sources include: Mortality data, hospital statistics, national surveys (NCDs and or/risk factors).

In some cases data on some of the indicators may be available from NGOs or particular facilities and although they may be non-representative of the respective patient group, they may still be useful in the analyses. Data can also be obtained from the WHO Statistics and other international databases.

Table 2 Health System Indicators

 

Health Systems Indicators

Information available Sources of Data

Human resources

Number of cardiologist per 1000 population Number of internal medicine specialists per 1000 population Number of General Practitioners per 1000 population Number of nurses per 1000 population Number of health graduates per 100,000 population

Physical resources

Availability of CVD interventions Secondary prevention (statins, aspirin, ACE inhibitors, beta blockers) Hypertension (diuretics, CCB) Smoking cessation services Availability and equipment in health care facilities Sphygmomanometer ECG

Intellectual Resources

Availability of evidence-based guidelines including recommendations for CG on Secondary prevention CG on Hypertension Data Information systems (How data is

recorded) Social resources

Communication between health care professionals and associations (share of information, practices, professional support) Formal organisation of patients Social support (families, neighbours, social capital) Are there any paid community health workers Are there any unpaid community health workers Outreach services?

Health Care Resources

Organization of delivery of services at primary health care level Organization of services at secondary care Coordination of services between the different levels Diagnostic, treatment, referral and complications pathways

Health Care Recipients

Patients attitude towards health care professionals Patients relationships with health care professionals Patients views on health services

Financing

% of GDP dedicated to health % of Budget devoted to CVD diseases

% of Out-of-pocket expenditure Patients transport costs and distance to facilities Patients expenditure on drugs Funding allocated for CVDs programmes Formal and informal payments for treatment Governance

Legislation describing the provision of CVD services Policy papers describing the policies on CVD treatment and prevention Action plans and strategies to implement CVD services at local, regional and national level. Linkages between level of care, between system Integration between different policies, inputs Political commitment for services Mentioned in General Policies

 

 

 

Semi-structured Interviews A total of 20-30 interviews should be conducted with patients, health care professionals and policy makers and key informants. Table 3 Participants in the Semi-structured Interviews Participants National Regional/Local level Policy Makers/Key informants

5 5

Primary Health Care Secondary care Health care professionals 5 5 Rural/Urban Female/Male Patients 5 each 5 each Totals 15 15 The questions identified in this study require the researcher to ask the interviewee about their ideas, experiences and interpretation. They required the interviewee to give detailed and thorough explanations about their health care experiences if interviewing a patient; and how the system works if we are interviewing a health care professional or policy maker. During interviews, the approach followed will be informal and broad with the aim of gathering the accounts of their perspectives and experiences. Efforts should be made to conduct the interviews in a private and comfortable space that is deemed suitable for the respondent. The interview guides included herein are intended to provide consistency and coherence in interviews. Interviewers will adapt the tools to the country. The interviews/FGDs should be recorded in writing or in audio with the permission of the interviewee. The interview will be undertaken in local language. Edited transcripts should be prepared for all interviews and FGDs. Interviewees should have the key priorities that have been identified in the road map in mind when asking the questions detailed in the topic guide annexes. This information will be fed into the policy dialogue and will help in refining the statement of the problem, the options and implementation considerations in light of health systems and implementation factors. Sample Strategy and fieldwork The interviews could use two methods to sample key informants. The first is purposive, selecting respondents on the basis of their characteristics (age, gender, rural-urban, hypertensive status (controlled, uncontrolled) and socio-economic status). Second, method consists of adopting a snowball sampling technique which involves asking interviewees to nominate other people they know who may have knowledge and experience that are particularly relevant to the study.

The selection of study sites will be discussed and decided with the country teams and will depend on the preferences and time availability at country level. If possible, the fieldwork should that place in two regions, one rural and one urban to provide a more comprehensive picture of the health system barriers. The interview locations should cover facilities/administrations involved in diagnosis, treatment, prevention and follow-up of CVD patients. In the capital city, along with centrally located PHC facilities, it is also recommended to select the PHC facilities in the suburb area. Analysis of the data The interviews will be recorded and transcribed in full. Data will be analysed thematically in two steps. The first step consists of a deductive analysis, coding units of data according to key inputs and other elements of the theoretical framework, which informed study design (e.g. inputs, funding, etc.). This is followed by an inductive analysis, seeking to elicit new themes or unexpected findings through coding and categorising, following some of the techniques of grounded theory which include looking for deviant cases and using the constant comparison method by comparing codes and categories9. The primary coding and analysis will be conducted independently by country partners to increase validity.

Table 4 Steps in the Analysis of the Data

• Preliminary analysis start after three interviews, write extended memos of emerging ideas. This process is helpful to gain an initial idea of what was contained within the data 10.

• Produce an initial coding frame and some descriptions and analysis of the identified codes.

• Conduct line by line analysis of subsequent interviews, naming each word, line and segment of data. Whenever possible, share some excerpts of data with colleagues, to discuss line by line the codes that emerge.

• Give a provisional name to each code, ask a battery of specific questions about words, phrases, sentences, and actions, carried out line by line analysis, move to dimensions that seem relevant, explore the dimensions in other cases, and compare the data in different settings 11, 12.

• The fourth step consists of a focused phase where one uses the most significant and frequent codes to organize and synthesize sets of data. Throughout the process, we compare data with data and then data with codes.

• The fifth step consists of adopting a systematic comparative approach to

identify regular features or differences across settings to identify contrasts.

• Categories are considered saturated when gathering fresh data no longer sparks new theoretical insights or revealed new properties of the core theoretical categories 12. Deviant cases are of crucial importance to ascertain saturation. There is a need to identify those cases that do not fit the models and explore them further.

• The data from patients, health care professionals and policy makers should be presented independently and then compared to identify differences and commonalities in the responses.

• The process of analysis is not linear. It involves going back and forward in trying to understand the phenomena being studied and what is happening in the data.

Ethical Considerations

As the proposed study involves collection of new data (mainly through interviews), it is necessary to check whether ethical approval from the national ethics committees is needed or whether there is existent national legislation that sets out the rules for this type of data collection method. For example, in Spain, the Organic Law 15/1999 on Protection of Personal Data (ref. BOE-A-2003-23936), regulates this type of data collection method and ethical approval is not required as long as you follow the rules of anonymity and confidentiality set in the legislation.

The respondents will be given an information sheet and asked to sign a consent form. Confidentiality will be ensured by giving each participant the option of not being quoted, even anonymously, in the study and subsequent publications; and quoting participants without reference to their age, sex, professional status and role. In the research paper, individual sub-groups will be referred to only in general terms. Participants will be given the option to refuse to answer any questions and/or withdraw from the study at any time. Efforts will be made to conduct the interviews in a private and comfortable space that is deemed suitable for the respondent. The interviewees taking part in the research will be in all cases reminded that it is entirely voluntary and withdrawal is possible at any time without having to give a reason. It is possible that some sensitivities may occur, related to barriers to effective care which may cause distress to the respondents. The research team will be trained to respond to these situations with appropriate wording, supportive statements and avoidance of excessive probing. To further protect the confidentiality of study participants, each participant will be assigned a unique Study Identification Number (SID). Interview tapes and transcripts will be available to the study researchers only and be stored in a secured file. The final outputs will not list names, organisations, institutions (government or otherwise), names of small residential areas, or any other personal details of respondents to prevent

identification. In the case of key informants, responses may reveal the organisation they work for, and the consent form will contain a separate clause of whether they agree for their organisation to be quoted (e.g. ‘representative of district health service’).

3 POLICY DIALOGUES Policy dialogues are a platform for sharing knowledge, experiences, and bringing evidence to practice. A policy dialogue is facilitated by an impartial mediator that promotes knowledge transfer under Chatham House rules. Policy dialogues should involve multiple stakeholders where the problem, the specific barriers and potential solutions of a policy are discussed and a bundle of appropriate strategies are selected according to the context. During the policy dialogue, participants are encouraged to contribute with their views and experiences and experts provide brief presentations to highlight the main evidence and policy concerns. Policy dialogues provide the opportunity for all important stakeholders in a country to discuss the policy questions and areas of concern regarding the selected policy for achieving the 25 by 25 goal. A policy dialogue report should be finally produced. The specific objectives of the policy dialogue are:

• To discuss the road map to implement priority secondary prevention cardiovascular interventions with a group of experts, policy makers, researchers, civil society groups and other relevant stakeholders.

• To discuss the findings of the health system’s appraisal and identify strengths and weaknesses of how CVD services are organized.

• To revise the roadmap in function of the findings from the health system’s appraisal.

• To discuss a number of policy options based on the results of the health systems appraisal.

• To discuss the feasibility of an implementation plan taking into account the strength, weaknesses, threats and opportunities.

• To consider policy recommendations that would improve the delivery of care for people with CVD in the country

• To discuss next steps and further actions.

Who will participate in the Policy Dialogue A policy dialogue on designing the WHF roadmaps should target a wide range of actors. In order to create an atmosphere in which lively debate is likely to take place, the number of participants in each policy dialogue will be restricted to around 20 people. These will preferably be identified after a stakeholder analysis has been conducted. A stakeholder analysis identifies the key actors, their knowledge, interests, positions, and importance related to the policy. The table below includes an example of the type of information that should be considered when conducting the analysis. Table 5 Stakeholder Analysis Matrix Stakeholders Involvement

in the issue Interest in the issue

Influence/power Position Influence of issue on actor

Ministry of Health

High Medium High Supportive High

NGO of CVD Low Low Low Supportive High

For a policy dialogue on the WHF roadmaps, there is a need to map both the stakeholders and the experts that will provide the evidence in the different sessions. 1. Mapping the stakeholders. These could include:

• Policymakers at all levels and including both political staff and civil servants. • Managers of hospitals, non-governmental organisations, and foundations • Civil society groups including consumer groups, health professional associations • The corporate sector including pharmaceutical companies, producers of medical

devices and consultancy firms working in the healthcare field. • Academics in national research institutions, universities, and from other countries

2. Mapping the experts. These could include: • Academics working in the field of CVD disease • International academics and policy makers working in the field of CVD disease • Health professionals working in CVD • Civil servants and managers working in prevention CVD programmes • Professionals and patients who suffering from a CVD

Examples of potential participants are: WHF members including Cardiovascular Society & Foundation, Nurses, Primary Care Health Workers, Government, Private Sector, Patients organizations, Regional World Health Organization.

How to conduct the policy dialogue The participants of the policy dialogue should receive at least two weeks in advance two documents one report highlighting the key issues in cardiovascular disease as elicited from the situation analysis; and the WHF roadmaps. These documents will be tabled in the policy dialogue in order to initiate reflections and pave the way, which should create the momentum and produce the concrete policy options to be translated in the implementation plan. An information pack on the organization of the event should also be provided including the agenda, list of participants and evaluation form). See Annex 8 and 9 for a draft agenda and a model evaluation form. An appropriate length is likely to be between one and one day and a half. The Policy dialogue will follow the Chatham House Rule which state "When a meeting, or part thereof, is held under the Chatham House Rule, participants are free to use the information received, but neither the identity nor the affiliation of the speaker(s), nor that of any other participant, may be revealed” (add ref). This rule allows people to speak as individuals, and to express views that may not be those of their organizations, encouraging free discussion. As a result, people feel more relaxed and open to discuss any policy issue. The following are some recommendations on how to organize the policy dialogue. These are adapted from the SURE Guides:

• The policy dialogue should encourage interactive discussions and dedicate the minimum amount of time for presentations.

• It is recommended to introduce key information from the roadmap and health system’s appraisal at several stages during the meeting and to invite comments from participants.

• Notes should be kept during the dialogue. Consent should be sought to audio record the dialogue, if this has been agreed by the organizers.

• A neutral facilitator with knowledge on CVD care and prevention is needed to ensure that time is used effectively and that the policy dialogue is well run. They will need the experience and skills to:

• Keep the discussions focused • Make participants feel at ease so they feel comfortable to share their

views • Ensure that all participants contribute • Interpret contributions from participants • Constructively challenge participants to elicit further information • Have a good sense and know when participants have to intervene • Assure neutrality to ensure that participants feel that they can share any

views that they hold and don’t fear that a viewpoint needs to be supported.

4 PRODUCE A CONCRETE PLAN REPORT

Once the policy dialogue has finalized the WHF team together with the country research teams will decide on the strategy to follow.

The overall aim is to produce a concrete plan report including recommendations of which of the potential solutions proposed are more relevant and feasible for the specific context in which they will be implemented.

This will be guided by the discussions that emerged in the policy dialogue and depending on at what stage the different policies on CVD disease are in the country, and what interest exists in implementing the road map on secondary prevention of cardiovascular disease.

After the dialogue has been conducted these are the recommended steps:

• Inform participants that a policy dialogue report will be produced with opinions presented without attribution. Set clear deadlines and inform participants that a certain date they will be asked to provide feedback on the content of the report.

• Discuss whether a list of participants can we included at the end of the report. Request participants whether they wish to be named as participants in the policy dialogue.

• Prepare the draft report. Produce a summary of the discussions that emerged during the policy dialogue.

• Circulate draft report to participants and revised taking into account participants’ corrections.

• Disseminate the report. Agree on a common strategy among the participants of the policy dialogue as to how they think the report should be disseminated.

• Disseminate the health system’s appraisal and arrange other dissemination activities

• Follow-up on any next steps that are identified. Prepare a strategy for follow up and agree with the participants of the policy dialogue on what is their preferred approach.

• Disseminate the next steps among participants and suggest that participants take on different roles to take forward the findings from the policy dialogue.

• Evaluate the policy dialogue. Distribute and evaluation form among participants to ask them about the things that worked well, the things that did not work that well, and the areas that need improving.

 

5 ANNEXES

Annex 1: Structure of the health system’s assessment report  

Executive Summary

1. Introduction

1.1 Background

1.2 Adapting the roadmap at the regional and national level

1.3 Objectives

1,4 Methods

2. Epidemiological Analysis and Literature Review findings

3. Health System Analysis

3.1 Human resources

3.2 Physical resources

3.3 Intellectual resources

3.4 Social resources

3.5 Health Care Delivery

3.6 Financing

3.7 Governance

3.8 Processes and Mechanisms

4. Barriers and Facilitators to providing CVD services

5. Recommendations

6. Conclusions

Annex 2: Topic guides

2.1 TOPIC GUIDE FOR POLICY MAKERS AND KEY INFORMANTS  

INTRODUCTION • Are you involved in any work that has relevance to CVD secondary prevention? [direct or

indirect: e.g. providing support to poor people to get medication] • Could you talk about the level of CVD and its complications in (selected country)? [morbidity,

mortality, who is affected, common and severe complications] • To what extent is CVD a health priority in (selected country)? Should it be of a higher priority? PREVENTION • What are your views on the way prevention of CVD works in (selected countries)? • Can you describe how primary and secondary CVD prevention programmes work in your

country? • What are the obstacles and facilitating factors?

TREATMENT • Who is involved in responding to CVD • Could you assess the existing physical infrastructure, human resources and capacity in CVD

care and prevention • How do patients get diagnosed usually? • What are the positive and negative aspects of this process? • Could you now tell us how do patients move through the system, once diagnosed? What are

the positive and negative aspects? • What are the most common risk factors for CVD? Are there any groups that are more at risk,

and why? • What are the requirements for effective management of CVD?

FINANCE • How is CVD care and prevention financed? • What are the costs for patients? • How are the methods of procurement and distribution of CVD drugs organised in your

country? How are these financed? • Are there shortages or other problems with this process? • What is the awareness among the population, CVD suffers and health staff regarding CVD • What information there is on CVD treatment and prevention?

-­‐ Currently what could be done – in short and longer term to improve the situation?

 

2.2 TOPIC GUIDE FOR INTERVIEWS WITH HEALTH CARE PROFESSIONALS Management and Prevention of CVD • What institutions or health care professionals are involved in management of CVDs and its

complications? • In your institution are there any activities regarding CVD • What are the usual tests, and where are these analysed • How effective is primary or/and prevention as a strategy to control CVD • How effective is secondary prevention as a strategy to control CVD? (discuss strategies:

population-based approaches, targeting high-risk groups) • How is prevention organised in your country [is it systematic, on campaign-based or ad hoc]?

Pathways to care • Usually how are CVDs diagnosed? • Are there delays in diagnosis CVD and its complications? • How could early detection of CVDs be facilitated?

Treatment • Once patients are diagnosed, describe what happens? • Do people face any barriers in treatment for CVDs or complications? • Is the treatment and referrals to other facilities effectively organised, does it involve

unnecessary delays? Risk factors assessment • What are the most common risk factors for CVD? • Are there any groups that are more at risk? [problems with access to appropriate care, socio-

economic, geographic characteristics…] • How do you decide when and to whom to offer testing, or treatment for complications? [e.g.

based on clinical symptoms, or patient characteristics, other…] Effective management of CVD • Could CVDs be managed effectively nowadays? • To what extent health care professional working in primary care, or in specialized facilities are

aware how to manage complications? Funding • How are CVDs financed? • How are pharmaceuticals financed in your country? • Are there shortages in drugs and consumables? Communication • To what extent there is an awareness among the population regarding the risk factors for

CVDs? • Once diagnosed, are people with CVDs sufficiently educated regarding its treatment and the

lifestyle changes required? Information • Is there a national CVD registry? • In the past decade are there any changes in terms of financing and provision of care for CVD

and its complications? • Are there changes that need to be done outside the health care system? • Is there a national strategy for CVD or non-communicable diseases in general? • Are there any formal guidelines or protocols on how to prevent and manage CVD?

2.3 TOPIC GUIDE FOR PATIENTS

Table 2 Interview Guide with patients using the example of Hypertension

KNOWLEDGE AND DIAGNOSIS • Can you tell us about your first symptoms of Hypertension? Do you have other health problems? • How did you decide to seek care? Did the family help in this process? • Can we talk about your experience of this process? • To what extent do you think HT is an important disease? • How much did you know about HT before your diagnosis? What were your information sources,

at the time and now? TREATMENT • What was the treatment that was first prescribed? Was it subsequently changed – in what way? • Did you have to pay anything out-of-pocket? • If any, what difficulties did you face during this process? [related to the health system, family,

work etc.] • Have you received any advice on preventive measures? • What in the process of treatment could have been handled better? ACCESS AND USE • Are there shortages of drugs and consumables? Or access problems to facilities? Discuss

problems. • Can you explain to us what type of health insurance you have and what it covers? • Have you got a particular doctor or health professional who is mainly looking after you and who

knows you well? HEALTH CARE EXPERIENCE AND RECCOMENDATIONS • How would you assess your communication with health providers you have encountered? • To what extent have you been kept informed about you treatment? • Have you heard of any initiative to improve prevention of HT? • From your experience what could be done to make life of people suffering from HT easier? [in

prevention, in diagnosis, in treatment] • Are there any changes that need to be made outside the health care system?  

 

ANNEX 3: INFORMATION SHEET  

A team of researchers (add institution) under the coordination of the World Heart Federation is conducting a research on assessing the barriers and facilitators to CVD prevention and treatment. The objectives of the research are:

More specifically, the study aims to:

1. Describe existent policies for CVD and hypertension both on prevention and treatment

2. Describe the system for CVD and HT diagnosis, treatment and control in the country and assess linkages between primary health care and curative activities

3. Describe how patients with CVD and HT seek and obtain health care and how follow-up and secondary prevention of cardio-vascular disease (CVD) is provided.

4. Identify barriers experienced by both patients and health professionals involved in CVD and HT treatment and prevention, with implications for adherence, and how they seek to overcome them.

5. Assess how well CVD care and prevention is integrated within the health system.

6. Describe barriers and facilitators to the provision of CVD and HT services at the micro, meso and macro level.

My name is (name of researcher) and I am (Position). I am approaching you today to invite you to take part this study which aims to understand your scope of practice and skills and experience. At the end of the interview we will ask you a few general questions following a questionnaire format.

Taking part in the research is entirely voluntary and withdrawal is possible at any time without having to give a reason. The interview will last approximately 30 minutes. Questions will be entirely focused on your experiences and may cause some minimal discomfort when reflecting on challenging professional moments. If at any point you feel uncomfortable and would like to stop you may withdraw from the interview and study without giving a reason.

I, (name of researcher) will be responsible for maintaining confidentiality of interview materials.

All transcripts of the interviews will be stored in password-secured files. These might be quoted

in scientific publications or a country report with no reference to your name, age, gender or

profession, in order to ensure confidentiality. However, you have the option of not being quoted

anonymously. Along with this information sheet, you will be provided with a separate form giving

consent to your participation in the interview.

The Ethics Committee of the particular country has approved the study.

My contact details are written below. You can contact me at any point with any questions or comments. (Add address and email of interviewee)

ANNEXE 4: CONSENT FORM

Multi-method health system appraisal of CVD secondary prevention interventions: Consent form for respondents  

For the Participant:

• I have read the information sheet concerning this study [or have understood the verbal

explanation] and I understand what will be required of me and what will happen to me if I

take part in it.

• My questions concerning this study have been answered.

• I understand that at any time I may withdraw from this study without giving a reason.

PLEASE CROSS OUT AS APPROPRIATE

I AGREE TO BE INTERVIEWED yes / no

I AGREE TO THE INTERVIEW BEING RECORDED yes/no

I AGREE TO BE QUOTED ANONYMOUSLY IN ANY PUBLICATIONS ARISING FROM THIS STUDY yes/no

Signature Date

 

ANNEX 5: POLICY DIALOGUE REPORT OUTLINE  

Executive Summary

I. Background II. The Problem

III. Policy options

Policy Option 1

Policy Option 2

Policy Option 3

Policy Option 4

IV. Implementation considerations

V. Annexes

Agenda

List of participants

ANNEXE 6 DRAFT AGENDA OF THE POLICY DIALOGUE

Agenda Policy Dialogue on Secondary Prevention of Cardiovascular Disease

8:30-9:00 Registration

9:00-9:15 Remarks /Introduction of participants & moderator

9:15-9:25 Procedures and Rules of the Dialogue (Moderator)

9:25-10:25 Problem Section (Discussion)

10:25-11:00 Coffee Break

11:00-13:00 Policy Options Sections (Discussion)

13:00-14:00 Lunch Break

14:00-15:30 Consider the broader health system and political context

15:30-17:00 Refine the statement of the problem, options and implementation considerations in light of health systems and implementation factors.

17:00-18:00 Make national policy recommendations or decisions and decide on

next steps

18:00-18:15 Closing Remarks

18:15 Reception

ANNEX 7 MODEL OF A POLICY DIALOGUE EVALUATION FORM  

Example Questions (WHO 2011)  

 

1) What is your overall assessment of the policy dialogue? (1 = insufficient - 5 = excellent)

1 2 3 4 5

2) Which topics or aspects of the workshop did you find most interesting or useful?

 

•

•

•

•

3) Did the workshop achieve the programme objectives?

Yes No

If no, why?

 

4) Knowledge and information gained from participation at this event?

 

Met your expectations Yes No Somehow

Will be useful/applicable in my work Definitely Mostly Somehow Not at all

5) How do you think the policy dialogue could have been made more effective?

 

 

6) Please comment on the organization of the event (from 1 = insufficient to 5= excellent)

1 2 3 4 5

7) Comments and suggestions (including activities or initiatives you think would be useful, for the future)

 

 

Further comments or suggestions

 

 

 

 

 

THANK YOU!