Research and Evaluation

The USAID ASSIST Project supports country-led research and synthesizes learning across country programs on topics such as the validity of improvement-related data, sustainability and institutionalization, scale-up, and cost-effectiveness of improvement activities. The ASSIST Research and Evaluation unit provides technical support to these efforts and works to disseminate knowledge from these studies to encourage wider adoption of improvement methods.

Data truth and truthiness

Edward Broughton

Director, Research and Evaluation, USAID ASSIST Project/URC

Proudly toxic

Edward Broughton

Director, Research and Evaluation, USAID ASSIST Project/URC

In January, the Institute of Medicine’s “Committee to Support USAID’s Engagement in Health Systems Strengthening” convened an open meeting to discuss methods for improving health care in low- and middle-income countries supported by USAID. I was asked to address the issue of cost-effectiveness analysis (CEA) in improvement.  My basic message was that it’s not easy but that’s no excuse not to try do CEAs as best we can.

How do we learn about improvement?

Danika Barry

Healthcare Improvement Fellow, USAID ASSIST Project/URC

M. Rashad Massoud

Director, USAID ASSIST Project/URC

Commentary on the Quality & Performance Institute's Technical Meeting held on December 17, 2014. A full transcript is available here.

For our December Quality & Performance Institute Technical Meeting, we invited Dr. Frank Davidoff and other thought leaders in the field of improvement science to comment on the issues raised in Davidoff’s recent article, “Improvement interventions are social treatments, not pills.”

A la recherche des patients « perdus de vue » en Côte d’Ivoire

Astou Coly

Senior Improvement Advisor, USAID ASSIST Project/URC

Les patients séropositifs qui ratent trois visites médicales successives sont désignés comme « perdus de vue » par leur centre de prise en charge. Cependant, souvent, le devenir de ses patients est inconnu.  Ces patients sont-ils décédés ? Reçoivent-ils des soins ailleurs ? Ou ont-ils tout simplement interrompu leur traitement?

Improving data visualization: Where do I put all those annotations?

Simon Hiltebeitel

Improvement Advisor, USAID ASSIST Project/URC

One of critical questions any improver hopes to be asked when presenting data is, “wow, those are really impressive results! How on earth did you achieve them?” The complete answer might be a long story, but often a few key parts of that story can be presented as time-series chart annotations.

Annotations are simply text that indicate a point on a time-series chart when a key event occurred. These key events help us understand the movement—up or down—in time-series data. Simple. What could possibly be complicated about that?

Sex and gender: how data disaggregation is central to improvement

Elizabeth Romanoff Silva


What is the best way to integrate gender effectively into an improvement program? Taking gender considerations into account in the program design, monitoring and evaluation aspects of a program is critical to integrating gender.

Improving data visualization: No more excel data tables!

Simon Hiltebeitel

Improvement Advisor, USAID ASSIST Project/URC

Excel data tables are awful. Still, we often use them when presenting time-series charts because they are a convenient way to display the denominator for percentage or rate indicators. Why do we need the denominator? Two reasons. First, the denominator communicates the scale either of the intervention or the sample. Second, variation in the denominator might explain some of the variation seen in the displayed indicator.

Freudian Slip

Edward Broughton

Director, Research and Evaluation, USAID ASSIST Project/URC

What do Sigmund Freud and some in the field of improvement have in common? No, this is not the beginning of a Woody Allen joke and I hope the answer is a simple “nothing”. But sometimes when I hear those immersed in improvement say that our work is too complex and nuanced for randomized trials or other rigorous research methodologies, it reminds me of the famous cigar-smoking psychoanalyst.