An Experiment on Building Evaluation Capacity to Address Maternal Health Inequities in China

Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

This presentation will discuss lessons for evaluators from a project titled, “Building Health Equity in China through Evaluation Capacity Building.” This paper describes an experiment to explore if evaluation — both in the form of evaluative thinking and applications of evaluation approaches and methods — can be used as an intervention to help precipitate thinking and also lead to action about health inequities. A case study of an intervention called “Equalization of the basic public health services” from the city of Qingdao, with a focus on maternal health equity, will be the focus of the presentation.  This experiment is being conducted at both the national and provincial levels in China; it includes evaluation projects in three provinces in China. Policy makers, practitioners and evaluators from the national, provincial, and local levels are involved in this project.  The question that this Qingdao case study raises is:  Can a program of evaluation help raise the salience of maternal health equities as important criteria for judging health systems performance in a setting like China? China serves as an interesting setting for such an experiment.  The primary view of accountability of health systems is driven by notions of effectiveness and efficiency. There is a spurt of interest from Chinese policy makers and academics on evaluating the health systems reform and also the impact of such reform on health inequities. There has been a far more limited focus on inequities as a performance dimension of health systems. This is paradoxical because the health system reform efforts have been driven by aspirations of reducing health inequities between urban and rural areas. This presentation will discuss efforts in Qingdao to raise additional focus on maternal health equities as a performance dimension for the local health system.