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How to Evaluate an Integrated Health Program Despite Strikes, Elections, and Delays


Sometimes reality gets in the way. But you can still get results.


“The best laid plans of mice and men often go astray.”

An 18th century poet like Robert Burns could scarcely have imagined something akin to the model that ideas42 and our partners at IntraHealth International designed to integrate family planning services with immunization days at health posts in Senegal, but he couldn’t have offered a better characterization of the challenges we faced implementing this intervention.

Our best laid plans

The months following childbirth are a critical time for women to adopt a family planning method and space out the births of their children, which has been shown to have long-term impacts on the health of both the mother and her children.

We know that over 90% of postpartum women in Senegal come to health facilities to access immunization services for their newborns. We also know that more than three in five Senegalese women have an unmet need for family planning.

We should keep ourselves open to pragmatic alternatives.

This gap in health services during the pivotal postpartum window—when health workers could be offering family planning to women when they are visiting the health facilities anyway and about to be fertile again—presented a key opportunity for ideas42 and IntraHealth to design a program called Innovation Comportementale dans l’Integration (ICI), which integrates immunization services with family planning services.

Read the full post now at ideas42: Of Mice and Mountains: The Case for a Pragmatic Evaluation