ARCHIVED - Integrated Strategy on Healthy Living and Chronic Diseases - Community Based Programming Functional Component

Recommendations

As noted throughout this evaluation report, the implementation of the ISHLCD, including CBP, has been hindered by a number of factors that often lie beyond the control of the program.  While this evaluation has found that Diabetes CBP has made promising progress in achieving some of its expected results, it has also identified a number of challenges in relation to its design and delivery approaches. What follows are recommendations for improving Diabetes CBP, including its evaluation function, and the broader ISHLCD Program and Evaluation functions:

Diabetes CBP:

• 1. Identify, assess and communicate risks to senior management associated with one-year funding agreements in community-based diabetes initiatives and within the broader context of the PHAC Gs&Cs Realignment initiative.  Through a business case, senior management should be made aware of the risks and limitations one-year funding agreements have on initiatives dedicated to improving the health and well-being of the population.
• 2. Enhance transparency and consistency in Diabetes CBP project solicitation and decision-making processes.  This should be done by ensuring the consistent application of PHAC Standard Operating Procedures for all projects.
• 3. Increase stakeholder awareness of Diabetes CBP priorities, progress, roles, responsibilities and vision.  A communication strategy should clearly outline key mechanisms and venues to communicate to stakeholders, and should also include guidelines relating to consultation with P/T governments.
• 4. Identify and communicate internal and external linkages between Diabetes CBP, KDED and the Healthy Living Program.  Through a consensus meeting, it is expected that greater integration with the Healthy Living program will be achieved, and the scope of both the Healthy Living program and KDED with regards to Diabetes CBP will be clarified, to avoid duplication and confusion within PHAC and among stakeholders.
• 5. Ensure dissemination of evaluation findings and lessons learned from funded projects.  Knowledge dissemination should be further explored to ensure information is shared with a view to improving future projects based on lessons learned.

Diabetes CBP Evaluation:

• 6. Establish a performance measurement framework and monitoring system to track activities, outputs and immediate outcomes at the program-level of the Diabetes CBP Functional Component.  The framework should include performance indicators and targets, and allow managers to track overall ISHLCD progress in achieving expected outputs and intermediate outcomes.
• 7. Improve project-level performance reporting by enhancing the diabetes-specific PERT questions.
• 8. Develop approaches and instruments to measure intermediate outcomes of Diabetes CBP to facilitate ongoing decision-making and future evaluation designs.
• 9. Strengthen the program and evaluation linkages within Diabetes CBP (between the Community-based Network and the Diabetes and Healthy Living Evaluation Working Group).  A strengthened relationship would facilitate the transfer/sharing of information between these two groups.

Overall ISHLCD Program and Evaluation:

• 10. Ensure all ISHLCD Functional Component Gs&Cs adhere to the forthcoming findings and recommendations from the PHAC Gs&Cs Realignment Initiative.  The actions taken as a result of this initiative will have a direct impact on the Gs&Cs function of the program; therefore, strong linkages should be created and maintained to ensure proper alignment.
• 11. Develop an approach and instruments to systematically assess the common immediate outcome of “engagement” which crosses all ISHLCD Functional Components.  Evaluations have struggled to define engagement and produce tools to measure it; therefore, by developing the tool for all Functional Components, engagement will be defined and assessed through a standardized process.
• 12. Establish a performance measurement framework and monitoring system for the ISHLCD as a whole to track key outputs and immediate outcomes.  A higher-level monitoring system would allow managers to see the progress of the ISHLCD through the tracking of key performance indicators vis-à-vis their targets.
• 13. Identify and communicate the Knowledge Development & Exchange (KD&E) linkages across Functional and Program Components of the ISHLCD matrix.
• 14. Identify, assess and communicate internal and external ISHLCD coordination mechanisms reflecting best practices for matrix management and an integrated approach to healthy living and chronic disease prevention and control.  This should be done by examining the operationalization of the current matrix, and studying best practices and lessons learned from other public sector organizations.  These exercises should then be communicated to the PHAC Branch Executive Committee through the presentation of a business case.