One of the components of the Global Fund’s evaluation strategy is a system of country reviews conducted with partner organisations. The reviews will assess (1) disease outcomes and impact; (2) the contribution of the Global Fund to these outcomes and impacts; and (3) what factors helped to bring about the changes in outcomes and impact. The last item is referred to by researchers as “causation.”

This information was contained in the Global Fund’s “Update on Results and Impact” report published on the eve of the Fund’s pre-replenishment meeting in Brussels, Belgium on 9–10 April.

The Global Fund has said that country reviews should assess both positive and negative impacts and outcomes, including risks in the portfolio and in individual countries.

Assessments of disease outcomes and impact will focus primarily on the following two questions:

1. Has there been a change in disease mortality and morbidity, or disease incidence and prevalence, positive or negative?
2. Has there been a change in outcomes and behaviours, positive or negative?

1. Has there been an increase in coverage of key intervention services, and have these reached groups at risk?
2. Has access by age, sex, equity and quality of key intervention services improved?
3. Have finances been disbursed for key services and contributors?
4. Was there sufficient quality data to detect the effect of increase in service coverage and quality on disease burden? What were sources of bias?
5. What was the Global Fund’s contribution in scale-up of resources, increased coverage of key intervention services, improvement of service quality and outcome?
6. What were the other competing explanations and hypotheses of changes in outcomes and impacts, positive and negative?
7. How can contributions of the Global Fund be improved to better influence outcomes and impact? What are the management recommendations?

The Global Fund said that initial country reviews have shown demonstrated impact on the burden of cases and deaths, as well as gaps. In some countries, the reviews have highlighted data-quality issues which will require investments in the capacity of countries to measure and analyse impact.

Information for this article was taken from the “Update on Results and Impact” report, released on 8 April. The report is available on the Global Fund website here. The report contain a partial schedule of country reviews. GFO hopes to report on the schedule in more detail in the near future.

This is one of a series of GFO articles on the documents released by the Global Fund for the pre-replenishment meeting in Brussels.