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In 2014 the authors of this paper, evaluators from China and Canada, jointly interviewed 12 policymakers in China at the national and provincial levels. This paper describes the needs of policymakers and how they view the evaluation capacity-building needs of the health system. The learnings from the policymaker dialogues informed the evaluation capacity-building efforts at three pilot sites in China. This paper focuses on the evaluation capacities needed by policymakers and implementers specifically to address inequities in the health sector, unlike most publications that focus on evaluation capacities of researchers. [ABSTRACT FROM AUTHOR]

This paper describes an evaluation experiment conducted in China between 2013 and 2016 to use evaluative thinking and evaluation approaches to help build the salience of health equity as a performance measure for health systems. This project was informed by a realist evaluation approach that sought to understand the context, mechanisms, and outcomes underlying health inequities. This chapter describes a theory of change that includes descriptions of the key actors involved in the project, the mechanisms of impact, and short- and long-term outcomes. Key questions that could help assess the impact of this project are also discussed. This paper contributes to the literature on building evaluation capacity for health inequities. [ABSTRACT FROM AUTHOR]

This paper discusses the development and implementation of structured guidelines that contained a fixed set of questions as part of a project in building evaluation capacity for addressing health inequities in the health sector in China. The ambition of the guidelines was to test whether a structured process of questions could aid teams that did not have a strong background in evaluation to complete equity-focused evaluations and also help raise the salience of health equity as an important goal of health systems reform among the participants of the project. The guidelines were informed by multiple perspectives that included the literature on social determinants of health, realist evaluation, and utilization/influence perspectives. One noteworthy aspect of this project was that the participants in this capacity-building project were local and national policymakers, practitioners, and university researchers. Our original goal was to test these guidelines in equity-focused policy interventions in three separate provinces of China. One key insight from this project was that there is a need to move away from a testing perspective to a developmental approach in formulating evaluation guidelines that can work across multiple organizational and country contexts and also closely reflect the needs of practitioners and policymakers in evaluation capacity-building efforts. [ABSTRACT FROM AUTHOR]

This paper raises questions about the impacts of one of India's most ambitious cash conditional transfer programs, Janani Suraksha Yojana. It incorporates the perspectives of a practitioner working on maternal health issues and discusses the importance of considering alternative explanations as part of any patterns of observed results. It argues for exploring the impacts of interventions on the most vulnerable and marginalized as an essential aspect of an equity evaluation and for exploring impacts on inequities from a human rights lens. It also discusses some of the core competencies that might be needed for evaluations of equity initiatives. [ABSTRACT FROM AUTHOR]

China's New Cooperative Medical Scheme (NCMS), established in 2003, is a universal health care insurance program for rural residents aimed to improve access to basic health care services and reduce financial risks of catastrophic illnesses in the rural population. It is a cornerstone of China's most recent health care reform efforts. The purpose of this paper is to share insights and learnings from two evaluations of NCMS payment reform. The evaluations were conducted by local researchers and evaluators who were deeply involved in the design and implementation of NCMS in their own region and have gone through a process of reflection of their own work to bring learnings to the broader health systems and evaluation communities in China. [ABSTRACT FROM AUTHOR]

In 2009 the national government of China launched massive health reforms, together with other social and economic reforms. For the first time, evaluation was included in the draft national plan of health reforms and development-the so-called '12th Five-Year National Plan for Health Development (2011-2015).' The Chinese and Canadian researchers, with the support of the International Development Research Centre, Canada, helped to facilitate a deliberative process by various actors by conceptualizing an indicators system and mapping out key questions to be addressed by evaluating implementation of the national health plan. The conceptual indicators system serves as a platform for users and implementers of evaluation program to understand needs for evaluation better and sharpen focus on more prominent dimensions such as equity and contextual analysis. [ABSTRACT FROM AUTHOR]

To reduce health inequities, Chile´s Ministry of Health embarked on an ambitious process to implement policy redesign involving six public health programs that used a system-level theory of change. The process brought together a large and diverse group of national and local actors from within and outside the health sector organized in a network of program nodes, who worked together on well-defined tasks over the course of a year with high-level political and technical support. The tasks were part of a coconstructed stepwise assessment methodology, based on understanding and testing program theory and uncovering theories of inequities, drawing on realistic evaluation approaches, the social determinants of health framework, and models of effective program coverage. Almost simultaneously, the program nodes proposed new program theories to address equities with an implementation strategy, which necessarily engaged other sectors and community actors. This chapter highlights some of the lessons to explain the success of Chile´s redesign process: (a) the diversity of knowledge and experiences across nodes enriched and enabled system-level change, (b) the key distinction between theory of change and theory of inequities required to address inequities, and (c) the long-lasting transformative capital for institutional change of training a network of agents for change. [ABSTRACT FROM AUTHOR]

The issue of equity is receiving increasing attention not only in health but in other areas of social development. It is often a highly charged and emotional conversation. This chapter argues that with better capacity to evaluate for equity, evaluators can make a significant contribution to clarifying the issues in the debate and, through that, to addressing inequities. Evidence is never the only element in a debate-politics and emotion always play important roles-but the absence of solid evidence fosters even stronger polarization of the debate. This chapter addresses a gap in our capacity to evaluate for equity so that evidence can make a central contribution to this debate. Building on the challenges to measurement in the equity space, the chapter identifies the process and systems thinking skills that are needed to complement our evaluation methods skills. [ABSTRACT FROM AUTHOR]

This chapter describes conditions and strategies that played a role in affecting actions taken by the Florida legislature and the South Carolina General Assembly in their respective Medicaid programs. [ABSTRACT FROM AUTHOR]