Submission ID 131604
| Issue/Objective | A persistent challenge in global health is not simply producing more data, but generating enough insight from an imperfect evidence ecosystem to inform strategic decisions that cannot wait. Funding, policy, and implementation choices are made regardless of whether the evidence base is complete, current, or fully aligned with the questions decision-makers face. In practice, leaders often must act using fragmented datasets or limited prior studies, while still being expected to justify decisions in ways that are evidence-informed and accountable. While a lot of evidence can be project level, most of the most consequential choices in global health concern broader strategic questions: which populations to prioritize, which assumptions are shaping investment logic, what barriers appear most important, and where different courses of action may be warranted. These require structured sense-making across multiple forms of evidence. This presentation uses a case study to examine how embedded evaluation can help bridge research and practice in such settings. The case involved collaboration with a major global health funder during a live multi-year strategy process. The objective is to show how an embedded evaluative partner can help convert available evidence into more useful strategic insight by testing assumptions, holding open multiple plausible options, and supporting decisions while they are still being made. The relevance to the conference theme lies in its focus on practical approaches for moving evidence into action. Rather than treating research uptake as a final dissemination step, this example presents a model in which evidence is actively interpreted within decision processes, with the supported of an embedded evaluative research team, to strengthen strategy, implementation, and accountability. |
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| Methodology/Approach | This presentation draws on a case of embedded collaboration with a major global health funder during an active family planning strategy process. One strategic question was whether women's reported intention to use contraception could serve as a stronger guide for future investment, given its apparent alignment with demand-led and non-coercive programming. To explore this, we conducted a reanalysis of recent DHS and PMA data across eight priority geographies, segmenting women by intention to use, parity, marital status, and life stage, and examining reasons for nonuse across groups. Findings were discussed iteratively with strategy and investment teams to test assumptions and consider implications for action. |
| Results | The analysis showed that focusing only on women with current intention to use contraception would miss large groups still relevant for future investment, especially pregnant or postpartum women and unmarried adolescents. It also showed that women without current intention often faced social, relational, or life-stage constraints rather than simple lack of demand. Patterns in reasons for nonuse varied across settings and pointed to barriers including side-effect concerns, partner opposition, fatalistic views, postpartum amenorrhea, and infrequent sex. Together, these findings helped shift the strategy discussion away from treating intention as a stand-alone targeting tool and toward using it as one input within a broader assessment of demand, agency, and barriers. |
| Discussion/Conclusion | This case illustrates a practical approach to bridging research and practice in real time. The embedded approach used existing data, research, and evaluation findings to test assumptions, open up strategic discussion, and strengthen the basis for action while investment decisions were still being shaped. Its value was not in producing a single definitive answer to a research question or assessment of a program, but in generating more useful insight from imperfect evidence and helping decision-makers weigh options more transparently. Although the example comes from family planning, the broader lesson is relevant across global health: when funding and policy decisions cannot wait for perfect evidence, we argue that a practice, rigorous, embedded evaluation partnership, can help government, policy, implementing and funding organizations make better use of the data and evidence available. |
| Presenters and Affiliations | Katherine Hay Center on Gender Equity and Health, University of California San Diego Katherine LaNasa Center on Gender Equity and Health, University of California San Diego Lotus McDougal Center on Gender Equity and Health, University of California San Diego |
