Evaluation, Effectiveness, and Efficiency in Complex Humanitarian Emergencies: The U.S. Centers for Disease Control and Prevention's WASH Activities in Post-Earthquake Haiti Pubblico

Abstract

Background: Evaluation in emergencies, disaster relief, and reconstruction is
often inadequate or incomplete. Although numerous actors, including UN agencies,
non-governmental organizations (NGOs), and governmental agencies (GOs), provide
aid, these efforts are often duplicative or insufficient for the needs of the affected
populations. Further evaluation of these humanitarian responses is needed to
improve program effectiveness.

Objectives: This study aims to assess the response and evaluation of the U.S.
Centers for Disease Control and Prevention's (CDC) water, sanitation, and hygiene
(WASH) response in post-earthquake Haiti.

Methods: To examine CDC's evaluation design, this paper uses a case study
approach of the agency's work in post-earthquake Haiti. To inform the analysis, a
total of six in-depth interviews were conducted, five within the CDC and one with an
external consultant involved in Haiti post-earthquake operations. All those
interviewed took part in the Haiti response, evaluation, or with post-disaster
activities at CDC. Secondary data was collected from evaluation reports, strategic
plans, policy documents, and government reports.

Results: In Haiti, a weak health infrastructure and competing programs created
particular barriers for CDC's evaluation design capabilities. In the health systems
reconstruction phase of its response, the agency is currently measuring its impact
via a comprehensive strategic evaluation plan. This plan includes objectives,
strategies, and indicators to evaluate the agency's work to improve the water
infrastructure and reduce the threat of cholera in Haiti.

Discussion: The CDC has made significant progress to strategically evaluate its
activities in Haiti. However, due to competing programs and a lack of
comprehensive international standards for emergency relief and reconstruction, the
agency continues to face challenges in determining its evaluation criteria.
Recommendations for strengthening the evaluation of CDC's WASH work include
further defining the indicators, strategies, and objectives in the plan.
Recommendations will be shared with CDC's Haiti Systems Reconstruction Office
(HSRO) to assist them in their efforts to improve Haiti's WASH system.

Table of Contents

INTRODUCTION... 1
COMPREHENSIVE REVIEW OF THE LITERATURE...7

EVALUATION THEORIES AND PRACTICE...8
THE RISE OF HUMANITARIAN AID EVALUATION...20
HAITI, A CASE STUDY IN EMERGENCY RESPONSE AND RECONSTRUCTION... 34
METHODS... 50
RESULTS... 55
RECOMMENDATIONS...77
CONCLUSION... 90
REFERENCES... 94
APPENDICES... 99
APPENDIX A: LIST OF KEY INFORMANTS BY POSITION AND ORGANIZATION... 99
APPENDIX B: KEY INFORMANT INTERVIEW GUIDES... 100

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	WASH interventions Evaluation Haiti
Committee Chair / Thesis Advisor	Di Meo, Nicholas, CDC
Committee Members	Stein, Aryeh D, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs CDC

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