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Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in conditions in different jurisdictions present very substantial challenges to reformers, and militate against adopting one-size-fits-all policy solutions. As a consequence, approaches to change management in China have frequently emphasised the importance of sub-national experimentation,...
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There is a growing recognition that programs that seek to change people’s lives are intervening in complex systems, which puts a particular set of requirements on program monitoring and evaluation. Developing complexity-aware program monitoring and evaluation systems within existing organizations is difficult because they challenge traditional orthodoxy. Little has been written about the practical experience of doing so. This article describes the development of a complexity-aware evaluation...
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Realist evaluation provides valuable insights into how and why programmes lead to change, and can generate transferable lessons to help practitioners roll out or scale up an intervention. However, as ...
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• Realist evaluation is a member of a family of theory-based evaluation approaches which begin by clarifying the ‘programme theory’: the mechanisms that are likely to operate, the contexts in which they might operate and the outcomes that will be observed if they operate as expected. • Realist approaches assume that nothing works everywhere for everyone: context makes a big difference to programme outcomes. A realist evaluation asks not ‘what works?’ but ‘how or why does this work, for...
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MEL4 Adaptive Management
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