NORC at the University of Chicago, the Instituto Nacional de Salúd Pública (INSP) of Mexico, and the Institute of Business and Economic Research at the University of California at Berkeley, designed and are implementing a rigorous impact evaluation for the Millennium Challenge Corporation, on four activities under the Millenium Challenge Account (MCA) Lesotho Program.
NORC is working with the Ministry of Health and Social Welfare (MoHSW) to carry out the evaluation of the Renovation Efforts for Health Clinics and the Hospital Outpatient Departments (OPDs) projects that distribute Anti-Retroviral Therapy (ART).
The water sector project includes improvements in rural water supply, sanitation, and hygiene awareness, an effort spearheaded by the Department of Rural Water Supply (DRWS); and improvements in the urban water/peri-urban water network and supply, implemented by the Water and Sewage Authority (WASA). NORC’s evaluations seek to detect causal effects through experimental design for the health centers and rural water activities, where the models for evaluations include stepped-wedge and double differences under a randomized cluster design.
For the other two components – OPDs and Urban Water Supply - where randomization was not possible, it will be a dose-response model. For this evaluation, NORC is working closely with the Lesotho Bureau of Statistics (BOS) to conduct a large-scale household survey (the Impact Evaluation Mulitpurpose Survey) designed to gather data for all components of the evaluation in both treatment and control sites. NORC is also overseeing the conduct of three health facility-level data collection activities: a patient Exit Survey, a Staff Satisfaction Survey, and a review of administrative records at health facilities. We will also use other secondary data sources such as the Demographic Health Surveys and the BOS Continuous Multipurpose Survey in the final analysis.