The constraints imposed by an intervention can often make designing an evaluation quite challenging. If a large-scale programme is rolled out nationally, for instance, it becomes very hard to find a credible comparison group. Many evaluators would shy away from evaluating programmes when it is hard to find a plausible counterfactual. Since it’s also harder to publish the findings of such evaluations, there don’t seem to be many incentives for evaluating such programmes.
The attempt to collect blood samples of children for a malaria treatment intervention in Kenya met with stiff opposition from the study community. There were rumours of blood stealing, covert HIV testing and suspicion about the safety of the study drugs. It may be quite easy to attribute this rumour to ignorance and superstition. But these rumours do not come out of the blue. Historical, anthropological and sociological accounts can trace the roots of such distrust and suspicion.
The word ‘evaluation’ has several different meanings in African languages. In the Yoruba language, evaluation is often associated with ‘ayewo’ which means ‘investigation’. The meaning ties in with the cultural concept of evaluation. Many African societies have ‘evaluation’ rooted in their traditions in that they undertake all kinds of ‘investigations’ before they embark on a major project – farming, marriage, travel, assessment of causes and sources of illness.