Evaluation components

In India, HealthRise was active in two locations. In Udaipur, HealthRise activities were led by the Catholic Health Association of India (CHAI). This program focused on screening and clinical and home-based followup, incorporating community mobilization campaigns, telephone and SMS messaging outreach efforts, and piloting patient support groups in five villages. In Shimla, the local HealthRise partner was the MAMTA Health Institute for Mother and Child (MAMTA). Interventions in this site included screening camps, developing e-clinics to provide virtual consultations, and facilitating community support groups.

In South Africa, HealthRise was active in two districts. In uMgungundlovu district of the KwaZulu-Natal Province, the HealthRise implementing partner was Expectra Health Solutions. Interventions in this location focused on building the capacity of community care givers (CCGs) through extensive trainings; screening for hypertension and diabetes through household and workplace visits and health education campaigns; and coordinating patient support and adherence groups. Project HOPE led HealthRise activities in the Emthanjeni sub-district of Pixley ka Seme, in the Northern Cape province. Key activities were promoting awareness and screening for diabetes and hypertension through the training of community health workers (CHWs); providing follow-up support targeted at diagnosed patients who failed to maintain engagement with the health system; and developing and recruiting for holistic, post-diagnosis support programs for patients.

All three HealthRise sites in the United States were in the state of Minnesota. In Rice County, HealthRise was implemented by HealthFinders Collaborative (HFC). In this site, interventions focused on integrating clinical and community-based care networks; training CHWs and community paramedics (CPs); and expanding community-based education and counseling. In Hennepin County, the local partner was Pillsbury United Communities (PUC). Key components of this program included training CHWs and providing holistic care focused on home visits. In Ramsey County, HealthRise was led by Regions Hospital Foundation. Here, the HealthRise program entailed integrating CPs and CHWs into traditional clinic-based care and utilizing an electronic medical record and documentation platform to promote care coordination.

Evaluation components

The global framework for needs assessment and monitoring and evaluation was designed to align with Medtronic Foundation’s continuum of care. The specific objectives of the needs assessments were to (i) estimate the prevalence of diseases and risk factors, (ii) identify major gaps along the continuum of care, and (iii) identify supply- and demand-side barriers that contribute to these gaps.

The monitoring and evaluation activities conducted by IHME can be broadly grouped into two categories: the process evaluation and the endline evaluation. The process evaluation, which had substantial overlap with the monitoring phase, offered insights into the various activities being executed across each of the implementation programs, and the endline evaluation measured changes in target health outcomes. Key outcome indicators for HealthRise included the number of individuals diagnosed with diabetes with their most recent blood glucose measurement below the threshold for controlled disease and the number of individuals diagnosed with hypertension with a decrease of 10% or more between their first and last blood pressure measurement.

For the endline evaluation, a mixed methods quasi-experimental approach was implemented in which both quantitative and qualitative data captured the different types of needs, barriers, and opportunities. A combination of quantitative and/or qualitative data were collected at each site, and when possible, data were collected from both intervention and comparison areas. These data were compared with data collected at