Measuring Up

by christine thetford

Do poor people in Uganda visit the doctor as often as rich people? Will a pregnant woman in Tanzania have a skilled attendant present at her delivery? How many clinics in Bangladesh are located in low-income neighborhoods?

These are some of the questions asked by researchers at the Carolina Population Center (CPC), which recently earned a $70 million, five-year award from the U.S. Agency for International Development. It is the largest social science award in Carolina's history. The award will fund the second phase of a program called MEASURE Evaluation. The goal is to boost health in more than thirty developing countries by collecting information on health-related programs and their outcomes.

"The MEASURE Evaluation project really puts UNC on the map with respect to international impact," says Barbara Entwisle, director of the CPC and professor of sociology. UNC-Chapel Hill is the lead institution in this effort, she says.

That leadership means developing new measurement approaches for health programs, such as Phase I's HIV-prevention strategy — based on high-risk places, not only high-risk populations — that is already being used around the world. Another Phase I project combined surveys with routine health information to determine the rate of maternal mortality in Guatemala. "Data on cause of death in developing countries is mostly absent," says Sian Curtis, research associate professor of maternal and child health and director of the MEASURE Evaluation program.

The scope of Phase II is wider — including studies of malaria, tuberculosis, maternal and child health, and family planning — and aims to "close the circle," Curtis says, by using the data to implement policy and program changes. For instance, clinics are offering more focused prenatal visits, including prevention of mother-to-child HIV transmission.