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Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020
Thesis (DPhil)--Stellenbosch University, 2025.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2026
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| _version_ | 1867613927085441024 |
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| access_status_str | Open Access |
| author | Ngwabi, Nozipho Theodorah |
| author2 | Wildschut, Lauren |
| author_browse | Ngwabi, Nozipho Theodorah Wildschut, Lauren |
| author_facet | Wildschut, Lauren Ngwabi, Nozipho Theodorah |
| author_sort | Ngwabi, Nozipho Theodorah |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (DPhil)--Stellenbosch University, 2025. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/135159 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:54.909Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/135159 Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 Ngwabi, Nozipho Theodorah Wildschut, Lauren Stellenbosch University. Faculty of Arts and Social Sciences. Centre For Research on Evaluation Science and Technology. Public health -- Africa, Sub-Saharan -- Evaluation Health planning -- Africa, Sub-Saharan -- Evaluation Health services accessibility -- Africa, Sub-Saharan -- Evaluation Evidence-based medicine -- Africa, Sub-Saharan -- Evaluation UCTD Thesis (DPhil)--Stellenbosch University, 2025. Ngwabi, N. T. 2025. Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/7a117e93-5b21-499d-90ec-28ecfb1464e0 ENGLISH ABSTRACT: Health evaluation has become an increasingly important instrument for improving health outcomes and accountability in sub-Saharan Africa. The growing demand for such evaluations has been shaped by increased investment in the health sector, the persistent burden of disease, and heightened expectations for evidence-informed policy and programme decision-making. While the field has expanded significantly across the region, there remains a limited understanding of the scope, characteristics, and evolution of evaluation practice. The current study aimed to explore the main trends and patterns in health evaluation studies in sub-Saharan Africa from 2000 to 2020. A mixed-methods research design was employed, combining documentary analysis of 404 health evaluation reports from AfrED, bibliometric analysis of 450 journal articles, and web-based surveys administered to health evaluators and journal authors. The study found that health evaluation reports predominantly employed mixed-methods and outcome-focused evaluations, with most evaluations being donor-funded and focused on communicable diseases, particularly HIV/AIDS, malaria, and tuberculosis. Critical methodological elements, such as evaluation design, sampling strategies, and theoretical frameworks were however often not reported. The review of evaluation reports showed a heavy reliance on international consultants and organisations, with limited representation of African-affiliated evaluators and institutions in lead roles. Survey findings indicated that methodological and theoretical choices were primarily shaped by evaluators’ individual skills and contextual factors. Respondents reported selecting approaches based on their own expertise and familiarity with specific evaluation methods and tools, and while many referenced international best practices, few adhered to formal evaluation standards or guidelines. The researcher also examined trends in journal publication output and research collaboration, and identified factors influencing publication and co-authorship. Bibliometric analysis showed that journal publications increased steadily from 2000 to 2020, reflecting the growing institutionalisation of evidence-informed health research. Most articles were published in public health journals, with relatively few in evaluation-specific journals, indicating the field remains largely embedded within public health. Authors were primarily based at universities in the United States of America, South Africa, and the United Kingdom. Local authorship was uneven, with some articles published without the involvement of authors affiliated with organisations in the countries where the evaluations were conducted. Most articles were co-authored and collaboration largely occurred between authors affiliated with African institutions and those affiliated with non-African institutions. Authors were primarily motivated by intellectual exchange and network building, although challenges, such as unequal authorship dynamics, limited infrastructure, and restricted access to funding were reported – particularly by early-career and African-based authors. The study makes a novel contribution to the field of evaluation by presenting a comprehensive mapping and analysis of health evaluation studies in sub-Saharan Africa over a twenty-year period. It introduced a conceptual framework distinguishing between demand-side, supply-side, and product-level drivers shaping the commissioning, implementation, and dissemination of evaluations. The findings revealed structural imbalances in authorship, funding flows, and publishing practices. In response, the research provided empirical insights and actionable recommendations to enhance the quality, visibility, and equity of health evaluation scholarship, including strengthening regional capacity, fostering intra-African collaboration, and developing contextually appropriate reporting standards. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar nie. Doctoral 2026-02-24T05:57:29Z 2026-02-24T05:57:29Z 2025-12 Thesis https://scholar.sun.ac.za/handle/10019.1/135159 en_ZA Stellenbosch University 384 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Public health -- Africa, Sub-Saharan -- Evaluation Health planning -- Africa, Sub-Saharan -- Evaluation Health services accessibility -- Africa, Sub-Saharan -- Evaluation Evidence-based medicine -- Africa, Sub-Saharan -- Evaluation UCTD Ngwabi, Nozipho Theodorah Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title | Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title_full | Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title_fullStr | Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title_full_unstemmed | Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title_short | Assessment of health evaluation studies in sub-Saharan Africa: 2000–2020 |
| title_sort | assessment of health evaluation studies in sub saharan africa 2000 2020 |
| topic | Public health -- Africa, Sub-Saharan -- Evaluation Health planning -- Africa, Sub-Saharan -- Evaluation Health services accessibility -- Africa, Sub-Saharan -- Evaluation Evidence-based medicine -- Africa, Sub-Saharan -- Evaluation UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/135159 |
| work_keys_str_mv | AT ngwabinoziphotheodorah assessmentofhealthevaluationstudiesinsubsaharanafrica20002020 |