Lapses,infidelities, and creative adaptations: Lessons from evaluation of a participatory market development approach in the Andes |
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| Affiliation: | 1. Research Manager, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa;2. Research Director, Human Sciences Research Council, Pretoria, South Africa;1. Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;2. Innovative Clinical Trials, Department of Cardiology & Pneumology, University Medical Center Göttingen, Göttingen, Germany;3. National Heart & Lung Institute, Royal Brompton & Harefield hospitals, Imperial College, London, UK;4. University of Bergen, Bergen, Norway;5. University of Stavanger, Stavanger, Norway;6. National and Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, Athens, Greece;7. Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK;8. Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy;9. Department of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;10. Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK;11. NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK;12. Department of Epidemiology, Biostatistics & Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands;13. Department of Heart Diseases, Wroclaw Medical University, Poland and Cardiology Department, Military Hospital, Wroclaw, Poland;14. Inserm CIC1433, Université de Lorrain, CHU de Nancy, Nancy, France |
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| Abstract: | Participatory approaches are frequently recommended for international development programs, but few have been evaluated. From 2007 to 2010 the Andean Change Alliance evaluated an agricultural research and development approach known as the “Participatory Market Chain Approach” (PMCA). Based on a study of four cases, this paper examines the fidelity of implementation, the factors that influenced implementation and results, and the PMCA change model. We identify three types of deviation from the intervention protocol (lapses, creative adaptations, and true infidelities) and five groups of variables that influenced PMCA implementation and results (attributes of the macro context, the market chain, the key actors, rules in use, and the capacity development strategy). There was insufficient information to test the validity of the PMCA change model, but results were greatest where the PMCA was implemented with highest fidelity. Our analysis suggests that the single most critical component of the PMCA is engagement of market agents – not just farmers – throughout the exercise. We present four lessons for planning and evaluating participatory approaches related to the use of action and change models, the importance of monitoring implementation fidelity, the limits of baseline survey data for outcome evaluation, and the importance of capacity development for implementers. |
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| Keywords: | Participation Fidelity of implementation Program theory Innovation International development |
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