The WHO defines health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’; nevertheless, mental health is too often neglected. Comprehensive prevention of mental health disorders focus on a three-pronged strategy: promoting a healthy sense of well-being and protective factors against mental ill-health, identification and detection of those at risk of mental ill health and referral, and lastly treatment for those who need it.
As one of the countries with the highest suicide rates in CEE/CIS region, UNICEF and the Ministry of Health of the Republic of Kazakhstan have recognised and acted to address poor mental health, especially among adolescents. At the global level, Kazakhstan was ranked as the 9th and 4th for suicide rates in children aged five to14 and youth between 15-29 respectively (WHO 2014). In response to this, in early 2015 the ministries of Health, Education and Internal Affairs and UNICEF developed an intersectoral programme on the prevention of suicides among adolescents which was initiated as a two-year pilot in Kyzylorda region (one of the 16 provinces of Kazakhstan).
Itad has been selected by UNICEF to conduct a summative evaluation of this adolescent suicide prevention (ASP) pilot. We are using a range of evaluation methods, including an evaluability assessment and contribution analysis to properly assess the data available, evaluate the contribution and strength of each strand of evidence in order to analyse the project’s outcomes.
We are incorporating a theory based evaluation design built around testing a theory of change (ToC) which lays out the objectives and activities of the ASP pilot programme and their contribution to improved outcomes across the identification, prevention and referral of adolescents at risk of suicide. The evaluation components are mapped against the ToC to investigate what the ASP pilot has achieved as well as how this has (or has not) happened. The assignment also includes a cost-benefit and if possible cost-effectiveness analysis of the ASP pilot which will consider if the resource allocation was appropriate for the achievement of the results and the outputs of the pilot and what returns on investment was made.
Furthermore, the evaluation is utilisation focused and will be implemented in a way that creates engagement and ownership at the outset of the process and within outputs among the intended users, and ensures timely and actionable findings, learning and recommendations. We will actively involve UNICEF, the Ministry of Health, the National Center for Mental Health, the Ministry of Education and Science, local governments and NGOs (as well as beneficiaries and their parents where and when appropriate) in our work in an iterative manner to ensure active participation and solid engagement, commencing in the inception phase.
Image © Korkyt Ata, Kazakhstan. Photo Credit: Ninara. (CC BY 2.0)