Chapter 6

Program
Objectives and
Setting Targets
 Learning Objectives
With this chapter, readers will be able to:
1. Write clear, measurable process and effect
objectives.
2. Distinguish between process and effect
objectives.
3. Develop realistic and achievable target values
for objectives.
 Key Terminology
• Goal
• Indicator
• Objective
 Goals vs. Objectives
Goals Objectives
• Broad, • Specific statements
encompassing about outcome to be
statements about achieved
impact to be • Shorter time horizon
achieved • Measurable
• Generally one per • Process and effect
program • “By when, who will
• Longer time horizon achieve what, by
• Not stated in how much”
quantifiable terms
Figure 6.1 Using Elements of Program Theory as the Basis for Writing Program
Objectives
 Process Objectives : TAAPS
• Encapsulate the essentials of the process
theory that describes how the program is
delivered, focusing on the activities of the
program staff members or the program
participant.
• Ought to have these elements
– Time frame, Amount of what Activities done by
which Participants / program Staff (TAAPS)
• “by when, which staff members will do what, to what
extent”
 Process Objectives : TAAPS
• TAAPS objectives focus on actions of
participants or on the activities of the program
staff members that DON’T directly cause the
effect
– Organisational plan and service utilization plan –
provide insights of what to be included in each
process objective.
– Eg: ‘By June, 100% of program staff will have
participated in 90% of the training sessions on how
to use health education modules being used in
Layetteville i-APP Program’
 Effect Objectives : TREW
• Focus on benefits that program participants will
experience as a result of receiving the program
interventions.
• Ought to have these elements
– Time frame, what portion of Recipients experience
what Extent of Which type of change (TREW)
• “by when, how many of which program participants will
experience what type of health benefit or state and to what
extent”
• “After how much intervention, how many recipients will
experience what extent of which type of change”
 Effect Objectives : TREW
• Theories of cause/determinants of the
intervention and of outcomes.
• Provides the basis for stating intervention, outcome
and impact objectives.
• Good effect objectives can include:
– Increasing or reducing the level of a certain outcome
compared to some benchmark level.
• Eg: After attending 90% of the session, 100% of the
Layetteville i-APP Program participants will have a 20% lower
pregnancy rate compared to girils not participating’
– Having the ‘extent’ parameter reflect a preferred level of
achievement or target value to be achieved.
• Eg: ‘After attending 90% of the sessions, 100% of Layetteville
i-APP Program participants will have a 3% pregnancy rate.
Figure 6.2 Diagram Showing Relationship of Effect Theory Elements to Process and
Outcome Objectives
 Objectives and Indicators
• Indicators refers to
– the ‘what’ portion of the objective;
– the variables used to measure the ‘what’;
– the performance benchmarks used to the determine
success or failure of the program.
• Sensitivity of the indicator selected may affect
the result of program evaluation.
 Objectives and Indicators
• Selecting proper indicators when developing
objectives will set reasonable target extent or
changes to be achieved.
• Most health program address one or more
domains of health or well-being consisting of
specific variables (indicators) to measure the
program effect on the domain.
 Criteria for Selecting Indicators
• Funding agency requirements
• Data collection is feasible to be collected
• Scientifically defendable
• Easy to analyze
• Returning to community health diagnosis
statements about health problems
 Good Goals and Objectives
• Criteria of good goals and objectives are:-
– Both process and effect objectives need to be tailored to
the specific health program being planned.
– Each objective must convey only one idea, so that each
statement can be related to only one measure.
– Objectives must be understandable to any stakeholders
who might read them.
– Objectives facilitate implementation by minding the
process and activities.
– Objectives facilitate direct evaluation by specifying the
desired effect to be achieved.
– Should be written to reflect the final rate or state of health
and not the change need to get there.
 SMART Objectives
• Specific
• Measurable
• Achievable
• Realistic
• Time
 Using Data to Set Target Values
• A critical step in developing a meaningful objective
is choosing a numeric value as the target for the ‘by
how much portion of the objective.
• For process objectives, the procedure to
establish the target value means using data from
the organizational and marketing assessments.
– Professional standards can be used particularly for
organizational plan objectives
– Eg: legal and professional standards have been
established for minimum qualifications for personnel can
be used as setting target value.
 Using Data to Set Target Values
• For effect objectives, the target-setting
process relies on the effect theory.
– The assumption is that as long as the objectives are
consistent with the program theory and level of
programmatic effort, targets can be achieved.
– Having reasonable target values directly influences
the extent to which a program is perceived as
successful with regards to outcomes and impacts.
• The target-setting approaches steps for effect
objective:-
– Establish guidelines based on a decision framework
– Choose one or more relatively simple statistical
procedures to yield target values consistent with the
decisions.
 Decisional Framework for Setting
Target Values
• The basic element in developing a target-setting
strategy is deciding how a program will be
deemed successful.
EITHER
– meeting or exceeding target -- then target must be
chosen more cautiously then cusses is defined less
strictly
OR
– success claimed by making meaningful progress
toward the target but not necessarily meeting it --
then ‘making meaningful progress’ must be
quantified.
Stratification and Object Target Values
• Extent to which disparities exist across or within
the intended population may affect the program
outcome.
• If the disparities exist by different income levels,
race/ethnicity or geographic location, the data
may need to be stratified by those factors.
• When data are not stratified, values are simply
averages that may mask every different
outcomes for different group within the
population.
Use of Logic Statements to Develop Target

• A technique for explicitly organizing and

documenting the process of setting targets.
• Logic statements are written in an ‘if, then’ or
‘otherwise, if, then’ format.
• Developing the if-then statements helps create
realistic objectives.
 Option for Calculating Target Values

• Ten (10) options for calculating target values

that can easily be done using calculator or a
spreadsheet.
• These options may be appropriate in some
circumstances but not in others.
• Table 6.8 summarizes the conditions under
which each of the 10 options would be best and
outlines the advantages and disadvantage of
each option.
 Caveats to Setting Goals and
Objectives
• Tenuous effectiveness of using objectives to
guide work
– Need staff buy-in, using resources to support
achieving objectives, and a reward system
• Need for spontaneity
– Complexity theory highlights the importance of
flexibility
• Messy interface between objectives and
performance measures
– More on this in Chapter 10