Evaluation of health promotion effectiveness: a political debate and/or a technical exercise?

Abstract

This article summarizes the points of view of professionals from different nationalities, working in diverse organizations and dealing with concepts and activities related to health promotion effectiveness evaluation. This collection of views came from a panel presentation and dialogue held during the First Brazilian Seminar on Effectiveness in Health Promotion. Four professionals working in evaluation and health promotion--two from the United States, one from French Canada and another representing an international professional organization--facilitated by one Brazilian and one Puerto Rican moderator, had an informal dialogue with the audience. Four questions about how these professionals perceive evaluation in health promotion were asked to initiate the dialogue. The panelists deliberated five aspects of health promotion evaluation, asking: "how", "how much", "what for", "with whom" and "why". Professionals working in developing countries (in this case, Brazil) and those dealing with indigenous communities (in developed countries) tended to put more emphasis on "what for?", "with whom?" and "why?" regarding initiatives to evaluate effectiveness of health promotion. Questions associated with "how?" and "how much?" were more often mentioned by professionals working for international or governmental agencies. A 90-minute dialogue among panelists with a clearly Brazilian bias, was not sufficient to produce conclusions on the predominant character of international evaluation efforts of effectiveness. Nevertheless, this debate framed the five aspects of evaluation into a value perspective. The questions, "what for?", "with whom?", "why?", "how?" and "how much?" are linked to a political or technical presumptions that could be orchestrated in evaluations of health promotion effectiveness.