Meta-evaluation as a tool for the improvement of public health policies evaluation

This study aims to meta-evaluate an evaluation process developed by policymakers and technical advisors of a Health Region of Sao Paulo, centering on criteria of utility and participation. It analyzes the feasibility and possible benefits of using a participatory methodology in Public Health evaluations, highlighting aspects that facilitate and hinder this undertaking. It is a qualitative research, which empirical basis was 1) the material produced in seven workshops with municipal representatives, aiming the evaluation of an aspect of health care from the perspective of integrity; and 2) semi-structured interviews with the same actors after completion of the evaluation process. KIRKHART´s theoretical framework (2000) was used to evaluate the utility criterion, in order to expand the analysis beyond the instrumental use of the evaluation findings, and focus it in identifying multiple influences exerted by a complex phenomenon as an evaluation process. The evaluation criterion of participation was based on references of COUSINS e WHITMORE (1998), aiming to identify decisions or contextual aspects in the empirical material that made participatory option limited or depth in the focused process. The work highlights the need to seek theoretical frameworks of analysis consistent with the methodological choice carried out in order to enhance the identification of evaluation gains and limitations, and enable evaluators to monitor the demand of participants in the evaluation process with flexibility to reach its best use, even in those cases where there are limitations on the possibilities of participation. The results confirmed the viability, with advantages, of holding local participatory processes with policymakers and managers in Public Health, highlighting the possibility of gains in education and the enrichment of the negotiation process in the territory level, consistent with the policy of building health regions in SUS. (AU)