Evidence Lab

Established in 2014, the Duke Global Health Institute Evidence Lab conducts objective and high-quality evaluations using rigorous and innovative research designs paired with cutting-edge methods. Our team blends theory and practice, and draws upon the research and policy expertise across Duke University to inform our evaluations and to disseminate new evidence to policymakers and diverse stakeholders.  Our team has deep, on-the-ground knowledge and experience with a wide range of global health projects and thus we can offer research and practice-based understandings of regional health challenges.  We also note that a core principle of the DGHI Evidence Lab is to strengthen the evaluation capacity of our local and project counterparts on collaborative projects.

Full Spectrum Evaluation

The DGHI Evidence Lab conducts evaluations ranging from formative, pre-intervention research to impact evaluation to policy recommendations and dissemination. We utilize quantitative, qualitative, and mixed-methods approaches. 

Evidence Lab Expertise Includes:

  • Impact evaluation
  • Formative evaluation
  • Process evaluation
  • Implementation science
  • Economic analyses
  • Policy research
  • Research dissemination and utilization

Examples Include:

  • Kathryn Whetten utilized a longitudinal cross-sectional time series design to evaluate orphan services in four geographic areas in Malawi.
  • Randall Kramer is leading an interdisciplinary study of malaria vector control and disease management interventions using a cluster-randomized factorial design in rural settings in Tanzania.
  • Krishna Udayakumar, through Innovations in Healthcare (formerly IPIHD), is developing a database and framework to categorize transformative health innovation globally, facilitating the evaluation of effectiveness and the scalability of global health enterprises.
  • Rae Jean Proeschold-Bell evaluated a hepatitis C knowledge and testing campaign for people with HIV infection in North Carolina, USA, using an interrupted time series design.
  • Joe Egger is leading a USAID-funded evaluation of the Social Entrepreneurship Accelerator at Duke (SEAD) initiative, an interdisciplinary program assessing factors that influence how organizations scale innovations in global health in India and East Africa.
  • John Bartlett evaluates the outcomes associated with antiretroviral therapy in cohort and randomized controlled studies in resource-limited settings.
  • Shenglan Tang is leading a team of researchers from DGHI, Duke Kunshan University, and four Chinese universities to evaluate innovative financing models of, and alternative provider payment methods used for, tuberculosis care and control in China.
  • Joy Noel Baumgartner utilized a cluster-randomized design to evaluate a job aid for family planning providers to improve contraceptive continuation for clients in rural South Africa.

Our ApproachOur TeamEvaluation ToolkitSample Publications


For social enterprises in health, thoughtful approaches to evaluation are critical for assessing their health and economic impact. The USAID-funded Social Entrepreneur Accelerator at Duke (SEAD) program, and the innovators it supports globally, have benefitted from partnering with the DGHI Evidence Lab to leverage its unique insights and expertise for how to gather and use quality evaluation data from dynamic organizations. Krishna Udayakumar, Duke Faculty, Co-PI of SEAD



Our Approach

Innovative Methods

For each evaluation, we consider all research designs and propose the design that offers the optimal degree of causal inference and understanding. We tailor the research design and data collection to each specific project.  Illustrative designs include randomized controlled trials (individual or cluster), interrupted time series analysis, randomized multiple baseline surveys, and quasi-experimental designs. We also often engage in mixed-methods research, utilizing qualitative methods including focus group discussions, in-depth interviews, observations, and daily diaries.

Health Policy Recommendations & Research Utilization

We approach each evaluation with the policy makers in mind, and build in the data collection needed to answer the most pressing policy questions.  We build relationships and take the time to craft useful, data-driven recommendations and disseminate them to a wide range of stakeholders.  Cognizant of the “research to practice” gap, we embrace strategies such as collaborative research, stakeholder engagement, advocacy, and communication that help link evidence to policies, programs and practice.

Building Local Capacity & Attention to Cultural Context

Capacity building activities (e.g. training, building internal assets, collaboration over the full course of project from inception to publication) within our local partnerships is a core principle of the DGHI Evidence Lab.  Local capacity among program and research partners allows communities and countries to utilize improved research methods and/or evidence-based practices after external resources have ended. In addition, together with local collaborators, we reach out to and solicit feedback from community stakeholders and create feedback loops that ensure the project’s research questions and data are accurate and useful.

Our Team

Joy Noel Baumgartner, Director

Joy Noel Baumgartner leads the Evidence Lab at the Duke Global Health Institute whose mission is to conduct rigorous evaluation research in low- and middle-income countries with local partners to inform evidence-based programs and interventions. She is also an Assistant Research Professor of Global Health at Duke University.  Joy Noel is a public health practitioner and health services researcher with 20 years of experience working in low-resource settings to strengthen the delivery of HIV, reproductive health, MCH, and mental health services.   Her previous projects have included working with Ministries of Health across sub-Saharan Africa to develop and test reproductive health and HIV-related health services interventions with a focus on services integration and meeting the health needs of adolescents.  

Some of Joy Noel’s current research projects include integrating HIV and mental health care in Zambia, developing and testing a model of integrated adolescent healthcare linked to schools in Tanzania, and in East Africa and India, supporting private sector healthcare entrepreneurs to collect stronger M&E data in order to highlight the impact of their innovations.  Joy Noel has a master's degree in Social Work from the University of Wisconsin at Madison and a PhD in Maternal & Child Health from the University of North Carolina at Chapel Hill, and she completed an NIMH postdoctoral fellowship in Psychiatric Epidemiology at Columbia University focused on global mental health.

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Rae Jean Proeschold-Bell, Advisor, Founding Director

Rae Jean Proeschold-Bell holds a PhD in clinical-community psychology. She has designed and conducted evaluations across a wide-range of interventions, including integrated physical and mental health interventions; sharing of electronic medical records; public health awareness and knowledge campaigns; and weight loss and stress reduction interventions. Rae Jean has employed a variety of research designs, including Randomized Controlled Trials; Interrupted Time Series analysis; and randomized multiple baseline designs. She is skilled in both qualitative and quantitative analysis and has developed and published measures culturally tailored for use with specific populations.

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Jennifer Headley, Evaluation Research Specialist

Jennifer Headley is an Evaluation Research Specialist with the Duke Global Health Institute Evidence Lab with almost 15 years of experience working in research and capacity building in the field of reproductive health and maternal and child health in low- and middle-income countries. Her current work focuses on helping social entrepreneurs determine how to use evaluation techniques to strengthen their impact statements for their innovations via an Evaluation Toolkit for social enterprises under the USAID-funded project Social Entrepreneurship Accelerator at Duke (SEAD). Previously, Jennifer worked in FHI 360’s Social and Behavioral Health Sciences department for more than 6 years serving as a research analyst and project manager for a wide range of studies, from impact evaluations and randomized controlled trials to formative research and behavioral studies. She has worked with diverse organizations, including universities, global non-profits, consulting firms, government ministries, and entrepreneurs.

Jennifer works on a variety or DGHI Evidence Lab projects and she particularly enjoys incorporating qualitative techniques and building capacity for research and evaluation. Jennifer has managed studies or led trainings in Guyana, India, Kenya, Kyrgyzstan, Malawi, Peru, South Africa, and Tanzania, and worked in Côte d'Ivoire as a Rural Health Peace Corps Volunteer. She holds a master's degree in Social Work and Social and Economic Development from Washington University in St. Louis.

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Joe Egger, Technical Expert

Joe Egger

Joe Egger is an epidemiologist who holds the position of Assistant Professor of the Practice of Global Health at the Duke Global Health Institute (DGHI). Dr. Egger is also Associate Director of DGHI’s Research Design & Analysis Core, which provides epidemiological and statistical support to DGHI students, faculty and affiliates. Joe works closely with faculty on a number of experimental and observational studies related to both chronic and infectious diseases. Much of his research has focused on longitudinal data analysis, time series methods, and multi-level modeling of cross-sectional data. Prior to joining Duke in 2013, Joe was the lead epidemiologist for SciMetrika, a public health consulting firm based in Research Triangle Park, NC. Joe has also worked in academic and government settings on a wide array of public health research topics, including influenza, HIV/AIDS, dengue, tobacco, obesity/nutrition, and cancers. He has a master’s degree in medical geography from the University of Washington, and a PhD in infectious disease epidemiology from the London School of Hygiene & Tropical Medicine.

Dr. Egger has been a frequent collaborator with the DGHI Evidence Lab, in particular for our evaluation activities for social enterprises. Dr. Egger is the research lead for a USAID-funded project called the Social Entrepreneurship Accelerator at Duke (SEAD). His SEAD-related work has included investigating factors that affect the scalability of healthcare innovations and evaluating clinical quality improvements among service delivery enterprises. His expertise is frequently utilized for designing impact evaluations for social enterprises in low-resource settings.

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Lavanya Vasudevan, Technical Expert

Lavanya Vasudevan

Lavanya Vasudevan is a public health researcher with training in epidemiology and biostatistics and an early training background in bench sciences. Dr. Vasudevan holds the title of Research Scholar at the Center for Health Policy and Inequalities Research (CHPIR) in the Duke Global Health Institute. Her research focuses on designing and evaluating novel digital health interventions to support maternal and child health outcomes, primarily with respect to childhood vaccinations and healthcare access among children in adversity in low and middle-income countries. She serves as a technical expert on mHealth to the World Health Organization’s Department for Reproductive Health and Research. She is the co-PI of an NIH R21 grant to examine the effectiveness of an mHealth-assisted conditional cash transfer and reminder system for improving timeliness of childhood vaccinations in Tanzania.

Dr. Vasudevan actively collaborates with the Evidence Lab on the above NIH grant and also supports other public health proposal activities for the Evidence Lab. She received her doctoral degree (Ph.D.) from Cornell University and a Master’s degree in Public Health (MPH) from the Johns Hopkins Bloomberg School of Public Health. She is Certified in Public Health (CPH) by the National Board of Public Health Examiners.

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Kendal Swanson, Associate in Research

Kendal Swanson joined the Evidence Lab a few months after completing her Masters’ in Economics at Duke in 2015. Using her training in quantitative research methods, statistical analysis, and economic theory, she is working with the team to develop and test an economic analysis toolkit for SEAD innovators. Kendal has hands-on experience working in the field and on qualitative and quantitative studies. She is also at the Sanford School of Public Policy as an associate in research working on impact evaluations of health interventions in India.



Evaluation Toolkit for Social Enterprises in Health

As part of the Social Entrepreneurship Accelerator at Duke (SEAD), the Evidence Lab developed a series of tools to help social enterprises in healthcare evaluate their services, products and/or technologies. Most social enterprises work in contexts where they lack the requirements for rigorous, gold-standard evaluations: finances, time to observe changes, and a controlled environment. The toolkit, however, outlines different ways social enterprises in health can better evaluate their work and communicate their results with tighter timelines and more limited resources. Donors and funders may also use the toolkit with their grantees, or to better understand what types of information are reasonable to request from social enterprises in health.

Funded by USAID’s Higher Education Solutions Network (HESN), the tools are publicly available.


Considerations in Leveraging Data for Expansion


Economic Impact: Finding the right analysis for your evaluation needs


Sample Publications

  • Park PH, Wambui CK, Atieno S, Egger JR, Misoi L, Nyabundi JS, Pastakia SD, Bloomfield GS, Kamano JH. Improving Diabetes Management and Cardiovascular Risk Factors Through Peer-Led Self-management Support Groups in Western Kenya. Diabetes Care. 2015 Aug;38(8).
  • Kramer RA, Mboera LE, Senkoro K, Lesser A, Shayo EH, Paul CJ, Miranda ML. A randomized longitudinal factorial design to assess malaria vector control and disease management interventions in rural Tanzania.  Int J Environ Res Public Health. 2014 May 16;11(5):5317-32.
  • Vasudevan L, et al. (2014). "Maternal determinants of timely vaccination coverage among infants in rural Bangladesh." Vaccine 32(42): 5514-5519.
  • Baumgartner JN, Green M, Weaver MA, Mpangile G, Kohi TW, Mujaya SN, Lasway C. Integrating family planning services into HIV care and treatment clinics in Tanzania: evaluation of a facilitated referral model. Health Policy & Planning 2014 Aug;29(5):570-9.
  • Proeschold-Bell, R.J., Swift, R., Bennett, G., Moore, H. E., Li, X., Blouin, R., Williams, V., Williams, R., & Toole, D. (2013). Use of a randomized multiple baseline design: Rationale and design of the Spirited Life holistic health intervention study. Contemporary Clinical Trials, 35, 138-152, doi: 10.1016/j.cct.2013.05.005.
  • Whetten, K., Ostermann, J., Whetten, R.A., Pence, B.W., O’Donnell, K., Messer, L.C., Thielman, N.M., & The Positive Outcomes for Orphans (POFO) Research Team (2009). A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations. PLoS ONE, 4 (12), e8169. 2009.
  • Kramer, R., Jenkins, A., & Lesser, A. (Forthcoming). The Role of Ecosystem Service Payments in Achieving Conservation Goals: Attitudes Among Farm Operators, chapter in Valuing Ecosystem Services – Methodological Issues and Case Studies, K.N. Ninan, editor, Cheltenham: Edward Elgar Publishers.
  • Wang, H., Liu, Q., Vu, H., & Tang, S. (2013). Comparison between peer-led and teacher-led education in tuberculosis prevention in rural middle schools of Chongqing, China. Asia-Pacific Journal of Public Health. Oct. 4, 2013, PMID: 24097927.
  • Proeschold-Bell, R.J., Hoeppner, B., Taylor, B., Cohen, S., Blouin, R., Stringfield, B., & Muir, A. (2010). An Interrupted Time Series evaluation of a hepatitis C intervention for persons with HIV. AIDS and Behavior, 15 (8), 1721-1731. DOI: 10.1007/s10461-010-9870-1.
  • Bartlett, J., & Shao, J. Success, challenges and limitations of antiretroviral therapy in resource-limited settings. (2009). The Lancet Infectious Diseases, 9, 637-649.
  • Baumgartner JN, Parcesepe A, Mekuria YG, Abitew DB, Gebeyehu W, Okello F, et al. Maternal mental health in Amhara region, Ethiopia: a cross-sectional survey. Glob Health Sci Pact. 2014;2(4):482-486.  With link since it’s an open access article  http://www.ghspjournal.org/content/2/4/482.long
  • Tolley EE, Kaaya S, Kaale A, Minja A, Bangapi D, Kalungura H, Headley J, Baumgartner JN.  Comparing patterns of sexual risk among adolescent and young women in a mixed-method study in Tanzania: implications for adolescent participation in HIV prevention trials. Journal of the International AIDS Society 2014, 17(3 Suppl 2):19149.
  • Headley, J, Lemons A, Corneli A, Agot, K, Amed, K, Weng, M, Odhiambo J, Skhosana J, Tharaldson J, Van Damme, L, MacQueen, K. “The Sexual Risk Context among the FEM-PrEP Study Population in Bondo, Kenya and Pretoria, South Africa.” PLoS One. 2014 Sept 17; 9(9).