Costa Rica’s Caribbean coast is known for its lush green landscapes, beautiful beaches and friendly people. But, unfortunately, it also stands out for its high incidence rates for several kinds of cancer. This prompted the region’s Health Boards (local bodies who monitor the quality of health services) to request an evaluation of cancer care and prevention services, taking advantage of the fact that at the time there was an open tender organised by the Costa Rica Ministry of Planning (MIDEPLAN) and the German cooperation programme, FOCEVAL to support capacity strengthening in evaluation.

And so, the evaluation was carried out from July 2016 to February 2017 in a rural Caribbean town called Valle de la Estrella. The evaluation began with incredibly high aspirations for citizen participation. In other words, it did not only consult or ask for opinions from various stakeholders but rather sought to provide the board members with evaluation tools so they could evaluate the cancer services themselves. Their role was that of protagonists; they were the evaluators.

Seven people from different areas of the Caribbean were added to the evaluation group. They were chosen due to the way they stood out for their contributions to community participation and their strong commitments to the communities they worked with in a voluntary capacity.

There was also a technical team who supported the process, made up of a main evaluator, a local facilitator and FOCEVAL, MIDEPLAN and Ombudsman representatives.  Therefore, the project was designed and executed by the evaluation team while the technical team collaborated with methodological consultancy and close support during each of the activities that took place on the field.

These testimonies have all arisen from the same experience: the participatory evaluation of cancer care and prevention services in the Valle de la Estrella region, in the province of Limón, Costa Rica. Here, we have selected a few testimonies that are representative of the evaluation team members. While the role of the external consultant has been important in terms of building capacity in the team, and the role of the local facilitator important in terms of the assistance they have provided throughout the process, it is the role of the local stakeholders that has been key. It was the Health Board representatives that took on all decision-making responsibility in terms of the evaluation and they demonstrated high levels of commitment by actively participating throughout the whole process, designing and applying tools for collecting, analysing and systematising data and subsequently sharing the lessons. These experiences, as seen in the testimonies (English subtitles), have strengthened the Health Boards, empowered community organisations and created conditions that make new self-managed evaluation processes more sustainable.

You can access to the full report and evaluation tools used in the evaluation in this link.