1.1 Project overview
1.2 Evaluation overview
1.3 Methodological overview

1.1 Project overview

The Australian Government's Department of Health and Ageing (the Department) has engaged Health Outcomes International to conduct a Mid-Term Evaluation of the Retractable Needle and Syringe Technology Initiative (the Initiative).

The Initiative comprised a number of components, each of which are considered in, and contribute to, the national Mid-Term Evaluation. These were:
  • The National Consultation process;
  • The 'Request for Information' process (RFI);
  • The 'Request for Product Information' process (RFP);
  • Pilot Studies of Retractable Needles and Syringes (Pilot Studies);
  • Economic Analysis;
  • National Audit of Community Needle and Syringe Disposal Facilities; and
  • Implementation Reference Group (IRG).
The Commonwealth Government, in the 2005 Budget, announced that the Initiative would not proceed past the 2004-2005 Financial Year, based on the information gathered in the first half of the Initiative. The Budget announcement resulted in the disbandment of the Implementation Reference Group, and so this individual component has been excluded from the Mid-Term Evaluation.

The primary objective of the Mid-Term Evaluation of the Retractable Needle and Syringe Technology Initiative is to "evaluate each component of the Initiative and provide the Department with a Mid-Term Evaluation Report including recommendations for progressing the Initiative."

1.2 Evaluation overview

The primary research question to be answered by the Mid-Term evaluation is:

"To what extent has the Retractable Needle and Syringe Technology Initiative (as a whole) contributed to identifying the relevant issues, and ways of addressing these, in relation to the use of retractable needles and syringes in Needle and Syringe Programs (NSP's) by injecting illicit drug users?"
Top of pageSecondary research questions which guide the conduct of the Mid-Term evaluation include:

"To what extent have the processes that have been used to implement the Initiative (particularly the Pilot Studies of Retractable Needles and Syringes, National Audit of Community Disposal Facilities and Economic Analysis) been effective?"
"Have the key stakeholders from each State and Territory participated in this Initiative?" and
"To what extent has the Initiative been implemented to enable retractable needles and syringes to be successfully trialled in the market and for the Initiative to meet its objectives?"
The primary and secondary research questions are to be answered through a process of meta-analysis. This process involves an examination of the seven components of the Initiative, both individually and collectively, with a view to identifying the degree of effectiveness of the Initiative. As some of the individual components are the subject of separate evaluation processes, the meta-analysis will be finalised upon completion of the individual evaluations (or projects), to address each of the secondary research questions. Analysis will then be conducted concerning the primary research question.

The Pilot Studies are the primary information source on the "suitability and acceptability" of retractable needles and syringes with respect to consumers, NSP workers and other stakeholders. The economic feasibility of retractable needles and syringes is to be addressed through the economic analysis component, while the other components examine such areas as industry views (through the RFI and RFP processes), disposal issues and coverage (though the National Audit process), and governance, management and planning (through the IRG).

The meta-analysis process enables conclusions to be ascertained about the extent to which the Initiative has been successful, the extent to which stakeholders have participated in the various processes, and the extent to which a permanent implementation of retractable needles and syringes is viable, sustainable and valuable.

1.3 Methodological overview

The Mid-Term Evaluation process is divided into two phases. Phase one was conducted between June 2004 and August 2004, and comprised of a retrospective evaluation (covering activities occurring during 2002-2003) of the:
  • Request for Information (RFI) Process;
  • National Consultation Process; and
  • Request for Product Information (RFP) Process.
In September 2004, a final report was presented to the Department of Health and Ageing which described the findings from the Phase One evaluation.

Phase Two of the mid-term evaluation commenced in early 2005 and the final report is due to be delivered six weeks after the completion of the last component (i.e. the National Mapping of Community Disposal Facilities). In the meantime, individual reports covering each of the remaining components of the Initiative are to be provided to the Department. These components are:
  • Pilot Studies (report completed);
  • Economic Analysis (report completed); and
  • National Audit of Community Disposal Facilities.
This report comprises the evaluation of the National Mapping of Community Needle and Syringe Disposal Facilities.
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1.3.1 Research questions

Key research questions to be answered by the evaluation of the National Audit of Community Disposal Facilities were developed and included in the Evaluation Framework document, delivered to the Department in early 2004. The research questions were subsequently updated to reflect the development of the Initiative since that time. The final set of research questions is as follows:
  • What process was used to undertake the audit?
  • To what extent have State, Territory and Local Governments participated in or contributed to this initiative?
  • What coverage has been achieved in the audit process to cover private and public sector (at all levels of government) disposal arrangements?
  • Have the performance indicators for this project been met?
  • To what extent does the final report reflect the extent of activities to address "inappropriate disposal" in each state and territory?
  • What were the findings from the National Audit project?
This report addresses each of these research questions in turn.

1.3.2 Data collected

The data used to address these research questions has been compiled from two primary sources: a review of key documents associated with the National Audit, and consultations with the consultants (Waste Audit and Consultancy Services (Aust) Pty. Ltd.) who conducted the project.

Documentation review

Documentation relating to the National Audit was obtained from the Department, and was analysed against key research questions. The documents made available for use in the evaluation of the National Audit of Community Needle and Syringe Disposal Facilities were as follows:
  • Australian Government Department of Health and Ageing (June 2004) "Request for Tender – National Audit of Community Needle and Syringe Disposal Facilities" (168/0304).
  • Department of Health and Ageing and Waste Audit and Consultancy Services (Aust) Pty Ltd (2004) Contract to conduct the National Audit of Community Needle and Syringe Disposal Facilities – Schedule A - Services.
  • Waste Audit and Consultancy Services (Aust) Pty Ltd (May 2005) "(Draft) Report on the National Audit of Community Needle and Syringe Disposal Facilities".

Consultations

A telephone interview was conducted with Mr Adrian Taylor from Waste Audit and Consultancy Services to explore some of the background issues associated with the conduct of the National Audit project and to gain his perspective on any issues faced and future actions that might be undertaken. The interview focused on the research questions as presented above.