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Methodological Peculiarities of Needs Assessment

Jiří Remr

Abstract

This article focuses attention on the importance of needs that are understood as a criterium for the evaluation of usefulness. The text proposes a usable conceptual framing of what evidence might be collected. Moreover, it identifies the role of needs within the theory of change that is presented by the generalized logic model and finally it points out the key situation when usefulness can successfully supplement other evaluative criteria like relevance or effectiveness. Discrimination of needs from similar constructs like wants, preferences and demand is analyzed and documented with vivid examples from a study that focused on the needs of informal caregivers providing care to the dependent seniors within their homes. Moreover, the key methodological peculiarities of the systematic process of the identification, analysis and evaluation of needs are brought to attention.

Keywords

Needs assessment; usefulness; evaluation; caregiving; social services; needs

Acknowledgement:

This work was supported by a project of the Czech Science Foundation No. 16-07931S “Needs Assessment of Family Caregivers of the Elderly”.

 

1. Introduction

In the currently performed evaluations, attention is placed on the relevance and effectiveness which is documented by e.g. OECD DAC (1991)[1]. Although such a focus of the conducted evaluations is feasible, in some cases it might lead to inappropriate conclusions about the intervention effects. In many evaluations, the two criteria serve as a merit of separate evaluation questions. However, the two independent conclusions (one for relevance, and the other for effectiveness) may not adequately indicate the true effects of the given intervention even when sufficient evidence is gathered.

As it is presented further, neither relevance nor effectiveness focuses on filling the gap between the initial situation of the target group (i.e. the recipients of the intervention) and the desired one when relevance describes the adequacy of intervention goals, whereas effectiveness reflects the level of their fulfilment. As a consequence of that, in an ex-post evaluation, the given intervention might seem as relevant and effective even if it does not satisfy the real needs of the target group. Therefore, an additional criterium – usefulness might be helpful because it would enable evaluating the extent to which the intervention attributed to satisfying those needs. Usefulness is considered as the extent to which the given intervention satisfies the feeling of shortage (James 1999).

The aim of this paper is (a) to focus attention on the usefulness of interventions, (b) to discriminate the needs from some similar constructs, and (c) to point out key methodological peculiarities of the systematic process of the identification, analysis and evaluation of the needs.

In some papers, needs are considered as a capacity to benefit (Wright et al. 1998; Stevens, Gillam 1998) that is influenced by the incidence and prevalence of the problem and the effectiveness of the intervention. However, such a definition is directed to specific measures of the need’s satisfaction where the capacity is associated with outcome measures rather than initial drivers. McKillip (1987) in this respect added that a need is a value judgement about some group that has a problem and that such a problem can be solved.

Davis (1955) defined needs as a subjective feeling initiating the decision-making process concerning the use of resources in order to satisfy that given need. Similarly, Crown (1991) perceived needs as a feeling of shortage that is combined with an effort to remove it. Moreover, Baldwin (1998) considered needs as an attempt to compensate for dis-equilibrium. All the above-mentioned definitions consider needs as a feeling that is recognized by the subjects, i.e. by the target group.

However, apart from these, rather normative concepts, there are other approaches to needs. For instance, Kaufman´s (1972) definition pointed out that needs represent the gap between the state that is desired and the actual state. His approach was further elaborated by Witkin and Altschuld (1995) who defined needs as the difference between the current and optimal state that is reflected by individuals or groups through certain values. These definitions stem from a discrepancy model, that describes needs as a state in which a person is situated below a certain standard when a harm is likely to occur (O´Brien 2010).

Barry (1965) came up with a rather instrumental definition of a need as something that is necessary in order to achieve the desired purpose. Such an approach is helpful for intervention evaluation because it leads to the specification of what is effective, to what extent and for whom.

Both the normative concept as well as the discrepancy model accept that the needs have an empirical and normative component (Bradshaw 1994). The empirical component represents a person’s actual physical, mental and emotional circumstances. It reflects attaining the goals aimed at the satisfaction of the given needs. The empirical component reflects that needs are relative and context-dependent. The normative component refers to the goals to follow and it reflects the desired level of needs. Such level, i.e. the “desired or optimal state” is usually based on professional standards that are relevant for the given field or discipline. However, it may also be identified in a participatory way by asking the target group and other stakeholders and it can be determined by experts or defined by professionals. The normative component significantly impacts the definition of the needs because the values and judgements of stakeholders may influence how the needs are defined and assessed (Guba, Lincoln 1982).

To sum up the above-presented definitions, needs are about problems (lacking) and solutions (satisfying). However, it is out of the scope of this paper to focus on actual problems – for some of those that are concerned with caregivers (see e.g. Remr 2016 or Remr 2018). Let´s also put aside how solutions are developed or decided upon, and get focused on how the different ways of needs satisfaction are evaluated, how to recognize what works, i.e. which interventions contribute to needs satisfaction and which do not.

Specific type of research – needs assessment should provide a guidance to such evaluations by providing the key criteria and standards (Donaldson et al. 2009). Needs serve as a source of key indicators informing about the usefulness of the given intervention (Berk, Rossi 1999). Based on such evidence, the intervention might be found useful once it satisfies the needs, or useless. Such a task is obviously extremely sensitive and therefore the proper methodology must be used in order to assure that the needs are properly identified, assessed, and distinguished from other constructs like e.g. wants, preferences or demands.

The next section clarifies the purpose of my paper, the section that follows that one defines the role of needs in an intervention logic, while further on needs are distinguished from wants, preferences and from demand. The concluding remarks then summarize and synthetize the knowledge gained during my effort to identify and analyze the needs.

2. Purpose of the paper

The purposes of the text are threefold: conceptual, methodological, and practical. The conceptual purpose aims to help operationalize and conceptualize needs, and to clarify needs as a research and evaluative construct. In this respect, the paper proposes a conceptual framing of what evidence might be collected, i.e. what type of information, data and indicators to use. An improper and imprecise conceptualization of needs might lead to misunderstanding the nature of them (O’ Brien 2010). As the importance of a clear definition of the needs is appreciated by many researchers (e.g. Baldwin 1998; Coryn 2007; Reviere et al. 1996), the paper turns attention to the precise delineation of the term, and distinguishes the different types of needs. It also explains the key distinctions from similar constructs. The methodological purpose is focused on a review of relevant approaches and procedures for gaining evidence about the needs. The paper proposes how such inquiries might be performed and what methodological approach could be taken. The practical purpose turns the attention to interventions evaluation that is based on needs. The text proposes the usual aims of such inquires and presents the impact of selected approaches on evaluative findings. All presented examples were taken from the research “Needs Assessment of Family Caregivers of the Elderly” supported by GA ČR (16-07931S).

3. Role of needs in intervention logic

Needs are important not only as they are; it is obviously interesting information about the target group or subjects that the intervention is focused on. However, needs represent more than just mere additional information that is nice to have. Within the intervention logic, the needs play an important role when they serve as a source of criteria and standards of usefulness. Awareness about the needs (gained from the needs assessment) may thus help in intervention evaluation. This section illuminates how the needs can improve the evaluability of interventions and how they can expand the evaluative conclusions to some evaluation questions.

3.1 Significance of needs for intervention evaluation

It is often that within the ex-post evaluations the following types of evaluation questions are set:

1. Was the intervention relevant? Did the intervention fit with the goals of the overall program? To what extent are the goals of an intervention adequate?
2. Were the defined goals really attained? To what extent were the set goals achieved?
3. What other results were achieved? Are there any other results that the intervention contributed to? What are the unexpected (unintended) effects of the intervention?

Source: Collection of evaluation reports in the Library of Evaluations (https://dotaceeu.cz/cs/evropske-fondy-v-cr/narodni-organ-pro-koordinaci/evaluace/knihovna-evaluaci)

For the first group of evaluation questions, the key criterium that underlines the above presented examples is the relevance. Relevance is defined as the extent to which the intervention is suited to the priorities and policies of the target group (OECD DAC 1991). Usually those “priorities”, “aims” and “goals” are specified in appropriate documents and therefore, objectives of a project can be compared with the aims of an overall program, or the goals of a program can be compared with the aims of a particular public policy. For this moment, I put aside the practical fact, that in some real-world cases the goals are too vague, too proclamatory and provide only limited guidance for setting the appropriate evaluation design. Evaluators, as experienced practitioners, should handle such an obstacle. What is important is that such goals are available for evaluation and therefore the relevance of the given intervention can be rigorously assessed. Simply put, having declared the goals, the given intervention is evaluable from the perspective of its relevance.

The second type of evaluation questions calls for evaluating the effectiveness of the given intervention. Effectiveness is understood as the way or extent of attaining the goal; it is a measure of the extent to which an intervention attains its objectives (OECD DAC 1991). A respective evaluation is typically focused on measuring the level of goal attainment; it takes into consideration the achieved and empirically proved outputs and outcomes. In this case, the evaluation is based on the predefined goals that are known to evaluators. Such goals are usually declared in project proposals, in feasibility studies, program documents, etc. Similarly as for the relevance, it may be necessary to put additional effort into operationalizing such goals, finding appropriate indicators, or transforming vague “intentions” to measurable variables. Anyway, having the declared goals and being able to collect empirical evidence about achieved real outputs and outcomes, the intervention is evaluable from the perspective of effectiveness by comparing the predefined goals with actually achieved results.

The third type of evaluation questions is different because it asks for taking the explorative approach rather than for testing the hypothesis about the achieved goals, or for comparing the actual results with the expectations. The third type of evaluation questions is solely explorative and aims at the mere identification of the unintended effects of the intervention. So, when the given intervention has some unintended effects, neither their relevance or effectiveness is evaluable. The fact is that unintended effects are not known in advance and therefore it is hardly possible to distinguish whether they are relevant or not. They are out of the scope of predefined goals and therefore, the assessment of their relevance (based on comparison with pre-set goals) is not possible.

Moreover, it is impossible to find-out to which extent these unintended effects are accountable for the overall results of the intervention. The expected amount or volume of such a result is obviously lacking (it is unexpected), so the effectiveness cannot be evaluated. As a consequence of that, the unintended results are not evaluable in the same manner as the intended ones. When inappropriate evaluation methods are used, the significance of unintended results might be underestimated and the ex-post evaluation might be biased.

Such a risk can be eliminated by having a common base against which the unintended results could be compared. The needs might serve as such a base. The needs in this respect provide necessary information that is independent from the predefined goals of the intervention. Therefore, they can help to distinguish what particular unintended results satisfy the needs (and are therefore useful) and what unintended effect does not. To sum up: in order to make the third type of evaluation questions fully evaluable, it is necessary to identify the needs and to add a usefulness criterium besides relevance and effectiveness.

 

3.2 Needs-based evaluation of usefulness

Besides the fact that needs can expand the way how certain evaluation questions (that are focused on unintended results) are responded to, they also increase the scope of the logic model by lengthening the mechanism of change. The needs grounded in the initial situation of the subjects or the target group, provide an empirical background for the elucidation and evaluation of intervention usefulness.

The review presented in Table 1 shows that usefulness brings specific knowledge about the intervention and adds substantial value especially in those cases when the intervention caused some unintended effects.

The above-presented overview shows that the awareness about needs enables evaluating the usefulness of the given intervention. It is necessary to point out that usefulness might also shed light on intervention performance from a different perspective than relevance and effectiveness. Awareness about needs enables identifying, assessing and comparing the unintended results side-by-side with the expected effects. The role of needs in intervention logic is shown in the following figure:

Figure 1 shows a simplified and generalized logic model that involves intervention goals, necessary resources and activities resulting in outputs, outcomes and impacts. Beside those “usual” elements, needs are placed at the beginning of the whole chain that corresponds with the assumption that an intervention is planned in order to satisfy the needs.

Example: Caregivers were not aware of how to set the senior into position, so intervention in the form of a training course was designed. Its goals were to improve the skills of caregivers in this respect; resources were represented by the personnel (lecturers/nurses, teaching aids, refreshments, etc.; activities were, among others, lecturing, practicing, testing. Outputs were the number of participants and the number of training hours. Outcomes were the skills that caregivers gained (acquired). Impact was the improved care.

What is special about needs in comparison to the objectives of the intervention and its goals is that the needs are not set arbitrarily (or by an agreement of the stakeholders) but they do exist per se. In a typical situation, needs cannot be found in any document and therefore desk research is not an appropriate research technique to use. Instead of that, primary research among the relevant stakeholders must be conducted (Labrecque, 1999). For instance, the lack of skills among caregivers mentioned in the example is a fact that is not dependent on the agreement or disagreement among stakeholders involved in intervention planning, design and administration. In order to use needs as a source of indicators for evaluating the usefulness, it is necessary to conduct a specific inquiry (needs assessment) that is aimed at the identification, analysis and evaluation of the needs (Witkin, Altschuld 1995). When performing such an inquiry, it is essential to identify the needs properly bearing in mind that such research brings the indicators, criteria and standards of intervention usefulness.

3.3 Summary

An evaluation of the expected effects of the intervention provides only partial knowledge because such evaluation does not take the unintended results into consideration. Therefore, such evaluation might be misleading while underestimating the real effects and their significance for satisfying the needs of the target group.

Evaluation focused on unintended results is usually explorative. It enables identifying such effects, however, the guidance for distinguishing the useful results (that satisfy certain needs) from the not useful ones (that do not satisfy any need) is in this case missing.

Therefore, the knowledge of needs is important not only for intervention planning and administration (when it helps to better target its specific measures), but also for intervention evaluation when it enables assessing unintended results and reducing potential bias.

Last but not least, Diwan and Moriarty (1995) pointed out the temporal dimension of needs. They conclude that needs do not remain constant throughout the time, and therefore the timeframe is important; for instance within a short period, drinking alcohol may be perceived as a need because it enables the subject to avoid severe withdrawal symptoms, however, in a long period no alcohol is a need.

4. Needs and other constructs

When extending the logic model by the needs, it is necessary to assure that real needs are assessed. If the evidence shows that the needs of target group were satisfied by the intervention, the evaluator should reflect such finding and conclude that the intervention was useful. However, as was mentioned in the introductory section, sometimes the term “needs” is used interchangeably with other constructs, like e.g. wants, preferences or demands. When such confusion occurs, it might result in biases and inaccuracies. The point is that intervention planners believe in satisfying the needs of the target group, however, the real needs remain unaffected. Therefore, it is important to distinguish the construct of “needs” from other constructs and assure that the needs are conceptually clear. Gupta (2007), Witkin and Altschuld (1995) or Soriano (1995) pointed out that the merit of needs is unique and differs from other constructs. Similarly, Bradshaw (1994) considered wants (and wishes) as a special category.

4.1 Needs vs. wants

Usually, individuals can identify their wants however, in many situations they cannot identify their real needs. The reason is that they do not know what they may or should ask for (McKillip 1987). The fact is that some needs might be unconscious and not recognized. Therefore, the question: “What do you need for providing the care?” hardly ever leads to real needs. It is just what the subject wants.

Needs assessment that mistakenly focuses on wants (instead of needs) omits the unconscious needs because wants are always conscious and recognized. The following overview inspired by Jeffers (1971) describes the most usual situations of needs-wants interchange and its impacts:

1. a) Subjects want exactly what they need

Exceptionally, in a short run or within the given situation such an option might bring valid results. However, it is still necessary to insist on a conceptual differentiation of wants and needs. The point is that wants may become distant from needs; over time they can change in different ways, or the knowledge and experience from the given situation might alter in another context. The overlap of needs with wants is misleading and a proper methodology that enables distinguishing between the two should be used.

 

1. b) Subjects want more than they need

In this case, individuals desire something without needing it (Wiggins, Dermen 1987). The declaration of exaggerative wants instead of modest needs during intervention planning may lead to the excessive design of the intervention. Consequently, it may have a negative impact on an evaluative statement concerning the (low) effectiveness and (poor) efficiency of such intervention.

 

1. c) Subjects want less than they need

Due to the conceptual interchange, the individuals who need a certain amount of support or help, get only the limited and scanty amount that they wanted. Then their need cannot be completely satisfied. For instance, an older study concerning the intervention aimed at satisfying the knowledge gap of caregivers showed that the caregivers needed comprehensive professional training, lasting at least 40-hours, but what they wanted was only a 3-hour course (Remr 2012).

 

1. d) Subjects do not want what they need

People do not want certain measures aimed at satisfying their needs. Some stakeholders intentionally do not declare their conscious needs (e.g. because they consider such needs as socially undesirable). Some of the unintended results are not considered as being capable of satisfying the given need and therefore they are eliminated as unwanted. Caregivers who needed certain treatment, did not accept it, either due to a lack of time, or because of the necessity to co-finance it, or a deficiency in interest (Remr 2005). The mismatch of both constructs driven by wants (instead of the needs) would lead to a lack of useful intervention that would have the capacity to improve the condition of subjects. As a result, their unsatisfactory situation had been prolonged.

 

1. e) Subjects want what they do not need

This is probably the most common type of interchange between wants and needs. Subjects desire a certain measure, treatment or intervention because they think it is useful. However, such a desire is not evidence-based, and if it is provided after all, it has no real impact on needs satisfaction. For instance, within the performed research, the caregivers wanted cleaning service provided by social workers, even though they had a close family member (even in the same household) who could do the housekeeping.

 

4.2 Needs vs. preferences

Preferences represent the construct where the subjects have the opportunity to choose from at least two options or alternatives. Then, they may prefer one option to the other(s). Preferences thus refer to options that are identified, explicitly declared, conscious, and recognized; subjects are able to distinguish among them, so the difference among available options is perceived by the subjects. However, that is not the case of needs which might be unconscious, not recognized, and implicit. The following overview describes the most usual situations of interchange between needs and preferences:

 

1. a) Subjects need all options (in a certain mixture)

An interchange of preferences with the needs might lead to designing an intervention that is too selective. Preferences may in the given context push the subjects to determine only one measure from the whole portfolio of available options, even though the subjects need a combination of different measures. For instance, some caregivers recalled that they were asked by service providers to express their preference for meal delivery, i.e. breakfast in the morning, lunch at noon or evening dinner. However, they needed all of those.

 

1. b) Subjects need something that is not prompted

Questions about preferences are typically closed ones with prompted options that are mutually exclusive. For instance:

“Which type of training course do you prefer? A course in the morning (i.e. 9:00 – 12:00) or an afternoon course (13:00 – 16:00)?”

The issue is when the subject needs a provision that is not prompted (i.e. neither morning, nor afternoon course). Asking the caregivers to identify the preferred timing of the course about caregiving does not satisfy the need of caregivers who cannot leave the household where the person they care for is. In the given case, caregivers needed a brochure instead of prompted course options.

 

1. c) Subjects prefer the option that they do not need

Due to poor contextual analysis, inadequate expertise or invalid prior research, irrelevant options are offered to the subjects indicating something other than their actual needs. Subjects are then pushed to identify the preferred option, however, neither one is really relevant in their given case and neither one would have an effect on the satisfaction of needs.

 

1. d) Subjects do not prefer what they need

When preferences are confused with needs, and the subjects are asked to determine the preferred option, the subjects might explicitly choose the option that opposes their needs. In this situation, a preference-needs interchange can lead to a suboptimal use of the intervention and may consequently result in its underperformance (e.g. non-take up effect). Moreover, the preferred option can even worsen the subject´s situation because the “wrong option” is not neutral and it may have a negative impact on the subjects. For instance, some respondents in conducted research needed a respite care due to long-lasting fatigue. However, the option to take a rest was explicitly refused by those subjects.

 

1. e) Subjects do not have any preference

In this case, the subjects are asked for their preferences however, they might not have any preference. A lack of preference can be observed especially in situations where there are higher amounts of options (usually more than five). Subjects can identify the most preferred option and then two or three others. However, it is too difficult for them to specify the order of options on further position, e.g. fourth to fifth or fifth to sixth. Similarly, such effect might appear due to acquiescence bias or inability to discriminate among proposed options.

4.3 Needs vs. demand

The construct of demand represents the capacity to satisfy the need. The construct of needs is rather passive whereas the demand involves an action – a willingness to pay, a readiness to do something, a propensity to act. As part of that, the availability of resources to satisfy the demand is involved. Demanding something without having available time and money (or other resources), is not counted as a real demand; the demand must be effective on the market (Dinero 1999). Moreover, what people demand might not be driven by their needs but rather by external determinants – the media, opinion-leaders, influencers, advertisements, etc. (Thompson et al. 1995). The following overview describes the interaction between needs and demand, and it also shows some of its impacts:

 

1. a) Subjects demand exactly what they need

Such a situation contributes to conceptual vagueness because demand might easily be interchanged with the needs. However, the two constructs should still be distinguished, even if they overlap in the given moment. The point is that the demand may change in a different way from the needs, e.g. as a consequence of decreasing marginal utility. Then the assessment relying on demand instead of the real needs would yield invalid evidence.

 

1. b) Subjects demand more than they need

It is a common phenomenon that occurs in many situational contexts. Demand being an action laden construct may lead to an excessive volume of intervention because the subjects have enough resources to acquire the putative need. As a consequence of that, demand-needs interchange may lead to the wasting and misuse of the intervention provided.

 

1. c) Subjects demand less than they need

In some cases, the lower demand may indicate that the needs are already met. However, the demand may be lower because of the unaffordability of measures and provisions for needs satisfaction. It may also correspond with higher transaction costs or other barriers. In this respect, it is worth mentioning that needs related research and needs assessments as such are not predictive. The aim of those inquiries is not to predict or even estimate the future demand or interest. For instance, the demand for meal delivery at twice-a-week frequency (instead of daily service) indicated in the given research partial satisfaction of such need (some days the meal was brought by other family members and/or by the neighbors) and unaffordability (the subjects could only pay a twice-a-week delivery).

 

1. d) Subjects do not demand what they need

The subject may have low awareness about their needs and therefore they are seeking intervention that cannot satisfy their real needs. They may intentionally opt for a different option due to a difference in the affordability of the demanded and needed intervention.

 

1. e) Subjects demand what they do not need

In the given case, the subjects make an effort to purchase or gain intervention that they demand in spite of the fact that it has no capacity to satisfy their need. For instance, caregivers in the conducted research demanded the visit at the doctor, although they did not have any symptoms of a particular disease.

 

4.4 Summary

Different approaches can be taken to the definition and refinement of needs. Apart from substantive variations among the needs, when e.g. Remr (2018) identified 78 needs of people who provide informal care to dependent seniors within their homes, the differences between needs on the one hand, and some other constructs on the other, should be reflected. Under the given circumstances, the needs might overlap with wants, preferences, or demand. However, in most situations it is essential to distinguish among the above-mentioned constructs properly and to choose the proper research or evaluation approach. Such task is about validity, especially construct validity. It is an important feature; the research or inquiry that is not valid in this respect can bring inaccurate or biased findings. Therefore, the attention paid to validity should be adequately high in the conducted researches.

The following situations may appear:

1. The needs and wants, preferences or demands are overlapping (i.e. subjects want, prefer or demand what they really need). Then, the interchange is hardly observable; criteria are not conceptually (or from merit point of view) correct but in the given situation they are practically usable (when performing a split-ballot experiment the results would be the same). However, putting the needs and wants/preferences/demands into one basket may distract the focus of such intervention (or its evaluation) and provide an invalid interpretation of the mechanism on how the given intervention contributes to satisfying the needs.

2. A false positive result of evaluation (i.e. an intervention is declared useful even if it is not). What the target group is really satisfied with are the wants or preferences but not the actual needs. There is a risk that no further attempts to satisfy the real need will be taken; the intervention is considered as useful even though it is not.

 

3. A false negative result of evaluation (i.e. an intervention is declared useless even if it is not). It seems that it is not useful, however, such intervention does not satisfy only the wants, preferences, or demand of the target group. In fact, it has the capacity to fulfill the needs and it is in fact contributing to their satisfaction. Due to attention that is biased to putative needs (i.e. wants, preferences or demand), evidence about the satisfaction of real needs is not gathered. The risk of this situation is a termination of an intervention that would be useful.

5. Conclusions

The definition of needs does not have only substantive implications, but different perspectives on needs are also associated with specific methods and techniques that are to be taken in practical situations. Differentiating needs from other constructs (such as wants, preferences and demand) has methodological implications. The uniqueness of the needs and the distinction of needs from other constructs requires cautious operationalization. Due to the fact that needs are often used as a criterium in evaluations focused on usefulness, its validity and conceptual purity is essential. Failing to identify the needs properly might result in poor intervention design, mistakes in planning, low performance, or inadequate results.

For the proper use of usefulness as a needs-based criterium, many scholars (e.g. Davidson 2005 or Scriven 2004 among others) consider needs assessment as the key source of evidence by which the intervention should be evaluated. Usefulness is recommended as an important evaluation criterium (Coryn 2007) that might provide important knowledge about the intervention. Moreover, Liddiard (2007) in this respect pointed-out another practical aspect while a proper definition of needs may lead to determination who gets what. Evaluation that takes the needs as a key criterium for assessment of intervention usefulness can focus on the extent to which needs are satisfied and supplement such finding with knowledge about effectiveness, efficiency, and relevance.

 

 

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[1] Obviously, there are also other criteria, for instance efficiency, economy, sustainability, etc. However, those criteria are not relevant from the needs-perspective. Therefore, I do not pay attention to them at this point and focus only on relevance and effectiveness.