Department of Health

Independent Evaluation

NCMS Phase 3 - Independent Evaluation

Phase 3 of the National Continence Management Strategy (the Strategy) was undertaken from 2006 to 2010. In Phase 3, the Strategy aimed to achieve its outcomes through four key action areas:

  • Improving the information and evidence base;
  • Raising awareness of incontinence;
  • Supporting the workforce; and
  • Improving access to continence intervention and management.

An independent evaluation was funded in order to improve the availability and quality of evidence and align projects with stakeholders. Overall the evaluation revealed that projects have been effective in raising awareness, supporting the workforce and improving both consumer and health professional practice.

Key outcomes

A number of awareness raising initiatives provided the Australian community with increased availability of information relating to bladder and bowel health and the management of incontinence. This resulted in an increase in the uptake of this information. The National Continence Helpline received almost 70,000 calls, with 80% of respondents highly satisfied with the way the National Continence Helpline met their needs. The Bladder and Bowel website and the National Public Toilet Map played an important role in providing the Australian community with access to bladder and bowel health information, including resources for culturally and linguistically diverse communities and Aboriginal and Torres Strait Islander people. The evaluation also found a general increase in the number of consumers seeking help for their incontinence.

Through continence education training initiatives, the professional knowledge of health workers has been increased by 16-54%, with improvements in levels of confidence in the practice arena.

Greater collaboration with stakeholders was a positive outcome of the Strategy, with a high level of stakeholder involvement seen across all projects.

Copies of the Evaluation Reports can be obtained by emailing


McCallum J, Millar L, Burston L, Butorac A, Calzoni C (2010). Final report for Phase 3 of the National Continence Management Strategy.

NCMS Phases 1 and 2 - Independent Evaluation

Management of the National Continence Management Strategy (NCMS) includes funding for an Independent Evaluation project to identify the policy, service development and practice implications of project outcomes and contribute to future planning and development.  The following provides a summary of the outcomes of the evaluation of Phases 1 and 2 of the strategy conducted by Victoria University.

The NCMS was established in 1998 by the Australian Government Department of Health and Ageing.  During Phases 1 and 2 funding has been provided to national research and service development initiatives aimed at prevention and treatment of this significant problem.

The NCMS has created a platform for advancement of the evidence available on continence issues within Australia and engagement of both the community and health professionals.  Support has been provided for more than 120 projects.  Projects have included:

  • studies of the extent of continence in the community;
  • initiatives to increase community awareness of continence and the treatment services available;
  • methodology to improve the quality of continence services;
  • studies of intervention and management alternatives; and
  • an independent evaluation to identify the policy, service development and practice implications of project outcomes.

Through a systematic review of projects an understanding has been gained of the current knowledge and the gaps in that knowledge.  Opportunities for future research to improve community understanding and the provision of quality continence care have also been identified.

The evaluation of the process and outcomes has revealed that many project specific outcomes were achieved through the project work undertaken in Phases 1 and 2.  Key outcomes in the context of this evaluation are those that can be identified as having a broader impact on the NCMS.

Key outcomes of the NCMS funding (Phases 1 and 2)

The key outcomes include a significant increase in the available information and evidence base with provision of a more accurate measure of the prevalence, impact and severity of incontinence within Australia.  Gains have also been made with the identification of data items appropriate for benchmarking and monitoring incontinence and an increased understanding of the cost of incontinence within Australia.  Outcome measurement instruments have also been reviewed and revised.  These outcomes have more clearly defined the scope of the effect of incontinence on the community and provide a context for Phase 3 planning processes.

Awareness raising strategies have been strengthened through recognition of the barriers to help seeking behaviour and identification of the most appropriate terminology and key messages to inform people with incontinence about management and preventative strategies.   A focus of much of the work undertaken to date has been the development and distribution of information resources for use by the general community and specific target groups.  The provision of an incontinence specific helpline has also been an important awareness raising initiative.

Workforce support initiatives have identified the implementation factors for a national model of continence care and recognised the support needs of the current workforce and those in training.  The initiatives have also produced training resources for a broad range of health professionals.

Intervention and management focussed projects provided a mechanism for the development of best practice guidelines for the management and treatment of continence problems and self help initiatives have resulted in the highly successful National Public Toilet Map.  The National Continence Helpline has provided an avenue for an increasing number of people to either self manage their incontinence or seek further help from health professionals.

The NCMS has engaged with stakeholder groups to ensure that the work undertaken is relevant.  This needs to be continued throughout Phase 3 to allow for continued capitalisation of the work to date and effective use of the research already undertaken.

The broad disbursement of research funds has built capacity, raised the profile of continence and fostered a culture of research especially amongst teams that may not have previously been involved in research.  In some instances the results have been less targeted which has diminished the quality of the outcomes.  A focus on outcomes and impact will need to be addressed in Phase 3. 

To inform policy decisions based on evidence the NCMS has produced a wide range of study designs with variable objectives, activities, duration and scale.  The results have fallen within each of the five levels of Cochrane review although predominately within the lower levels of evidence.  Expected outcomes for projects in Phase 3 will need to include provision for a higher level of evidence.


McCallum, J., Millar. L., Dong, T., Burston, L., (2006). National Continence Management Strategy (NCMS) - Independent Evaluation Advisor Final Report: Phases 1 and 2.