Sustainable interventions to strengthen an integrated health system: Evaluation of best practices in Azerbaijan

Purpose-A mid-term evaluation of the USAID-funded Azerbaijan Strengthening Heath Systems through Integrated Programs (AZ SHIP) project was conducted to determine its effectiveness and timeliness in achieving its strategic and technical approaches; and gauge the willingness and ability of the Ministry of Health (MOH) to sustain activities. Data- The evaluation achieved these objectives: 1) assessed project success in terms of its technical objectives and implementation strategy; 2) validated the quality of the project's monitoring systems, and assessed whether it achieved objectives on time; 3) examined stakeholders' perceptions, including their willingness to support interventions after the project's end. Methods- Data were collected from a sample of stakeholders in Baku and the seven implementation districts. The evaluators applied a mixed-methods approach to solicit and triangulate information from a variety of data sources. These methods included: a document review, key informant interviews, site observation visits, and focus group discussions. Results- The project strengthened government capacity through supporting knowledge transfer and the institutionalization of best practices. The evaluators developed an innovative framework to assess the sustainability of capacity building efforts. The analysis enabled USAID to make an informed transition of its reform efforts to appropriate MOH bodies. Recommendations- Examples of best practices include: 1) Sustainability Plans should indicate the key objectives and expected results for transitioned interventions; 2) Meet with district level government actors and committees to plan resource allocations and mobilization activities that within their purview; 3) Develop a user-friendly analytical tool for District Monitoring Teams to independently generate aggregated results for district-wide decision-making.