142nd APHA Annual Meeting and Exposition

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312179
Ten Years Later: Results from a Performance Evaluation of the USAID/Mali health portfolio (2003 to 2013)

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 2:54 PM - 3:06 PM

Dr. Swati Sadaphal, MD MHS , Global Health Practice, International Business & Technical Consultants, Inc. (IBTCI), Vienna, VA
Pierre Claquin , Independent Consultant
Mamadou Kone , Independent Consultant
Iain Mclellan , Independent Consultant
Bouaré Mountaga , Independent Consultant
USAID/Mali’s health portfolio of “High Impact Health Services” was designed to affect the high levels of under-five and maternal mortality, persistent high fertility, and HIV/AIDS prevalence among vulnerable populations. The health portfolio was implemented from 2003-2008 with modifications that extended programming through 2013.

The objectives of this external performance evaluation was to capture the value of USAID investments over the past ten years and inform the design and/or implementation of any future activities. A mix of evaluation methods were employed including: a) key informant interviews with stakeholders, service providers, and beneficiaries to understand historical and current perspectives on portfolio implementation; b) a longitudinal trend analysis of performance indicators triangulated with external data sources; and c) the development of case studies at two comparison sites with high and low levels of investment, to understand impact of interventions at the community level.

Major contributions were found in strengthening the Malian health system including improvements in monitoring and evaluation; improved coverage of family planning, reproductive health, and childhood immunization interventions; and amelioration of gender issues. Two particular approaches were effective in improving service delivery and health system performance: a) the capacity building technical assistance provided at national, regional, district, and health center levels; and b) strengthening the management team of community based organizations. Program weaknesses were found such as capacity building for social-behavior change communication; sustaining community based groups and health agents; and donor duplication. Health indicators were not significantly different between high and low level investment sites due to donor overlap.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related research

Learning Objectives:
Describe the method utilized for conducting performance evaluation of a long term health services portfolio in a low-income country. Identify implications for improving the next phase of health programming in the Mali context.

Keyword(s): Performance Measurement, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed the initial evaluation plan and analysis matrix for this program evaluation. I am an MD with MHS in population, family and reproductive health. I have been doing international public health program evaluations for the past ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.