Online Program

Let's Work Together - Partner Coordination and Implementation of Health Interventions: Results from the evaluation of USAID/Malawi Support for Service Delivery Integration Project

Monday, November 2, 2015

Dr. Swati Sadaphal, MD MHS, Global Health Practice, International Business & Technical Consultants, Inc. (IBTCI), Vienna, VA

USAID/Malawi supports the Government of Malawi, through its Support for Service Delivery Integration project (SSD-I), to improve the effectiveness of the Essential Heath Package (EHP) and efficiency in the management of integrated services delivery in 15 districts. SSD-I consists of three inter-related sector activities: health services, behavior change communications (BCC) and systems strengthening. This innovative model was designed as one program to be implemented by three separate implementing partners.  We conducted a mid-term evaluation to understand the effect of joint coordination and implementation of SSD-I on the achievement of sector-specific objectives.


The evaluation used a mixed methods approach, including: data review of 22 performance indicators; 93 key informant interviews; 63 facility mini-surveys; and 48 focus group discussions with community volunteers.

Major Results:

Implementing partners are cognizant of the same end-goal, are collaborating and coordinating to maximize their program impact. The major achievements include:  1) integration of key services at the facility level; 2) co-locating all interventions in the same districts; 3) synchronizing activity start and end dates; and 4) coordinating, planning and leveraging of resources. However, ambiguities persist vis-à-vis:  strengthening referral systems; improving data management and use; monitoring and evaluation of BCC; and supportive supervision within the district health management. 

Policy Implications:

The SSD-I model holds potential to improve the effectiveness and efficiency of EHP services. While the integration of service delivery at the facility level has been successful, greater efforts are needed to ensure synergy and coordination among the three sector activities at the district level.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
Evaluate the effectiveness of partnership collaboration and coordination for integrated health services provision in a resource-poor setting. Identify policy implications for improving the next phase of integrated health programming in the Malawi context.

Keyword(s): Health Care Delivery, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Director of multiple External Evaluations of USAID-funded Global Health Programs. I provided technical and managerial oversight for this program evaluation.
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.

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