Evaluation of the Project to Strengthen Mother and Child Health and Health Information Systems (Pasmesiss) Government-To-Governm
Total Page:16
File Type:pdf, Size:1020Kb
PERFORMANCE EVALUATION EVALUATION OF THE PROJECT TO STRENGTHEN MOTHER AND CHILD HEALTH AND HEALTH INFORMATION SYSTEMS (PASMESISS) GOVERNMENT-TO-GOVERNMENT FIXED-AMOUNT REIMBURSEMENT AGREEMENT FEBRUARY 2018 This publication was produced at the request of the United States Agency for International Development. It was prepared independently by Peter Cleaves, Lisa Slifer Mbacké, Mamadou Fall, Ndaté Guèye, Déguène Pouye and Mame Aïssatou Mbaye of Management Systems International, A Tetra Tech Company, for the USAID/Senegal Monitoring and Evaluation Project. EVALUATION OF THE PROJECT TO STRENGTHEN MOTHER AND CHILD HEALTH AND HEALTH INFORMATION SYSTEMS (PASMESISS) GOVERNMENT-TO- GOVERNMENT FIXED-AMOUNT REIMBURSEMENT AGREEMENT Revised February 2018 Contracted under AID-685-C-15-00003 USAID Senegal Mission-Wide Monitoring and Evaluation Project Cover Photo: A mother with her child in Kaffrine Regional Hospital for a consultation. Credit: USAID/Senegal Monitoring and Evaluation Project DISCLAIMER The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. CONTENTS Acknowledgments ..........................................................................................................................ii Acronyms .......................................................................................................................................iii Executive Summary ...................................................................................................................... 1 Evaluation Purpose and Questions ....................................................................................................................... 1 Activity Background .................................................................................... Error! Bookmark not defined. Evaluation Design, Methods and Limitations ...................................................................................................... 1 Findings, Conclusions and Recommendations ................................................................................................... 1 Activity Background and Objectives ........................................................................................... 6 Activity Objectives ................................................................................................................................................... 6 Evaluation Questions .................................................................................................................... 6 Evaluation Methods and Limitations ........................................................................................... 7 Methodology .............................................................................................................................................................. 7 Limitations .................................................................................................................................................................. 8 Findings and Conclusions.............................................................................................................. 9 Question 1: Pros & Cons? ...................................................................................................................................... 9 Question 2a: Building Institutional Capacity? ................................................................................................... 13 Question 2b: Training Gaps? ................................................................................................................................ 16 Question 3 Level of Ownership? ........................................................................................................................ 16 Question 4: Sustainability? .................................................................................................................................... 18 Recommendations ...................................................................................................................... 20 Annexes ........................................................................................................................................ 23 Annex I: PASMESISS Implementation ................................................................................................................. 23 Annex II: Sources of Information ........................................................................................................................ 33 Annex III: List of Key Informant Interview and Group Interview Participants ........................................ 35 Annex IV: HSS+ and PASMESISS Comparative Advantages ......................................................................... 40 Annex V: Notes sur la Comptabilité et Gestion Financière ......................................................................... 46 Annex VI: Notes sur le DHIS2 ............................................................................................................................ 54 Annex VII : Matrice des Recommandations et actions à mener ................................................................ 63 Annex VIII: Evaluation Statement of Work ...................................................................................................... 72 Annex IX : Data Collection Instruments .......................................................................................................... 31 Annex X: Evaluation Team CVs .......................................................................................................................... 35 Annex XI: Disclosure of Any Conflicts of Interest ......................................................................................... 50 PASMESISS G2G FARA PERFORMANCE EVALUATION i ACKNOWLEDGMENTS The evaluation team would like to express its sincere gratitude to the medical officials and stakeholders in the Kaffrine Region, particularly Mr. Jean Baptiste Coly, governor, and Dr. Momodou Moustapha Diop, chief regional doctor. From the outset of the team’s visit to Kaffrine, we were welcomed and provided with an open door to frank discussions about the strengths and weaknesses of PASMESISS. The evaluation team would also like to thank the many Ministry of Health and Social Action staff members in DAGE, DPRS and DSISS who took the time to meet with the evaluation team and answer numerous follow-up questions via phone and email. Special thanks go to the PASMESISS AOR at USAID, Dr. Oumar Sagna, who worked closely with the team in developing the original statement of work and field workplan and provided immediate and detailed responses to our numerous requests for additional documents and clarifications. PASMESISS G2G FARA PERFORMANCE EVALUATION ii ACRONYMS ADIE Agence de l’Informatique de l’Etat ADS Automated Directives System AOR Agreement Officer’s Representative ARD Agence régionale de développement ARMP Autorité de Régulation des Marchés Publics CRV Comité Régional de Validation CS Comité de Santé DAGE Direction de l’Administration Générale et de l’Equipement DCFE Direction de la Coopération et des Financements Extérieurs DHIS District Health Information System DSISS Direction du Système d’information sanitaire et social DPRS Direction de la Planification de la recherche de des statistiques DS District Sanitaire EPS Etablissement Public de Santé FARA Fixed-Amount Reimbursable Agreement FCR Findings, Conclusions, Recommendations FD Financement Direct FY Fiscal Year GAT Government Agreement Team GATR Government Agreement Technical Representative GAVI Global Alliance for Vaccines and Immunization G2G Government to Government GoS Government of Senegal GoTAP Government Technical Assistance Provider HSS Health System Strengthening IGE Inspection Générale d’Etat IL Implementation Letter IP Implementing Partner LE Lettre d’Exécution MCD Médecin Chef de District MCR Médecin Chef de Région M&E Monitoring & Evaluation MEFP Ministère de l’Economie, des Finances et du Plan PASMESISS G2G FARA PERFORMANCE EVALUATION iii MSAS Ministère de la Santé et de l’Action sociale MSI Management Systems International NHP National Health Plan OFM Office of Finance and Management (USAID) PASMESISS Programme d’amélioration de la santé, de l’enfant et du système d’information sanitaire et sociale PFMRAF Public Financial Management Risk Assessment Framework PNDS Plan National de Santé POCL Plan Opérationnel des Collectivités Locales PS Poste de Santé PTA Plan de travail annuel PTF Partenaire Technique et Financier PV Procès-Verbal (minutes, proceedings) RBM Results-Based Management REDISSE Projet Régional, d’amélioration des systèmes de surveillance des maladies régionales en Afrique de l’Ouest RM Région Médicale RSS Renforcement du Système de Santé SOW Statement of Work SRMNIA Santé Reproductive, Maternelle, Néonatale, Infantile et de l’Adolescent TDR Termes de Référence (Scope of Work) TOMPRO Logiciel de Management et Système automatisé intégré de gestion comptable USAID United States Agency for International Development USG United States Government PASMESISS G2G FARA PERFORMANCE EVALUATION iv EXECUTIVE SUMMARY Evaluation Purpose and Questions The purpose of this evaluation is to support both USAID/Senegal and the Government of Senegal (GoS) in identifying strengths and weaknesses in the current Government to Government (G2G) approach in improving health systems at the regional level. Through this evaluation