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Final Evaluation Report [Insert high-quality photograph representing the project being evaluated to replace this instruction and fill this text box.] FINAL EVALUATION REPORT PARTNERSHIP FOR THE COMMUNITY MANAGEMENT OF CHILD HEALTH/PARTENARIAT POUR LA PRISE EN CHARGE COMMUNAUTAIRE DE LA SANTÉ INFANTILE (PRISE-C) Benin, Health Zones of: Allada/Ze/Toffo (AZT) Dassa/Glazoue (DAGLA) Save/Ouesse (SAO) December 2014 This publication was produced at the request of the United States Agency for International Development. It was prepared independently by Renée Fiorentino with the support of Marthe Akogbe to, PRISE-C Director; Ramzia Akonde, PRISE-C Child Health and M&E Advisor; and Sara Riese, PRISE-C Technical Advisor. For the Final Evaluation Brief and other Child Survival and Health Grants Program materials, please visit http://www.mcsprogram.org/CSHGPproducts Acknowledgements The author wishes to acknowledge the Government of Benin and USAID for their commitment not only to decentralized heath care services, but to the evaluation and continuous improvement of them. Thank you to the representatives of each entity and to the community health care and formal heath sector workers in the regions of Allada/Ze/Toffo (AZT), Dassa/Glazoue (DAGLA), Save/Ouesse (SAO) who made time to speak to me about the PRISE-C program. FINAL EVALUATION REPORT PARTNERSHIP FOR THE COMMUNITY MANAGEMENT OF CHILD HEALTH/PARTENARIAT POUR LA PRISE EN CHARGE COMMUNAUTAIRE DE LA SANTÉ INFANTILE (PRISE-C) Benin, Health Zones of: Allada/Ze/Toffo (AZT) Dassa/Glazoue (DAGLA) Save/Ouesse (SAO) December 29, 2014 Project Duration: September 30, 2010 – September 29, 2014 Cooperative Agreement Number: AID-OAA-A-10-00047-00 DISCLAIMER The author’s 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 Contents ......................................................................................................................... 4 Acronyms ........................................................................................................................ 5 Evaluation Purpose and Evaluation Questions .............................................................. 9 Evaluation Purpose ................................................................................................................................ 9 Evaluation Questions .............................................................................................................................. 9 Project Background ........................................................................................................ 9 Evaluation Methods and Limitations ............................................................................ 15 Findings ................................................................................................................................................ 19 Conclusions .......................................................................................................................................... 28 Recommendations ................................................................................................................................ 31 Annexes ........................................................................................................................ 32 Annex I. List of Publications and Presentations Related to the Project ............................................... 33 Annex II. Project Management Evaluation ........................................................................................... 34 Annex III. Work Plan Table ................................................................................................................... 35 Annex IV. RapidCATCH Indicator Table .............................................................................................. 38 Annex V. Final Knowledge, Practice, and Coverage Survey Report ................................................... 40 Annex VI. Community Health Worker Training Matrix .......................................................................... 41 Annex VII. Evaluation Scope of Work .................................................................................................. 42 Annex VIII. Evaluation Methods/Data Source Mapping ....................................................................... 48 Annex IX. Data Collection Instruments ................................................................................................. 50 Annex X. Sources of Information .......................................................................................................... 56 Annex XI. Disclosure of Any Conflicts of Interest ................................................................................. 58 Annex XII. Statement of Differences .................................................................................................... 60 Annex XIII. Evaluation Team Members, Roles, and Their Titles .......................................................... 61 Annex XIV. Final Operations Research Report .................................................................................... 63 Annex XV. Operations Research Brief ................................................................................................. 97 Annex XVI. Stakeholder Debrief Powerpoint Presentation .................................................................. 98 Annex XVII. Project Data Form ............................................................................................................120 Annex XVIII. PRISE-C Performance Monitoring Plan .......................................................................... 121 ACRONYMS ACT Arteminisin-based combination therapy ARI Acute respiratory infection AZT Allada/Zè/Toffo health zone CEID Centre d'Expertise d'Ingenierie pour le Developpment Durable CHW Community health worker CHS Center for Human Services C-IMCI Community Integrated Management of Child Illnesses CSHGP Child Survival and Health Grants Program DAGLA Dassa/Glazoué health zone DIP Detailed implementation plan FCFA Communauté Financiere Africaine FGD Focus group discussion HIIP-COM High-impact intervention package for community HMIS Health management information system ITN Insecticide-treated mosquito net KII Key informant interview KPC Knowledge, practice, and coverage LEADD Leadership & Development research firm MCHIP Maternal and Child Health Integrated Program MoH Ministry of Health OR Operations research ORS Oral rehydration solution PILP Projet d'Intensification de la Lutte Contre le Paludisme PISAF Projet Intégré de Santé Familiale PMP Performance monitoring plan PRISE-C Partenariat pour la Prise en Charge Communautaire de la Santé Infantile PROMUSAF Promotion des Mutuelles de Santé en Afrique QC Quality collaborative QIT Quality improvement team RAMU Régime d'Assurance Maladie Universelle RAS Réseau Alliance Santé SAO Save/Ouesse health zone SOW Scope of work TT Tetanus toxoid vaccination USAID U.S. Agency for International Development VHC Village health committee [Insert photo] PRISE-C FINAL EVALUATION Report - Executive Summary This project was funded by the U.S. Agency for International Development through the Child Survival and Health Grants Program. The Community Health Worker of Ahokpogon displays her stock of December 2014 medical supplies during an education session Evaluation, Purpose, and Evaluation Questions • Evidence of project contribution to The final evaluation of the Partnership for Community Child Survival accelerated delivery of (PRISE-C) was conceived as both a performance and a process proven, low cost evaluation. It serves as a source of evidence to help inform decisions maternal and child about future program designs and policies including in-country partners at health interventions by national, regional, and local levels (e.g., the Ministry of Health (MoH) of strengthening Benin, other relevant ministries, district health team, local organizations, community health communities in project areas, U.S. Agency for International Development delivery systems (USAID) (Child Survival and Health Grants Program [CSHGP], Global • Community engagement Health Bureau, USAID Missions), other CSHGP grantees, and the (as defined by the international global health community at large. project) achieved • Demand for community The evaluation explores the extent to which the assumed causal pathways prevention and curative between the project’s outcome objectives and its activities are sound and services is evident, but whether or not activities yielded the intended outcomes. It sought to not well captured by identify bottlenecks and constraints experienced in pursuit of the outcomes PMP indicators and to provide an opportunity for project stakeholders to take stock of • Strong evidence that QI accomplishments and lessons learned to date. approach contributed to increased CHW The final evaluation sought to answer the following questions: performance 1. To what extent did the project accomplish and/or contribute to the • Resolute attempts on results (goals/objectives) stated in the Detailed Implementation the part of the project to Plan (DIP)? facilitate sustainability were optimistic in the 2. What were the key strategies and factors, including management health sector context in issues, that contributed to what worked or did not work? Benin 3. Which elements of the project have been or are likely to be sustained or expanded through the Beninese MoH (e.g.,
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