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Report End Phase Evaluation REPORT END PHASE EVALUATION (Epidemic Control and Reinforcement of Health Services (ECRHS) Phase 1 Programme in Sierra Leone) Ebola Emergency Response Commissioned by: CARE International in Sierra Leone Prepared By: Teddy Amara Morlai (Lead Consultant) Inclusive Development and Research Consultancy The ECRHS Phase 1 Programme was supported by the German Government (KFW) April 2019 Table of Contents Table of Contents ............................................................................................................................................. i List of Tables ..................................................................................................................................................... i List of Figures ................................................................................................................................................... ii Acknowledgement .......................................................................................................................................... iii List of Abbreviations and Acronyms ..............................................................................................................iv Executive Summary ........................................................................................................................................ v 1. BACKGROUND OF THE EVALUATION ................................................................................................. 1 1.1 Background/ Context of the Programme .................................................................................................................................... 1 1.2 Evaluation Purpose and Objectives ................................................................................................................................................ 1 2. METHODLOGY ........................................................................................................................................... 2 2.1 Design of the Evaluation ................................................................................................................................................................... 2 2.2 Sampling selection procedures ....................................................................................................................................................... 3 2.3 Desired Data for the Evaluation ..................................................................................................................................................... 5 2.4 Sources of information/data and evaluation Tools .................................................................................................................... 5 2.5 Data Collection Method ................................................................................................................................................................... 8 2.6 Data Management and Quality Control ....................................................................................................................................... 8 2.7 Methods for Analyses of Data/ Information ................................................................................................................................ 9 3 EVALUATION FINDINGS AND DISCUSSIONS ................................................................................... 10 3.1 Objective level Programme achievement ................................................................................................................................... 10 3.2 Programme Effectiveness ............................................................................................................................................................... 25 3.3 Relevance of the Programme ........................................................................................................................................................ 38 3.4 Efficiency of the Programme .......................................................................................................................................................... 40 3.5 Changes in general conditions (context)and perspectives .................................................................................................... 43 3.6 Programme sustainability ................................................................................................................................................................ 44 3.7 Key challenges and lessons learnt/best practices ..................................................................................................................... 44 4 CONCLUSION ........................................................................................................................................... 47 5. RECOMMENDATIONS (ECRHS11, DECISION MAKERS, UPSCALING OF SRH ACTIVITIES) .... 47 ANNEXES ......................................................................................................................................................... i Annex I: Terms of Reference ..................................................................................................................................................................... i Annex II: Household/Personal Interviews Questionnaires ................................................................................................................. i Annex III: Health Facility Assessment Tool ............................................................................................................................................ i Annex IV: Focus Group Discussion (FGD) Guide ................................................................................................................................ i Annex V: Key Informant Interviews (KIIs) Guide ................................................................................................................................. i Annex VI: Key Informant Interviews Guide for CHWs/CWM ......................................................................................................... i List of Tables Table 1: Geographic Coverage of the proposed exercise ........................................................................................................................... 2 Table 2: Distribution of sampled number of health catchments//communities using stratification ......................................................... 4 Table 3: Number of PHUs assessed by type and district ........................................................................................................................... 4 Table 4: Desired sample size and actual number of respondents targeted for household/personal interviews ..................................... 5 Table 5: Number of PHUs/health catchments assessed by district and chiefdom ..................................................................................... 6 Table 6: Number and types of respondents targeted for key informant interviews ................................................................................... 6 Table 7: Evaluation Design Matrix .............................................................................................................................................................. 7 Table 8: Level of achievement of Programme targets for the three Programme objective indicators .................................................. 10 Table 9: Trend in total reported cases of diseases/events across the intervention districts ................................................................. 11 Table 10: Case Studies/Insight Studies on the contribution of community-based surveillance .............................................................. 1 4 Table 11: Level of achievement of Programme targets for the two new Programme objective indicators .......................................... 18 Table 12: Logistic regression model showing the relationship (Odds Ratio) between urban-rural characteristics and improved food and nutrition security situations across the four intervention districts .................................................................................................. 22 Table 14: Logistic regression model showing the relationship (Odds Ratio) between urban-rural and Ebola-affected characteristics and food and nutrition security situations across the four intervention districts .................................................................................. 24 Table 15: Level of achievement of targets set to achieve intermediate results for objective 1 ............................................................. 25 Table 16: Logistic regression model showing the relationship (Odds Ratio) between risk minimizing behaviours and Ebola-affected and availability of water facilities across the four intervention districts .................................................................................................. 28 Table 17: Logistic regression model showing the relationship (Odds Ratio) between risk minimizing behaviours and rural-urban settings across the four intervention districts .......................................................................................................................................... 28 Table 18: Logistic regression model showing the relationship (Odds Ratio) between urban rural characteristics and availability of and access to safe/improved water supply across the four intervention districts .................................................................................
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