Providing Child Survival Services to Rural and Peri-Urban Populations in Bolivia District 8 of El Alto, Department of La Paz, Bolivia Montero, Department of Santa Cruz, Bolivia FINAL EVALUATION REPORT Cooperative Agreement No. HFP-A-00-02-00035-00 October 1, 2002 - September 30, 2007 Submitted to: USAID/GH/HIDN/NUT/CSHGP U.S. Agency for International Development, Ronald Reagan Building, 1300 Pennsylvania Avenue NW, Room 3.7-74, Washington, D.C. 20523-3700 Submitted by: Curamericas Global, Inc. 2245 North Hills Drive, Suite E, Raleigh, NC 27612 Telephone: 919-510-8787 Fax: 919-501-8611 Team Leader for Final Evaluation: Dr. Richard Crespo, Consultant Field Contact: Dr. Irma Condori, Project Director Curamericas Global Headquarters Contacts: Nancy Nix, Senior Program Specialist and Teresa M. Wolf, Executive Director December 21, 2007 1 A. Summary .......................................................................................................................................... 4 1. Brief description of the project ....................................................................................................... 4 2. Main accomplishments .................................................................................................................... 4 3. Highlights of comparison between baseline and final surveys ..................................................... 5 4. Priority conclusions ......................................................................................................................... 6 B. Assessment of results and impact ................................................................................................... 6 1. Results: Summary chart .................................................................................................................. 6 2. Results: Technical approach ........................................................................................................ 11 a. Brief overview ............................................................................................................................ 11 b. Progress by intervention area .................................................................................................. 11 c. New tools and approaches ........................................................................................................ 19 3. Results: Cross-cutting approaches .............................................................................................. 20 a. Community mobilization .......................................................................................................... 20 b. Communication for behavior change ...................................................................................... 21 c. Capacity building approach ..................................................................................................... 22 d. Health facility strengthening .................................................................................................... 24 e. Sustainability strategy ............................................................................................................... 25 4. Results: Family planning ............................................................................................................... 26 5. Results: TB ..................................................................................................................................... 26 C. Project management ...................................................................................................................... 26 1. Planning .......................................................................................................................................... 26 a. Inclusiveness of the planning process ...................................................................................... 27 b. Practicality of the DIP work plan ............................................................................................ 27 c. Gaps in the DIP ......................................................................................................................... 27 2. Staff training .................................................................................................................................. 27 a. Changes in knowledge and skills .............................................................................................. 28 b. Adequacy of training resources ................................................................................................ 28 c. Lessons learned about building capacity of the project staff ................................................ 28 3. Supervision of project staff ........................................................................................................... 28 a. Adequacy of the supervisory system ........................................................................................ 28 b. Institutionalization and sustainability of the supervisory system ......................................... 29 4. Human resources and staff management .................................................................................... 29 a. Personnel policies and procedures in place ............................................................................. 29 b. Morale, cohesion and relationships ......................................................................................... 29 c. Staff turn-over ........................................................................................................................... 29 d. Staff transition ........................................................................................................................... 30 2 5. Financial management .................................................................................................................. 30 6. Logistics .......................................................................................................................................... 30 a. Adequacy and impact of logistics on implementation ............................................................ 30 7. Information management .............................................................................................................. 30 a. Effectiveness of the HIS system for measuring progress ....................................................... 30 b. Procedure for collecting, reporting and using data ................................................................ 30 c. Staff skills for maintaining HIS system ................................................................................... 31 d. Use of special assessments ......................................................................................................... 31 e. Extent of strengthening MOH data collection systems .......................................................... 32 f. Partners’ comprehension of the project’s accomplishments ................................................. 32 g. Use of HIS beyond CS project .................................................................................................. 32 8. Technical and administrative support ......................................................................................... 32 a. Types of technical assistance received ..................................................................................... 32 b. Headquarter support of the field project ................................................................................ 32 9. Mission collaboration .................................................................................................................... 32 10. Management lessons learned ........................................................................................................ 33 D. Other issues .................................................................................................................................... 33 E. Conclusions and recommendations .............................................................................................. 33 1. Achievement of objectives and outcomes ................................................................................ 33 2. Most important achievements and factors affecting project performance .......................... 33 3. Outline of best practices and lessons learned .......................................................................... 34 4. Recommendations for USAID .................................................................................................. 34 5. Potential for sustainability ........................................................................................................ 34 6. Headquarter application of best practices and lessons learned ............................................ 34 7. Potential for scale-up ................................................................................................................ 34 F. Results highlights ........................................................................................................................... 35 ATTACHMENTS ...................................................................................................................................... 36 A. Evaluation team members ........................................................................................................ 36 B. Final KPC report ......................................................................................................................