Purpose: The midterm performance evaluation of MEASURE Evaluation Phase IV seeks to inform technical programming and program management activities. Questions: The evaluation responds to three overarching questions: (1) Is the project meeting its stakeholders’ needs? (2) What are the benefits of a health sector–wide versus a health area–specific approach? (3) Are the tools developed useful? Methods: This evaluation used a mixed-methods approach. The team conducted in-person interviews with 117 stakeholders in Cote d’Ivoire, Mali, and Nigeria; 49 virtual or in-person interviews with internal and external stakeholders in Washington, D.C., and other countries; an online survey with 120 internal (U.S. Government) and external stakeholders; and a review of 104 project documents. Findings and Conclusions: MEASURE Evaluation has been successful in meeting many needs at country and global levels, but has been challenged to comprehensively and consistently meet all needs. Stakeholders perceive a unique role for the project in the USAID landscape in strengthening heath information systems (HIS), conducting health impact evaluations, and building evaluation capacity. They view the project’s approach to technical assistance and capacity building as facilitating ownership and sustainability at the country level. Almost all stakeholders see the benefits of a health sector–wide approach to strengthening HIS; however, this is challenging for USAID, given the funding streams it has to manage. Stakeholders appreciate and use the many tools that the project has developed and adapted. Strengthening data quality and data use for decision making and facilitating interoperability of databases remain the most pressing HIS strengthening needs. (Author abstract)

