End-of-activity evaluation : the new partnerships initiative expand / new partners for better health (NPI EXPAND)

Palladium implemented the two-year activity, with an effective start in June 2022. The activity was designed to increase the availability and utilization of high-quality health services through local partners. The evaluation addressed five questions: 1) How has the organizational capacity among the seven CSOs changed as a result of the activity? 2) How has the project contributed to the Community Scorecard (CSC) process nationally and the capacity of the six CSOs to facilitate the CSC and other reproductive health (RH)/maternal and child health (MCH) technical capacities? 3) What promising and innovative practices were produced through this activity intervention? 4) How has the CSC process contributed to gender equality and social inclusion (GESI)? 5) What are the major lessons learned from implementing social accountability and capacity strengthening for local CSOs? The evaluation team conducted a desk review, interviews, and community focus group discussions, reassessed the capacity of CSOs using standardized and validated organizational development tools, and collected secondary data from local primary sources specializing in health. The evaluation team found that NPI EXPAND contributed to and strengthened the organizational and technical capacity of six CSOs. At the same time, there was not enough evidence to conclude outcomes for the seventh CSO. The activity contributed nationally to the CSC process, revitalizing and contributing to the implementation of the full CSC cycle. There was an improvement in all six CSC indicators over time, although the activity did not meet its end-ofproject targets. Higher commitment, ownership, and responsiveness of health facilities indirectly contributed to improving family planning (FP)-reproductive, maternal, newborn, and child health (RMNCH) indicators but not to the extent of meeting the activity’s targets. The evidence was inconclusive on the effectiveness of innovative programming implemented by the CSOs, although three innovations were deemed promising for scale-up. When it comes to GESI, gender equality was not maintained in terms of participation in trainings, CCs, HDAs, and Joint Meetings. However, the efforts of NPI EXPAND contributed to social inclusion of marginalized groups and women"s empowerment, particularly in enabling women to voice their opinions. CSOs and other community networks were deemed vital for mobilizing and establishing a supportive environment for empowerment and active participation. Lessons learned demonstrate the crucial role of community engagement in strengthening social accountability and, to a more limited extent, the sustainability of health services. Generally, findings showed that when the community was more engaged with their local health facility, they were more likely to contribute to solutions for local issues. The community also recognizes issues beyond its capacity and that of the local health authorities. Organizational capacity building takes time, and this evaluation found that strengthening local CSO capacity requires a long-term mindset and effort. Employing consultative, collaborative, and needs-based approaches can help solidify the transfer of skills and knowledge.