Evaluation of the Pathfinder International family planning services project (936-3062)

Midterm evaluation covers the period 9/92-3/95. PI has done very well in expanding the availability of FP services. Specifically, PI has: (1) supported 71 subprojects in 18 countries, 2/3 of which are service delivery projects; (2) transferred 65% of USAID funds to host-country institutions, mostly NGOs, while allocating just 30% for administrative overhead; (3) supported improvements in the quality of care through provider training and expansions in the method mix; and (4) developed strong administrative and financial systems for processing proposals, channeling and accounting for funds, and tracking program activities. PI is on track in meeting quantitative targets for Couple Years of Protection (CYPs). When the Service Delivery Expansion Support Program (SDES) activities are included, PI has far exceeded most original targets. In 27 months, PI has distributed 1.5 million of a targeted 4.3 CYPs, trained 12,278 of a targeted 30,000 individuals, and disseminated FP information to 3.3 million of a targeted 6.7 million persons. New users reached through the project are estimated at 3.5 million. The quality of care is generally good in PI-supported subprojects. Providers are well-trained, and facilities are typically clean and properly maintained. However, despite the availability of medical services expertise at PI headquarters, little TA has been provided to subprojects in the areas of quality medical care, method choice, client-provider interactions, and client satisfaction. It is difficult to assess PI"s success in achieving the goals of improved sustainability, institutional strengthening, and cost-efficiency/effectiveness of developing country FP institutions. While PI reports supporting 19 institutions, countries differ greatly in their progress and PI"s contributions are difficult to track. New indicators are needed which relate to all of the goals of the cooperative agreement. There are also some management problems. (1) Although the project"s decentralized structure has streamlined decisionmaking and improved communications, it has not been balanced by sufficient oversight and support of the PI regional offices by PI headquarters. (2) While PI has a comprehensive financial management system in place, the system"s extensive documentation and reporting requirements place too much emphasis on financial management, detracting from program content. (3) Better communications between PI and USAID are needed. Some USAID staff are not well-informed about PI"s activities. In sum, PI"s performance has been good overall, though there are important weaknesses in urgent need of attention. Some of these weaknesses are a result of PI"s efforts to be responsive to USAID and/or reflect the difficulties inherent in working in a bureaucratic context. Despite these weaknesses, there is a clear and continuing need for a general, multipurpose FP service delivery project like the present cooperative agreement.