Mid-term evaluation of REACH (resources for child health project)

The evaluation covers the period 9/85-9/88. In the EPI component, overall management, leadership, and performance have been of high quality and demonstrated effectiveness. Coordination with other donors has also been strong. As indicated by the number of buy-ins, there has been high demand for project services, which include identifying cost- effective delivery mechanisms, developing methodology and information systems for monitoring coverage, strengthening the capacity of nongovernmental providers, and developing training and informational materials. On the negative side, the technical advisory group (TAG) has not performed the expected in-depth technical reviews of project programs and strategies, but has instead functioned as a donor coordination mechanism, which could be performed more economically through other means. The HCF component is much less focused than EPI. The component was plagued early on by staffing problems and inadequate economic talent during the early stages, making the refinement of strategies more difficult. In addition, TAG efforts relative to the HCF component have been expensive and less beneficial than expected. While the project has been extremely responsive to Mission requests, it is in danger of becoming overly burdened by institutional efficiency and reform activities, to the neglect of more promising interventions in cost recovery, partially because the latter is insufficiently emphasized in A.I.D.'s HCF guidelines. With the demand for HCF assistance rising dramatically, the component needs to define its strategy and involve subcontractors as true collaborators in implementing it.