Performance evaluation of USAID/Uganda capacity program

UCP aims to strengthen human resources for the delivery of health and HIV/AIDS services. It contributes to Uganda’s Country Development Strategy Development Objective (DO) 3: "Improved health and nutritional status in focus areas and population groups," as well as several Intermediate Results (IRs) and sub-IRs that constitute DO 3. The evaluation team conducted an evidence-based performance evaluation of the UCP to independently establish the effectiveness of the interventions of the program. The evaluation relied on a mix of qualitative and quantitative methods, including a UCP and country-specific document review, key informant interviews with relevant stakeholders, focus group discussions, and direct observations. Four specific questions guided the UCP performance evaluation: (1) How effective has the project been in achieving its Intermediate Result 1:"Increased Capacity for HRH Policy and Planning" by the third year and are the outcomes expected by September 2014 still valid and achievable, or do they need to be adjusted to reflect realities of the current context; (2) does performance in the last three years demonstrate an appropriate technical and strategic approach by UCP to performance management and performance improvement in the current context [and] what interventions are yielding, or have the potential to yield, the greatest impact and what interventions are not, and are there any additional interventions that could be more effective; (3) how well has UCP strengthened country ownership and sustainability of their HRH - related interventions, and are there any additional interventions/activities that could enhance country ownership and sustainability; and (4) how well has UCP strengthened and supported the private not for profit (PNFP) sector, and how well has UCP supported the work of USAID implementing partners? The evaluation concluded overall that the UCP is an ambitious venture that effectively increased national and district HRH policy and planning capacity, galvanized a wide range of stakeholders from the public and private sectors and the donor community to collaborate in rolling out new HRH systems and policies nationally. Together, UCP and the Uganda Ministry of Health (MOH) mounted an outstanding advocacy and lobbying effort to address a well-documented shortage of health workers in the country, resulting in allocation of substantial funding to recruit and deploy more than 7,000 health workers across the country, and contributing considerably to reducing national health worker shortages. Evaluators agree with MOH officials, that while the program made great strides, the capacity at central and district levels to manage, coordinate, and sustain HRH policy and planning is still not optimal, due in part to structural and motivational issues. Performance management fits well within the UCP's HRH strategic focus and was an identified priority by stakeholders. Overall, GOU is now in a better position to lead, prioritize HRH issues, but independent implementation, performance and accountability with regards to key interventions are still variable. (Excerpt, modified)