Sudan health transformation project phase II : end of project performance evaluation report

The project ran from February 2009 to October 2012 with a total available funding of $58,497,880. SHTP II had three result areas: (1) service delivery; (2) health system strengthening; and (3) demand increase. The project was designed to accelerate health system development by making the provision of essential health services compatible with the Ministry of Health"s (MOH"s) capacity to manage the service delivery system. Management Sciences for Health (MSH) was contracted to manage SHTP II and provide support to 166 government-owned health facilities through performance-based contracts (PBCs) with lead agencies in each of the 14 focus counties. The seven high-impact services to be provided were based on the MOHs Basic Package of Health Services (BPHS), including: child health, nutrition, hygiene and sanitation, malaria, maternal health, family planning (FP), and prevention of HIV/AIDS. To underpin delivery of these essential services, SHTP II was designed to support the strengthening of South Sudan"s health systems at the facility and county levels. Under SHTP II, emphasis was also put on involving the community and increasing its demand for health services. The purpose of this end of project (EOP) evaluation, which was based on a series of specific research questions, is to understand the strengths and weaknesses of SHTP II"s approach to its three stated result areas in order to develop recommendations for new health program planning and for USAID"s South Sudan health portfolio in general. The evaluation took place during May and June 2012 and relied on an extensive document review, key informant interviews, a rapid survey of sub-contracted partners, and field visits to a representative sample of health facilities. The findings of the evaluation are: (1) service delivery: the evaluation found that the SHTP II project achieved some encouraging results at the supported facilities, however, the availability of services was vulnerable to persistent supply and equipment shortages and lack of qualified health workers; (2) in health systems strengthening, the evaluation assessed response to health system challenges at the facility and county levels, with the process revealing that the very low baseline of national health systems posed significant implementation challenges for SHTP II and the sustainability of health services; (3) increasing demand for services: the project successfully used standardized trainings to rapidly increase the number of trained community members, namely home health promoters and village health committees. The evaluators also outline specific recommendations for each of the project"s result areas. (Excerpt, modified)