USAID/Haiti sante activity : mid-term evaluation final report

Santé began in December 2017 and is scheduled to end in November 2021, with a total estimated ceiling of $98.5 million. The evaluation assesses Santé’s achievement of key results, relevance of its design, ability to respond to requests from key stakeholders, and plans to transition staff to the Ministry of Health.Santé was designed to improve utilization and quality of the health services for a catchment area of more than 4 million people, or 47 percent of Haiti’s population. To do so, Santé worked at the facility and community levels to promote a service-oriented culture, enhance local accountability, and strengthen management and operational capacity. In addition, the Activity aimed to build local organizations’ capacity and transfer implementation responsibility to the Haitian Government.The evaluation team found that Santé has expanded access to and use of essential health services. Improvements were also noted at the community level, particularly due to community health workers’ efforts. Santé has proven adaptable even though the original program assumptions did not hold true. It responded to numerous emerging demands, most notably from the President’s Emergency Program for AIDS Relief (PEPFAR) program, and political, economic and security instability throughout Haiti. However, Santé still faces challenges, particularly in achieving its Health Systems Strengthening Objective, potentially undermining the Activity’s long-term sustainability.