USAID/Nicaragua family planning graduation strategy : final evaluation report

The report is intended to inform USAID and other United States Government personnel, health donors, representatives from the Government (GON), non-governmental and civil society organizations. The USAID Nicaragua"s Family Planning Graduation Strategy (FPGS) was implemented from October 1st, 2007 through September 30th, 2012, with a budget of approximately US$ 13.5 million. The implementing partners included John Snow Inc. (DELIVER Project), University Research Co., LL (Health Care Improvement Project), NicaSalud Federation (FamiSalud project) and MSH (PRONICASS Project). Taking into account the USAID Technical Note on Graduation for Family Planning and based on the findings discussed in this section, the evaluation team concludes that Nicaragua has achieved a successful graduation stage and that it is reasonable to expect that the provision of family planning (FP) services will be sustained in the future, that the Contraceptive Prevalence Rate (CPR) will be maintained at the level achieved prior to graduation and that inequities in access will not be increased. Overall, the implementation of USAID/Nicaragua"s FPGS has been successful. USAID has achieved the main goals included in the strategy, and 15 of the 17 indicators defined by the FPGS have been met. The two unmet indicators, which are related to market segmentation and the participation of the Ministry of Health (MOH) and the social security in the market share, are in the process of being achieved. Through the implementation of the FPGS, USAID contributed to establishing a foundation for a solid, efficient and sustainable provision of family planning services in Nicaragua. It should also be noted that all recommendations presented in the mid-term evaluation of 2010 were implemented and monitored by the USAID health office, allowing adjustments to be made during implementation. (Excerpt, modified)