IN THIS ISSUE01 2016 LOOK BACK. Welcome

to EHG’s Highlights of 2016

02 Global Fund Thematic Review of National Strategic Plans

03 End Line Evaluation of the H4+ Joint Programme Canada and Sweden (Sida) 2011-2016)

04 Combatting HIV&AIDS, STIs, TB and gender based violence along road construction sites in Tanzania

05 Euro Health Group in Belarus

06 Evaluation of UNFPA support to Family Planning (2008-2013)

07 Uganda Health Supply Chain (UHSC)

08 Conducting the Global Fund Thematic Review of Regional and Multi Country Grants

08 Data for Decision Making – Mozambique and Sri Lanka Experience

09 The Millennium Development Goal Initiative (MDGi) in Zambia

10 EHG Launhcing New Internship Programme

10 Evaluation of National Reproductive, Maternal, Newborn and Child Health Plans and Programmes of the Ministry of Health in Burkina Faso

11 Evaluation of WHO PQ for UNITAID

12 New projects

In 2016 EHG continued to demonstrate its expertise in designing and imple-menting complex multi-donor and mul-ti-country theory based evaluations

in the health sector. These complex theory based evaluations focused on reproductive, maternal, newborn and child health and nutrition along with sexual and reproductive health at regional, country and global levels. Of high importance was the completion of the EVALUATION OF UNFPA SUPPORT TO

FAMILY PLANNING (http://www.unfpa.org/admin-resource/evaluation-unfpa-sup-port-family-planning-2008-2013) and the initiation of the END LINE EVALUATION OF THE H4+ JOINT PROGRAMME CANADA AND SWEDEN (JPCS) (http://www.unfpa.org/sites/default/files/admin-resource/H4_Inception_Report_Final.pdf). These two high profile evaluations utilized a contri-bution analysis lens based on theories of change developed at the global level and in

countries in Africa, Asia and South America (H4+). These complex evaluations have been met with praise by UNFPA along with other relevant agencies including UNICEF, UN Women, UNAIDS, World Bank and WHO. Additionally, we initiated a similar evalu-ation for UNICEF looking at the RMNCH Trust Fund. Although in the initial stages of implementation, we are confident that this �

2016 LOOK BACK Welcome to EHG’s Highlights of 2016By MICHELE GROSS

Community Radio Mbanza­Ngungu, DRC

EHG HIGHLIGHTS OF 2016IMPROVING GLOBAL HEALTH

2016 LOOK BACK Welcome to EHG’s Highlights of 2016By MICHELE GROSS

challenging assignment will yield findings and recommendations that can be used to shape similar initiatives in the future. For the EU, EHG initiated an evaluation of the Millennium Development Goals initiative (MDGi) in Zambia which aims at accelerat-ing the reduction of reproductive, maternal, newborn, and child mortality (RMNCH) and nutrition deficiencies in 11 districts in two provinces. The mid-term evaluation is part one of a two-phase contract culminating with an ex-post evaluation of the initiative in 2018.

We saw the successful closure of our long term project in Kazakhstan, Twinning Arrangement for Pharmaceutical Poli-cy Project, and the implementation and completion of a follow on assignment under the Kazakhstan Health Sector Technology

Transfer and Situational Reform Project. The two projects were implemented over a six-year period by a core team of interna-tional, regional and national consultants. We thank the leadership of Frans Stobbe-laar for securing a place for the projects high on the agenda of the Ministry of Health and for establishing a strong relationship between EHG and the key stakeholders in the health care response in Kazakhstan.

Our team also created a four-year strategy for EHG. The focus remains largely the same with our four core areas: Health Systems Strengthening, HIV & AIDS and SRHR, Pharmaceutical Management and M&E. We will further expand into the field of Universal Health Coverage and RMNCH in the coming years. We will also place more focus on Health Care Financing and Social

Inclusion Programmes. Geographically we expanded our scope of services to new coun-tries including Burkina Faso, Guinea, DRC, Moldova, Georgia, Sri Lanka, Laos PDR, Bolivia, and Liberia undertaking both short and longer term projects during the year.

I am personally proud to be a part of the EHG family. We are a small group of highly professional, dedicated, ethical and hard working specialists who have fostered rela-tionships with experts whom we consider part of our family and gained the respect of clients globally. We are excited to leap into 2017 with even more determination to help the global community gain access to quality health services in a safe and trusting environment.

We hope you enjoy reading the 2016 Look Back.

�

As the Global Fund to fight AIDS, Tuberculosis and Malaria geared up towards launching its new stra-tegic plan 2017-2022 and preparing

for the next round of funding applications, its thoughts were very much on how to en-sure that the NSPs, which formed the basis for funding applications, met the minimum requirements. In 2014, the Global Fund had rolled out the New Funding Model (NFM) to have a larger impact on the three diseases and at the same time strengthen country commitment. The NFM aimed to focus on national priorities by building directly on existing NSPs without requiring extensive grant applications (Concept Notes (CNs)). However, experiences with the NFM to date had shown that NSPs were used to a limited extent as the base for Global Fund applica-tions. Many countries still prepared Global Fund specific CNs that were not directly linked to the NSPs, often duplicating the efforts that had gone into NSP development.

In addition, the grant application process, procedures and requirements under the NFM are still strongly centred on the Global Fund and its procedures.

Therefore, the Global Fund’s Technical Evaluation Reference Group commissioned a review to assess to what extent existing disease-specific NSPs were sufficiently detailed, prioritised and costed to be used as a basis for grant applications. The purpose of the review was to inform the improvement of NSPs in order to move towards a higher proportion of NSP-based funding requests. The review was conducted by a team of four EHG consultants, JOOST HOPPENBROUW-ER (team leader), DR ARLETTE CAMPBELL WHITE, LASSE NIELSEN and DR SANJA MATOVIC MILJANOVIC.

The review had three specific objec-tives: (i) establish a categorised checklist of the minimum requirements for Global Fund grant applications; (ii) assess NSPs against the minimum requirements; and

(iii) document key findings and recom-mendations. The team employed four main data collection methods: 1) desk review; 2) interviews with stakeholders/key inform-ants at the global and country level; 3) an exhaustive review of 22 selected NSPs (ten HIV, four TB, six malaria, one TB-HIV and one National Health Strategy) from 17 countries using a specially developed NSP Review Checklist. Special attention was paid to budget and financial information, with a focus on transparency, costing method used and comprehensiveness and consistency. Finally, an electronic online survey was conducted in four languages to maximise input from all key stakeholders across the selected countries.

This must be one of the most chal-lenging evaluations ever undertaken by EHG, but with enormous benefits to resource-poor countries if the NSP Review Checklist is used for the development of future NSPs and leads to better funding opportunities.

How can countries’ national strategic plans (NSPs) for HIV, TB or malaria be strengthened so that they provide a robust basis for donor support without necessitating a detailed and lengthy funding proposal?

GLOBAL FUND THEMATIC REVIEW OF NATIONAL STRATEGIC PLANS By DR ARLETTE CAMPBELL

2 EHG Improving Global Health www.ehg.dk

A Euro Health Group team is con-ducting this major evaluation of a ten-country, 100 million USD programme delivered jointly by

the H4+ (now H6) partnership using direct funding from Canada and Sweden. The programme aimed to accelerate progress toward reaching Millennium Development Goals four and five and improving access to quality care in Reproductive Maternal Newborn Child and Adolescent Health (RM-NCAH) in ten countries in Africa: Burkina Faso, Cameroon, Cote d’Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea Bissau, Liberia, Sierra Leone, Zambia and Zimbabwe.

The H4+ JPCS programme rep-resents an effort to fund, plan and implement coordinated interven-tions in RMNCAH at both global and country level, undertaken by UNFPA, UNICEF, WHO, UNAIDS, UN Women and the World Bank. It aims to complement existing programmes, accelerate progress in RMNCAH through catalytic interventions, and support inno-vative methods which can be taken to scale.

The programme is focused on im-proving access to quality care in RMNCAH for adolescent girls and women of child bearing age. Key intended beneficiaries include adolescent girls and young women at risk of early marriage and/or teenage pregnancy; women of child bearing age in disadvantaged groups or under-served communities; and infants and children. All of these beneficiary groups are at risk of avoidable deaths and increased burden of disease due to weaknesses in national and local systems for providing accessible prevention and care in RMNCAH.

The evaluation was commissioned by UNFPA who also leads the three-agency Evaluation Management Group composed of representatives of the Evaluation Offices of UNFPA, UNICEF and Global Affairs Canada.

The evaluation is being carried out by a core team of four members: TED FREEMAN (team leader), LYNN BAKAMJIAN (deputy team leader), ALLISON BEATTIE (RMNCAH and Health System Strengthening special-ist) and CAMILLA BUCH VON SCHROED-ER of EHG who provides the team with expertise in adolescent sexual and repro-

ductive health. The team carried out intensive field work in four of the ten programme countries, with mem-bers of the core team leading the work in each country. Ted Freeman served as team leader for the pilot country

(Zimbabwe) while Allison Beattie led the country field study teams in Liberia and Zambia, and Camilla Buch von Schroeder led the team in the Demo-cratic Republic of the Congo.

The evaluation of H4+ JPCS was designed by EHG as a theory-based study applying a mixed-methods approach (case studies, document reviews, online surveys) and utilising contribution analysis as the core analytical model. The inception phase involved development of a comprehensive set of theories of change for the programme at global and country level along with the identification of a full set of key causal assumptions. The causal assumptions were then the central focus of field work and re-porting for the then programme countries.

This evaluation is an important tool for both accountability and learning, and will be one of the foundations for the planned work of the H6 agencies in their efforts to support progress in RMNCAH under the Sustainable Development Goals.

END LINE EVALUATION OF THE H4+ JOINT PROGRAMME CANADA AND SWEDEN (Sida) 2011-2016 By TED FREEMAN

Rural health facility in Mosango DRC

Figure 1: PowerBI. A dynamic

and innovative approach to data

analysis and reporting

Focus group discussion with girls in Mbanza­Ngungu DRC

Community health workers at

Cheboken Clinic, Liberia

Going for field work,

Liberia

3www.ehg.dk EHG Improving Global Health

Since 2014, in close collaboration with TANROADS (Ministry of Works), Tanzania, Euro Health Group and Amref Health Africa-Tan-

zania have been implementing the four-year AIDS-awareness project, which is now more than half way through successful implemen-tation. The project focuses on increasing awareness, knowledge, and preventive behaviours with regard to HIV and AIDS, STIs, TB and gender-based violence among migrant workers and people living in the communities along two on-going road con-struction projects. The project team works closely with local government institutions, community-based organisations and work-ers, such as HIV and AIDS control coordi-nators, village- and ward multi-sectoral AIDS committees, community development officers, and others. Under the project we have recently started collaborating with religious leaders and secondary schools in the catchment areas, as teenagers are seen to be particularly vulnerable and suscepti-ble to promises of gifts and cash from road construction workers.

The project staff have successfully carried out 32 village bonanzas – a spe-cial “edutainment” weekend with a mix of activities including: entertainment by popular musicians; a tent with trained health care workers administering HIV

testing and counselling services, where people are informed immediately of their sero status and, if needed, referred to treat-ment at relevant health facilities; and free distribution of female and male condoms including information on their correct use.

Of the nearly 7,000 people tested under the project, about 3% have tested HIV positive, two-thirds of whom are women. Further, 180 peer educators (96 men and 84 women), mainly well-known and dedicated people from the surrounding villages have been trained to advocate for responsible sexual behaviour and gender awareness. Village multi-sectoral AIDS committees (VMACs) have been revitalised in villages along the road project, and 360 members (165 women and 195 men) received short training on planning for community-based HIV & STIs prevention activities.

The project has produced training ma-terial and guidelines for the peer educators, and a communications strategy is currently under production, having been discussed in several workshops among project partners. This strategy will be used by TANROADS in future projects. Day-to-day running of the project is dealt with by ANATORY DIDI (sociologist, training, M&E), assisted by DR FAUSTIN GABRIEL (Community Health and Clinical Expert) with DR AMOS NYIRENDA (team leader).

COMBATTING HIV&AIDS, STIS, TBAND GENDER BASED VIOLENCE ALONG ROAD CONSTRUCTION SITES IN TANZANIA By ANATORY DIDI

Health education,Tunduru

Community peer educator distributing condoms

4 EHG Improving Global Health www.ehg.dk

EHG is taking part in the 2016-2018 project “International Accredi-tation of Testing Laboratories for Medical Products (BELMED)”,

funded by the European Union. The main beneficiary is the Ministry of Health of the Republic of Belarus (MoH), and EHG is a part of consortium led by The British Standards Institution (BSI).

The overall objective of the project is to contribute to the improvement of the health care system by ensuring the quality, effec-tiveness and safety of medicines through quality assurance infrastructure and control of medicines. It is aimed at the alignment of the structural units of the MoH (official medicines control laboratories and the Pharmaceutical Inspectorate) to European and international standards.

The project consists of two independent components: Component A: Laboratory and Component B: Inspection. EHG’s main role is in supporting Component B, aimed at strengthening the capacity of the Pharma-ceutical Inspectorate in the field of inspec-tion of manufacturing processes and inter-national integration, followed by entry into the Pharmaceutical Inspection Cooperation System (PIC/S). This will be achieved by:

• Improving professional competences of GMP (Good Manufacturing Practice) inspectors by organising appropriate trainings according to the identified needs

• Development and implementation of the Quality System of Pharmaceutical in-spectorate, harmonised with standards of Pharmaceutical Inspection Coopera-tion System (PIC/S), and preparation for the subsequent joining with the PIC/S

• Assistance in gradual aligning of the national legislation of the Republic of Belarus by regulating the medicine pro-duction and quality assurance with the current international and EU require-ments in this area.

EHG fields two long-term experts: VESNA KOBLAR, MD, PHD (Expert in the Quality System of the Pharmaceutical Inspectorate) and JIRI HOLY, MSC (GMP Inspector).

During the inception phase, the general situation in the Pharmaceutical Inspector-ate was assessed concerning staff, organisa-tion, infrastructure, quality system, training skills and legislative background. The team gave recommendations for necessary improvements and alignment with interna-

tional networks’ requirements during the implementation phase.

Mobilisation of senior non-key experts started in the implementation phase, where Jiri Holly worked on developing Quality System (QS) documents, as well as observing inspection and conducting a seminar on quality system requirements for Pharmaceutical Inspection Cooperation System (PIC/S). During this phase, Vesna Koblar performed a detailed analysis of the legislative background needed for PIC/S

compliance, and is now working with the beneficiary in the consultation phase. Several training programmes have been organised, including a seminar and a work-shop on the Pharmaceutical Inspectorate Quality System. In the next programming, strengthening the system of medicinal products authorisation and aligning with EU procedures are planned to contribute to the improvement of the health care system by ensuring the quality, effectiveness and safety of medicines.

Health is a major national strategic priority of the government and has been identified as a key resource for social and economic development in Belarus. The EU Delegation plays a vital role in supporting the health and pharmaceutical sector in

Belarus. The institutional and staff capac-ity building intends to further support the Belarus government in updating the medi-cines policy and strengthening the quality assurance of infrastructure and control of medical products produced in Belarus, as well as the quality control of imported products with the aim to ensure the quality, efficacy and safety of medicines used for prevention and treatment. We are confident this project will be a significant contribution to these efforts.

EURO HEALTH GROUP IN BELARUSBy VESNA KOBLAR

ISO workshop in Belarus

The overall objective of the

project is to contribute to the improvement of the health care system by ensuring the quality, effectiveness and safety of medicines

5www.ehg.dk EHG Improving Global Health

For the past two years, EHG has, in consortium with the Royal Tropi-cal Institute of Amsterdam (KIT), carried out the Evaluation of UNFPA

support to Family Planning (2008-2013) with the team MEG BRADDOCK (team leader), LYNN BAKAMJIAN, HERMEN ORMEL.

This evaluation was commissioned by UNFPA to meet accountability requirements as an independent assessment of the pro-gramming and implementation of UNFPA family planning interventions during the period 2008-2013. At the same time, it was forward-looking to focus on lessons learnt to inform ongoing implementation of related programmes and strategies under the UN-FPA Strategic Plan (2014-2017) and the Fam-ily Planning Strategy Choices, not Chance (2012-2020).

The evaluation process was highly participative and was marked by fruitful exchanges involving the UNFPA Programme Division, Technical Division, as well as representatives from Regional Offices and Country Offices.

The evaluation covered all countries where UNFPA works in family planning, with a particular focus on the 69 priority countries with low rates of contraception use and high unmet need for family planning, identified by the London Summit on Family Planning in 2012. It included family planning interven-tions covered by core and non-core resources, including those financed through the global programme to enhance reproductive health commodities and security (GPRHCS), and those which are integrated into programmes and projects in maternal health, adolescent and young people's sexual and reproductive health, HIV and AIDS, gender, and humani-tarian support.

The team undertook five field and seven desk country studies as well as two online surveys, all of which went into the final report. The final report and field visit re-ports as well as the Evaluation Brief have all been published on the UNFPA publications website: www.unfpa.org/admin­resource/

evaluation­unfpa­support­family­plan­ning­2008­2013

OBJECTIVES

OVERALL ASSESSMENT: UNFPA has achieved significant progress in revitalising its own commitment and attention to advance family planning globally, resulting in important gains in many areas. This progress has required UNFPA to navi-gate effectively across many complex issues in order to build consensus and partner-ships for change. UNFPA has three main strengths:

• UNFPA effectively leverages its country presence and develops close relation-ships with national governments. This successfully raises the profile of family

Evaluation of UNFPA support TO FAMILY PLANNING (2008-2013) By LYNN BAKAMJIAN

EVALUATION QUESTIONS COVERED THE FOLLOWING TOPICS:

1 Integration of family planning

with primary health care

programmes

2 Coordination with other

family planning and sexual

and reproductive health

stakeholders

3 Brokerage and partnership to

strengthen national leadership

of family planning

4 Providing an enabling

environment to ensure family

planning information and

rights

5 Vulnerable and marginalised

groups: their needs, allocating

resources to them and

promotion of their rights

6 A human rights-based

approach: access, quality of

care and support to country

offices

7 Modes of engagement adapted

to country needs: using

evidence and best practice

8 Supply-side activities

improving access to quality

voluntary family planning

9 Support to country offices

from UNFPA Headquarters

and regional offices across all

evaluation questions.

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“Family planning is about women's right and their capacity to take decisions about their health and well­being, contributing to the objectives of FP2020. It is a most significant investment to promote human capital development, combat poverty and harness a demographic dividend, thus contributing to equitable and sustainable economic development within the context of the Sustainable Development Goals.”

Dr. Babatunde OsotimehinInternational Conference on Family Planning in Nusa Dua, Indonesia (2016)

To ASSESS HOW THE FRAMEWORK as set out in UNFPA Strategic Plan 2008-2013 and further specified in the Repro-ductive rights and sexual and repro-ductive health framework (2008-2011)as well as in the GPRHCS (2007-2012) and the HIV/Unintended Pregnancies framework (2011-2015), has GUIDED THE PROGRAMMING AND IMPLEMENTA-TION OF UNFPA INTERVENTIONS IN THE FIELD OF FAMILY PLANNING

To FACILITATE LEARNING AND CAPTURE GOOD PRACTICES from UNFPA experience across a range of key programmatic interventions in the field of family planning during the 2008-2013 period

6 EHG Improving Global Health www.ehg.dk

planning both globally and at country level and, at the same time, promotes strong national ownership and govern-ment leadership

• UNFPA successfully advocates for re-newed national commitments to family planning. This leads to stronger national commitment in terms of resource allocation and to the strengthening and improvement of policy environments for family planning

• UNFPA effectively supports national governments to increase investments for reproductive health commodity security and supports a strengthened management of supplies for contracep-tives chains

MAIN RECOMMENDATIONS OF THE EVALUATION:I. UNFPA should strengthen alignment of

family planning programming with the International Conference on Popula-tion and Development commitments to integration and to a human rights-based approach

II. UNFPA should further refine and tap into the potential of its comparative ad-vantage as the key partner with national governments

III. UNFPA should strengthen documenta-tion of, and accountability for, results and organisational learning and clarify roles and responsibilities

Since September 2014, Euro Health Group has partnered with Manage-ment Sciences for Health (MSH) to implement the follow-on project

to SURE; the Uganda Health Supply Chain (UHSC), a five-year programme funded by USAID. EHG’s main role is to lead the Management Information System/Infor-mation Technologies (MIS/IT) activities of the UHSC, leveraging and building upon the experiences gained through the SURE pro-gramme. Currently, almost half way through the programme, one of the key deliverables is close to completion for handover and transition to the Ministry of Health: the Pharmaceutical Information Portal (PIP) – development headed by EHG Technical Adviser PETRA SCHAEFER – which is used

on a daily basis by about 400 Medicine Man-agement Supervisors to oversee and manage medicines in their districts and health facili-ties. The hand over will be supported by TA for part of 2017.

EHG Technical Officer BRIAN SEKAY-OMBYA contributes to the UHSC support to the National Drug Authority (NDA), to strengthen regulatory and reporting mech-anisms as a way to improve the quality of pharmaceutical products and services in the public and private sectors. Training in the electronic inspection system (e-GPP) will be stepped up, to enable inspectors to enter data and generate reports to ensure good pharmaceutical practice (GPP). Further, in the programme’s continued support to ensure continued good distribution prac-

tices, with wholesalers instituting improved systems and SOPs, an e-GDP tool has been developed, and a number of NDA inspectors will be trained to use this tool.

EHG Technical Adviser KIM HOPPEN-WORTH has been instrumental in planning the roll out of the national pharmaceutical management information system (RxSo-lution) to manage stock and dispensing at more than 100 hospitals and health centres with an overall expansion target of 400 facilities. After more than 5 years with SURE and UHCS, Kim has decided to seek other challenges and will no longer be part of this programme. Kim has worked with EHG on various challenging assignments for the past 10 years and we wish him the best of luck in his new assignment.

Uganda Health Supply Chain (UHSC)

�

5 COUNTRY REPORTS & EVALUATION REPORT, EVALUATION BRIEF

(ENGLISH, FRENCH AND SPANISH)

By JETTE RAMLØSE

7www.ehg.dk EHG Improving Global Health

In February 2016 Euro Health Group was commissioned by the Global Fund to undertake a thematic review of regional and multi country grants. The

aim of the review was to gain systematic and critical evidence and lessons learned from implementing regional and multi-country grants, and to further inform discussions within the Global Fund Secretariat and Board on allocations for future regional and multi-country grants.

A four person team, comprising of DR TIMOTHY CLARY (Team leader), DAVID WILKINSON (Deputy Team Leader) and two EHG in-house senior evaluation specialists MICHELE GROSS and DR SANJA MATOVIC MILJANOVIC assessed strengths and weaknesses of 13 selected regional and mul-ti-country grants identified in close collabo-ration with Global Fund Secretariat staff and the Technical Evaluation Reference Group (TERG). The team identified key success criteria, as well as bottlenecks encoun-tered at different stages of the grant cycle,

circumstances in which the regional and multi-country grants can add value and/or make a larger impact over national grants; and proposed parameters to be considered for better governance arrangements for regional and multi-country grants to better align with national governance mechanism and to reduce transaction costs.

The review team used a mixed-methods approach and based its findings, conclu-sions, and recommendations on a triangu-lation of evidence from different sources involving both primary and secondary data collection methods and analysis. The team reviewed relevant Global Fund documen-tation along with programme evaluation reports, baseline and end line studies of selected regional programmes and perfor-mance frameworks.

The findings, conclusions and recom-mendations were presented at the 29th TERG meeting at the Global Fund in Geneva in June 2016.

CONDUCTING THE GLOBAL FUND THEMATIC REVIEW OF REGIONAL AND MULTI COUNTRY GRANTS By SANJA MATOVIC MILJANOVIC

• members of the Technical Evalua-tion Reference Group (TERG)

• members of the Technical Review Panel (TRP)

• regional managers

• members of the regional and country coordination mechanism (RCMs and CCMs)

• principal recipients (PRs)

• sub-recipients (SRs)

• representatives of civil society organisations

• Global Fund partners

PEOPLE INTERVIEWED

EHG, in a consortium led by Khulisa (RSA), began work in Mozambique and Sri Lanka under a framework contract with the Global Fund

focusing on Implementation of the Global Fund’s Programmatic Quality Assurance and Improvement Approach.

In MOZAMBIQUE, under the consor-tium leadership of HELDER NHAMAZE (Khulisa, RSA) with assistance from MICHELE GROSS (CEO, EHG), the team initiated Phase I of a Data Quality Review (DQR), working hand in hand with the Ministry of Health, more specifically the National Institute for Health (INS). INS will spearhead the implementation of the DQR in 2017 which will cover all three diseases (HIV, TB and Malaria). Data collection will

take place at the local, district and provin-cial levels covering a sample of 146 facilities across all 11 provinces. The methodology will follow WHO guidelines and tap into the recent experience of the INS in implement-ing the national HIV and malaria survey (IMASIDA) and experience of the HIV and AIDS Programme in implementing a DQR for the programme.

In Sri Lanka, under the leadership of BANDULA SIRIMAL and CHANDANA MENDIS, the team worked with the Minis-try of Health, Nutrition & Indigenous Medi-cine (MoHNIM) to plan for the implementa-tion of a DQR and a Service Availability and Readiness Assessment (SARA). The WHO was also involved in the planning phase and will be active during implementation in 2017.

The findings of the DQR and the SARA will be used to improve: programme manage-ment, performance monitoring, quality of care, disease surveillance and also to allow for more accurate comparison of perfor-mance with global health achievements. The team assisted in setting up a National Steering Committee for the DQR/SARA exercise co-chaired by representatives from the MoHNIM. The steering commit-tee is responsible for overall coordination, execution and oversight of implementation, and tasked with providing guidance to the technical working group created for the exercise. The DQR/SARA will cover a sample of 557 facilities from the tertiary, secondary, primary and clinic levels including private facilities.

DATA FOR DECISION MAKING – MOZAMBIQUE AND SRI LANKA EXPERIENCE By MICHELE GROSS

8 EHG Improving Global Health www.ehg.dk

EHG (lead), in partnership with Itad, is currently carrying out a mid-term evaluation and an ex-post evaluation of the MDGi, contracted by the EU.

The assignment has two distinct phases; the mid-term evaluation (MTE) (October 2016 – March 2017) and the ex-post evaluation (Sep-tember 2019 – February 2020). The MDGi is a 48.7 million Euro programme funded mainly by the EU with additional funding from UNICEF, geared towards supporting the Re-productive Maternal Neonatal Child Health and Nutrition programme (RMNCH&N) in two provinces covering about 30% of the Zambia’s population. The programme aims to increase the availability and use of, as well as demand for, quality health and nutrition services by vulnerable women, adolescents and children in selected urban and rural districts in the two provinces.

Both evaluation phases will distinguish between programme support to national health systems strengthening (HSS) and improved RMNCH&N service delivery to the final beneficiaries at health facility and community levels. The MTE will focus on processes, activities and outputs and include an analysis of available indicators, and the sharing and use of information so as to understand the extent of progress. The focus will also take into account people’s percep-tion of progress, and what could be improved in terms of design and implementation. The evaluation will assess performance to date and propose actionable, realistic recommen-dations for implementation during the rest of the programme.

The team of eight will seek information from programme documents, interviews with staff at central and facility levels, as well as end-user interviews and focus group discussions. Following the field work, the findings will be shared with the direct users in provincial validation workshops, as well as with key policy makers and senior MoH staff and partners in a national workshop with the aim of making practical use of the results in future implementation of this and other programmes.

The core team consists of four senior consultants; CHRISTINE THAYER (team leader), MARIA PAALMAN (deputy team leader), BEYANT KABWE and NKENDA SACHINGONGU. They are assisted by four national consultants; CYNTHIA BANDA, PRISCA KAKENE, HELLEN MTONGA and MADALISTO MWANZA.

THE MILLENNIUM DEVELOPMENT GOAL INITIATIVE (MDGi) in Zambia By JETTE RAMLØSE

Community­based volunteers,Mikomfwa Urban

Women returning home after under­5 clinic Kafubu Block

Young mothers at Kafubu Block

Youth friendly corner Estate Clinic

9www.ehg.dk EHG Improving Global Health

Euro Health Group's Internship Programme offers a wide range of opportunities for students to gain insight into EHG core areas of

expertise and experience in the technical, administrative and implementation aspects of programmes. If you are interested in completing an internship at the Denmark or Serbia office, please send your CV and cover letter to Susanne Andersen on sandersen@ehg.dk

“Working as a global health intern at Euro Health Group has given me the experi­ence and helped me develop my skills in implementation of health projects. With its

mission to promote global health, EHG has given me the opportunity to gain experi­ence in the fields of health management and projet implementation. It is a very dy­manic working environment and tasks have been different every day. My confidence to contribute to improving global health as soon as I gradudate, stems from working with a team of experienced, most dedicat­ed, motivated and professional individuals. Working as an intern at EHG has been a great opportunity for me and has helped shape my experience and build myself for a career in the health sector.” Rhoda, student of Global Health, University of Copenhagen.

EHG LAUNHCING NEW INTERNSHIP PROGRAMME By RHODA ADJEI-BAFFOUR

EVALUATION OF NATIONAL REPRODUCTIVE, MATERNAL, NEWBORN AND CHILD HEALTH PLANS AND PROGRAMMES of the Ministry of Health in Burkina Faso By DR JUMA M. KARIBURYO

MATERNAL, NEWBORN AND CHILD HEALTH

The Government of Burkina Faso has made the acceleration of the reduction of maternal and infant mortality a national priority to be

integrated into all socio-economic, politi-cal and strategic instruments at the highest level of the country. In this context, UNFPA is supporting the Ministry of Health to strengthen the policy framework and im-plementation of its reproductive, maternal, neonatal, child, adolescent health (RM-NCAH) programmes. EHG was contracted by UNFPA to (i) conduct an evaluation of six RMNCAH strategic plans and programmes and to (ii) define the strategic priorities for a single and overarching RMNCAH national strategic plan that adopts a holistic approach and consolidates all existing plans and programmes aiming to reduce maternal, neonatal and child morbidity and mortality. The evaluation focuses on the effects and results of six plans: (i) the Plan to Relaunch Family Planning 2013-2015; (ii) the Strategic Plan for Reproductive Health Commodities 2009-2015; (iii) the Road Map to Accelerate the Reduction of Maternal and

Neonatal Mortality; (iv) the PMTCT National Strategic Plan; (v) the implementation of the approach to engage village committees in the management of obstetric and neonatal emergencies; and (vi) the National Pro-gramme to Fight Obstetric Fistula 2011-2015. The evaluation is engaged to:

• Provide an independent assessment of the performance of the six plans and programmes with regard to their imple-mentation

• Analyse the interrelations between the different plans and programmes

• Assess the achievements, strengths and weaknesses of these plans and programmes, and identify lessons learnt with regard to their implemen-tation with a view to improving future programmes

• Provide strategic direction for the devel-opment of a consolidated plan to reduce maternal and neonatal deaths within the context of national development policies and frameworks.

The evaluation team consists of one in-ternational and two national senior experts: JUMA KARIBOYO (Team Leader), GUY ZOUNGRANA (Public Health and RMNCAH Specialist), and YARO ROMAULD (Phar-macist and PSM Specialist). During a one month field mission, the team undertook a comprehensive desk review, interviewed key stakeholders at national level, and visited health facilities and communities in 23 districts in four regions (Hauts-Bassins Region, Boucle du Mouhoun Region, Centre Region, Centre-West Region). The evalua-tion report provides strategic and operation-al recommendations for the improvement of the RMNCAH policy framework and the development of a new consolidated national strategic plan. This serves the overarching purpose of transitioning from a vertical to a horizontal and integrated approach to RMNCAH policy development, programme implementation, and service delivery in Burkina Faso.

10 EHG Improving Global Health www.ehg.dk

In mid-2016, two EHG consultants, JENNIFER LISSFELT (team leader) and JULIE PASQUIER, conducted an evaluation for UNITAID of their

2014-2016 project to support the World Health Organization’s Prequalification of Medicines and Diagnostics (WHO PQ pro-gramme). The PQ programme plays a vital role in assuring the quality of medicines and diagnostics being procured for health programmes worldwide. WHO PQ activities are central to UNITAID’s strategy to combat HIV, Malaria, and TB; and UNITAID is a major funder of the PQ programme. UNI-TAID requested a forward-looking review to assess what has been done under the grant, challenges encountered and priorities and lessons learned to help inform the design of a potential next grant to PQ to begin in 2017.

This evaluation entailed extensive document collection and review; meetings and interviews in Geneva with UNITAID, the WHO PQ team and others; phone interviews of other key respondents from partner organizations, manufacturers, and countries; and analysis and triangulation of findings. The team examined the project’s objectives, targets, and key performance indicators (KPIs), and measured the PQ’s performance against these indicators. The evaluation also assessed the project’s align-ment with UNITAID’s strategic objectives; its relevance, effectiveness and efficiency; and project impact (where possible). Finally, the evaluation reviewed recommendations made in previous evaluations, to assess pro-gress made on these recommendations.

THE EVALUATION FOUND THAT THE PQ PROJECT: • is well harmonised with UNITAID

strategies;

• has made progress on recommendations from prior reviews;

• largely met its targets;

• has impacted on the market in enhanc-ing availability of Quality Assured (QA) products and suppliers, encouraging competition and price reductions, and improving product quality (with poten-tial for greater impact to help set global QA standards for diagnostics);

• is integral to global QA efforts and widely recognized for the valuable role it plays;

• is currently over-reliant on donor fund-ing, with discussions under way to devel-op a new financing model to ensure PQ sustainability; and

• is highly relevant and effective, could become more efficient and streamlined, and has significant impact globally.

Beneficiaries and persons affected by the important work of the PQ programme are diverse and wide-ranging. The chart depicts the various key WHO PQ stakehold-ers and beneficiaries within and outside of WHO. PQ is critical to the work of WHO, to donor organisations and procurers, to man-ufacturers/ suppliers, and to countries and their national regulatory authorities (NRAs). PQ is a key part of the QA continuum globally, but there are many stakeholders in the QA process, and much collaboration required.

EVALUATION OF WHO PQ FOR UNITAID By JENNIFER LISSFELT

The PQ programme plays a vital role in

assuring the quality of medicines and diagnostics being procured for health programmes worldwide

WHO Regulation af Medicnes and Other Healt Technologies

Unit (RHT)

COUNTRIES, NRSs, PATIENTS

UNITAIDOther WHO RHT

Programmes

Technologies Standards and

Norms

Regulatory SystemStrengthening

Saftety and Vigilance

WHO PREQUALIFICATION PROGRAMME

DX MEDS VX TECH. INSPECTIONASSESMENTS ASSIST. SERVICE

GatesFoundation

Other fundingSources

SuppliersCollaborating centres,

Donors, Procurers, Partner Orgs

WHO DiseaseProgrammes

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KEY STAKEHOLDERS

EHG Highlights

Chief editor: Camilla Buch von Schroeder / Jette RamløseLayout: Made by Thomas (art@madebythomas.dk)

Euro Health GroupTinghøjvej 77, DK 2860 SøborgPhone +45 3969 6888

Homepage: www.ehg.dkEmail: eurohealth@ehg.dk

Opportunities with EHG

EHG is always looking to build its cadre of expert health consultants. We welcome CVs and/or contact details from experts interested in short- or long-term assignments within our focus areas. Please contact us at ehg@ehg.dk for more information.

EHGs Partners

We would like to take this opportunity to extend our gratitude to those partners who work with us on projects and programmes around the globe. Whilst EHG is always looking to forge new partnerships we aim to build on and strengthen our existing relationships and continue to offer the highest quality services that result from our collaborations.

EHG is proud to be associated with:AKROS Global Health (Zambia)AMREF Health Africa (Tanzania)British Standards Institution (BSI) (UK)Bruyere Research Institute, University of Ottawa (Canada)COWI (Denmark)DMR-LM (Myanmar)Evidence Based Networks (United Kingdom)Imperial Health Sciences (South Africa)Itad Ltd (UK)evaplan GmbH (Germany)Khulisa Management Services (South Africa)Makerere University (Uganda)Management Sciences for Health (USA)Royal Tropical Institute of Amsterdam (KIT) NetherlandsTranstec (Belgium)University of Copenhagen University of New South Wales (Australia)University of California San Francisco (UCSF) (USA)WHO Collaborating Centre on Medicines Pricing and Reimbursement (Austria)WYG (UK)

Technical as­sistance to align CCMs to national health sector co­ordination

The German BACKUP Initiative (GIZ) award-ed a contract to EHG

for the provision of technical assistance to the Global Fund country coordinating mecha-nisms (CCMs) in five selected countries in 2017 and 2018. The purpose of the assignment is to assist host governments and CCMs to support CCM evo-lution, alignment to national health sector coordinating mechanisms, and in some coun-tries, possibly CCM integration into those structures. This is a follow-on contract to the CCM Integration study conducted by EHG in 2015-2016.

TIM CLARY is the team leader for this assignment, working with DAVID WILKIN-SON, JUMA KARIBURYO and EHG in-house staff SANJA MATOVIC MILJANOVIC and CAMILLA BUCH VON SCHROEDER.

EVALUATION OF THE RMNCH TRUST FUND

EHG has been contracted by UNICEF to evaluate support to the RMNCH

Trust Fund and assess its con-tributions to results in repro-ductive, maternal, newborn, and child health (RMNCH) across the 19 programme countries. This comprehensive assignment, which will take place from January to June 2017, will include field visits to five countries (Burkina Faso, DRC, Malawi, Tanzania and Uganda) and in-depth desk review of

programme documents from the remaining 14 countries. The evaluation team will also design and implement an online survey, and conduct phone in-terviews with key stakeholders at global, regional and country level.

In charge of this assign-ment is team leader KAREN BEATTIE, working with JOSEPH RUMINJO, BETTY FARRELL and CAMILLA BUCH VON SCHROEDER.

Speeding Treat­ments to End Paediatric Tuber­culosis (STEP – TB) end­of­proj­ect evaluation

UNITAID awarded EHG a contract to carry out an end-of-project evalua-

tion of their support to STEP-TB. The STEP-TB project was designed to provide improved access to correctly dosed, properly formulated, afforda-ble high quality TB medicines for children in 22 high-burden countries with high prevalence of TB in children. The project was carried out by Global Alli-ance for TB drug development (TB Alliance) with the support of UNITAID in the period August 2013 – January 2017.

The evaluation will provide UNITAID with an assessment of the programmatic implementa-tion of the project, with a focus on overall market and public health impact.

The assignment will be carried out by BERNADETTE BOURDIN TRUNZ (team leader) and MIRANDA BROUWER, both experienced TB experts.

REPUBLIC OF MOLDOVA - DRG COSTING EXERCISE

EHG will be implementing a 16-month project under the Ministry of Health

(MOH) in Moldova to provide technical assistance to the Na-tional Health Insurance Compa-ny and the MoH. Activities focus on strengthening the function and capacity of procurement of hospital services by calculating the hospital costs for services paid based on diagnosis related groups (DRGs) mechanism and recalculation of cost-weights of DRGs used to fund the hospi-tals. The team of specialist led by PROF DUSAN KEBER and including SIMON JARMAN, TATYANA MAKAROVA and HYNEK KRUZIK will propose a methodology on costing, develop costing tools, conduct the costing study, calculate a new set of local cost-weights for all 695 DRGs and develop a set of recommendations to improve hospital funding policies in Moldova.

NEW PROJECTS

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