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Titleusaid/benin integrated family health program & accelerating the reduction of malaria morbidity and
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March-April 2015

This publication was produced at the request of the United States Agency for International Development. It was

prepared independently by Barbara Jones, Dr. Jaime Benavente and Dr. Moussa Couilbaly, consultants of the Global

Health Program Cycle Improvement Project (GH Pro).

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Cover Photo: A woman and child with their new mosquito net in Dangbo, Benin, which

experiences large-scale flooding every rainy season. Long-lasting insecticide treated nets

provided by the President's Malaria Initiative were provided to every family in the area.

© 2009 Nate Miller, Courtesy of Photoshare

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38 Evaluation: USAID/Benin IFHP & ARM3 Project

5. Based on evaluation findings, what are recommendations for the final year of the ARM3 and future
(follow on) program(s), with a focus on priority strategies and activities.

Given levels of funding, staff size, and environmental factors, the next integrated health program
needs to carefully determine the appropriate mix of activities and levels of the health system to
maximize results. USAID/Benin desires to work towards a truly integrated family health program in
the coming years while ensuring the successful completion of ANCRE and the need to put in place the
follow on bridge activity to ARM3. Findings from this question will be used to design the next PAD and
follow on to ARM 3 and therefore recommendations must be specific, actionable, relevant to the
context, and provide short and longer term options where appropriate.

Other Questions [OPTIONAL]
(Note: Use this space only if necessary. Too many questions leads to an ineffective evaluation.)
Evaluation questions should consider the following program elements:

 Malaria (PMI/ARM3)

 High impact interventions package (PIHI)

 Public sector health system strengthening based on six health systems building blocks

 Private sector quality of services

 Gender

 USAID/Benin’s IFHP PAD modifications during the life of the project

E. Methods: Check and describe the recommended methods for this analytic activity. Selection of

methods should be aligned with the evaluation questions and fit within the time and resources
allotted for this analytic activity. Also, include the sample or sampling frame in the description of
each method selected.

 Document Review (list of documents recommended for review)
USAID Health Program Documents

 IFHP PAD (and amendments)

 ARM3 agreement and modifications

 ARM3 annual workplans and reports

 ANCRE RFA and cooperative agreement workplan

 Community PIHI RFA and workplans

 GHI Benin country strategy 2011-2016

USAID funded reports

 Demographic Health Survey 2012

 Health Facility Survey, 2013 (pending)

 Health Systems Evaluation, AZT HZ, 2012 (PISAF)

 SHOPS private sector assessment

 Routine Malaria Indicators Surveillance Reports, Quarterly

 End User Verification Surveys for malaria commodities, Quarterly

 Health Systems Evaluation, Zou/Collines Department, 2011 (PISAF)

External documents and reports

 Government of Benin health planning documents—PNDS 2008 - 2018, PIHI Package, revised
National Malaria Strategic Plan 2011 – 2018

 UNICEF’s Multi-Cluster Survey 2014 (pending)

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Evaluation: USAID/Benin IFHP & ARM3 Project 39

 Annual National Health Management Information Reports (MOH)

Key Informant Interviews (list categories of key informants, and purpose of inquiry)

 USAID/Benin Health Team leader

 PMI residential advisors and logistics specialist

 Directors/coordinators and service heads at NMCP, DSME, National Public Health Department,
and Planning and Prospective Department

 Leadership teams of Implementing partners: ARM3, ABMS/PSI (SIFPO), LMG, ANCRE, APC

 Department medical coordinators, malaria cell coordinators, health zone medical coordinators,
statisticians, depot staff

 Focus Group Discussions (list categories of groups, and purpose of inquiry)

The purpose of these focus group discussions will be to gain information about target beneficiaries’ use
of services, reasons for using or not using services and attitudes and practices regarding health issues
covered by IHFP and ARM3, such as use of bednets, FP, MCH services, etc. Discussants will include
community members who represent target beneficiaries for IHFP and ARM3, including women and their
partners of reproductive age, who are pregnant or were pregnant during the life of the project and
parents with children under age 5. Female and male discussants should participate in separate focus
groups to avoid potential influence of men over women due to culture based power differentials.

 Group Interviews (list categories of groups, and purpose of inquiry)
Using a semi-structured question guide to get feedback on the project(s), effectiveness of technical
assistance provided, and recommendations for future programming, respondents will be clustered by
type of work, and level of system:

 Maternity and dispensary staff from both public and private facilities

 Community health workers

 Project staff

Note: management and frontline staff should not be in the same groups to avoid undue influence of
management over their staffs.

 Client/Participant Satisfaction or Exit Interviews (list who is to be interviewed, and purpose
of inquiry)

Comprehensive patient/client interviews from antenatal clinic and out-patient clients about level of
service provided. This information will complement existing sources from ANCRE, ARM3 and project
evaluations in 2012.

 Data Abstraction (list and describe files or documents that contain information of interest,
and purpose of inquiry)

Review trends in malaria services from quarterly malaria surveillance bulletins, end-user verification
surveys and the health facility survey. This includes ITN distribution for pregnant women and children
under 5, intermittent presumptive treatment of malaria in pregnancy (IPTp), correct malaria case
management, malaria commodity availability at point of service, and completeness and promptness of
routine malaria reporting.

 Case Study (describe the case, and issue of interest to be explored)
The Team will discuss the possibility of a case study at the team planning meeting, including points such

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Evaluation: USAID/Benin IFHP & ARM3 Project 89

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Global Health Performance Cycle Improvement Project

1299 Pennsylvania Avenue NW, Suite 1152

Washington, DC 20006

Phone: (202) 625-1190

Fax: (202) 517-9181

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