This evaluation of the MSF OCB Maputo HIV/Aids Project aims to provide a comprehensive overview of the implementation phases of the MoH handover and related consequences to the continuity of patient care, and with the added objective to make clear recommendations towards improvements and replicability of the handover ‘tool’ itself. The report concludes that the dashdboard tool functioned reasonably well in illustrating the progress and complexity of the handover, however the tool was found to be limited in its design and application, particularly relating to the use of the monitoring indicators. There were difficulties in understanding if levels of care have been maintained since there was no baseline level defined. The biggest challenge related to the replacement and absorption of MSF staff in the health centres; however acceptable outcomes were said to have been achieved. Looking forward the evaluation urges MSF to define and highlight a supportive and innovative role in the next phase of the handover, stressing the MoH’s position of primary responsibility. Also, very clear and practical recommendations are made towards improving the dashboard as a handover tool, such as including qualitative indicators (like patient satisfaction and staff perspectives), as well as benchmarks aimed at fostering motivation towards ambitious end targets.
This evaluation finds that the Kibera Project has had a tremendous impact at the patient, community and policy level. Additionally, the report points out that the decentralisation of health services at the primary health care level has been a core tenet of the project as it has evolved from a vertical HIV/AIDS programme to a multi-clinic operation offering comprehensive health care. Related to the handover, the evaluation describes a generally positive and well supported outlook, pointing to MSF’s strong stakeholder partnerships and MoH ownership of the KSHC (Kibera South Health Centre) project, as well as the handover experience within the MSF team as some of key strengths. Conversely, there remain concerns over MoH ownership of the Silanga Clinic leading to the recommendation that MSF considers closing this project. Additionally, the evaluation recommends that MSF capitalise on its credibility by advocating for needs based distribution of county health resources to ensure Kibera receives adequate resources to meet the needs of the population. 

Evaluation of MSF OCB Khayelitsha Project, Cape Town, SA (by: Khurshida Mambetova, April 2014)

This report describes the OCB Khayelitsha Project, initiated in 2000, as one of the first MSF projects in Africa to introduce antiretroviral treatment (ART) into the public sector. Currently implementing HIV and tuberculosis (TB) programs, it has produced dozens of very well-received publications in peer-reviewed scientific journals, in large part because of its innovative strategies, major investment in a locally driven monitoring and evaluation system, and a long-standing collaboration with the University of Cape Town (UCT), civil society and local health authorities. Today most organizations and governmental bodies in South Africa perceive MSF as a catalyst for innovation and look forward to testing new approaches piloted by the organization. The evaluation urges MSF to maintain a balance between new pilots and a focus on the big picture to keep influencing the system as a whole. Other recommendations focus on optimising the learning provided by MSF's pioneering approaches in South Africa.

Innovation project: Learning how to “How” (by Khurshida Mambetova, July 2014)

This end of project cycle evaluation aimed at determining the Innovation Project’s relative value and contribution to the organization as well as providing recommendations towards the project’s future. The findings highlight the need for the Innovation Project to close the gap between the What (as in the need for innovation in MSF) and the How, as in how to achieve the expected results for the Project and meet the operational needs for innovation in MSF. Whilst the evaluation finds that stakeholders appreciate the methodology and process of the Innovation Project towards problem solving and innovation, at the same time it reflects the need for a less laborious process, which is linked to a lack of tangible outcomes – regarded as a handicap of the project. Using the immunity to change framework allowed for a deeper analysis on how existing mind-sets are blocking the system-wide innovation process as well as limiting Operational Centre buy-in. Ultimately however, the evaluation urges MSF Sweden to revisit the original objectives for creating the Project and see if these are still valid. The evaluation outlines practical recommendations to both the Swedish section as well as the Project itself in the event that MSF Sweden decides to continue with investment and support towards the Innovation Project.

Evaluation of Kitsch Briefing and Debriefing Project in OCB: Full Version ( by: Liza Cragg and Annie Park, December 2014) 

This evaluation was commissioned in June 2014 to explore how the KITSCH Project has performed and make recommendations on how it could be improved, finding that whilst the OOPs platform has limitations and needs improving in some areas, it is being increasingly used. For the majority of missions comprehensive and up to date information is available on the OOPS platform. The report makes a number of specific recommendations for the on-going management and further improvement of briefing and debriefing processes and related tools. It also suggests several learning points for other OCB transversal projects


By: Association Intern