Evaluations 2018

MSF Sweden Pediatric Days (by: Nicole Henze), January 2019

The Paediatric Days have been held only twice so far, 2016 in Stockholm and in Dakar in 2017. A third edition is planned for April 2019, again in Stockholm. The event is an international MSF event for MSF Headquarter and field staff of all Operational Centres, academic researchers, partners like Ministry of Health and other agencies; all sharing an interest in improving humanitarian paediatrics. It is organized jointly by MSF Sweden and OCBA in cooperation with the MSF International Paediatric Working Group. This evaluation assessed both editions of the Paediatric Days against general evaluation criteria aiming to describe potential improvements of preparations and management of the Paediatric Days as well identifying opportunities for additional efforts to refine and fulfil the Paediatric Days’ objectives. The evaluation collected, reviewed and analysed primary and secondary data. Primary data was collected through 56 semi-structured in-depth interviews with 48 key stakeholders selected according to their roles in relation to the Paediatric Days and paediatric field programmes and an online survey of all participants (103 responses/32% response rate). Secondary data reviewed were for example Paediatric Day reports, videos, meeting minutes, budgets, governance documents. Primary data was triangulated with secondary data and between interviewees and online respondents. The evaluation findings are limited by the low response and availability rate of Paediatric Advisors (50%) and stakeholders that have previously not directly been involved with the Paediatric Days (23%); creating a lack of perspective on the Paediatric Days from non-participants and those who manage and support paediatric programme components in MSF. 

OCA Chad Unallocated Stocks (by: Alxandre Crubézy), April 2018

In 2012 MSF OCA’s mission in Chad was running a so-called anchor project in Am Timan while responding to various emergencies in the rest of the country. Those emergency responses were opening and closing at fast pace and were sustained by supplies from the anchor project. In addition, difficulties were encountered regarding the capacity of the Chadian labour market to yield skilled supply personnel, and of the Head Quarter (HQ) to find experienced international staff. The mission’s overall storage conditions were poor and all locations required large investments to reach minimum standards for space and quality. Therefore, during the course of 2012, MSF OCA in Chad decided to change the inventory management system from a decentralised model to a centralised unallocated one, based in the mission coordination centre in N’Djamena. The scope of the present evaluation is to analyse, a few years down the line, how this decision was defined, supported and deployed. It intends to determine whether it was in line with the initial needs and whether it has fulfilled them, as well as to compare its performance against a classic decentralised model. The evaluation follows OECD Development Assistance Committee (DAC) criteria and concentrates on determining the Relevance, the Appropriateness, the Effectiveness, the Efficiency and the Replicability of the deployment of a centralised unallocated inventory management in OCA’s mission in Chad.3 To base our findings, we reviewed project and institutional documents, guidelines and policies, and analysed management and monitoring databases - although the latter transpired to be too weak to support proper quantitative analysis. We also conducted semi-structured interviews with stakeholders involved both at mission and HQ level to compile qualitative historical and perceptive data.

OCB Corridor Programs for Key Populations (by: Richard Bedell and Victoria Bungay), October 2018

Since 2014, MSF has been implementing health programs for key populations (KP) mainly along a major transport corridor running through Mozambique and Malawi. Programs serving KP were developed in Beira, Tete (Mozambique), and in Mwanza, Zalewa, Nsanje and Dedza (Malawi). Some programs cover large geographic areas (Tete, Nsanje), while others are focussed on an urban/peri-urban setting (Beira, Mwanza, Zalewa, Dedza). The nature of the collaboration with the relevant Ministry of Health varies and different models of care have evolved at various locations, mainly aimed at reaching commercial sex workers (CSW) and transactional sex workers (TSW) and, in one location, men who have sex with men (MSM). This evaluation was conceived to evaluate each program individually, and then to look at all programs comparatively in order to discern which interventions were most effective in reaching the objectives set forth – which were largely concerned with HIV prevention, diagnosis, and treatment, given the inordinately high prevalence HIV infection among SW, as well as with other common issues in sexual and reproductive health. Furthermore, our intention was to consider the sum of the MSF experience in these programs to infer an optimal model of care that responds best to the health needs of KP. A detailed evaluation matrix was developed to fully explore several aspects of each of appropriateness (from the perspectives of KP members), effectiveness (in terms of health-related objectives), and connectedness (including capacity-building, replicability, and sustainability of programs). The planning process was informed by extensive documentation and 19 key informant interviews. A month was spent in Malawi and Mozambique undertaking rapid assessments of all programs, involving site visits to 5 of 6 sites, extraction of quantitative data, focus group discussions and informal interviews with beneficiaries, and interviews with 88 key informants (MSF project personnel and representatives of other agencies working with KP). 

By: Rebecca Cederholm