Partnering for Transformational Change, Strengthening Liberia’s Surgical Health System 2021-2023” Mercy Ships Norway

The report describes the main findings of the review of the project “Partnering for Transformational Change: Strengthening Liberia’s Surgical Health System”, 2021-2023, implemented by Mercy Ships, with funding from Norad. The project aims to make a significant, concentrated impact in Liberia by strategically focusing on strengthening the health system; specifically, by improving the availability, accessibility, and quality of its surgical system in Liberia. It consists of three main components, implemented in different hospitals: training, the provision of anaesthesia equipment, and the provision of nursing kits for nurses and nursing drug reference books, and tool kits for Biomedical Technician (BMETs). The project period has been extended to mid-2024 to make up for delays caused by Covid-19 and other challenges. 

Hera consultancy has independently assessed the programmatic performance of the project this far, with a focus on effectiveness, (cost) efficiency, and sustainability. The review used a mixed-method approach. In this report they document that most activities in the project are implemented, and important short-term results achieved. However, the effects are not jet documented, and the monitoring and evaluation set up is not fully fit for that purpose. The contribution to a sustainable strengthening of the health system is questionable, both due to the short project period but also a lack of transformation of MS’ approach towards institutional strengthening of health systems as compared to their previous on-shore and on-ship activities, despite the best intentions. Grant management has been cumbersome and unsatisfactory from both MS and Norad’s perspective.