GHCBP Terminal Evaluation Report 2007

Background

Ginir Hospital Capacity Building Project (GHCBP) is one of the Norwegian Lutheran Mission Projects located & implemented in Bale Zone, Oromia National Regional State. First phase five years (2003-2007) project agreement was signed among the partners ODPPC and OHB, EECMY-DASSC and NLM to contribute to the Ginir Hospital services start up efforts.

The objective of the project was to strengthen the hospital capacity on sustainable basis through strengthening of its service delivery functions quality of care and to strengthen the HIV/AIDS prevention and control efforts.

Purpose/objective

The purpose of this evaluation is mainly to assess the performance against the plan and other procedural and technical issues of the project and provided the outcome of the evaluation to the relevant government organization, funding partner and to the implementing agency.

Methodology

? Document reviewing (project document, mid term evaluation report etc.)
? Discussions with the project staff, hospital management and with the relevant local government offices
? Interviewing beneficiaries
? Observation and visit of activity sites (outpatient & inpatient departments, laboratory department)

Key findings

Overall, the project achieved its major objective, and the hospital service delivery has improved significantly. Ginir Hospital is attracting beneficiary communities both in the catchments area and out of the catchments area, as a result of project intervention. Utilization rate of service has increased, especially when it comes to the need of surgical procedures. Provision of essential drug supply and improvement of maintenance department has contributed to improve the hospital service delivery.

Recommendations

See evaluation report for details, pages 18-19.

Comments from the organisation

We have given the following comments to the project:

Evaluation report:
It's good to hear how the district is satisfied with the hospital services, even if there is some waiting for admission on surgery ward. We're also pleased that local governments take their part of responsibility as far as possible. This is very crucial if the project is to be sustainable. Even if there is budget constraint at OHB level and thus affect the hospital, this should not be the project's responsibility.
It is positive to read how the maintenance department is functioning well (Chapter 3.5 & 6), and also that cooperation with stakeholders is good (Chapter 5). Regarding the steering committee (Ch.4), the project should try and find out how involvement of this committee could be strengthened.

Regarding recommendation no. 2:
The project needs to pay attention to how to move towards sustainable activities. If there's budget constraint at OHB, the recommendation no.4, of employing more staff, seems hard to follow up. If will be very difficult for the project to depend on the financial situation at governmental level before planning their own phasing out. Even if sustainability seems hard to reach, it is a very central objective. If the project does not have this objective in mind, it will most probably never be reached. Therefore, the project must be pro active and make specific interventions for this purpose. I'd like to remind about the Phasing Out plan which is to be worked out within 2008, as written in the Annual plan 2009.

Also, we support the recommendation no.7 and 8, which is somehow related to the issue above. We'd like to encourage the hospital to keep focussing on income generation, as mentioned in ch.3.6.

Regarding recommendation no.6 and chapter 3.2:
Even if the PD still has a component called care and support, I see that the evaluation team reports no such activity. From our side, we do not support the recommendation from the team about starting with care and support. We understand this is a difficult dilemma. But the project has chosen to scope their HIV/AIDS activities towards prevention, and thus avoid activities that may generate donor dependency, which is a good strategy. We'd like to use the opportunity once again to stress that income generating activities for PLWHA should be given high attention in the coming period.