Project Final Evaluation Report, 2012 – Strengthening Primary Health Care Project, 2008-2012

Background:
The Strengthening Primary Health Care project implemented in Khovd, Gobi Altai and Bayan Ulgii aimags was based on an initiative from the Ministry of Health as well as NLM-Mongolia’s previous experiences from the successful implementation of “Health Development Project” in Darkhan and Selenge aimags from 1998-2008. The overall development goal has been “To improve the health status of the population in the target provinces through strengthening the primary health care”.

Purpose/objective:
Assess the project achievements towards improving the health status of the population in the target provinces since 2008 up till mid-2012. Assess the lessons learned to be used in the upcoming second project period.

Methodology:
Analysis were done reviewing project documents, local health statistics, planning documents and reports on project activities and monitoring and evaluation documents. At the beginning of the analysis, issues that needed to be studied by qualitative or quantitative methods were identified. A questionnaire survey was conducted among doctors and staff working in the project area to evaluate accessibility and quality of activities that have been implemented by the project. The knowledge of the local population on health education and project outcomes was also assessed. Qualitative methods were used to identify project successes, problems, causes of them, the participation level of project stakeholders (local administration, health professionals, volunteer workers and community), further issues that need to be addressed and sustainability. Qualitative data were collected using individual interviews with local administrative staff and observation check-lists used for doctors and medical professionals’ activity.

Key findings:
The project has been successfully implemented. The project has been a good experience of multilateral collaboration as it has involved local health and non-health people and has implemented activities through public health committees.  The analysis of the project’s effectiveness, efficiency, impact, relevance and sustainability shows that the project has met all activities and indicators under its goal and objectives. The model nursing hospital, the bagh feldsher’s post and healthy streets were positive opportunities to promote sharing of experience, motivating staff and improving accessibility and quality of care.

Recommendations:
1. Continue the project in order to sustain positive results and to fully achieve project’s goal to improve the general population’s health status of the project aimags; 

2. Need to further build capacity of specialists of aimag Health Department and involve them as supervisors from the beginning of project;

3. To continue to focus on strengthening capacity of doctors and professionals of family and soum health centers to provide primary health care;

4. Monitor activities of the Public health committee on quarterly basis in order to maintain their regular functions;

5. Conduct advocacy activities targeting local health and governor’s office administrative staff to increase their support, funding and supervision;

6. Share experiences and introduce new initiatives to other aimags and soums including “Model bagh feldsher’s post” of Must soum of Khovd aimag, “Model nursing center” of Chandmani soum of Khovd aimag and Khaliun soum of Gobi-altai aimag, “Healthy street” and “Model public health center” of Delger soum and Guulin village of Gobi-Altai aimag.

Comments from the organisation, if any:
The project will continue in a second five-year period in which most activities will be implemented by the Aimag Health Department to ensure long-term sustainability.