Evaluation of the Implementation of the Project “FOKUS Project 10801–Women’s Health Association of Ethiopia”

Background

Women’s Health Association of Ethiopia (WHAE) is a non-profit, non-governmental association. WHAE works with groups of grassroot/underprivileged Ethiopian women to be drivers of change in their society through knowledge building on healthy lifestyle, leadership and Job creation. WHAE have established 10 local units with groups of fifty women in nine regions in Ethiopia

The organization is founded on three pillars:

1. establishing and developing a nationwide organization for all women
2. health education
3. profitable employment

The project is financed by Norad, via FOKUS. Partnership for Change are assisting the business part of the project, and Norwegian Women's Public Health Association (NKS) also directly invests in WHAE. In addition, there have been established sponsors in Norway for each local organization in Ethiopia through local NKS chapters.

Purpose/objective

The evaluation covered the period from 2015 to 2017, and the main purpose was to undertake learning focused evaluation based on key evaluation questions and DAC criteria - relevance, effectiveness, efficiency, impact and sustainability. Specifically, the evaluation had the following objectives:

Methodology

The evaluation applied three models, namely the project evaluation and control cycle, earned value management, evaluation matrix and organizational self-assessment tool. Methods were developed to assess activities done at different levels, the results of these activities, what went well and not which were the base for recommendation.

Considering both geographical and thematic representation, the consultancy firm in consultation with WHAE/NKS identified four sample project areas which could represent the project. To carry out the evaluation, the consultant employed quantitative and qualitative methods to collect data from primary and secondary sources of information.

Key findings

Impact: The project has impacted project direct beneficiaries in terms of the use of contraceptives and prenatal and postnatal services, balance diet improvement, change in health seeking behavior including medical checkups and health insurance, and women’s visibility. Local unit women have been empowered and capacitated to contribute towards positive health practices of the community by providing health outreach services

Effectiveness: In relation to improved health seeking behaviors the project has achieved about 90% of its plan as of August 2017.  Communities and partners confirmed that hygiene and sanitation have been improved. Local unit women have contributed to the sanitation and reduction of some diseases.

Efficiency: Efficiency was measured by comparing the performance of similar interventions. The evaluation team tried comparing the activities/outputs of the local units against the Women Development Army (WDA) – a women group organized by government. The performance of the local unit was more efficient and satisfactory to the villagers than WDA.  Some of the reasons for the superiority to WDA in the services and practices for the local unit is the nurse provides closes support to the local unit.

Sustainability: Most likely the health benefit will be sustained for the local women. But without further support by WHAE, the capacities of local units are not yet  not adequate to keep the momentum going. 

Organizational Capacity: The capacity of WHAE was found better in areas of board of directors, strategic planning and management, leadership and management, program design, accounting and reporting, and human resources; however, the organization was not found strong in areas of partnership, monitoring and evaluation, financial sustainability, and public relations

Recommendations

The most important recommendations from the evaluation was;

• WHAE should strengthen its organizational capacity mainly in areas of human resources, fund raising/financial sustainability, partnership, monitoring & evaluation, and public relation.
• More emphasis is needed on the economic component of the project. Low economic performance was found to be a major reason for dropouts. Out of the total programme expenditure, 72% has been allocated for health, and on average only ETB 817 have been provided to each   members, not enough to on economically empower the poorest of the poor.
• WHAE should diversify its funding base in order to reduce financial risks and to get flexibility on where to invest.
• WHAE should lobby more with the government and line offices to prioritize and support local units; and to reduce time spent for project agreement process as WHAE is reaching the most vulnerable women in line with government priorities.

Comments from the organisation

WHAE agreed with most of the recommendations, and saw the evaluation as a good opportunity for learning.  Together with FOKUS and NKS a follow-up plan has been developed to implement these during the next project period. More funding will also be allocated to the economic component of the programme.