Final Evaluation "Healthier Kosovo" Project

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Evaluation Plan:
2016-2020, Kosovo
Evaluation Type:
Final Project
Planned End Date:
12/2020
Completion Date:
12/2020
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
13,500

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Title Final Evaluation "Healthier Kosovo" Project
Atlas Project Number: 00109215
Evaluation Plan: 2016-2020, Kosovo
Evaluation Type: Final Project
Status: Completed
Completion Date: 12/2020
Planned End Date: 12/2020
Management Response: Yes
Focus Area:
  • 1. Others
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Output 3.3.1 Evidence-based assessment and planning tools and mechanisms applied to enable implementation of gender-sensitive and risk-informed prevention and preparedness to limit the impact of natural hazards and pandemics and promote peaceful, just and inclusive societies
SDG Goal
  • Goal 1. End poverty in all its forms everywhere
  • Goal 11. Make cities and human settlements inclusive, safe, resilient and sustainable
  • Goal 12. Ensure sustainable consumption and production patterns
SDG Target
  • 1.5 By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure and vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters
  • 11.6 By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management
  • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
Evaluation Budget(US $): 13,500
Source of Funding: Luxembourg
Evaluation Expenditure(US $): 10,400
Joint Programme: Yes
Joint Evaluation: Yes
  • Joint with UN Agencies
  • Joint with UNDP, UNV, WHO
Evaluation Team members:
Name Title Nationality
Gresa SefaJ Junior Project Evaluation Consultatn KOSOVO
Rozeta HAJDARI Senior Evaluation Consultant KOSOVO
GEF Evaluation: No
Key Stakeholders: Ministry of Health, Ministry of Environment and Spatial Planning, KEPA, WHO, UNV, UNDCO
Countries: KOSOVO
Lessons
1.

HK project in cooperation with National Institute of Hydrometeorology and National Institute of Public Health has a great potential for success


2.

The potential for success is working with CSO grant teams who are highly motivated to work on environment and health issues even with small grant amount. CSO grant projects also motivate youth to be engaged with UNV activities.


3.

The best practice is to activate NGOs in environmental and health issues and work concretely with young people and citizens, as throughout Kosovo it is much better to work directly with citizens and young people in order to use more creative methods to approach the community in the right way to educate and raise their awareness about the environment and health.


4.

HK project also could follow the practice of being focused i.e 2-3 main activities that can draw synergies and thus results in higher project effectiveness, sustainability and impact.


5.

Healthier Kosovo project has responded to COVID 19state of emergency very quickly in the fragile context of Kosovo, is in line with OECD DAC principle 9 for International Engagement in Fragile States: Act fast...


Findings
1.

HK project team consisted by UNDP, WHO and UNV has worked hard to achieve the overall objective, but project implementation suffered from political instability, and from COVID state health emergency. There has been lack of political commitment from the 2019 outgoing government, therefore, HK team had limited access to institutions and many of the activities that involved EHCo were reflected (output 1.1).


2.

HK team managed to build on capacities – through study tours in Lithuania and Austria, and through WHO trainings on Air Quality + software, of beneficiary institutions in central level, namely National Institute of Public Health (NIPHK) Hydrometeorology Institute of Kosovo ( IHMK) and Agency of Kosovo Statistics ( ASK). This approach is highly appreciated from these beneficiary institutions, as after visiting relevant institutions in Lithuania and Austria, they understood and clarified more on their roles and mandates.


3.

Institutional data collection and monitoring of air quality and health impact assessment are of high importance for evidenced based policy making in national and municipal level. Both institutes are in need for software development for disease classification under the responsibility of NIPHK, and for IHMK laboratory management in need for improving quality of data results and accreditation.


4.

There is ongoing cooperation of NIPHK with Ministry of Health and IHMK. However, there is not much cooperation between the Agency of Environment Protection (KEPA, under which agency is IHMK) and the Ministry of Health. Information and data sharing is a key challenge between these governmental institutions.


5.

HK project has built on capacities of the Environmental Civil Society Organizations (ECSOs) in Kosovo. This work has empowered environmental civil society actors in Kosovo by enabling them to better access information and to become a stronger partner pursuing transparency and central institutions engagement with the civil society in Kosovo.


6.

HK project has contributed to increased awareness of adverse impacts of air pollutions on health in Kosovo. Respective success activities are #ecokosovo online campaign through social media with very high outreach.


7.

The project timeframe was short and affected by the Covid-19 related lockdown measures, therefore so far reached results cannot ensure sustainability and impact. However, the project was quick to re-prioritize some activities, by donating ventilators and sensors as a response to COVID health emergency.


Recommendations
1

 Support government institutions for law enforcement with national and local level institutional governance in tackling air pollution

2

Support National Institute of Public Health (NIPH) meta data collection and statistical analysis by developing a software for disease classification and burden which can be interactive batched for policy making e.g. SPSS and HIS

3

Support  Hydrometeorological Institute of Kosovo (HMIK) for quantitative and qualitative data by developing a software for its MIS.

4

Review Government policy decisions of year 2014 and year 2018 on creating environment health committee and address inaction of the HMIK

5

Review and support implementation of municipal plans for environment and waste management. Municipal plans of FushëKosova/Kosovo Polje  and Obiliq/c are not updated due to lack of financial resources

6

a) As CSOs cooperation with municipalities has been successful on raising their concerns about environment and waste management, the project is  recommended to consider  raising the capacities of local municipalities on waste management; b) CSO trainings on watchdog functions and public participation efforts to be focused on rights, citizen’s charter, environmental and health audits, research practices, community mobilization, awareness campaigns; c) CSOs grants for those in particular located in different municipalities that would help them display watchdog skills and/or public participation efforts in one or multiple environmental topics. Furthermore, it would also complement the trainings that the CSOs have been part of thus far, and the suggested future training modules

7

Continue with existing #ecokosovo campaign by developing new ways to engage the public, inform them and have them join a sustainable lifestyle for a cleaner environment

8

Decrease air pollution in targeted municipalities through implementing human centered design and co-designing prototype solutions that reduce air pollution

9

Address household air pollution by raising institutional knowledge and capacity (through assessments, trainings), and through awareness raising campaigns with focus on women and the most vulnerable. 

1. Recommendation:

 Support government institutions for law enforcement with national and local level institutional governance in tackling air pollution

Management Response: [Added: 2020/12/28] [Last Updated: 2020/12/29]

UNDP will continue to build based on the best practices of the Healthier Kosovo project,  and continue its efforts in reducing exposure to air pollution, as one of the main threats to the health of the Kosovo population.  In the second phase, the project will focus in supporting Ministry of Health and Ministry of Economy and Environment on prevention of air pollution and its impact on health of population.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Support the Environmental Inspectorate from the Ministry of Economy and Environment (MEE) with raising capacities, research, policy design and policy execution.
[Added: 2020/12/29]
Project 2022/12 Initiated History
2. Recommendation:

Support National Institute of Public Health (NIPH) meta data collection and statistical analysis by developing a software for disease classification and burden which can be interactive batched for policy making e.g. SPSS and HIS

Management Response: [Added: 2020/12/28]

The need for this software is to receive hospital admission data only related to respiratory and cardiovascular diseases, that are sometimes influenced by air pollution. While the need for such data is real, it normally should have been solved by the Health Information System (HIS) which is a Kosovo wide network that so far has failed to function although many investments have been done by different parties over the years. While addressing this need, we will be cautious to make sure that such a software does not conflict with the existing infrastructure and scope of HIS itself. Healthier Kosovo,  as a joint UN project between  UNDP, UNV and WHO worked intensively to support the procurement of such software by IPH. Due to internal IPH policies, such support was not able to be carried out in the first phase. During Healthier Kosovo 2, we will explore other modalities to support the provision of such software (or explore other ways to collect hospital data related to respiratory and cardiovascular diseases) such as directly by WHO or through other UN agency mechanisms, if it does not conflict with the existing SISH structure.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Carry out an assessment to see the best way to continuously provide access to such data for NIPH, while not being in conflict with existing structures and national policies. Depending on the findings, a tailored support might be provided as per recommendations of such an assessment.
[Added: 2020/12/29]
Project 2022/12 Initiated History
Advocate in donor health and a air quality group for concerted donor support to strengthening data systems.
[Added: 2020/12/29]
UNDP 2022/12 Initiated History
3. Recommendation:

Support  Hydrometeorological Institute of Kosovo (HMIK) for quantitative and qualitative data by developing a software for its MIS.

Management Response: [Added: 2020/12/28]

UNDP will continue with the provision of further support in capacity building of Hydrometeorological Institute of Kosovo.  UNDP will coordinate its activities with other stakeholders in Kosovo working in the sector of air pollution and Air Quality Management, MCC and JICA.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Host quarterly Air Quality Donor Coordination Meetings
[Added: 2020/12/29]
Programme Team 2022/12 Initiated First meeting held on 21.12.2020. RR highlighted in her opening remarks the importance of enhanced coordination and cooperation in addressing environmental problems in Kosovo. RR emphasized that COVID recovery is an opportunity for economic transformation. RR highlighted the efforts made under the joint UN project Healthier Kosovo in raising environmental awareness and identifying local solutions in addressing air pollution, and UN agencies commitment to continue working in this area.
4. Recommendation:

Review Government policy decisions of year 2014 and year 2018 on creating environment health committee and address inaction of the HMIK

Management Response: [Added: 2020/12/28] [Last Updated: 2020/12/29]

UNDP acknowledges the  importantance to increase support to the Environment and Health Committee (EHCo), so it becomes an active entity responsible for coordination in this area. During the implementation of the project there have been fundamental changes in central institutions three times. This factor impacted functionalization of the Committee. As an alternative, the Healthier Kosovo project team decided to continue working with key institutions and actors in the field of environment and health, including MoH, IPH, IHMK, Agency of Statistics, Municipalities of Obilic and Fushe Kosove, NGOs. With such attempts, we’ve managed to increase cross institutional cooperation and understanding of issues related to environmental health, which in itself was one of the objectives of the committee and is one of the areas that most needed to be improved in order to better address the issues of environmental health

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The project will continue to work with the same pool of actors throughout the second phase of the project in order to strengthen the Environment and Health Committee.
[Added: 2020/12/29] [Last Updated: 2021/07/15]
Project 2022/12 Initiated History
5. Recommendation:

Review and support implementation of municipal plans for environment and waste management. Municipal plans of FushëKosova/Kosovo Polje  and Obiliq/c are not updated due to lack of financial resources

Management Response: [Added: 2020/12/28]

This is a very relevant and important point. The programme and project team will start reviewing the municipal plans in both municipalities and will also consult with other international actors likely to continue their interventions in similar sectors and geographic areas, to ensure inter-project coherence and synergy.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The Programme and Project team will support Fushë Kosova/Kosovo Polje and Obiliq/c municipalities to develop the municipal plans for air pollution reduction.
[Added: 2020/12/29]
UNDP 2022/12 Not Initiated History
6. Recommendation:

a) As CSOs cooperation with municipalities has been successful on raising their concerns about environment and waste management, the project is  recommended to consider  raising the capacities of local municipalities on waste management; b) CSO trainings on watchdog functions and public participation efforts to be focused on rights, citizen’s charter, environmental and health audits, research practices, community mobilization, awareness campaigns; c) CSOs grants for those in particular located in different municipalities that would help them display watchdog skills and/or public participation efforts in one or multiple environmental topics. Furthermore, it would also complement the trainings that the CSOs have been part of thus far, and the suggested future training modules

Management Response: [Added: 2020/12/28]

UNDP is committed to increase the voice of the people to demand accountability from public institutions who are responsible to deliver on their strategic objectives in regard to reduction of environmental pollution. Building on its long-term experience with Civil Society Organizations (CSOs) - globally and regionally - UNDP will continue to work closely with CSOs to strengthen their ‘watchdog’ function to put pressure towards public institutions and represent the needs of communities. In addition, youth engagement activities with adequate gender mainstreaming, provided opportunities for community members top become active agents in addressing the problems caused by environmental pollution, in line with project’s targets set originally. 

Key Actions:

Key Action Responsible DueDate Status Comments Documents
This recommendation has been incorporated in the activities of Healthier Kosovo 2
[Added: 2020/12/29] [Last Updated: 2022/01/12]
Programme Team 2021/12 Completed The recomandation is incorporated in Healthier Kosovo 2 and the project has already resumed with the activities. History
7. Recommendation:

Continue with existing #ecokosovo campaign by developing new ways to engage the public, inform them and have them join a sustainable lifestyle for a cleaner environment

Management Response: [Added: 2020/12/28] [Last Updated: 2020/12/29]

The new phase of the project will focus on innovative environmental campaigning for an increased environmental awareness among the general population.  The new phase will enable the existing #ecokosovo campaign by developing new ways to engage the public, inform them and have them join a sustainable lifestyle for a cleaner environment and cleaner air. In the new phase, the awareness raising campaign will also have new timely elements related to deforestation/biodiversity and zoonotic diseases, and climate change and health.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
This recommendation has been incorporated in the activities of Healthier Kosovo 2
[Added: 2020/12/29] [Last Updated: 2021/07/15]
UNDP 2021/06 Completed The rcomandation is incorporated in the HK2 project which will be launched in August 2021 History
8. Recommendation:

Decrease air pollution in targeted municipalities through implementing human centered design and co-designing prototype solutions that reduce air pollution

Management Response: [Added: 2020/12/28]

Building up on the successful implementation of innovative initiatives (prototypes) which created a venue for communities to voice their concerns about environmental impact on health through utilization of human centered design and co-design techniques and enabled communities and local institutions to be part of the solutions and to contribute to environmental protection and decreasing of the air pollution. In In the second phase of the project (Healthier Kosovo2) which was endorsed by the donor, the programme has foreseen the implementation of three prototype solutions in the targeted municipalities which will further contribute to the reduction of air-pollution and will increase the engagement of communities and local institutors in tackling this threat

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Based on the evaluation recommendation, the programme has designed targeted activities and included three prototype solutions to be implemented in the Healthier Kosovo 2 project, this will further contribute to the reduction of air-pollution in targeted municipalities and will increase the engagement of communities and local institutors in tackling this threat.
[Added: 2020/12/29]
Project 2022/12 Initiated History
9. Recommendation:

Address household air pollution by raising institutional knowledge and capacity (through assessments, trainings), and through awareness raising campaigns with focus on women and the most vulnerable. 

Management Response: [Added: 2020/12/28]

Healthier Kosovo project has already started supporting IPH on assessing indoor air pollution. This first began with measuring such indicators in schools, and it was made possible through project’s support which included trainings, methodologies, and procuring of samplers and sensors necessary for such measurements. In the Healthier Kosovo 2, it was envisioned from the beginning to address this issue more head on. Specifically, activities will be undertaken to understand better the sources of indoor pollution, types of pollutants most present, and raising awareness of steps households can undertake to create safer and healthier indoor environments.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The Healthier Kosovo 2 has incorporated: a) workshops on household air pollution and related health threats and WHO tools; b) Studies/assessments to better understand the sources and types of indoor AP; c) awareness raising on steps needed to decrease exposure
[Added: 2020/12/29]
Project 2022/12 Initiated History

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