End of Program Evaluation for Malaria Round 2

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Evaluation Plan:
2009-2012, South Sudan
Evaluation Type:
Project
Planned End Date:
03/2010
Completion Date:
03/2010
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
--

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Title End of Program Evaluation for Malaria Round 2
Atlas Project Number:
Evaluation Plan: 2009-2012, South Sudan
Evaluation Type: Project
Status: Completed
Completion Date: 03/2010
Planned End Date: 03/2010
Management Response: Yes
Corporate Outcome and Output (UNDP Strategic Plan 2014-2017)
Evaluation Budget(US $): --
Joint Programme: No
Joint Evaluation: No
Evaluation Team members:
Name Title Email Nationality
Dr Amusaa Inambao Team Leader
GEF Evaluation: No
Key Stakeholders:
Countries: SOUTH SUDAN
Lessons
Findings
Recommendations
1 GOSS should solicit for resources to undertake a population based household survey to provide baseline benchmarks for program and planning proposes. Limited population studies could be undertaken and data used for development of future project proposal that would then be based realistic assessment.
2 MOH should immediately constitute a panel of experts to develop a malaria follow-on program to ensure continuation of the services in the country. There is an opportunity to develop such a program for the Round 10 GFATM proposal.
3 The CCM should be strengthened to enable it to diligently select PR based on a set of criteria that would not only be based on financial frugality of the organization but also on flexibility of their systems to respond changing and emerging needs from the field during implementation. Although UNDP systems have worked well for the grant management Although UNDP systems have worked well for the grant management, the inflexibility of its procurement of technical services and goods were slow and not adequately responsive to changing needs in the field.
4 The MOH capacity should be developed to assume the role of PR for all health programs
5 The CCM should critically vet technical staff employed by SRs to ensure that only the duly qualified personnel are engaged in the implementation of the program. Guidelines on job specifications should be provided for the vetting exercises to avoid engagement of personnel not duly qualified in the field as is the case as was the case in the program
6 Program resources could be optimized by using locally based organizations as SRs to avoid the high costs of external offices, staff R&Rs
7 The National Malaria Control Directorate should take charge of all the technical and M&E aspects of the next program. The directorate should provide technical oversight on all implementation efforts on malaria in the country. The Directorate should develop a research agenda to include development of capacity for operations research to determine the long term impact of the LLITN on the development of mosquito resistance to insecticides. This will be a rational enquiry given the expected development of natural selection of insecticide resistance mosquitoes.
8 In the next Country proposal consideration should be made to include environmental management including indoor spraying for mosquito control
9 In order to safeguard the efficiency of drugs for malaria and prevent development of resistance to current and second line drugs against malaria, the country should immediately consider development of legislation regulating importation, distribution, sale, prescription and use of anti malarial drugs
1. Recommendation: GOSS should solicit for resources to undertake a population based household survey to provide baseline benchmarks for program and planning proposes. Limited population studies could be undertaken and data used for development of future project proposal that would then be based realistic assessment.
Management Response: [Added: 2011/12/19]

GoSS through support of its partners is currently undertaking the Sudan Household Health Survey II (SSHHSII). The GFATM invested US$470,000 in the HIV/AIDS component of the survey. Other surveys that are underway are the Malaria Indicator Survey and ANC Sentinal Survey. UNDP/GFATM will also fund the TB/HIV survey under the Round 5 Grant in 2011.

Key Actions:

2. Recommendation: MOH should immediately constitute a panel of experts to develop a malaria follow-on program to ensure continuation of the services in the country. There is an opportunity to develop such a program for the Round 10 GFATM proposal.
Management Response: [Added: 2011/12/19]

The National Malaria Control Program (NMCP) through support from PSI/GFATM has undertaken Malaria Indicator Cluster Survey (MICS). The final report will be used as a key document for the development of the Round 10 GFATM proposal. The CCM has also established the Malaria Technical Working Group which will provide additional support to the NMCP, including the development of the FGATM proposal.

Key Actions:

3. Recommendation: The CCM should be strengthened to enable it to diligently select PR based on a set of criteria that would not only be based on financial frugality of the organization but also on flexibility of their systems to respond changing and emerging needs from the field during implementation. Although UNDP systems have worked well for the grant management Although UNDP systems have worked well for the grant management, the inflexibility of its procurement of technical services and goods were slow and not adequately responsive to changing needs in the field.
Management Response: [Added: 2011/12/19]

Key activities to strengthen CCM have been undertaken which includes recruitment of CCM Secretary and Monitoring and Evaluation Analyst. The CCM has submitted proposal to the Global Fund to finance administration activities.

Key Actions:

4. Recommendation: The MOH capacity should be developed to assume the role of PR for all health programs
Management Response: [Added: 2011/12/19]

CCM through support from the GFATM has set up a fully functional office (with internet connectivity in anew block) and recruited additional staff, including an M & E Analyst to further strengthen its supervisory role. UNDP will continue to build the capacities of the directorate of Research, Monitoring and Evaluation, by providing direct technical support. The M & E office of the GFATM currently seats at the main office block of the MoH where the staff have direct access to specialists of the UNDP/GFATM. UNDP has also recruited the National TB Program (NTP) as one of its SR?s hence building its capacities to manage the TB grant as a PR in the future.

Key Actions:

5. Recommendation: The CCM should critically vet technical staff employed by SRs to ensure that only the duly qualified personnel are engaged in the implementation of the program. Guidelines on job specifications should be provided for the vetting exercises to avoid engagement of personnel not duly qualified in the field as is the case as was the case in the program
Management Response: [Added: 2011/12/19]

The CCM has taken necessary steps to ensure that all technical staff employed by SR?s are qualified and vetted. The CCM approves job descriptions for all technical positions and are members of the intervie panel.

Key Actions:

6. Recommendation: Program resources could be optimized by using locally based organizations as SRs to avoid the high costs of external offices, staff R&Rs
Management Response: [Added: 2011/12/19]

Due to the long-standing conflict with subsequent implications, particularly in human resource and financial capacities of local organizations, it is difficult under the current context to optimally use them as SR?s. However, under the Round 9 ?HSS grant, capacity building of locally based organizations is planned so that they can eventually implement the GFATM grants. Some local NGOs are already SRs in other Global fund program

Key Actions:

7. Recommendation: The National Malaria Control Directorate should take charge of all the technical and M&E aspects of the next program. The directorate should provide technical oversight on all implementation efforts on malaria in the country. The Directorate should develop a research agenda to include development of capacity for operations research to determine the long term impact of the LLITN on the development of mosquito resistance to insecticides. This will be a rational enquiry given the expected development of natural selection of insecticide resistance mosquitoes.
Management Response: [Added: 2011/12/19]

There is already a technical working group for malaria grant. Besides the National Malaria Control Program with support from the GFATM has undertaken a Malaria Indicator Cluster Survey whose results have been used to improve implementation of the malaria program.

Key Actions:

8. Recommendation: In the next Country proposal consideration should be made to include environmental management including indoor spraying for mosquito control
Management Response: [Added: 2011/12/19]

The CCM has taken note of this recommendation and will put emphasis on it in the next strategic plan for the NMCP.

Key Actions:

9. Recommendation: In order to safeguard the efficiency of drugs for malaria and prevent development of resistance to current and second line drugs against malaria, the country should immediately consider development of legislation regulating importation, distribution, sale, prescription and use of anti malarial drugs
Management Response: [Added: 2011/12/19]

The Directorate of pharmaceuticals has developed guidelines that govern the importation and exportation of drugs including malaria drugs. Besides these, it has developed and circulated a list of essential medicines that are to be imported into the country. While the capacity of the directorate of pharmaceuticals is weak, concerted efforts have been made to build it. Under the Round 9-HSS grant, a key intervention is to strengthen the drug supply management with an objective of ensuring the population has access to safe and effective drugs, including malaria drugs.

Key Actions:

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