Terminal Review of the Single Stream Funding Malaria Project

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Evaluation Plan:
2017-2023, Iran
Evaluation Type:
Final Project
Planned End Date:
02/2018
Completion Date:
03/2018
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
40,000

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Title Terminal Review of the Single Stream Funding Malaria Project
Atlas Project Number: 00040048
Evaluation Plan: 2017-2023, Iran
Evaluation Type: Final Project
Status: Completed
Completion Date: 03/2018
Planned End Date: 02/2018
Management Response: Yes
Focus Area:
  • 1. Others
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Output 1.3. Solutions developed at national and sub-national levels for sustainable management of natural resources, ecosystem services, chemicals and waste
  • 2. Output 3.3. National institutions, systems, laws and policies strengthened for equitable, accountable and effective delivery of HIV and related services
SDG Goal
  • Goal 3. Ensure healthy lives and promote well-being for all at all ages
SDG Target
  • 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
Evaluation Budget(US $): 40,000
Source of Funding:
Evaluation Expenditure(US $): 40,000
Joint Programme: No
Joint Evaluation: No
Evaluation Team members:
Name Title Nationality
Zanjan Social Determinants of Health Research Center Zanjan Social Determinants of Health Research Center
GEF Evaluation: No
Key Stakeholders:
Countries: IRAN (ISLAMIC REPUBLIC OF)
Lessons
Findings
1.

Is the SSF malaria project relevant to globally agreed malaria elimination goals, policies and strategies?

 Desk review findings: A world without malaria is a global vision and the malaria elimination is a globally agreed goal. The review of the relevant literature reflects the full coherence between the global and regional goals with the SSF project goals, objectives and service delivery areas. WHO’s global technical strategy for malaria includes the following goals, milestones and targets:


Tag: Relevance Health Sector

2.

Is the malaria project relevant to National Malaria Elimination program (NMEP)?

Desk review findings: In 2010 the Council of Ministers endorsed ‘The Long-term Strategic Plan for Malaria Elimination (2010-2025)’ as an integral part of the National Plan of Development (‘Iran’s 2025 Horizon’).  Malaria Elimination is also among the macro goals of the National Long-Term Plan for Health. Executive decisions on the NMEP at the national level are made in the Supreme Council of Health and Food Security (SCHFS.), which is led by the vice president. Reports and any special follow-ups are made by the minister to the SCHFS.

The bills ratified by the Cabinet Ministers on the development of a National Action Plan on the management of social determinants of health under the Fifth Development Plan include the NMEP 2025 Horizon. Full compliance with SSF project with goals, strategies, and objectives of the National malaria elimination plan was fund.

Interviews findings: All executives and policy makers interviewed (62 individuals), emphasized the full alignment of the objectives and strategies of the malaria elimination plan project with National malaria elimination plan.


Tag: Relevance Health Sector Country Government

3.

Are the SSF malaria project Goals/objectives concordant with beneficiaries’ assessed needs in target provinces?

Interviews findings: In total, more than 95% of the beneficiary managers and malaria experts (57 out of 62) interviewed, agreed on the great compliance of the objectives and activities of the SSF project with the requirements and conditions of malaria in the target universities.

While the majority of the interviewees considered the project to be highly relevant to the needs of their universities, a few mentioned some local needs ignored such as the lack of attention to student education, the mismatch of distributing RDT kits and LLINs to local conditions in a few settings, the project weakness in setting up sustainable RDT passive post with the participation of the community in some foci.

FGDs Findings: As a local need little attention was paid to the training of students and volunteers collaboration on the launching of RDT passive posts were not sustainable in some foci. Another mismatch was not raised in focused discussion sessions.


Tag: Coherence Relevance National Regional Health Sector Education Capacity Building

4.

Is the SSF malaria project internal coherent in its design?

Desk review findings:  Good internal coherence was found in the components of the SSF malaria project, including concordance between prompt diagnoses and treatment, case finding, surveillance system, vector control (IRS, LLINs, larviciding) and epidemics early detection with supportive and logistic activities designation like as providing technical staff, training sessions, community participation, PSM plan, inter-sectoral cooperation and transportation. However, advocacy rising activities could be given more attention.

Interviews findings: A little number of interviewees believed that advocacy rising and inter- sectoral cooperation was poorly designed in the project initially however addressed in reprogramming, however in practice, implementation of multi-sectoral actions encountered to some problems.


Tag: Coherence Health Sector Monitoring and Evaluation Programme/Project Design

5.

Project concept and design evaluation

In terms of the project concept and design, the evaluation team recognizes it highly relevant given the project outputs and outcomes are consistent with national and local policies and priorities and are in line with the needs of intended beneficiaries. The project also captured the UNDP priority areas in changing and emerging development areas in a responsive manner.


Tag: Relevance Programme/Project Design Strategic Positioning Country Government

6.

Project management and arrangements

Evaluation team adapted seven criteria to examine SSF malaria project management and arrangements, including: preparation and readiness, country ownership, stakeholders’ involvement, financial planning, supervision and support, and delays and project outcomes and sustainability.


Tag: Relevance Sustainability Ownership Project and Programme management

7.

Preparation and readiness

Were the project’s objectives and components clear, practical, and feasible within its time frame?

Desk review findings: According to the accessed documents and data, the majority of the objectives and activities show desirable improvement over the time, which assumes that they are clear, practical and feasible within their time frame.  

Interviews findings: No weaknesses in this regard were raised by the interviewees.

FGDs findings: In most of the FGD sessions, there was no mention of the difficulty or impracticality of the goals, activities and the project components.


Tag: Relevance Sustainability Programme/Project Design Project and Programme management

8.

Were the capacities of the executing institution(s) and its counterparts properly considered when the project was designed?

Desk review findings: According to the project components, forecasts were made to strengthen the capacity of universities to implement the planned activities, including the human resources, empowerment and training of health workers, strengthening of infrastructure and laboratory standards, improving the transportation system by purchasing motorcycles and cars, procuring IRS , larvicidals and LLINs,  providing microscopes and RDTs and strengthening border surveillance and , M&E and reporting system.

Interviews findings: At least 50% of interviewees believed that their universities and organizational capacities were significantly considered when the project designed, while 6% believed that little attention had been paid to this issue. The rest of the manager’s view was average.

FGDs findings: Participants in FGD sessions greatly acknowledged taking care of their universities capacities and good designation in the project to improve it.  A little concern was mentioned about ignoring some universities fundamental weaknesses prior to implementation of the project. 


Tag: Sustainability Health Sector Implementation Modality Monitoring and Evaluation Country Government Education Capacity Building

9.

Were the partnership arrangements properly identified and roles and responsibilities negotiated prior to project approval?

Desk review findings: CCM acts as a national coordination body which carries out the necessary arrangements with the stakeholders prior to the project approval. Accessed documents confirmed PR, CDC –MOHME and target UMSs full involvement in the negotiation process to determine roles and responsibilities. The grant proposal and work-plan originally have been initiated by a technical team led by CCM and in participation with CDC (MEP) as the government representative and has been endorsed by CCM.

Interviews findings:  % 69 of interviewees said they had a great deal of involvement in SSF project design. However, only 45% of managers and experts believed that their partnership, roles and responsibilities in the project were highly defined. The remaining respondents reported moderate and low levels of participation.


Tag: Relevance Partnership Programme/Project Design

10.

Were the counterpart resources (staff, and facilities), and adequate project management arrangements in place during the project implementation?

Desk review findings: The fourth objective of the Global Fund Malaria project focused on the capacity building, strengthening Malaria Unit and the role of stakeholders. According to report of PR   in order to enhance and strengthen the technical capacity of the Malaria Unit within UNDP and CDC, one Project Associate (CDC), three Project Assistants (two at CDC and one UNDP), and one Procurement Assistant (were recruited. At peripheral level, totally 20 staffs were contracted by CDC to cooperate with GFATM/UNDP project in line with National Malaria Elimination Programme. The team consists of 10 persons as malaria monitoring and evaluation Focal Points in provinces of Sistan and Baloochestan, Hormozgan, Kerman, Booshehr, Khoozestan, Fars and Isfahan, and 10 health-care providers specifically for Setri women in Sistan and Baloochestan. 88 desktop computers and printers to be sent to the district level, and 13 laptop computers for CDC staff and the Focal Points in UMSs were purchased and distributed. Also, 500 motorbikes and 27 double-cabin pick-ups were procured and distributed in order to facilitate the health-care providers’ transportation in remote rural areas. With the purpose of capacity building, 22 persons from the health-care staff at the peripheral level from the UMSs were selected for taking part in epidemiology, parasitology, and entomology courses at Master’s Degree level. All of the MSC candidates passed the courses successfully. 


Tag: Relevance Health Sector Human and Financial resources Implementation Modality Procurement Project and Programme management Capacity Building

11.

Country ownership

Were the relevant partners from public, private and government involved in the project?

Desk review findings: To increase the collaboration of the public and private sector and community leaders and also to raise their awareness about monitoring areas of the National Malaria Elimination Programme and GFATM/UNDP malaria project, intra- & inter-sectoral malaria elimination committees and regular quarterly meeting were planned to convene by presence of representatives from public and private sectors, NGOs, urban and rural Islamic committees and communities at district levels.


Tag: Relevance Ownership Bilateral partners Country Government Civil Societies and NGOs Private Sector

12.

Did the government maintain its financial commitment to the project?

Interviews findings: Only 26% of respondents believed that government funding has been timely. And less than 21% of them believed that government's funding was sufficient. Allocation of needed financial resource s in absence of the global fund grants and allocation of funds timely is vital for sustainability of the project.


Tag: Sustainability Country Government

13.

Stakeholder involvement

Did the project involve the relevant stakeholders through information sharing and consultation and by seeking their participation in project design, implementation, and M&E?

Desk review findings: The main stakeholder organizations have membership of the CCM and inter-sectoral cooperation has been done this way. In order to facilitate project activities, local Inter- sectoral committees were formed in 14 UMSs.

Interviews findings: % 69 of interviewees believed a great deal of involvement in SSF project design. The remaining respondents reported moderate and low levels of participation.

FGDs findings: According to the FGDs result for the next time inter-sectoral cooperation committees in the malicious areas were formed and better cooperation between police force, local governors and authorities took place.


Tag: Monitoring and Evaluation Programme/Project Design Project and Programme management Bilateral partners

14.

Financial planning

Did the project have the appropriate financial controls, including reporting and planning, that allowed management to make informed decisions regarding the budget and allowed for timely flow of funds?

Desk review findings: LFA produced regular audit reports to ensure maximum   proportionality between the fund disbursements, expenditures and project planned outputs and outcomes. Every activity implemented by the UMSs/ CDC followed up and reported in terms of financial reports and statements. A very good auditing and accounting system observed at UNDP. Regular PUDs and EFRs produced by PR. According to variances in planned budget and expenditures necessary adjustment was taken by PR under supervision of CCM. Precise tracking of the costs allowed better management and reprogramming of the project.

Interviews findings: 91 % of respondents identified that there was a great financial control in place, including timely flow of funds.

FGDs findings: A sophisticated financial system was established by PR facilitating financial management of the project. The accounting unit of UNDP draws up every money spending to the last cent. Funds were released on time and precisely by donor. Reimbursement of SSRs was time-consuming mainly because of delays in receiving supporting documents form peripheral level.


Tag: Efficiency Human and Financial resources Operational Efficiency Project and Programme management

15.

Did Promised financing materialized?

Desk review findings: The PR produced regular reports on money disbursement over the project lifetime. The overall disbursed fund was in line with planned budget (see 3.3.1 for details)

Interviews findings: More than 90% of respondents believed that the project had greatly complied with its financial commitment. Nobody estimated the level of financial commitment as being weak. Nevertheless, the remaining 10% of managers and experts’ assessment were average.

FGDs findings: No particular comment was made by the participants in this regard.


Tag: Sustainability Resource mobilization Human and Financial resources Project and Programme management

16.

Supervision and support

Did CCM has enough supervision and oversight of project activities and SRs/SSRs performance in this regard?

Desk review findings: CCM appeared to be a high-level, strategic coordinator. The biggest role of the CCM was the fund request from Global Fond, recruiting consultants to oversight of the overall effectiveness and efficiency of project, and handling key reports for the grant-making bodies.

Interviews findings: The interviewees believed that the role of CCM in project at the end years was more prominent than before. Nevertheless, they believed that the CCM could play a more effective role in facilitating the project implementation whenever there is a need for collaboration of other sectors outside of health sector.

FGDs findings: No particular comment was made by the participants in this regard.


Tag: Sustainability Human and Financial resources Coordination

17.

Did UNDP provide the right staffing levels, continuity, skill mix, and frequency of field visits for the project?

Desk review findings: (See 3.3.5.1 for details)


Tag: Sustainability Human and Financial resources Project and Programme management

18.

Did UNDP staff provides technical support and advice to the project, modifications in time, and restructure the project when needed?

Desk review findings: PR established a project management unit. PR benefited hiring consultants whenever needed to provide necessary support to the project implementers. Multiple adjustments and modifications were made according to the project activities actual performance and cost savings.

Interviews findings:  91% believed that the PR had a great role in providing technical support to the universities.

FGDs findings: No particular comment was made by the participants in this regard.


Tag: Sustainability Human and Financial resources Project and Programme management Technical Support

19.

Financing and project outcome and sustainability

If there was a difference in the level of expected financing and the financing actually realized, what were the reasons for the variance?

Desk review findings: PR reported variances in money disbursement to the SRs/SSRs. The main reasons for the fund variances were mentioned because of delays in starting SSF project and cash disbursement from GFATM, open commitments on some activities, delays in reporting the planned activities and some modifications in the project activities (See 3.3.1.2 for details).


Tag: Sustainability Human and Financial resources Project and Programme management

20.

Delay and project outcome and sustainability

Desk review findings: No evidence of undesirable impacts of delays in money disbursements on project outcomes and sustainability was found.


Tag: Efficiency Sustainability Human and Financial resources

21.

If there were delays in project implementation and completion, what were the reasons?

Desk review findings: (See 3.3.1.2. for details)


Tag: Effectiveness Sustainability Project and Programme management

22.

Did the delays affect project outcomes and/or sustainability, and, if so, in what ways and through what causal linkages?

Desk review findings: No evidence of undesirable impacts of delays on project outcomes and sustainability was found.


Tag: Sustainability Project and Programme management

23.

Project management and arrangement evaluation

Based on overall reviewed documentation and observations, evaluation team considered the management and arrangements of the SSF malaria project as satisfactory, which means that the project had minor shortcomings in its management and arrangements in terms of 7 selected criteria.


Tag: Sustainability Project and Programme management

24.

Project progress and achievements

Project progress and achievements in term of evaluation of the actual outputs, outcomes and impacts of the SSF malaria project, were assessed by criteria of efficiency, effectiveness, and project sustainability and catalytic role.   

Project efficiency

To assess the efficiency of the project following criteria were selected:


Tag: Effectiveness Sustainability Health Sector Monitoring and Evaluation Donor

25.

Was the SSF Project delivering on time?

Desk review findings: Following delays were reported by PR:

-Due to the delays in receiving funds for procurement and distribution of supplies and equipment, the establishment of rapid response teams were delayed in 2011-12 (Annual report 2012).

-Delayed activities of forming inter-sectoral committees and annual seminars were reported by PR (EFR-2014).

- Postponed activities to have NSP finalized and to better use of resources are reported.  Implementation of technical services encountered with delays because of difficulties of malaria field. For instance, online course, lab refresher courses and delay in training event of RDT courses (EFR-2014).

-Postponed training activity to have LLINs in the field and implementation of some refresher courses for lab technician due to the shortage of technical peoples (EFR-2014).

-Delayed technical activities on the recruitment of international consultants for ToT of malaria microscopy due to the shortage in global human resource market (EFR-2015).

-Delays in development of PHC staff technical manuals (EFR-2015)

-Postponed training activity to have LLINs in the field (EFR-2015)


Tag: Sustainability Procurement Project and Programme management Capacity Building

26.

Could more have been achieved with the same input? / Could the same have been achieved with less input?

Desk review findings: Regular and periodic reprogramming and cost savings in project activities were observed.  Protocol-based process for outsourcing activities and purchases based on the lowest possible price and the best quality were realized resulted in huge savings.  In addition, a PSM plan was drafted and PR organized a department including adequate and competent staff for handling procurements and contracts based on the integrated manner to handle other projects as well. Bidding advertisements in compliance with the protocols whenever required and stakeholders have been presented at the opening sessions of the tenders. The value for money and optimal use of funds and resources in the SSF project is acknowledged.


Tag: Effectiveness Sustainability Operational Efficiency Project and Programme management

27.

What measures have been taken during planning and implementation to ensure that resources are efficiently used?

Desk review findings: The SSF project same as other projects within UNDP has been evaluated by internal audit mechanism as well as LFA as donor local partner. PR/ SRs/SSRs supply chain management system of the project periodically was assessed by external evaluator organizations. In addition, M&E experts were hired and trained to supervise project activities and resource usage at different administrative levels including project unit at the UNDP as PR, Malaria office at CDC-MOHME, target medical universities and even malaria endemic districts. As a result, a comprehensive OSDV and SCM random check system as a routine practice was established in target provinces going deep through peripheral units in the field. In addition, this practice was carried out by independent third parties two times during the project implementation period.  


Tag: Efficiency Health Sector Operational Efficiency Country Government Donor

28.

To what extent is the organizational structure of UNDP, CDC/MOH and UMSs, the managerial support provided to the SSF Project, and the coordination mechanisms used by CCM supporting the SSF Project?

Desk review findings: CCM as the high level coordination mechanism was originally formed to coordinate Global Fund supported projects in the country. Good coordination mechanism was found between the CCM/ PR/ SRs/ SSRs. However, CCM performance was improved over the time. A well-staffed project management unit was formed at UNDP. The operations unit of the PR efficiently equipped and strengthened by hiring competent staff to the purpose of supporting malaria project administrative, procurement and supply chain affairs. Likewise, Malaria office of the CDC-MOHME strengthened by establishment of a project management unit and employment of technical staff. At each project target medical universities, at least one project focal point was assigned to monitor and coordinate the planned activities of the SSF malaria project. At universities of Zahedan, Iranshahr, Hormozgan, Bousher and Fars the project focal points were assigned at zone B and AHR districts. In the reviewed documentation, no conflicts or inconsistencies were found between organizational structure and routine performance of the project stakeholders with the SSF Malaria project implementation.  


Tag: Relevance Sustainability Global Fund Human and Financial resources Education Coordination

29.

Project Efficiency evaluation

Based on the Evaluation team observations, documents reviewed and interviews with key informants the evaluation team concluded that the project performance has been satisfactory which means the project had minor shortcomings in the achievement of its objectives in terms of efficiency.


Tag: Efficiency Project and Programme management

30.

Project Effectiveness

Are the actual project outcomes in concordance with project original or modified objectives?

FGDs findings:

- Project greatly helped reduce the prevalence of malaria along with other factors

- The role of the project in the history of malaria is unique

- Almost all the goals that were seen in the project were realized

- Most of the activities planned for the project were carried out according to the timetable


Tag: Effectiveness Efficiency Health Sector Project and Programme management

31.

Objective two: Protection of target population through use of LLINs, IRS and larviciding

Distribution of 700,000 LLINS was targeted and actual achievement in 2013 was very close (659,744). From 2013 to 2016 the need to LLINS decreased however people who needed LLINS received bed net every 3 years. A significant number of LLINs have been distributed during project implementation that is in line with the intended targets.   

A considerable number of people and households received education on the use of LLINs much more beyond of intended targets

According to protocol, IRS is highly dependent to the changes in the foci classification. Therefore, decrease in the number of IRS eligible foci   justifies the decreased number of target population to be covered by IRS.  According to the last available report (2016-2017: Oct-Mar), due to a reduction in the number of malaria cases and foci the IRS target population was less than the estimated target. This practice has been very successful in effective use of the resources and foci which based on an updated situation didn’t need to be covered by LLINs were excluded from the list.    


Tag: Health Sector Education

32.

Objective three: Early detection and control of malaria epidemics

No epidemic happened during phase one however this indicator was removed in SSF Malaria project reporting mechanism.

According to the report of PR totally 76 Rapid Response Teams have been established and are functional. The achievement is beyond the intended target. This indicator was removed in SSF Malaria project reporting mechanism.


Tag: Effectiveness Impact Health Sector

33.

SSF Malaria project impactAn overview of the available reports shows a clear picture of malaria stepwise diminishing trend in Iran. The graphs (Figs 6 and 7) show a significant decline in the incidence of Malaria cases, especially the indigenous clearly.  Given the fact that the burden of a disease depends on several factors, it is very difficult to judge the contribution of a particular factor, such as the Global Fond project.


Tag: Effectiveness Impact Regional Health Sector

34.

Table 27 and Figures 8,9, 10 provide an overview of the malaria epidemiological evolution. There has been a steady decline in incidence, more for local cases than for all cases. In the Southeast, the number of imported cases has been almost constant since 2012. However, some transmission has been observed also outside the Southeast, as late as 2015.  The number of reported deaths has been 1-2 per year through the period, which is high given the low incidence of falciparum malaria.Table 27: Number of malaria cases and deaths in Iran from 2009 to 2015 classified by importation status and species (Local includes all cases transmitted in Iran. Falciparum includes mixed infections).


Tag: Effectiveness Relevance Health Sector

35.

Project Effectiveness score

 The evaluation team awarded project outcomes as satisfactory concluding that the project had minor shortcomings in the achievement of its objectives in terms of effectiveness mainly due to high rate of population movement with endemic neighboring countries.

Project catalytic role

SSF malaria project itself has made considerable achievements in improving MEP management and building successful examples of using technical innovation in target provinces. However, the question is, whether the project has been able to show any scaling up, replication and demonstration of a malaria related services?


Tag: Effectiveness Regional Health Sector Results-Based Management Women and gilrs

36.

SSF malaria project sustainability

Desk review: The aim of ensuring sustainability should be achieved by the continuation of the project’s goals, principles, and efforts to achieve the desired outcomes through institutionalizing the process in the MEP. This aim does not strictly refer only to maintaining the additional resources provided by the project, to continue project’s activities beyond the grant period, maintaining staff’s positions and all project’s activities. Ensuring sustainability in the malaria project here means to make sure that the objectives of the project continue to be met through activities that are consistent with the conditions existing at the end of the grant. Therefore, sustainability is the most important concern of the post GF malaria project. How the infrastructures, best practices and results achieved through the project (including new extra funding, improved planning, logistic, training human resources, technical assistance…) should be maintained and continued.


Tag: Effectiveness Sustainability Health Sector

37.

FGDs findings: The following points were put forward in the FGD sessions:

  • Project infrastructure such as cars, motorcycles, sprayer pumps, border surveillance containers, malaria labs equipment, all are still available after project termination.
  • During the project, a good investment was made on the training and empowerment of human resources and these forces could still work in malaria elimination program.
  • Good practices were institutionalized through the project. For example, the monitoring and evaluation system, the supply chain and procurement and documentation. The continuation of these does not require much money and the only thing needed is the willingness of the managers to keep and continue them.
  • In this project, inter-sectoral cooperation was much better and could continue.
  • We had good experiences of community participation and education which could be continued.
  • Innovations such as RDT have a great impact on surveillance system and case finding, and given the fact that it does not cost much so could be easily continued by government funds.
  • The project has led malaria to be seen in the community and among managers, which helps to provide more advocacy and support for the project.

Tag: Effectiveness Health Sector Project and Programme management Capacity Building

38.

Project Sustainability score

With regard to three sustainability criteria (Financial risk, Sociopolitical risks, Instructional risk and governance), evaluation team gave score 3 out of 4 revealing that there are moderately likely risks that may affect sustainability of the GF malaria project achievements, emphasizing that project sustainability does not necessarily mean retention of current staff or continue to the current grant. Despite this, evaluation team acknowledges the significant contribution of the GF malaria staff at national and local level to the project achievements.

Finally, from the standpoint of sustainability, evaluation team gave score 3 out of 4 revealing that there are moderately likely risks that may affect sustainability of the GF malaria project results


Tag: Sustainability Risk Management

39.

Project Overall Score

Evaluation team developed a tool for the final rating of the SSF malaria project concept and design, management and arrangements, and progress and achievements. Based on this rating tool and abovementioned scores, the total score of 16 out of 20 calculated for the project, meaning that project has met expectations and only a few and minor shortcomings were observed during final evaluation.


Tag: Effectiveness Sustainability Project and Programme management

40.

One of the most important issues emphasized was on the supplement and strengthening of infrastructures and procurement of the items required for malaria elimination activities, which was frequently discussed by the participants in the group discussions of the target universities.

Some examples were given as below:

  •  A very good supply chain management guaranteed on time provision of needed standard supplies and equipment based on principles efficient usage of resources
  • Providing high- quality lab and RDT passive posts supplies and equipment and mobile shelters
  • Provision of standard equipment’s for vector control (sprayer pumps, insecticides, larvicides, and thermal fog machines)
  • Provision of standard medicines
  • Provision of logistics and transportation facilities including motorbikes for remote areas
  • Strengthening border malaria surveillance system through established RDT passive posts in border area
  • Improvement of case finding and prompt treatment through introduction of RDT kits and expansion of malaria treatment centers
  • Establishment of a comprehensive M&E system including Midterm review, Population bases surveys and external evaluation of malaria labs
  • Good examples of community participation in the field (Setrii women, hamyar daneshamooz, safiran salamat.)
  • Local leaders (shoura) supports on households spraying
  • Local inter-sectoral committees
  • Integrated malaria database
  • Initiation of easy to use early warning tool
  • Development of result oriented cost detailed operational plans for UMSs in a participative manner and that is effective tool for resource allocation based on priorities and improved efficiency of the project
  • Enhancement of malaria surveillance system and excellent OSDVs SCM random check
  • Malaria labs accreditation and quality assurance
  •  Capacity building of human resources

Tag: Sustainability Health Sector Procurement Capacity Building

Recommendations
1

Focus on more advocacy rising at country and local levels.

2

Invest in community participation and facilitating NGOs involvement in field of malaria.

3

Strengthen the inter-sectoral cooperation with special attention on border areas.

4

Keep going on the border surveillance.

5

Focus on migrants and population movement.

6

Find local solutions on illegal migrants screening for malaria.

7

Enhance the maintenance system to prolong performance and efficiency of provided equipment in the project.

8

Build a knowledge transfer mechanism to share the project best practices and lessons learned.

9

Integrate current malaria database with Samane Seeb software.

10

Benefit the opportunity of recent initiatives in health system including Health Transformation Plan and Family Physician Scheme and use Moraghebin-e Salamat as new malaria workers.

11

Procure and distribute RDTs widely throughout the country.

12

Review and retry on RDT passive posts set up with participation of Volunteers.

1. Recommendation:

Focus on more advocacy rising at country and local levels.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Consolidation of National Malaria Elimination Programme activities/services into the other sectors policies and programmes as well as support of decision-makers, implementers, and beneficiaries at national, provincial and district levels will be advocated.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The recommendation to be implemented through integration of required actions in the workplans of Universities of Medical Sciences under supervision of CDC.
[Added: 2018/09/10] [Last Updated: 2018/12/12]
Center for diseases Control (CDC) 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
As the project terminated, UNDP is no longer engaged in the process but CDC is following up the matter in the framework of the National Strategic Plan for elimination of malaria. History
2. Recommendation:

Invest in community participation and facilitating NGOs involvement in field of malaria.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Community groups will be formed to support vector control measures with participation of local communities, their leaders and local service providers.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Community groups to be established at the field level by Universities of Medical Sciences in follow up to this recommendation.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
UNDP is no longer engaged in the project, however, UNDP has the capacity to promote and facilitate the approach if request comes from the Government. History
3. Recommendation:

Strengthen the inter-sectoral cooperation with special attention on border areas.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Inter- and intra-sectoral working groups will be formed at national, provincial and district levels in the endemic foci in order to ensure effective cooperation.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Working groups are under formation stage and CDC through Universities of Medical Sciences is doing follow up.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
The action is on-going by the Government. History
4. Recommendation:

Keep going on the border surveillance.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Population movement information will be collected, updated and mapped.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Surveillance is taking place on borders.
[Added: 2018/09/11]
CDC and Universities of Medical Sciences in coordination with BAFIA 2018/12 Completed The process is on-going. History
5. Recommendation:

Focus on migrants and population movement.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Population movement information will be collected, updated and mapped.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Population movement is controlled and recorded
[Added: 2018/09/11]
CDC and Universities of Medical Sciences. 2018/12 Completed Control is done on borders.
6. Recommendation:

Find local solutions on illegal migrants screening for malaria.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Population movement information will be collected, updated and mapped, and the required supplies will be procured for centers for prevention and containment of epidemics and for Rapid Response Teams.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Local solution to be designed after formation of community groups. Local community training going on by the government.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC 2019/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
Although the joint project is terminated but UNDP is partially involved through extended procurement supports for purchasing some of the required materials including insecticides ensuring continuity of control activities. History
7. Recommendation:

Enhance the maintenance system to prolong performance and efficiency of provided equipment in the project.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

A strengthening project for intelligent system will be developed and implemented for assessment and distribution of supplies and equipment at national, provincial and district levels.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The project to be developed by the Government.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
CDC to follow up. UNDP is ready to assist. History
8. Recommendation:

Build a knowledge transfer mechanism to share the project best practices and lessons learned.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

To sensitize medical personnel for malaria diagnosis, the required knowledge will regularly be shared, and books, training materials, and national guidelines’ as relevant will be developed and published.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Knowledge sharing mechanism to be established, however, there are none-systematic ways of communicating results and best practices within the Government. In the meanwhile in the last year of the project a few knowledge management tools, lessons learned were published.
[Added: 2018/09/11]
CDC and Universities of Medical Sciences. 2017/12 Completed Although the status is marked as completed but this is an evolving process and will need to be continued by the government. History
9. Recommendation:

Integrate current malaria database with Samane Seeb software.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

The comprehensive system of malaria case reporting, epidemiological data of malaria cases and foci, the pertinent database and web-based system in accordance with malaria elimination requirements will be updated and maintained, and eventually will be incorporated into the software.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The integration is planned and will be done by CDC Universities of Medical Sciences.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC and Universities of Medical Sciences. 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
Required follow ups and actions are in place. History
10. Recommendation:

Benefit the opportunity of recent initiatives in health system including Health Transformation Plan and Family Physician Scheme and use Moraghebin-e Salamat as new malaria workers.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Malaria elimination services will be incorporated into Health Reform Plan.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Required action to incorporate malaria elimination services into Health Reform were suggested. However, the reform is not advancing as planned.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
The reform is to make better progress. History
11. Recommendation:

Procure and distribute RDTs widely throughout the country.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Rapid-Diagnostic Test kits will be procured and distributed to the target universities of medical sciences.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
CDC to allocate required budget for procurement of RDTs.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
CDC and Universities of Medical Sciences. 2019/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
Country budget constraints to be acknowledged in implementation of this recommendation however given the background engagement and existing capacity, UNDP is willing to offer support if government deems necessary. History
12. Recommendation:

Review and retry on RDT passive posts set up with participation of Volunteers.

Management Response: [Added: 2018/05/16] [Last Updated: 2021/01/14]

Local volunteers will be recruited in high risk areas in line with implementation of malaria elimination programme focusing on malaria case finding among at-risk groups and provision of incentive measures.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
A mechanism to be established for deployment of volunteers by Universities of Medical Sciences.
[Added: 2018/09/11] [Last Updated: 2018/12/12]
Universities of Medical Sciences 2018/12 No Longer Applicable [Justification: The project ended and UNDP is no longer engaged in the process. ]
History

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