The following description of the deviation from plan is related to the activity progress and to the state of achievement of the expected results of the initiative AID 9147, as observed in May 2013, month in which the evaluation exercise was completed. In fact as already mentioned, the initiative is still ongoing.
The analysis is based on the project logic as described in the approved project proposal and relies on the indicators identified during the project planning. It is also based on the information gained during the evaluation exercise, on the available documents and the interviews with two out of the three long-term experts who worked in the project26.
26 Interviews were carried out with Claudio Volpe MD (long-term expert in charge for technical assistance in the Municipality of Maputo,
and following the interruption of the project manager’s contract also in charge of the ad interim coordination of the initiative) and with
integrated and coordinated support to the health system in Mozambique
better planning and managing the health systems in Sofala and Maputo
> financial transfer to the PROSAUDE fund
> appointment of 2 medical doctors for the support of the capacities of the provincial and district health system in Maputo and Sofala + short term consultancies
> appointment of 1 medical doctor as project coodinator (+ role of coordinator for the projects financed by the Italian government in support to the Mozambican health system)
Allocated resources (estimate): € 2.500.000 Allocated resources (estimate): € 2.118.000
promotion of health in Mozambique
improve access to health services + improve quality of health services strengthen ownership of health policies
endorse the Italian contribution to the Country health system
Organisational Building ' Component Capacity Building ' Component
The funds are available and are managed in compliance with the Memorandum of Understanding and related clauses
Better planning & management of health system in the Provinces of Sofala and Maputo thanks to technical assistance
55
Logic of intervention Indicator Initial
Target
Actual Target
Reason for deviation / remarks
General obj. – contribute to the promotion of health among the Mozambican population; improve the quality of health services; make the Country health services gradually accessible to the whole population basing on criteria of fairness and equality
rate of vaccination coverage
(DPT/EB-3° dose) n.a. n.a. The joint annual evaluation (ACA) is considered the reference document for the analysis of the improvement of health status. In the matrix of the indicators used by ACA (QAD) there are several indicators (the ones mentioned in this logic of intervention and some others) which are jointly analyzed by MISAU and by the partners of the initiative rate of assisted deliveries n.a. n.a.
number of pediatric Antiretroviral Treatments (TARV)
n.a. n.a.
number of pediatric cases under Antiretroviral Treatments
n.a. n.a.
number of pregnant HIV positive women + in prophylaxis treatment
n.a. n.a.
Specific obj. – financially and technically contribute to the development of the Mozambican health system, with particular reference to the decentralization process and the coordinated, efficient and effective use of the technical and financial resources allocated accordingly
planning tools developed and
institutionalized n.a. n.a.
Reference is on the tools defined and discussed by the technical working groups established by the MoU of the PROSAUDE II fund and used during the joint annual evaluation (ACA). The participation of the experts’ team to the technical working groups ensures the Italian contribution to the achievement of objectives; however, it is very complex to quantify such contribution.
evaluation and monitoring tools developed and institutionalized
n.a. n.a.
Result 1 – increased financial resources available to the
Mozambican health sector managed according to harmonization and alignment criteria
central level capacity of
expenditure n.a. n.a.
Even in this case, reference is on the ACA document and on the minutes of the meetings of the various technical working groups. However it is not an element which was used during the project progress to describe the activities progress / the achievement of results
Result 2 –Italian health cooperation initiatives coordinated and
harmonized in the framework of the sector wide approach
level of coordination and harmonization of the initiatives
n.a. n.a.
As described in the following sections, the expected level of coordination relates the Italian Cooperation initiatives
level of active participation to
the technical working groups n.a. n.a.
Despite the standard of the ‘active participation’ has not been defined, the experts participated constantly and regularly to the various working groups (PIME, HR first of all)
co-chairmanship of a
technical group 1 0
The Italian experts did not cover the position of co-chairman in any of the technical working group in the coordination mechanisms for the common fund PROSAUDE II
Result 3 –increased planning and management capacity of the Sofala and Maputo local health systems
capacity of expenditure in the
target provinces n.a. n.a.
The component of technical assistance to the two provinces was not carried out as planned and it was interrupted after the termination of the two experts’ contracts (see following section).
However, for the period during which such support was provided, no evidence has been
Giuseppe Braghieri MD (long-term expert in charge of technical assistance in the Sofala province). It was not possible to interview the long-term expert in charge of general coordination of the initiative, Giuseppe Masala MD
56 provided to describe the initial expenditure capacity and to confirm the change over time. As shown in the following table, in essence, it was not possible to reconstruct the deviations from plan compared to the original plan for two reasons:
→ firstly because the initial targets of the selected indicators were not defined and, in addition to that, there was no documentary evidence for their monitoring, thus making it difficult to describe the implementation status,
→ secondly, because the appointed experts used other indicators, such as accounting – financial ones, to describe the progress of project activities.