KZN Provincial Evaluation and Research Seminar : Twende Mbele Presentation
March 2023
The presentation by Dr Dlakavu introducing the work of Twende Mbele to delegates of the KZN Provincial Evaluation and Research Seminar.
Peer-learning as an M&E systems development approach and the innovation of rapid evaluation
March 2023
The presentation by Dr Dlakavu presenting on the development and use of rapid evaluation by Twende Mbele partner countries.
Rapide de la Mise en OEuvre de la Mesure de Gratuité des Soins Aux Femmes en Âges de Procréer et Aux Enfants de 0 à 5 ans dans la Region de Dosso – Bref
March 2023
Le Niger met en oeuvre, depuis 2006, la mesure de la gratuité des soins de santé. Celle-ci consiste à rendre gratuit pour certaines catégories de la population, particulièrement les enfants de moins de cinq (5) ans et les femmes, des prestations de services de santé sans paiement à savoir: la planification familiale, la consultation prénatale, la césarienne/grossesse extra utérine/rupture utérine, et le cancer gynécologique. Quant aux enfants de moins de cinq (5) ans, la gratuité des soins concerne tous les soins préventifs et curatifs.
Le HCME en collaboration avec le Ministère de la Santé Publique, de la Population et de l’Action Sociale a commandité une évaluation rapide de la mesure du paquet de gratuité de soins dans la région de Dosso avec l’appui financier de TWENDE MBELE et de l’UNICEF pour apprécier la mise en oeuvre de cette intervention.
Cette évaluation a permis de relever certaines insuffisances dans la mise en oeuvre de cette mesure du paquet de gratuité de soins à savoir:
– le retard et/ou le non remboursement d’une masse critique de factures aux formations sanitaires;
– une insuffisance de ressources humaines et de médicaments ;
– un afflux massif des patients vers les centres de santé ;
– une réduction de la qualité des prestations ;
– une absence de sources pérennes pour garantir un financement durable à la politique de gratuité des soins ;
– l’existence de gros problèmes quant à la jonction de la fiabilité et la pérennité du système d’exemption de soins d’une part, et à la qualité des soins délivrés d’autre part ;
– l’impossibilité de suivre la traçabilité des remboursements reçus par les structures sanitaires et de déterminer la part exacte de la gratuité des soins dans le fonctionnement des services de santé.
La politique de la gratuité des soins de santé au Niger a toutefois permis d’améliorer significativement l’accès des populations vulnérables aux soins et services de santé. Elle a amélioré la fréquentation des formations sanitaires par les populations et est associée entre autres à la réduction de taux de mortalité maternelle et des enfants de 0 à 5ans,
La prise en compte des recommandations présentées supra permettra une meilleure mise en oeuvre de la réforme au regard du nouveau cadre institutionnel de pilotage coordonnée par l’INAM.
Evaluation of the Implementation of Free Health Care for Women of Childbearing Age and Children Aged 0 to 5 in the Dosso Region – Brief
March 2023
Since 2006, Niger has been implementing the measure of free health care. This includes providing free health services for certain categories of the population, particularly children under five (5) years of age and women, including: Family planning, prenatal consultation, caesarean section/ectopic pregnancy/uterine rupture, and gynecological cancer. For children under five (5) years of age, free health care covers all preventive and curative care. HCME in collaboration with the Ministry of Public Health, Population and Social Action commissioned a rapid evaluation of the measure of the free health care package in the Dosso region with the financial support of TWENDE MBELE and UNICEF to assess the implementation of this intervention. This evaluation revealed certain shortcomings in the implementation of this measure of the free care package, namely:
• the delay and/or non-reimbursement of a critical mass of invoices from health facilities; • lack of human resources and medicines;
• a massive influx of patients to health centers;
• a reduction in the quality of services;
• a lack of sustainable sources to guarantee sustainable funding for the policy of free health care;
• the existence of major problems with the reliability and sustainability of the care exemption system on the one hand, and the quality of care provided on the other;
• the impossibility of tracking the traceability of reimbursements received by health facilities and of determining the exact proportion of free care in the operation of health services.
However, the policy of free health care in Niger has significantly improved the access of vulnerable populations to health care and services. It has improved the attendance of the population at health facilities and is associated, among other things, with the reduction of maternal mortality rates and of children aged 0 to 5.
Taking into account the recommendations presented above will allow a better implementation of the reform with regard to the new institutional framework for steering coordinated by INAM.
Curriculum Development Project: Competence Framework for an Africa-Wide Evaluation Practice
January 2020
Evaluation capacity development remains a critical feature on the African continent, as the strengthening of M&E (Monitoring and Evaluation) systems and practice hinges on the capacity of both the demand and supply side to meet the dynamic needs in international development for monitoring systems as well as evaluations. The Collaborative Curriculum Development Project is intended to facilitate the harmonisation of evaluation education offerings by institutions, including particularly institutions of higher learning, in order to support the strengthening of M&E post-graduate training on the continent.
There have been growing calls to professionalise the field to address the challenge of poor quality evaluations and evaluators. The rationale for professionalization is borrowed from professions such as auditing, accounting and the medical field. However, one of the distinct challenges is that evaluation continues to grow and emerge, with new approaches, theories and methods added and implemented by professionals in practice. In addition, indigenous methods and approaches are increasingly being explored, and therefore gaining consensus on a set of general competencies and curriculum in building the necessary skills and capabilities for quality evaluation practice in Africa is an exercise in complexity. Attempts towards developing generally accepted benchmarks and standards to follow in developing M&E ECB programmes are therefore increasingly difficult. However, action needs to be taken to strengthen the practice of M&E and to ensure greater levels of professionalisation, and the challenges therefore need to be overcome. To this effect, this Collaborative Curriculum development project aims to be a contribution to this effort, towards ensuring that the necessary skills and expertise is built towards developing appropriate M&E systems to aid African and international development.