Country: Ethiopia
Sector: Health, Systems Strengthening
Background:
A major international health donor partnered with the national government to strengthen Ethiopia’s primary healthcare delivery. Our role was to provide third-party Monitoring and Evaluation (M&E) over a 3-year period, ensuring timely feedback loops and accountability for all activities implemented across 5 regions.
We developed a structured M&E framework aligned with OECD-DAC criteria – tracking inputs, outputs, outcomes, and unintended effects.
Field teams conducted quarterly data collection through health facility surveys, direct observation, patient exit interviews, and health worker performance audits. In addition, mobile-based dashboards were used to streamline monthly reporting from health posts and district health offices.
Findings:
The project achieved 78% of its planned output targets, including improved availability of essential drugs and expanded immunization coverage. However, issues emerged with staff retention in rural areas and delays in replenishing maternal health supplies. Real-time data flagged these problems early, allowing for immediate remedial action.
Impact:
Our continuous feedback loop enabled adaptive programming. For example, after identifying low antenatal care visits in Somali region, mobile clinics were rapidly deployed. By year three, those visits had increased by 46%. Additionally, our final evaluation highlighted sustainability gaps in local capacity-building, informing the donor’s next cycle of investments.
