Evaluation of UNICEF Health Systems Strengthening Programming

The substantial investments and comprehensive development strategies driven by the Millennium Development Goals agenda resulted in laudable successes in many countries, with improvements in health outcomes and health coverage. Nevertheless, it is widely acknowledged that the successes have not been evenly spread and that the poorest and most vulnerable people are being left behind.

The recently agreed Sustainable Development Goals (SDGs) aim to achieve greater equity and a more integrated development focus with women and health at the center of the agenda and in this context, UNICEF has designed a Health Strategy 2016-2030 and an Health Systems Strengthening (HSS) framework that seeks to deliver on this agenda.

As UNICEF and its partners move forward with the post-2015 agenda, it is a corporate priority for UNICEF to examine its work in health system strengthening – understanding what works in different contexts and identifying opportunities for course correction in coming years. As such, HPI together with Itad have been commissioned to undertake a formative evaluation of UNICEF’s health systems strengthening efforts under this framework and Health Strategy.

The evaluation will employ a mixed methods approach to ensure strong evaluation design, deploying case studies, structured document reviews, key informant interviews, focus group discussions and a survey to unpack and test a reconstructed Theory of Change, generating evidence of UNICEF’s contribution.

The organisational domain of the evaluation will examine UNICEF as an organisation – inclusive of its mandate, policies, procedures, behaviour and practice and structures at different levels, and the extent to which it is set up to deliver on the adaptation of its approach to health systems strengthening.

The implementation domain of the evaluation will be centred on five ‘thematic case studies’ which will explore the implementation of specific interventions in more detail, and generate evidence of UNICEF’s contribution to strengthening health systems at country level.

Evidence from across both of these domains will be synthesised and recommendations generated, which will be refined in conjunction with UNICEF, to ensure that they are actionable and relevant to the needs of the end user.

Paula Quigley is the evaluations’ Deputy Team Leader, and is a medical doctor and health systems strengthening specialist with over 25 years of international experience in health program design, evaluation, management and review. She has extensive experience in working at multiple levels of the health system, applying the use of evidence-based interventions and developing strategies to achieve universal health coverage and address inequity. She has broad evaluation experience, including formative and summative evaluations using both qualitative and quantitative methods, for a range of donors.

Andrew McKenzie is the senior health systems strengthening sxpert on the evaluation and has extensive expertise in health systems strengthening and evaluation, as well as over 30 years’ experience in sub-Saharan Africa.

Cathy Green is on the experts panel for this evaluation. Cathy is a social development and health systems consultant with extensive experience in the health sector. She has worked in a senior advisory capacity for several large health systems strengthening programmes over the last decade.