Evaluation of Gavi support to CSO 2012

Introduced in 2006 with a budget of US$29.2m, the Gavi civil society organisation (CSO) programme comprises:

(i) Type A support, to strengthen the coordination and representation of CSOs by providing lump sum grants between US$10,000-100,000, available to all 72 Gavi eligible countries;

(ii) Type B support, for ten selected pilot countries to help implement the Gavi health system strengthening (HSS) proposal or comprehensive Multi-Year Plans (cMYPs).

The CSO support was set up as a pilot, initially for the period 2007-09 and subsequently extended by the Gavi Board.

Objectives

This evaluation aimed to assess the policy rationale, programme design, implementation and results of Gavi’s support to CSOs.

The purpose of the evaluation was to:

• document how resources have been expended to support CSO activities in immunisation, child health, health system strengthening, and government/CSO partnerships;
• document the effectiveness of the programme;
• enable Gavi, partners and others to learn from the experience;
• account to Gavi funders, partners and the public health community (including governments, CSOs and the private sector) on the performance of the programme with regard to strengthening civil society engagement at country level in service delivery, coordination and policy development, and;
• inform future programme design and activities and ensure maximum benefit to country partners and beneficiaries.

Methods

The Cambridge Economic Policy Associates (CEPA) used a mixed methods approach to this review. This included a desk based review and analysis; comparator analysis with similar organisations; structured interviews; five countrycase studies (Afghanistan, Democratic Republic of Congo, Ethiopia, Indonesia and Pakistan) and e-surveys.

These methods were used for all three themes of the evaluation framework (policy rationale and programme design, implementation and results), albeit with some methods being more relevant for particular evaluation questions than others.

Findings and recommendations

Overall CEPA concluded that Gavi’s support to CSOs is, in principle, important to achieve the country’s and its own immunisation objectives, particularly in countries where CSOs play a key role in immunisation service delivery and supporting activities. However, there have been a number of issues with the programme design and implementation, warranting a ‘significant re-think’ of the support going forward. These issues have diminished the programme results achieved to date, although there is evidence of some positive outputs and outcomes.

CEPA developed numerous recommendations for Gavi to consider as it further develops its support to CSOs related to the structure of Gavi CSO support, programme design and programme implementation. Their main recommendation was to integrate Gavi’s CSO support (as a single funding stream) with the HSS / Health Systems Funding Platform.