This report presents the main findings from an evaluation of Gavi’s support to civil society organisations (CSOs) during the period 2011 to 2017. The evaluation was conducted by Itad in 2018.

The evaluation assesses the overall relevance, efficiency, effectiveness and sustainability of the Gavi CSO Platform model as well as of Gavi’s support to CSOs through country Health System Strengthening (HSS) grants - jointly referred to as the “Gavi CSO Model”.1 

The primary purpose of the evaluation is learning and the evaluation findings and recommendations are informing decisions on how Gavi engages with CSOs during the current as well as the next Gavi Strategy. The evaluation also provides evidence on the degree to which Gavi’s support to CSOs has been efficient and effective, which is critical to guide Gavi’s future approach to engaging with CSOs in a manner that best contributes to the Gavi mission.

APPROACH METHODS

This evaluation is utilisation-focused and theory-based. A mixed methods approach to data collection was employed during the evaluation, leading to a synthesis and reporting phase that focused on systematically validating the findings and co-creating conclusions and recommendations with the stakeholders and primary evaluation users.

Itad used a mix of quantitative and qualitative methods in the evaluation, including:

  • A desk review of relevant documents regarding Gavi’s CSO support
  • Key informant in-depth interviews at global, regional and country levels
  • Country case studies in eight countries2 (including country visits in five countries)
  • Quantitative data analysis
  • A Theory of Change validation workshop
  • A recommendations co-creation workshop with primary users of the evaluation

MAIN FINDINGS

The evaluation has three work streams:

  1. CSO governance and management arrangements
  2. Regional and country processes and implementation
  3. Outcomes and sustainability

The main findings in the respective areas include:

1. CSO GOVERNANCE
AND MANAGEMENT ARRANGEMENTS

  • While the CSO Model design is relevant and aligned with Gavi’s strategy, Gavi has not articulated a clear vision of how CSO support can support Gavi’s wider Strategic Goals.
  • Platform objectives have shifted significantly over time.
  • The overall governance and management structure for the CSO Model is very complex
  • Governance and management decision-making processes have not been performed in an effective and/or efficient manner.

2. REGIONAL AND COUNTRY PROCESSES AND IMPLEMENTATION

  • The selection and engagement of Fund Managers was not conducted in a transparent manner and there have been significant inefficiencies.
  • There is mixed evidence on the efficiency and effectiveness of selecting Facilitating Organisations.
  • The funding mechanisms and processes for CSO Platform support have not operated efficiently at all times, with substantial delays in disbursements.
  • The proposed two-year duration of Platform support was not adequate or realistic to achieve the planned objectives.
  • The size of budgets has been sufficient to meet the CSO Platform objectives.
  • There is evidence of increasing commitment to the principle of CSO inclusion in HSS country funding application and monitoring and evaluation processes.

3. OUTCOMES AND SUSTAINABILITY

  • CSO Platform objectives related to improving Platform functionality and increasing engagement in national health sector and immunisation processes have been achieved in many, but not all, countries.
  • CSO Platform support has enabled increased engagement with the EPI and participation in immunisation and health sector committees.
  • CSO Platforms have contributed to Gavi-related processes (e.g. HSS funding applications, joint appraisals).
  • Very few, if any, Platforms have reached a point of financial sustainability.
  • In the very few countries where implementation of CSO activities through HSS grants has occurred, there is some limited evidence to suggest these have contributed to EPI improvements.
  • The prospects for programmatic and/or financial sustainability of CSO activities are extremely limited

1 It is acknowledged that this support is only a subset of Gavi’s work with CSOs and that other components of Gavi’s engagement with CSOs were not included within the scope of the evaluation.

2 Burkina Faso, Ghana, Guinea, Kenya and Pakistan with remote case studies in Chad, Liberia and Mali.

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