The Afya Bora ya Mama na Mtoto project was launched in 2015 and designed to address maternal and child mortality as well as improve health and overall well-being for mothers and children in Zanzibar. The project targeted the following in Zanzibar:
• 75,000 Pregnant Women
• 130,000 Caregivers of Children 0-59 months
• 260,000 Children 0- 59 months
• 130,000 Adolescents
The project was funded by the Government of Canada to the tune of 15 million Canadian dollars. It was a UN joint programme between UNICEF, UNFPA, and the Revolutionary Government of Zanzibar with Save the Children as the contracted NGO to facilitate the implementation of the community health component. The project addressed health systems management and coordination, quality health service delivery for RMNCAH services, and high-quality nutrition interventions.
The main outcome of the project was improved health and well-being of women and children in Zanzibar. This was supported by two overarching objectives that sought to:
1. Strengthen and ensure the health system delivers equitable and integrated health services including improvements in the referral system, and
2. Increase coverage of quality emergency obstetrics, newborn, and child health services, including high-impact nutrition interventions.
Coverage was increased by ensuring strategic facilities are “service ready” (offering quality newborn, child, and 24/7 EmONC services including emergency referral) and strengthening community health systems to promote RMNCAH Care-seeking behavior and positive health, nutrition, and WASH practices.
Muthengo Development Solutions was tasked to undertake an end-of-project evaluation with the aim to a) demonstrate the effectiveness of high-impact RMNCAH interventions in low-income contexts; b) improve institutional framework to support the delivery of the RMNCAH in Zanzibar; and c) generate knowledge among practitioners.
The evaluation included an evaluability assessment and retrospectively developing the Theory of Change of the programme to facilitate evaluation. Based on the evaluability assessment the evaluation adopted a One-shot Retrospective Design premised on a combination of recall and reconstruction of baseline, especially for intermediate outcome indicators. This analysis was undertaken for data that was provided through the district health information system (DHIS2) and implementing partners. Recalling the baseline situation during primary data collection was used as another method to reconstruct the baseline situation for different respondents.
The evaluation covered all districts in Ugunja and Pemba Islands.
Full evaluation report https://www.unicef.org/tanzania/reports/final-evaluation-afya-bora-ya-ma...