The purpose of this evaluation was two-fold: (1) to identify lessons learned from USAID/Cambodia’s current health office portfolio and inform the future portfolio currently in design, given the Ministry of Health’s (MOH) strategic direction; and (2) to measure the progress of specific activities on their performance, namely: Quality Health Services (QHS), Empowering Communities for Health (ECH), and Social Health Protection (SHP), and identify the potential synergies among these activities to improve outcomes for the health project.
The mechanisms that are the focus of this evaluation are working to achieve improvements in three of the main building blocks of a better health care system in Cambodia: (1) quality health services that are widely available; (2) sufficient community-level participation and support; and (3) reduction of financial barriers to health care. For example, the QHS mechanism works to improve basic neonatal health competences related to the major causes of newborn mortality at all levels in the public sector. The ECH mechanism is working to build the capacity of Commune Councils (CC) to manage and support the health system functions delegated to communities in Cambodia. Implementation activities within the SHP mechanism are assisting the Royal Government of Cambodia (RGC) to expand the coverage of the health equity fund (HEF) so that more poor individuals can access health care services. SHP implementation helps to ensurethe quality and efficiency of HEF operations and provides international technical assistance to various parts of the RGC as it institutionalizes and scales up the HEF.
The evaluation team’s approach facilitated the pursuit of specific information relevant to the scope-of-work questions for each mechanism while also providing sufficient information to answer the broader, crosscutting questions related to development assistance to the health sector. The evaluators used a variety of data collection methods that yielded both qualitative and quantitative data. These included key informant and focus group interviews and reviews of existing data sets and documents. The use of focus groups was largely limited to the community or health facility level. The combination of these information-gathering methods allowed a consistent triangulation of quantitative and qualitative data, which helped ensure that findings were drawn from quality data and facilitated the identification of patterns or trends.