The USAID/Angola Health for All (HFA) project works to increase the use of long-lasting insecticidal nets, improve malaria and family planning services, establish sustainable service provision for HIV/AIDS, and improve the capacity of municipal and provincial governments to manage health programs. This midterm evaluation of the HFA project has three objectives: (1) provide information about gaps and opportunities for the project; (2) understand the project’s effectiveness in meeting intended results; and (3) identify areas for improvement. Evaluation methods include document review, key informant interviews, secondary analysis of program data, focus group discussions, facility observations, and organizational capacity assessments.
- There has been general adherence to HFA’s technical approach of co-diagnosis, co-design, and co-implementation, although progress toward targets has been uneven.
- The malaria municipal supervision tool is a strength, although provincial and national supervision tools need considerable revision.
- HFA has a strong HIV index case program but an infrequent measurement of retention in HIV care.
- Current training and supervision systems do not assure voluntarism and informed choice in family planning counseling.
- Overall, organizational capacity gaps include (1) the implementing team’s not maximizing collaboration, (2) an insufficient performance management system, (3) incomplete quality and quantity of local capacity building, (4) stagnant progress on local handover, and (5) low potential for technical and financial sustainability.
- Align training and supervision into an integrated capacity building approach.
- Jointly monitor health worker competence and performance with Government of Angola supervisors.
- Work with government counterparts to develop an HFA sustainability plan.
- Consider opportunities for integrating the community health worker role across service areas.
- Intensify local capacity building.
- Strengthen HFA’s human resources to support operations.