The evaluation’s principal objective was to assess progress that the Integrated Health Project Burundi (IHPB) has made through September 2016 in achieving its objectives and document the effectiveness of the project’s approaches and responsiveness to integrating and improving health behaviors, services, and systems. This evaluation used a combination of qualitative and quantitative methods of primary data collection. Primary data were supplemented by secondary data from the IHPB project and from U.S. and Burundi government documents. Although heavy daily patient flow and the limited number of service providers at the majority of health centers prevented the full integration of all services, all respondents recognized that improved client access to integrated services—such as pre-natal care and HIV/AIDS testing or MCH and malaria prevention—represented an important contribution to the improved quality of services. The project’s limited success in facilitating effective joint planning with hospitals and districts is a challenge that, if addressed during the project’s remaining two years, can make a significant contribution to expectations of sustainability following the project’s completion in September 2018.
At district health officer levels, there was general agreement that a major lesson learned was that project initiatives cannot be sustained unless there is full and effective involvement of district managers in the planning and implementation of a technical assistance project. At the hospital level, key informants reported that without attention being directed toward enabling hospitals to fulfill their role as technical resources for their client health centers, there is limited expectation that the project’s technical interventions can be sustained. From the perspective of health center professionals, CHWs, and clients, a key lesson learned was that integration has played a key role in changing the mentality of the population on the expanded role of the health center as a principal force for preventive health care. It is recommended that any future project with a technical focus similar to IHPB’s should: 1.) Plan from the outset to ensure long-term sustainability, 2.) Work toward maximum flexibility in the project’s execution through the contract’s definition as a cooperative agreement, 3.) Balance the provincial and central project structures and functions.