Posted by nimda on mai 1, 2016 at 4:21
This mid-term evaluation focuses on the Sexual and Reproductive Health and Rights project as implemented by Health Net TPO and funded by the Netherlands Embassy in Burundi. This SRHR project, also called ‘‘BIRASHOBOKA ‘’, a local name meaning ‘‘IT’S POSSIBLE’’, was adopted as a result of a brainstorming session and based on related challenges, existing opportunities and commitment of stakeholders.
The project covers three provinces of the western part of Burundi,namely Bubanza, Cibitoke and Bujumbura, over a period of 4-years (2012-2016).
The purpose of this mid-term evaluation was to understand what is happening in the field, the way the activities of the project are conducted, what are its strengths and weaknesses, what are the lessons learned and what could be the strategies for the next two years in order to offer the best services and sustainable solutions to the community in relation to the areas of intervention which are:
- Adherence to family planning (FP)
- Improved sexual and reproductive health (SRH) for adolescents and youth
- Prevention and management of sexual and gender-based violence (SGBV)
For this evaluation a qualitative research method has been used (focus groups and individual interviews, review of materials, documents, reports). Different stakeholders have been contacted at all levels of society; beneficiaries living in villages, stakeholders at district and provincial level, and health care providers at the level of communities, districts and provinces.
- The project has proven its relevance since it seems to be an appropriate response to improved sexual and reproductive health of the beneficiaries.Interviews with beneficiaries have confirmed these statements. It also takes into account the needs and national priorities in terms of SRH.
- The approach » Resource Mapping & Mobilization (Renforcement des Systèmes Communautaires), RMM in short, is the backbone of the strategies deployed and is proving its effectiveness within the context of the implementation of the project activities in the areas of intervention through results in the field.
- Furthermore, the training for key members at different levels of society, the awareness raising sessions for communities at large, the collaboration with the administrative authorities, the availability of Health Net TPO’s field agents seem to be essential factors that enables the project to increase knowledge and build the capacity of the beneficiaries in connection with the three areas of project. These factors enabled the beneficiaries to adopt to a certain degree responsible behaviors, initiatives that need to be further supported and developed to prevent relapses that would hamper the behavioral change process in progress.
- It should also be noted that the dynamism within community based networks, among change agents, participants of group discussions and socio therapy groups and peer educators constitute an added value in achieving positive results in the intervention areas. The home descents by change agents to support families are an eloquent testimony of outreach and interpersonal communication.
- The report deals with each of the interventions that are part of the overall RMM approach and describes the strengths that largely dominate the weaknesses. For example, socio therapy shows clearly how pain can be verbalized and alleviated and as a consequence creates peace within many families.
- In terms of family planning there are important positive changes; namely an increased number of users of Modern Contraceptive Methods (MCM) and a gradually lifting of taboos on frequent rumors regarding MCM.
- Furthermore, young people state that as a result of this project, realities on sexuality and reproduction are no longer private issues but have become points of discussions among young people, and between authorities and their subordinates. Thus, this brings a significant reduction of unwanted pregnancies in schools, as well as a mutual respect among youth to defend their sexual and reproductive health rights.
- As far as the youth are concerned, the evaluation also points out that thanks to the information provided, the perception of sexuality among young people within the target areas has evolved and has resulted in a change of attitude towards sexuality, which seems to have an impact on school results.
- The evaluation among beneficiaries regarding the concepts around sexual violence shows that in general there is a good understanding of these concepts. The project is creating a favourable environment to discuss issues
that used to be taboos among community members; the project seems t0
make it possible to talk about domestic violence, a pre-dominated type of gender-based violence.
- Regarding the innovative aspects of the project as implemented by Health Net TPO; working through socio-therapy groups, discussion groups, with change agents and the “braves”, all local actors that are selected with the help of the established networks at “colline” level, made it possible for marginalized and vulnerable people to have access to RH services. A clear link has been established between improved reproductive health and increased social and family cohesion through socio therapy and group discussions while adapting a multi-sectoral approach based on existing structures at community level.
- Despite the evidence of the positive results, the evaluation could not systematically detect the project’s contribution to the increase in the use of the RH services due to the unavailability of facts and documentation within this specific regard. Indeed, other actors are operating in the same area and within the same domains and the health care providers recognize that they cannot tell whether a client referred to their center is the result of the interventions as implemented by HNTPO through its RMM approach. In this sense, the success of the project and added value of the specific approach of HNPO can’t be proven by only taking into account the results of this mid-term evaluation. More time is needed to get a better understanding of the specific effects and impacts as a result of the proposed intervention logic of HNTPO on the increased use of RH services.
- There are some challenges regarding the sustainability of actions. The project is ambitious and many staff members of Health Net TPO are involved. Many local actors are working on a voluntary basis. The community mobilizers of Health Net TPO will not be there after the end of the project. Although the capacity building of local actors is one of the priorities of the project, it is highly recommended to start thinking how the sustainability of actions can be further ensured. Linking the SRHR related issues in a structural way to activities that permit to save and loan and to generate income is one of the examples that are currently discussed within the team.
MTE Report of the SRHR project HN-TPO