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The aim of this evaluation is thus to evaluate the performance of Australia’s support to the Solomon Islands health sector to collect evidence to help improve Australia’s next phase of support. Specifically, this evaluation seeks to:
Conduct an analysis of the overall health sector to inform the assessment of the relevance of Australia’s contribution to the sector.
Evaluate Australia’s bilateral program of support to the Solomon Islands health sector over the period 2012-2015, including an assessment of its relevance, effectiveness, efficiency and sustainability.
Based on the evaluation findings, make recommendations to improve the relevance, effectiveness, efficiency, and sustainability for Australia’s future support to the sector.
The recommendations of this evaluation are intended to feed into the design of the next phase of Australia’s support. As such the primary users of this evaluation will be the GoA, represented by Honiara Post, DFAT and the SIG – primarily the MHMS, but including other relevant ministries – for example the Ministry of Finance and Treasury (MFT) and the Ministry of Development, Planning and Aid Coordination and their various appointed agents. Secondary users of this report may be other development partners in planning their future support in parallel to or alongside any Australian funded support.
Summary of the evaluation methodology
The evaluation was conducted in two phases using a mixed methods approach including document review and analysis, field visits and stakeholder interviews, and review of project and other data, including government and financial data. The literature review began on 25 May 2015 with the in-country visit conducted 18 June to 2 July 2015 (see Annex 2).
Table 2: Summary of evaluation methodology
Phase 1: Document and literature review
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Review and analysis of existing primary data / literature
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Review and analysis of existing secondary sources / literature
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Review of documents and data not readily available but identified during field work
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Analyses of data / information
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Phase 2: In-country Visit
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Interviews with selected key informants
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Visits to two selected Provinces and interviews with key informants
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Triangulation and verification of quantitative and qualitative data
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Observation of central level and provincial health facilities
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Where project and government data were not sufficient for the purposes of the review, the review team sought further information from government and partner staff – including from in-line and other TA staff. The team identified several additional documents and resources and the DFAT team were extremely helpful in providing access to the documents.
Field visits included:
Guadalcanal: meeting with the Provincial Health Authority, visits to the NRH and Good Samaritan Hospital.
Central Province: visits to Tulagi, meetings and group discussions with the Provincial Health Authority, viewing the second level medical stores and a visit by boat to Tarbawara Area Health Clinic.
Makira-Ulawa Province: meetings with the Provincial Health Authority, visits to the provincial hospital, the second level medical stores and visits to two peripheral health units by boat, Kerepe health clinic on Ugi island and Maonosugu health clinic.
Data from the literature review and the in-country visit were triangulated and verified where possible. Discrepancies in information (both in qualitative and quantitative data) were noted. Quantitative data were compared with qualitative data available from government, program and consultants reports and discussions/interviews in the field from implementers and partners to confirm reliability. There was a very well attended and useful focus group session with National Program Directors. Qualitative data collected in group discussions and interviews were examined for themes, and compared and confirmed with data collected across the program. A meetings program for the in-country visit is shown at Annex 2.
Limitations of the evaluation
The ToR call for the team to conduct an analysis of the overall health sector to inform the assessment of the relevance of Australia’s contribution (Annex 1). Whilst this was possible to some extent, in the time available, the evaluation of the sector was limited to the data readily available and did not entail a full and detailed new analysis of the whole health sector. While there is extensive documentation of HSSP and HSSP2, there is less formal documentation of the health sector as a whole, particularly the capacity constraints. This is addressed in the recommendations.
The ToR call for recommendations to improve the relevance, effectiveness, efficiency and sustainability for Australia’s future support to the sector. However, given the fiduciary concerns identified in the ToR, and confirmed during the in-country work, recommendations are likely to carry different levels of fiduciary risk, a level of risk that this evaluation is not equipped to assess fully. Detailed fiduciary risk and procurement assessments had been completed just before the fieldwork for this review was completed. The preliminary results were available to the evaluation team and the recommendations of this evaluation should be interpreted in conjunction with the recommendations of the fiduciary risk and procurement assessments.
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