External Evaluation of the Project: «Mental Health of Panzi Foundation» in South Kivu

Background:

The Panzi Foundation Mental Health Project funded by the Norwegian Church Aid (NCA) is implemented by the Panzi Foundation and the Provincial Health Inspection (IPS). The Project was implemented throughout the entire South Kivu Province and started in 2010. The overall objective of the Mental Health Project is to improve the psychosocial care for trauma victims, including sexual violence survivors.

Purpose/ Objective:

The objective of this evaluation was to: 1) provide an analysis of results achieved by activities already carried out 2) enable NCA, the Panzi Foundation and the IPS to review and compare methodologies used during the second and third phases and 3) to guide the strategy/methodology and the activities for the next period (2015 – 2017).

Five sets of questions guided this evaluation:

• In what the context of project implementation and activities planned have been relevant? Do these activities meet the expectations of the target group?
• Were the activities planned as part of this project achieved and what was the degree of achievement of the objectives targeted by the project?
• How was the project efficient, and what was its impact on the beneficiaries?
• What are the chances of viability/sustainability of the activities initiated from this project?
• Based on the different phases of the project, which strategies to adopt for the future activities by the Mental Health Project?

Methodology:

To answer these evaluation questions, the consultant undertook the following steps:

• A scoping of the mission with the NCA, the Panzi Foundation and the IPS.
• An analysis of the Project documents.
• In-depth interviews with all the Project stakeholders (the NCA, the Panzi Foundation, the IPS, health workers, some RECO who benefited from the training on mental health, the other mental health stakeholders operating in South-Kivu, etc.)
• Visits and direct observations of health structures.

The methodology used for the evaluation was an active and collective participatory method involving all the Project stakeholders in the study. This methodology took into account the objectives of the mission.

Key Findings:

After five years of project implementation, the result as a whole is satisfactory.

• The activities carried out were relevant and met the expectations and needs of the target group.
• Almost all the activities planned and amended during project implementation were completed. The large majority of the objectives are being achieved.
• NCA and the Panzi Foundation made an efficient choice by involving local partners in the implementation of activities.
• The impact on beneficiaries is very satisfactory (improved knowledge and professionalism of health workers on mental health, awareness of the authorities and/or health stakeholders of the DRC on the need to take into account mental health in the primary health care system, restoring family balance in the families of victims of psychosocial disorders, healing and recovery of self-esteem of people with mental health disorders; etc.
• The technical viability of the project is ensured, but concerns loom over the project's financial viability because of the financial dependence of the IPS.

Recommendations:

To the State (DRC health authorities):

• Integrate mental health training module in initial health worker training at the Institute of Medical Technology(ITM)/Higher Institute of Medical Technology (ISTM);
• Recruit indefinite term contract clinical psychologists for the General Referral Hospitals;
• Accelerate the integration of mental health in the primary health care system.

To the Panzi Foundation/IPS:

• Harmonize the duration of training sessions in all health zones (at least 6 work days);
• Train opinion leaders, pastors/leaders of prayers chambers, traditional healers using the RECO training module;
• Select three territories for 2015, and two territories for each 2016 and 2017. The supervising nurses must receive training on mental health;
• During the training, clearly specify the transport costs for the participants before the start of the training;
• Motivate the service providers, RECO, pastors/leaders of prayer chambers, traditional healers through the awarding of mental health certificates and T-shirts.

To the IPS:

• Intensify supervision/monitoring. Join the BCZ IS during the supervisions(at least two supervisions per year) with the service providers;
• Formalize awareness sessions for pastors/leaders of prayer chambers and traditional healers through supervisions/monitoring by the BCZ IS with the requirement of awareness raising activities and referral of mental health patient reports;
• During the training and retraining, integrate lessons on reporting, database and the use of the modem;
• During the supervision, engage all the health care staff, including those who have not been trained;
• Raise the awareness of the MCZ to accept the integration of mental health;
• Harmonize mental health reporting documents in all the health care structures. The cases of mental health patients should be included in the health care register and avoid having a specific register for mental health patients. Just put in place a list of mental health patients to facilitate the identification and/or follow up if necessary;
• Enforce/make effective the filling of the reference and feedback sheets of the mental health patients.

To the Panzi Foundation: To further empower the IPS and ensure the sustainability of the project, the Panzi Foundation could consider a gradual withdrawal during the last years.

To NCA:

Provide significant funding to cover the other seven territories which have not benefited from the training of RECO, ITA and IT retraining.