Final Evaluation of the Safer Motherhood Project in the Deou Division, Oudalen Province

Background

According to a report by Save the Children entitled State of the World's Mothers from 2004, Burkina Faso was ranked 104th on a list of 105 countries, in where comparison is made on the situation of the needs of mothers and children. The project intervention area (Oudalen Province) is one of the most landlocked and underdeveloped regions of Burkina Faso.

In this context, AMURT has since 2004 been implementing a project referred to as "Safer Motherhood". The main goal of the project was to contribute in meeting needs in the area of mother and child health care in cooperation with the local health authorities.

The project enabled AMURT to train village Birth Attendants. The birth attendants developed skills covering population health in general, with a particular focus on pregnancy, delivery care as well as women post-partum follow-up. In addition, awareness raising actions on targeted themes such as breast feeding and HIV/AIDS were also implemented.

Purpose/objective

The purpose of the final evaluation was to give an account of the level of achievement of the project objectives. The evaluation aims at meeting this basic concern among the key actors involved in the project and to assess the relevance of the action. The evaluation focuses on activities implemented over the 2005-2007 period (i.e. 3 years), and it took place from 5 to 25 November 2007 in the Déou Division.

The evaluation results will be used for the consolidation of the NGO and its partners approach within the context of problem analysis and quest for solutions by AMURT, partners and target beneficiaries.

Methodology

The evaluation is based on a crosscutting qualitative descriptive and analytical approach. Thus, three data collection techniques were used for information collection with target groups. These techniques include: documentary review, detailed discussions with individuals and managed group discussions known as "Focus Groups".

Key findings

The evaluation concludes that the quality of outcomes achieved by AMURT is a real source of satisfaction after three years of activities in partnership with the health and grassroots community actors. For example, the number of deliveries supervised by qualified health personnel increased from 175 in 2003 to 358 in 2007. AMURT Burkina Faso has through its work gained acceptance by the communities. Operational methodologies and tools are available today to serve as dynamic references in the implementation of future actions by AMURT in the field of health and/or any other initiative that takes over.

However the analysis made in the evaluation reveals that the project appears as an unfinished work. The architecture is rational but the elements composing it show some technical weaknesses or gaps. AMURT has been operating in a very isolated environment, and this has made the work difficult.

The change of behaviour among the local population is a long term work and it is the impression that the duration of the intervention is too short. It is a challenge to find mechanisms to be put in place in order to sustain or secure an actual ownership of the project achievements by beneficiary populations in the future.

Recommendations

The following are the key recommendations of the evaluation:

1. Take measures for a capitalisation and broad dissemination of the project achievements for the actors involved in the project implementation.
2. Build the coordinating unit, notably through the recruitment of a specialist in monitoring / evaluation.
3. Strengthen support for birth attendants by putting in place a mechanism of partnership between birth attendants and health institutional actors.
4. Establish consultation and exchange frameworks among birth attendants on the one hand, and between institutional actors, the coordinating unit and birth attendants.
5. Improve the literacy of birth attendants and populations.
6. Acquire transportation means (bicycles or cars) for birth attendants.
7. Build "maternity houses" for the most dynamic birth attendants, taking into account the size of the population covered.
8. Increase the allocation of technical materials and drugs for birth attendants.
9. Diversify the sources of financing and support for the activities of birth attendants.
10. Involve other actors (local council authorities, Education Department, Agriculture Department...) in the support for the activities of birth attendants.
11. Increase the purchasing power of birth attendants through the promotion of income generating activities.
12. Advocacy with local council and district authorities to set up a mechanism for registration and issuance of birth certificates for delivery carried out by birth attendants, in order to enhance the value of their activities.
13. Increase in the future, financial resources allocation for the project activities by taking into account, the concerns and needs expressed by beneficiary grass-root populations.
14. Accelerate in a timely manner, funds disbursement and transfer procedures for AMURT Burkina Faso, to allow for a greater promptness in the implementation of activities on the ground.