Abstract
Health Program of the Community Livelihoods Project (CLP) in Yemen is an integrated, multi-sectoral, assistance project designed to mitigate the instability in some of Yemen's most difficult regions through the facilitation and implementation of quality government service delivery, job creation, responsive local governance, and active civic participation. Within the CLP the health program has focused largely on the extension of reproductive health care to populations that did not have access to health services. The health project of the CLP aimed to improve maternal, newborn and child health (MNCH), and ultimately intending to reduce maternal, neonatal and child mortality. This goal is aligned with the health goals of the Ministry of Public Health and Population (MoPHP), as well as USAID's MNCH and Reproductive Health (RH), Family Planning (FP), and Nutrition priorities. This evaluation of the CLP Health Program aims to provide USAID with recommendations to inform the design of future health programs in Yemen and similar fragile states. To this end, the evaluation assessed: (1) the quality of the program design and the strategic and operational approach; (2) the quality planning, monitoring, data quality and reporting; and (3) the efficiency and effectiveness of the program. There were improvements seen in access to and the quality of health services during the life of the project. Health-sector activities related to private provider midwife (PPM) and mobile medical team (MMTs) were particularly effective in contributing to improved health access in rural areas. From 2011-2013 9 health centers were rehabilitated: (1) the numbers of assisted births in specific areas increased from 206 in 2011 to 894 in 2013;(2) the project made key investments in training; (3) the project can claim credit for 352 midwives being trained between 2011 and 2013; and (4) during that same period, 213 other staff were trained in maternal-child care. The original hypothesis of the project's logic model -- that health service delivery would contribute to national political stability and peace -- remains undetermined. The lack of counterfactuals and the existence of other numerous extraneous driving factors make it difficult to measure any attribution. The CLP health project demonstrated reasonable resilience in re-inventing itself in response to changing conditions in Yemen and evolving analyses and priorities. (Excerpt, modified)