Evaluating the Health Systems Advocacy Partnership Programme

Health Systems Advocacy Partnership is a programme funded by the Dutch government and brings together Amref – Flying Doctors, the African Centre for Global Health and Social Transformation (ACHEST), Health Action International (HAI), Wemos and the Dutch Ministry for Foreign Trade and Development Cooperation. The programme aims to enable people to realize their right to the highest attainable sexual and reproductive health in Kenya, Malawi, Tanzania, Uganda and Zambia. The programme aimed to contribute to achieving sexual and reproductive health and rights (SRHR) by creating space for strong civil society to engage effectively with governments, the private sector and other stakeholders accountable for health systems to deliver equitable, accessible and high-quality SRHR services. The main strategies included capacity strengthening of civil society organisations, research, public awareness raising, and lobbying and advocacy.

As the partnership ends in 2020, they asked ResultsinHealth (RiH), an international public health advisory agency, to conduct an end-term evaluation. For the evaluation, RiH used Sprockler in two ways: to collect stories of change and to harvest and substantiate outcomes using Sprockler’s Outcome Harvesting feature.

Stories of change and outcomes

126 stories of change were collected in the different countries of the programme as well as in the Netherlands. To reveal the community empowerment activities, storytellers reflected on the work they had done during or after involvement with the HSAP or their partners. Questions included for example “Did a person or group do something differently or for the first time due to their advocacy efforts? If so, what changed?”.

“The approach taken in engaging communities changed from top down to bottom up. We have engaged our leaders and community members in social accountability to hold their leaders accountable. As a result, the Ministry of Health at some clinics are now providing services (including SRHC). This is because our communities now know about social accountability.”

Through a series of workshops and online sessions assisted by the Sprockler software, they also harvested 240 outcomes. 69 of them were subsequently substantiated through sending out links to external substantiators who were knowledge about the topic but without direct connection to the partnership. The external substantiators were amongst others asked to verify the outcomes. As enough substantiators expressed their agreement with the outcomes, the whole set of 240 was declared credible enough.


RiH concludes that HSAP has made progress toward achieving its objectives related to capacity strengthening of individual CSOs, CSO networks, communities, and media. Advocacy by HSAP partners and CSOs across contexts showed results. Notable outcomes included policy adoption, budget and policy implementation (especially for HRH), governance, health financing and sexual and reproductive health commodities. Approaches were complementary and mutually reinforcing. HSAP contributed to CSO increased capacity, visibility and legitimacy, which enabled their involvement in dialogue and dissent with their governments and other stakeholders.

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