Mid-Term Evaluation of the Immunization and Health System Strengthening Program in Burundi

The HSSIII, which is the subject of this evaluation, aims to improve equity in immunisation by emphasising performance-based financing (PBF) at the community level, and equity in immunisation through the stimulation of demand for immunisation services by civil society organisations among others.

The evaluation was funded by Gavi and outsourced by UNICEF Burundi. The primary purpose was for accountability and learning and the specific objectives were as follows: 

• To assess the achievement of the objectives set out in the country’s proposal and its contribution to the improvement of the health system;
• To assess whether the programme has been able to achieve its ultimate goal of ensuring the universal right to immunisation and quality health systems by ensuring that all groups, including the most vulnerable, have benefited from the interventions;
• Analyse the influence of the socio-political context that prevailed in the country on the implementation of activities and its impact on the achievement of objectives;
• To understand the most significant factors in the performance of the health system strengthening and immunisation programme in order to improve the effectiveness and impact of future interventions;
  Identify strengths and challenges and their causes in order to propose improvements;
• Provide strategic recommendations for the new proposal to be submitted to Gavi for immunisation-related health system strengthening

The hera team methodology involved the use of quantitative and qualitative data collection and analysis techniques, including triangulation of information. The evaluation findings were based on secondary data review (document review) and primary data collection and analysis (key informant interviews, focus group discussions). The team collected data at the community, health centre (HC), health district (HD), provincial and central levels.