Abstract
The United States Agency for International Development (USAID)/Ethiopia designed the Strengthening Ethiopia?s Urban Health (SEUH) Activity to support the Government of Ethiopia?s (GoE) Urban Health Extension Program (UHEP) by improving the quality of urban health services, strengthening referral linkages, building the institutional and technical capacity of regional health bureaus, and promoting intersectoral collaboration on urban health challenges. Using a mixed-methods approach, this final performance evaluation examines SEUH design, implementation, effectiveness, and sustainability. The evaluation findings and recommendations can guide the U.S. government in its allocation of resources to support UHEP.
Findings show that the design of SEUH was aligned with UHEP priorities?hygiene and environmental health; family health; disease prevention and control; and injury prevention and control, first aid, and referral services?and responded to most UHEP needs. However, SEUH?s design lacked a strategy for the health needs of the homeless urban poor and of youth and adolescents and did not sufficiently address interventions for noncommunicable diseases (NCDs). SEUH?s main contributions to supporting UHEP included human resource capacity building, quality improvement, demand creation, and regional platforms strengthening and establishing WASH platforms. SEUH contributed extensively to improving the health system for the housed urban poor and increasing the demand and delivery of health services. Except for the integrated refresher training of health workers which has been shifted to the government, the evaluation concluded that at the time of the evaluation, most of the SEUH strategies were not sustainable by the government without donor funding.