The main purpose of the evaluation was to understand the extent to which the NSF model achieved its objectives, and to document successes and challenges to inform future model designs. Specifically, the evaluation sought to: (i) determine the effect of the NSF model on country ownership and use of national systems; (ii) assess the effect of this model on program focus and prioritization to achieve better programmatic results; (iii) determine the influence of the NSF model on investment decisions, VfM and transactional costs for the Global Fund Secretariat and Principal Recipient (PR); and (iv) document strengths and weaknesses of the Results-Based Financing (RBF)/NSF model, lessons learned and to recommend areas of further improvement to inform future RBF grants.
The evaluation team used a mixed-method approach to data collection and analysis. Data collection methods included document review, quantitative data analysis, key informant interviews and direct observation of health facilities. Specific method included: comprehensive desk review; semi-structured interviews with key stakeholders; and visits to selected health facilities
It was difficult to isolate and attribute the impact of the Global Fund’s financing of the three sub-strategies, since these programs were also being financed by the GoR and other partners. The evaluation therefore used contribution analysis as the core methodology for analysing information and data and for formulating findings and conclusions.