Midterm evaluation of UNFPA Maternal and Newborn Health Thematic Fund - Phase III


Euro Health Group conducted the midterm evaluation of the Maternal and Newborn Health Thematic Fund (MHTF). The evaluation assessed the MHTF midterm progress to identify key lessons and challenges to support its future evolution. One of MHTF three transformative results is ending preventable maternal and newborn deaths and particularly focusing on the integration of sexual and reproductive health and rights with maternal and newborn health services.

The MHTF delivers technical and financial support in 32 high burden countries to create catalytic or accelerated progress in one or more of four priority technical areas including midwifery, emergency obstetric and newborn care, maternal and perinatal death surveillance and response processes, and the prevention and treatment of fistula and other obstetric morbidities. This evaluation assessed MHTF progress and considered the extent to which it has contributed to strengthening health systems, improving quality of care, and advancing equity, human rights, and accountability to stakeholders in partner countries. The evaluation team adapted the MHTF theory of change to incorporate all aspects of UNFPA support and developed a series of nine detailed evaluation questions to set out and define the areas of research. Data collection was structured around six country case studies (four field studies – Benin, Sudan, Uganda and Zambia, and two desk studies – Bangladesh and Togo) as well as global engagement and used a range of methods and sources including document review, 100+ country and global interviews and, where feasible, given COVID-19 legal and public health restrictions, site visits and observations. In addition, an online survey was completed by respondents from MHTF partner countries (response rate 51%). The evaluation team analysed and triangulated the data to respond to the nine evaluation questions. The findings point to a well-designed programme that deliver visible results and value for money in many countries. The notable gaps found, included inconsistent community engagement, uneven progress on sexual and reproductive health and rights and maternal and newborn health integration, especially with family planning, and a need to strengthen programming to promote sustainability. The recommendations developed based on the findings, focused on improving the profile and positioning of the MHTF, adopting a more structured approach to catalytic working, community engagement and gender and human rights to further scale-up and sustain outcomes.

This theory-based evaluation began with a refinement of the existing MHTF theory of change and the identification of key causal assumptions to be tested during the evaluation.

The evaluation had two overall objectives:

  1. Analyse how and to what extent UNFPA support to maternal newborn health has been guided by the theory of change and results framework as set out in the MHTF Phase III Business Plan (2018-2022) and assess the progress made thus far in the implementation of the MHTF strategic interventions.
  2. Facilitate learning and capture good practices from the MHTF across its components and areas of health system strengthening to inform the implementation of the MHTF current phase, other ongoing programmes with a link to maternal newborn health, as well as programmatic interventions in the four overlapping and mutually reinforcing UNFPA outcomes.

The evaluation group successfully conducted an analysis workshop, organized partly in-person and partly online respecting COVID-19 restrictions. The team has compiled the country study reports and finalized the synthesis report.

The evaluation report published by UNFPA can be downloaded here:

UNFPA Maternal and Newborn Health