The project has been working to improve access to and availability of high-quality MNCH/FP/RH services in fragile and conflict-affected settings, achieve resilience of the services, and then scale them up and increase the capacity of partner country institutions. MIHR is unique in its focus on populations facing shocks, crises, and fragility, and health systems affected by social and ethnic conflicts, civil wars, and natural calamities on top of poor economic conditions. This project is implemented in ten countries in Africa, Asia, and Latin America. 

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The purpose of the Midterm evaluation was to document key MIHR achievements, outline the strengths and opportunities, document lessons-learned and best practices and propose actionable recommendations to meet programmatic objectives with a clear timeline and specification of responsibility. 

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The evaluation employed a mixed methods approach to obtain and triangulate evidence from multiple sources. These methods included examination of over 120 documents, interviewing over 70 key informants, conducting twelve focus-group discussions (FGDs), and an online survey of 24 stakeholders that included USAID, host country governments, and NGO officials. Key informants (KII) included USAID officials in Washington and in four selected countries, senior MIHR HQs. staff and in-country teams. The twelve focus groups included subject matter experts and Monitoring, Evaluation, Research, and Learning (MERL) experts from project HQs. and the four selected countries of South Sudan, Sudan, Mali, and Burkina Faso. 

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GDS analyzed how the interventions were selected and adopted to meet the challenges of natural disasters such as floods, volcanic eruptions, food insecurity, and conflict/political crises including coups and consequent USG sanctions, conflict and disaster settings as well as built the capacity of local public and private sector institutions and communities to ensure resilience and sustainability. We also analyzed the development and functioning of supply chain management system, quality of care, preparation and implementation of crisis sensitivity plans and sharing of the experience with peers and providing global leadership.

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Throughout the process the assessment team had regular consultations with project leadership and made several presentations to the senior project management team and the top executive leadership of Corus International. With the final report, the team provided recommendations covering the areas of project design, management, experience sharing, and global leadership as well as some tools for use by the project. As required by the SOW, the team also provided a work plan for implementation of the recommendations with priorities and timelines.