Endterm evaluation of 'Innovative Partnership for Universal and Sustainable Healthcare (iPUSH)' programme in Nairobi and Kakamega Counties

Background
Amref Health Africa and PharmAccess Foundation collaborated in the implementation of the Innovative Partnership for Universal and Sustainable Healthcare (iPUSH) programme for a period of five years (2017 – 2021). The iPUSH programme leveraged on mobile technology to focus on inclusive health financing for Women of Reproductive Age (WRAs) in Kenya as well as increasing health knowledge on maternal and child health. Through a mobile health wallet, the programme aimed to empower low-income communities in Kenya to effectively save for their health expenditure. The programme was implemented in Nairobi and Kakamega counties of Kenya representing the urban informal settlements and rural settings respectively.

Objectives of the Evaluation
The evaluation was guided by the following objectives: a) to determine the effectiveness of the program in achieving its expected outcomes; b) to assess efficiency of the program’s strategy in achieving its goal; c) to assess the relevance of the program within the prevailing context of devolved health system in relation to Universal Health Coverage; and, d) to assess mechanisms in place towards program sustainability.

Evaluation Methodology
The evaluation was conducted between 14th to 25th February 2022. A mixed methods approach was utilized and entailed desk review, household survey with women of reproductive age, focus group discussions with the WRAs and Community Health Volunteers (CHVs) and key informant interviews with representatives from the sub-county, county, and programme levels. The target population comprised of targeted beneficiaries and partners in the twelve project sub counties of Nairobi and Kakamega Counties. The sampling frame for the WRAs comprised of the list of community health units (CHUs) and WRAs that are within the programme intervention areas (the 12 sub-counties). At the CHU level, survey data was collected from the 820 WRAs through direct interviewing using a structured questionnaire. The participants were selected through a simple random sampling approach. Survey data was collected electronically using smart phones in order to facilitate efficient data entry and linking of data from each survey tool to the households’ demographics. Quantitative data was analyzed descriptively using Statistical Package for Social Sciences (SPSS, Version 26) while qualitative data was analyzed thematically using NVIVO computer application.