Objectives of the evaluation:

To review relevant lessons learnt from German-Rwandan cooperation in the health sector over the past 30 years.

Specific objectives of the evaluation:

• Document and assess how German-Rwandan cooperation has developed in the health sector;
• Assess the relevance, effectiveness, efficiency, impact and sustainability of German-Rwandan Cooperation in the health sector and point out the specific contributions of both sides;
• Provide findings, draw conclusions, and give recommendations with respect to both successful and less successful aid modalities and instruments as well as their interactions which can be transferred to other sectors under the same conditions;
• Identify factors that formed ownership and assess the extent to which the German-Rwandan cooperation in the health sector was integrated into the Rwandan aid architecture;
• Provide an assessment of the exit strategy, or elements thereof, with regard to the phasing out and end of German aid in the health sector;
• Contribute to the development of evaluation methodologies;

Health Focus provided the evaluation team member in charge of the component “Health Financing” who took part at the first evaluation mission with the specific objectives:

• Understand how Rwandan-German Cooperation in the health sector has evolved since 2003 and set it in its socio-economic and political context;
• Gather, structure and analyze the perceptions of key actors of the joint Rwandan-Health programme at central and district level according to the key questions developed in the preliminary evaluation matrix;
• Research, gather and structure available data in Rwanda both regarding the overall socio-economic and political context since 1980 as well as the development of the Rwandan-German health cooperation;
• Develop a design for the next steps of the evaluation, particularly regarding how to review and assess the early period of the Rwandan-German health cooperation and how to assess the impact level.

• Review key documents and relevant data on Rwandan-German Cooperation in the health sector regarding the component Health Financing;
• Specify and complete key questions of the preliminary evaluation matrix with regard to the component Health Financing; develop first hypothesis regarding causal pathways;
• Contribute to the definition of health financing indicators for the context analysis;
• Comment on list of partners to be interviewed with regard to the component Health Financing in Rwanda and contribute suggestions;
• Develop interview guides;
• Lead national expert supporting the evaluation team in the component Health Financing ;
• Conduct interviews with actors at central and district level and programme managers of implementing agencies in Germany;
• Prepare and participate in the de-briefing at the end of the mission;
• Contribute to the interim report produced by the evaluation team, including a description of the contextual and sectoral trends regarding health financing in the country since 2003, a review of how the component Health Financing has evolved, the analysis of the interviews conducted during the mission and a proposal of which aspects should be assessed in detail in following missions and with which methods.
• Present and discuss the interim report at the DEval and with the Reference Group in Bonn.