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Evaluation report

2004 BTN: Country Programme Evaluation (1997-2001) & (2002-2006)



Executive summary

Background:
Since the Basic Cooperation Agreement (BCA) signed in 1974, UNICEF has been an important supporter and contributor to the Royal Government of Bhutan through a variety of collaborative programmes. In the initial years of the cooperation, some of the programmes, such as EPI, also supported the expansion of the basic health care network to the rural areas, on which the health delivery system is based today. The overarching goals of the successive collaborative programmes have been to enhance the rights and welfare of children and women.

The Country Programme for the period 1997-2001 essentially adopted a sectoral framework for programming. The three main programmes were Health and Nutrition, Rural Water and Sanitation and Basic Education. The Country Programme for the period 2002-2006 followed a different framework with three major programmes: (i) Child Care and Development; (ii) Expanded Basic Education; and (iii) Health and Nutrition. Even though the programmes are clustered slightly differently, the two country programmes are essentially the same in their content and should be seen as a continuum. The similarity is particularly striking when we go down to the activity level. This implies that, in essence, UNICEF-supported programme interventions have been the same for at least the last seven years and there has been no major re-strategizing of its programme interventions.

Purpose/Objective:
Due to the changing context of social development in Bhutan as well as the new perspectives, programming frameworks and priorities of UNICEF, the manner in which collaborative programmes between UNICEF and the Royal Government of Bhutan are planned and functioning needs to be reassessed. This is the overarching rationale for the present Country Programme Evaluation. The objectives of the Country Programme Evaluation are therefore:

  • To assess the relevance of UNICEF’s core strategy for the realization of the rights of Children and Women in Bhutan.
  • To review the progress of UNICEF’s country programme in order to determine the effectiveness and efficiency of its programme interventions in meeting their planned objectives and coverage, as identified in the last two Master Plan of Operations (1997-2001) and (2002-2006).
  • To examine the experience of implementation of the country programme and draw out lessons that can be used to improve programme planning and implementation in the future, especially with reference to sustainability and replicability.

Methodology:
The Country Programme Evaluation methodology employed the following process. For the ongoing Sectoral Assessments, draft reports provided the initial information on the progress and constraints in each of the four current programmes of collaboration between the Royal Government of Bhutan and UNICEF (Child Care and Development, Health and Nutrition, Expanded Basic Education and Planning, Communication and Participation). This was followed by a desk review of the several studies and programme evaluations supported by UNICEF-BCO. Consultations were held with M&E Officer-ROSA to integrate UNICEF frameworks for country programme evaluation into the reporting process. A field visit to three districts within Bhutan was undertaken next to conduct semi-structured interviews with beneficiaries, frontline workers and district officials. Based on the data collected from the desk review and field visits, discussions with programme officials of both UNICEF and the Royal Government of Bhutan were undertaken. The interconnection between different data sources were established and the data analyzed from the perspective of the evaluation criteria. A draft evaluation report was prepared and the major findings of the country programme evaluation presented to a wider body of stakeholders in the social development sectors of Bhutan. Based on their comments, the CPE report was finalized.

Findings and Conclusions:
The progress in the key indicators of human development for children and women between 1997 and present shows that the UNICEF-supported country programmes, combined with the strong commitment of the Royal Government of Bhutan to social development, has been very relevant for Bhutan’s social development. The expansion of the social infrastructure in health, primary education and rural water supply has enabled a majority of the Bhutanese population to access services in health care and basic education. Both the Community School concept, with its element of community contribution, and the Non-formal Education programme, with its components of functional literacy, have been effective instruments for the participation of women and children towards their empowerment. However, specific problems remain in the realization of the rights of all children and women, especially those in vulnerable situations. Issues of protection of children in vulnerable situations from abuse and exploitation have not been addressed in the current country programme. This is because it was not perceived to be a major social issue during the planning of the current country programme. However, with the establishment of the National Commission on Women and Children, it is being taken up in a priority manner. Also, the recently published Assessment of Protective Factors for Vulnerable Children in Bhutan by the Ministry of Health discusses issues of child protection. The issue of providing high quality health care to pregnant women to bring down the Maternal Mortality Rates, which continue to be high, needs to be given a much higher priority within the general health care system. Child nutritional status and the extremely high prevalence of anemia within children have only recently been accorded the strategic priority they deserve in the programme framework.

Overall, the Country Programme has been comprehensive in its effectiveness in addressing the objectives set forth in the current country programme. The general quality of services offered in the different sectors, particularly in primary health care and primary education, was observed to be of fairly acceptable levels by general standards. However as these service facilities are upgraded, it is important to have clear benchmarks and guidelines for standard setting in all programmes and make this clear to frontline workers. Both policy formulation and preparation of National Action Plans have been a key feature in many projects within the country programmes. Examples include a National Action Plan for Children, National EPI Action Plan, and National Plan for Education. Recent examples include an Early Childhood Development Policy and the setting up of the National Commission for Women and Children. Hence, the advocacy role of UNICEF has proven very effective in creating a positive environment for programme implementation. To further enhance programme effectiveness, it is necessary to set uniform standards of quality in all services: institutionalize monitoring, evaluation and MIS systems; create formal community groups, and enhance specialized subject-based refresher training for frontline workers.

The UNICEF-supported country programme has been reasonably strategic in both the choice of interventions to be prioritized and the nature of partnerships within the UNDAF framework. Although the UNDAF, as a comprehensive method of integrating UN responses, has not evolved with the Royal Government of Bhutan, there are examples of multilateral cooperation between UNICEF and other UN agencies with the Royal Government of Bhutan. A recent example is the MOU signed between UNICEF and World Food Programme offices of Bhutan for an integrated approach to nutrition for school children.

Institutional arrangements for programme planning and implementation within the government system at the central level have been well established. The UNICEF country programmes have supported the putting in place of such structures both for a programme, as well as different projects, which has enhanced programme efficiency. While the Ministry of Education and Health are the overall co-coordinating bodies for the major sectoral programmes within these ministries, specific units have been created to plan and manage specific projects like the non-formal education cell within the Ministry of Education. A recent example of the efficient response to making such institutional arrangements has been the creation of an Early Childhood Development Section within the Ministry of Education. As many of the emerging issues in social development, such as early childhood development, providing health care to school children and child protection, are cross-sectoral in nature, renewed emphasis on inter-sectoral co-ordination mechanisms would be necessary to ensure continued efficiencies in programme implementation. Programs that attempt to selectively look at specific districts, such as Family Child Care and Development, have not been as effective as the process of decentralization within the government system, which is still ongoing.

It is the Royal Government of Bhutan’s policy to provide free health care and primary education to its population. The policy is particularly relevant to the context of Bhutan where there is no private sector in health and a very small one in education. The logical corollary of this decision also implies that gradually, as capacity is built up, and the system expands, it is necessary that certain activities and inputs previously supported by UNICEF are gradually taken over by the government and made sustainable as an integral part of the government system. An example of this process established by the Royal Government of Bhutan is the creation of the Health Trust Fund.

The example of community schools is a good case for replication in other programme areas, especially in programmes, which combine the need for behaviour change with service delivery. Another case for replication is the case of rural water supply systems where the locally trained water mechanic and user community take over the maintenance of the rural water supply systems. However, the key to successful replication of such community participation-based programmes is the creation of semi-formal bodies from within the communities. There are other successful programme experiences which can be replicated. For example, the initial success in goitre eradication can be replicated for anemia control.

Recommendations:
The analysis of the mix of programmes in the Master Plan of Operations (2002-2006) shows a very high number of projects and sub-projects over which resources are spread thinly. There is a need to consolidate the UNICEF-supported programmes in a more cohesive manner and make some strategic choices.

The programming framework to be used for the planning and design of different programmes must first specify the results to be achieved in terms of the change in the situation of children and women’s rights, before structuring into either projects or locating them in specific counterpart Ministries. The desirable results would be linked to both the national priorities, as articulated in the Ninth Five Year Plan of the Royal Government of Bhutan, as well as the Millennium Development Goals. The Results Based Framework being currently used in the sectoral assessments would become the basis for such programme planning. Such an approach to programming would become increasingly critical as a variety of situations affecting children and women cut across sectoral and project boundaries. Cross-sectoral programmes around early childhood development and child protection particularly need such an approach. It will also allow for clearer monitoring of results achieved through UNICEF-supported programmes.

One area where strategies for implementation need further strengthening within UNICEF-supported programmes is where the community and society have to be reached directly for behaviour change (i.e. social mobilization and advocacy). All programmes have a strong component of this and, in addition to the channels of formal institutional structures like schools and health units, there is a need to develop alternative channels of communication and advocacy. A successful example of such alternative communication strategies for behavioural change is the experience of the Religion and Health project. The absence of civil society institutions and private media in Bhutan is a constraint and creative solutions need to be continuously searched for in this field. The initiative taken in partnering BBS should be further expanded and consolidated. Local initiatives like developing wall newspapers by non-formal education groups/youth forums, linkages with systems having strong rural extension systems such as the agriculture extension networks are two other possible small initiatives.

The long-term collaboration process between UNICEF and the Royal Government of Bhutan has been very beneficial to move social development in Bhutan forward. Specific operational issues such as the streamlining of the cash assistance component within programmes have also been dealt with in a timely manner. However, there are certain constraints that have risen, in the quality of the partnership process between the Royal Government of Bhutan and UNICEF country office at the operational level, because of procedural requirements in programme implementation and because the basic planning document (MPO) does not provide enough guidance for the preparation of a focused Annual Plan in the joint programme planning processes between UNICEF and the Royal Government of Bhutan. It is recommended that the opportunity provided by the MTR process be used productively to transform the quality and level of relationship between two critical national and international institutions through the following processes:

  • Creating a small Programme Planning Consultative Group with representatives from UNICEF and the Royal Government of Bhutan at the thematic programme level that can coordinate the redesign and selection of programmes and projects for the balance of the country programme period. 
  • Each programme organizing a Programme Design Workshop that looks at the vision, components and needs of different programmes/interventions.
  • A short joint UNICEF–RGoB familiarization visit to neighboring countries, especially India, could be organized so as to get oriented on how such multilateral collaborations are being managed in different situations. The team should be representative of all collaborating sectors i.e. Ministries of Health and Education, in addition to the DADM from the Government.



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Report information

Date:
2004

Region:
ROSA

Country:
Bhutan

Type:
Evaluation

Theme:
Program Review

Partners:
Royal Government of Bhutan

PIDB:

Follow Up:

Language:
English

Sequence Number:
2004/009

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