01 December 2020

Performance Evaluation Report - Lady Health Workers Programme in Pakistan

This document is the report for the Performance Evaluation of the Lady Health Worker Programme (LHWP). It is based on a methodology set out in the Inception Report and draws on evidence provided through reports on Evaluation Research Activities (ERA) undertaken by the Evaluation Team. The LHWP’s purpose is to ensure the provision of primary, preventative, promotive, and curative care services mainly in marginalised remote rural and urban slum communities, with the main objective of providing these services at the community level, particularly for women and children. Through almost 90,000 Lady Health Workers (LHWs), a population of approximately 115 million, women, men, and children who would otherwise lack access to health services are provided with Primary Health Care (PHC). The Evaluation follows a theory-based evaluation approach based on an explicit formulation of a Theory of Change (ToC) for the LHWP (which has not been produced before). The ToC is used to test the extent to which the key links in the causal chain by which the LHWP generates results have held, as well as investigating the contextual factors that influence these links. The Evaluation has followed a Realist Evaluation perspective that focuses on understanding variations in performance, particularly those relating to differences in policy and resourcing decisions over time, between regions, and in different contexts.