Health 2013

To comprehensively evaluate the MCA Mongolia Health Project, the Independent Evaluator compared various survey data, reviewed project documents, and conducted interviews with project stakeholders.

The evaluator reached the following conclusions (more can be found in Chapter 11 of the full report):

1. The Health Project has delivered a major contribution to Mongolia. Its courageous design that favored primary care and adopted a very population oriented approach - in contrast to a health system and hospitals first approach - has meant that the project had and still has ramifications in the most far away soums and khoroos.

2. Strategies and activities of the Health Project were comprehensive and well chosen, some of them can be considered as good practice, see below. The expected impact of the NCDI strategies on the health of the population is long-term; effects of the Health Project on the Health System are short- and mid-term.

3. The Health Project has implemented all the activities of the amended Compact, and more than that. In spite of serious obstacles, most activities were well planned and implemented. Exception to be made for the planning of the Stroke and AMI Units.

4. The Health Project has strengthened the health system rather than weakened it, although there are areas for improvement.

5. Beyond NCDIs, the Health Project has strengthened a culture of quality and thoroughness of planning and analysis in the Health System. It also has stimulated a culture of efficiency and accountability in the health sector.

6. The period of actual implementation of the Health Project was between 24 and 30 months. This is far too short for a complex program that is so deeply embedded in the health system. Many components of the Health Project are half-finished, like training and the establishment of smooth running screening programs.
   In terms of sustainability, the Health Project missed a few opportunities, like leaving behind a costing plan for further investment and activities on NCDI's and a repository of relevant documents. Bits and pieces have been left behind but no complete repository.