Report | Transform: Primary Health Care Activity | Final Impact Evaluation | USAID Ethiopia

Abstract

This report outlines the findings from the impact evaluation of the five-year Transform Program supported by USAID/Ethiopia. Transform’s objective was to address maternal and child morbidity and mortality in Ethiopia, focusing on maternal, newborn, and child health, and family planning (MNCH/FP). To determine program impact, the evaluation collected baseline and endline data from Transform intervention areas and from non-Transform intervention areas. The net relative difference over time in Transform intervention areas revealed the contribution of the Transform program activities, via Difference-in-Differences (DID) analysis. The surveys included over 6,500 respondents, all women aged 15-49.

The impact evaluation focused on indicators in four different categories: family planning, maternal health, child health and immunizations, and cross-cutting issues. In the area of family planning, all three indicators (modern contraceptive use, long-acting contraception use, and postpartum family planning use) showed significant positive differences in Transform intervention areas compared to the non-Transform intervention areas. In the area of maternal health, five of the seven indicators – including metrics such as early antenatal care visits and skilled birth attendance – showed significant positive differences. The results were mixed for child health and immunizations and the cross-cutting themes. In separate multivariate analyses, higher education levels, fewer births per woman, and having received MNCH/FP messages were consistently relevant predictors of desired outcomes. The report concludes with recommendations for the Ministry of Health and USAID.