Empowerment Voice and Accountability for Better Health and Nutrition (EVA-BHN) Assessment: Executive Summary

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EVA-BHN is an £18.86m health voice and accountability programme working at community, district and province level in Punjab and Khyber Pakhtunkhwa (KP) since February 2014. It is part of DFID’s Provincial Health and Nutrition Programme (PHNP) to support delivery of an Essential Health Services Package (EHSP) by the Governments of Punjab and KP.

This assessment provides an external and critical view of the EVA-BHN programme. It provides learning for improving the programme effectiveness over the remaining 16 months, for informing the design of potential future DFID health programme(s) in Pakistan and for communicating with stakeholders.

The assessment was conducted in October – December 2017 through a desk review of international evidence, and programme documentation and data, and through a visit to four of the programme districts and the two province capitals where qualitative data was collected. Eight focus groups with community group members and 55 key informant interviews were conducted across the two provinces. Findings in this report come from a desk review of EVA monitoring data, EVA research and case studies and also from the limited primary data collection of the assessment. It is not possible to generalise many of the findings, but they give information that can be used.

This programme has produced an innovative and high-quality community voice and accountability system that is showing some signs of increasing accountability and government responsiveness. Programme MIS data is almost accurate and can be improved with minor adjustments.

However, the programme has not adequately analysed and addressed at policy level the serious health systems issues, not least health financing, human resource management and access to medicines and supplies. There is evidence that this could be limiting government engagement.

The full report is available here.

Suggested citation:
Taylor, G. and Khan, S. (2018). Empowerment Voice and Accountability for Better Health and Nutrition (EVA-BHN) Assessment: Executive Summary. London, UK: High-Quality Technical Assistance for Results (HEART).

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