The Technical Evaluation and Reference Group (TERG) of the Global Fund gave its report to the Board at the pre-Board meeting session held on November 13, 2018, at the new Global Health Campus in Geneva, Switzerland.
TERG Chair Jim Tulloch opened the session by saying that his presentation was intended to be a brief update on process rather than a presentation on the content of the TERG’s work. One reason for this was that most of the activities the TERG is engaged in had only recently been started or were still ongoing, Tulloch said.
The presentation covered the TERG’s key activities for 2019, and updates on TERG thematic reviews, Prospective Country Evaluations (PCEs), and Strategic Reviews.
TERG’s key activities for 2019
In 2019, in line with the TERG Evaluation Plan 2017-2022, the TERG aims to
- Further emphasize implementing the Prospective Country Evaluation (PCE) in the eight countries in which the evaluations are already underway (Congo [DRC], Cambodia, Guatemala, Mozambique, Myanmar, Senegal, Sudan and Uganda);
- Conduct “three to four” thematic reviews
- Hold three meetings and proactively implement its learning and advisory functions
- Launch and complete another TERG renewal and recruitment process.
Update on thematic reviews
The update on thematic reviews revolved mainly around a session that had taken place at the previous Strategy Committee (SC) meeting (to which the TERG reports) on Resilient and Sustainable Systems for Health (RSSH). TERG Chair Jim Tulloch said that the TERG had provided substantial inputs to the RSSH ‘deep dive’ session at that meeting.
Three thematic reviews are currently underway:
- Global Fund country-level technical support partnership model (final report, in collaboration with Gavi, is due at the end of January 2019)
- Investments in RSSH (final report is due by February 8, 2019)
- Sustainability, Transition and Co-financing policy (final report is due by May 10, 2019)
With regard to future thematic reviews, Tulloch said that the TERG has reviewed and discussed the Strategy Committee’s suggestions and was engaged in a consultative process with the SC and the Secretariat to agree on the priority themes for the next round of reviews to take place in 2019-2020. The decision would take into account “the ideal timing to feed into Secretariat work” and/or SC and Board decision processes, he said. Tulloch also mentioned consideration of whether some topics that have been proposed could be covered by other, ongoing or planned Secretariat work or TERG thematic reviews or PCEs. In addition, consideration would be given to which topics would most benefit from independent assessment.
For the next step in the selection of thematic review choices, the TERG will share a rationalized shortlist after further consultations with the SC, the Secretariat and the OIG. Some of the topics currently on the table include the concept of country ownership, the Global Fund in the SDG landscape, market shaping, country absorptive capacity, a review of catalytic investments, community workers’ role in optimization and delivery of results, and country adoption of WHO guidelines.
(Editor’s note: The GFO will follow up with an article on this once the TERG’s rationalized shortlist is made available.)
Update on Prospective Country Evaluations
The PCEs, which began in 2017, are evaluations following grant implementation in the eight selected countries (Congo [DRC], Cambodia, Guatemala, Mozambique, Myanmar, Senegal, Sudan and Uganda), using disease-specific results chains as the analytical framework to address various evaluation questions. In other words, “looking at how Global Fund inputs turn into outputs at the other end,” as Tulloch said, while examining the assumptions and the conditions underpinning grant operations.
The TERG discussed the progress of all eight countries at its September 5-7, 2018 meeting in Nay Pyi Taw in Myanmar, one of the PCE countries.
The results-chain approach, Tulloch said, affords the Global Fund a holistic understanding of how Global Fund investments translate to impact at the country level (while tracking progress on the six-year strategy); a common framework, allowing synthesis across the eight countries; and a platform for analysis and discussion among key partners (such as ministries of health, Principal Recipients, other implementers, development partners), with an independent facilitator.
Tulloch emphasized that the PCEs are taking “quite a holistic approach” to understanding the issues that may be impeding grant progress, such as human rights, gender, RSSH or other barriers.
Preliminary results of the PCEs were presented to the Strategy Committee in March 2018.
Tulloch (and the report) said that at the end of the PCEs – a 3-year or possibly 6-year process – the TERG expects improvements in the national programmes and Global Fund operations in the eight countries; a better understanding of how Global Fund policies and processes play out in countries, and how they can be improved; progress towards more robust and data-based estimates of outcomes and impact; lessons learned that could inform a more thorough approach by the Global Fund to evaluation; and the development of in-country capacity.
The next steps for the PCEs include completion of the initial results chains for each country by the end of 2018; deeper analysis (Tulloch emphasized that the TERG was “putting pressure on teams to get to the ‘why’ behind the observed findings”); and work with Country Teams and CCMs to improve data availability.
Each country will develop country reports and a synthesis report to discuss at the TERG’s January 2019 meeting. The TERG will present a position paper with a PCE synthesis report to the Strategy Committee’s first-quarter meeting in 2019.
Update on Strategic Reviews
The TERG has committed to conducting periodic reviews of all evaluation activities; these will be synthesized for the Strategic Reviews 2020 and will feed into the development process for the next Global Fund strategy. The scope of the 2020 review will be developed with the SC and the Secretariat.
The Report of the Technical Evaluation Reference Group (GF/B40/08) will be available shortly on the Global Fund website along with other Board documents from the 40th Board meeting, at www.theglobalfund.org/en/board/meetings/40.