In 2015, Samaritan's Purse had just completed implementing a three-year maternal and child health (MCH) project in Napal district in north-east Uganda. Health indicators in Napak have historically been very poor: infant and maternal mortality rates are high and there is chronic under-nutrition. The project aimed to empower women with the knowledge, skills and attitudes needed to improve their health and the health of their children. It was implemented through the care group model, selected as a low-cost, effective and sustainable model of promoting healthy behaviours and improving access to services.

Samaritan's Purse asked Jigsaw Consult to undertake the final programme evaluation. The purpose of the evaluation was to assess the extent to which the project achieved its planned objectives, to assess the extent to which the project was good value for money, and to identify lessons for future projects.

The programme was evaluated in line with DFID guidelines for the GPAF fund. This included analysis of the relevance of the programme, effectiveness of implementation, efficiency in use of resources and in value for money, the sustainability of activities and results, and the impact on the community in Napak.

The research team used a mixed-method approach to assess the project. Qualitative data was gathered through participatory focus groups and observation, and was used to obtain information on the causes and drivers of behavioural change. An LQAS household-level survey was used to obtain information on the scale of the results.

The evaluation team found that the project had achieved an impressive level of knowledge transfer to the mothers involved in care groups and saw evidence of behavioural change, particularly in relation to hygiene and sanitation practices, exclusive breastfeeding at 0-6 months and attitudes towards maternal care. Key barriers to the programme's implementation had included delays to distribution of insecticide treated nets, and cultural resistance to some teaching modules. The team made several recommendations, including greater inclusion of men in knowledge transfer.

"Jigsaw helped us evaluate a DFID-funded multi-year MCH programme, identifying some great successes and enabling us to make key improvements for future programming. Their impressive subject area knowledge combined with incredible flexibility and professionalism produced a quality set of report. It was a real pleasure working with Jigsaw and I would wholeheartedly recommend them for future work with our organisation and others." - Chris Blackham, Head of Programmes & Projects, Samaritan's Purse UK