Work package 7: Monitoring and evaluation

Overall objective

  • To measure the overall effect of the implemented intervention strategies on sexual and reproductive health service use and outcomes among women in general, and female sex workers in specific

Specific objectives

  • To assess the feasibility and acceptability of the models and services that were introduced
  • To measure the utilisation of the services and the coverage of the targeted populations
  • To assess the quality of the offered services
  • To estimate the effect and impact of the interventions on sexual and reproductive health, in particular among female sex workers


The intervention packages in each study site was assessed using a pre- and post-intervention case study methodology, including examining (1) feasibility and (2) adequacy of the models and services that were introduced; (3) service utilisation and coverage; (4) cost and sustainability of the services, and (5) equity of the interventions. Only measures that could be feasibly and realistically used were selected. The measurement of population-level SRH outcomes was not feasible for a number of reasons; e.g. prohibitive costs across the four study sites and some of the impacts of the intervention that have a significant time lag, such as morbidity/mortality due to unsafe abortion and HIV prevalence. 

Feasibility and acceptability was assessed by repeating the qualitative research methods that were applied in the situational analysis, such as focus group discussions with beneficiaries and providers, and key informant interviews. Utilisation of services was assessed by monitoring and analysing service uptake over time. Coverage was (1) estimated based on the available population and epidemiological data, and (2) measured through interviews with a cross-sectional sample of most-vulnerable populations. Quality of the services was to some extent assessed by a combination of a health facility assessment, provider interviews and client exit interviews. The analysis of cost is addressed in work package 8. Effect was partly assessed through the comparison of some SRH outcomes that were measured in the baseline cross-sectional survey and repeated in a second cross-sectional survey at the end of the project. These included behaviour change indicators (contraception use, condom/barrier use, voluntary HIV testing, etc.), occurrence of unplanned pregnancies, among others. Results of pre- and post-intervention assessment was analysed for each of the 4 study sites.