Table of Contents

Executive Summary 1

1. Introduction 7

1.1. Background of the project 7

1.2. Uganda refugee context 9

1.3. Overview of intervention areas (Kyaka II, Kampala, Adjumani) 11

1.4. Objectives of the evaluation 13

General Objective 13

Specific Objectives 13

Purpose of the Evaluation 14

2. Description of the Intervention 15

2.1. Project rationale 15

2.2. Specific Objective (SO) 16

2.3. Results (R1–R4) 16

Result 1 (R1): Improved access to quality healthcare services 16

Result 2 (R2): Strengthened community capacities for GBV prevention and response 17

Result 3 (R3): Increased awareness and advocacy on refugee and GBV issues 17

Result 4 (R4): Strengthened participation and accountability mechanisms 17

Linkage to the Specific Objective 17

2.4. Key components (SRHR, MHPSS, GBV, community systems, AAP) 18

2.5. Theory of change 19

3. Methodology 21

3.1. Evaluation approach (mixed methods, participatory, theory-based) 21

3.2. Evaluation Criteria 21

3.3. Data Sources and Collection Methods 21

Document Review 21

Key Informant Interviews (KIIs) 22

Focus Group Discussions (FGDs) 22

3.4. Sampling Strategy 23

3.5. Data Analysis 23

3.6. Ethical Considerations 23

3.7. Limitations of the Evaluation 24

4. RESULTS 25

4.1. Achivement of the Objectives. 26

4.2. Achievement of intended outcomes and results 30

5. Findings Against the Evaluation Criteria 74

5.1. Relevance (Adequacy and Relevance) 75

5.2. Effectiveness 77

R1 – Health services (SRHR, MHPSS, GBV response) 84

R2 – Community capacity and GBV prevention 84

R3 – Awareness and advocacy 84

R4 – Participation and accountability (AAP) 84

Achievement of the Specific Objective 85

Differences across locations 85

Contribution of partners 85

5.3. 5.3 Efficiency 86

Use of financial resources 86

Timeliness of implementation 86

Use of existing systems 86

Cost-effectiveness 86

Coordination efficiency 87

5.4. 5.4 Impact 87

Changes in health access and outcomes 87

Changes in GBV response and reporting 87

Changes in community behaviour and awareness 88

Changes in institutional capacity 88

Intended versus unintended effects 88

Differences across locations and contribution versus attribution 88

5.5. 5.5 Sustainability (Viability) 88

Institutional ownership 88

Community ownership 89

Continuity of services 89

Financial and operational sustainability 89

Integration into existing systems 89

5.6. 5.6 Connectivity / Coherence 89

Link between humanitarian response and system strengthening 90

Alignment with policies and frameworks 90

Appropriateness of tools, equipment and approaches 90

Continuity post-project 90

5.7. 5.7 Coordination 90

Collaboration within the consortium (Farmamundi, AHA, EMESCO) 90

Collaboration with government (MoH, OPM, KCCA, districts) 91

Collaboration with other actors and functionality of mechanisms 91

5.8. 5.8 Coverage 91

Who was reached 91

Equity of access — gender, age and vulnerable groups 91

Gaps in reach 91

5.9. 5.9 Ownership and Participation 92

Role of communities as rights-holders 92

Role of local institutions 92

Functionality of AAP mechanisms 92

Level of engagement in decision-making 92

5.10. 5.10 Cross-Cutting Issues (Integrated Analysis) 92

Gender and age 93

Human Rights-Based Approach (HRBA) 93

Conflict sensitivity / Do No Harm 93

Environmental considerations 93

Inclusion of vulnerable groups 93

6. Conclusions 94

7. Recommendations 96

5.11. 7.1 Donor (Basque Government) 96

5.12. 7.2 Farmamundi (lead / coordinating partner) 96

5.13. 7.3 Implementing partners (AHA and EMESCO) 97

5.14. 7.4 Government of Uganda (MoH, OPM, KCCA, District Health Offices) 97

5.15. 7.5 Community level (community committees, leaders, VHTs, rights-holders) 97

Consolidated Synthesis of Beneficiary and KI Proposals 98