Rapid Feedback Monitoring, Evaluation, Research, and Learning in Mali

Healthcare funding and delivery remains a challenge in Mali, particularly in areas where conflict-related instability remains acute. Mali’s healthcare is highly decentralized, with communities largely responsible for establishing and funding health centers. USAID invested in two major initiatives to strengthen the health system and improve community health outcomes largely through governance reforms. This bold idea represents a long causal chain from governance reform to improved health outcomes. Collaborating, learning, and adapting (CLA) was required to interrogate that causal chain and make evidence-based decisions about reforming project activities to increase the likelihood of long-term impact. In order to test the effectiveness of governance reform at improving health outcomes USAID’s Global Health program in Mali contracted another USAID initiative, the Rapid Feedback Monitoring, Evaluation, Research, and Learning (RF MERL) to deliver the CLA needed. This two-pronged CLA activity generated evidence around specific program elements that the implementing partners were both uncertain about and were at key nodes in the theory of change, then conducted an impact evaluation to measure effectiveness. The results of our CLA activities are a strengthened program, stronger relationships between the two implementing partners, and high-quality learning around which messages engage community members and what can be expected of community members at home and across the global diaspora to deliver higher quality healthcare in Mali.