MID-TERM 
EVALUATION REPORT 
SAVE THE CHILDREN’S CAPACITY BUILDING FOR 
QUALITY HIV/AIDS SERVICES (UMOYO NETWORK) 
JUNE 2005 
This publication was produced for review by the United States Agency for International Development. It 
was prepared by Initiatives Inc. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI i
ACKNOWLEDGEMENTS 
The Umoyo Network mid-term evaluation team is grateful to USAID/Malawi colleagues for their 
support of and interest in this assignment. In the USAID HPN Office we want particularly to thank Elise 
Jensen for her help and support throughout the assignment, and Mexon Nyirongo for his wise counsel. 
We also appreciated the support of the staff of Initiatives, Inc. of Boston, who contracted with us for the 
assignment, especially the steady, responsive back-up provided by Nicole Dupré. And our work in 
Malawi would not have been nearly as enjoyable or rewarding without the excellent logistical and 
administrative support given us by Dianne Parker. 
At various key stages throughout the evaluation we were privileged to benefit from the insights and 
advice of Roy Hauya, Director of Programs for the National AIDS Commission, and Chris Moyo of the 
Monitoring and Evaluation Office in the Ministry of Health. The time they spent with us as team 
members, notably during the week when we visited the Umoyo Network office and partner NGOs in 
the Blantyre area, were invaluable in enabling us to understand how the work of the Network 
complemented the strategies of their agencies, and how this might be further enhanced. 
We wish to thank the entire Umoyo Network staff, in Lilongwe and Blantyre, for making themselves 
readily and enthusiastically available to us throughout the assignment. We especially thank Save the 
Children/US Field Office Director Jennifer Froistad for her insights, Chief of Party Carrie Osborne for 
all of the time, support and information she gave us, and Deputy Chief of Party Express Moyo for his 
overall coordination and availability. And a special word of appreciation to Joyce Wachepa, for spending 
four days guiding us to partner NGOs in the Northern Region and three more in the Southern Region, 
never flagging in her willingness to answer our myriad questions. 
Finally, we were enormously grateful for the chance to meet and talk with staff and volunteers of almost 
all of the NGOs that are current or pending members of the Umoyo Network. We found ourselves 
infused with their positive outlook and commitment to their mission in the face of daunting obstacles 
and statistics. They understand full well that this work deserves no less, and we wish them and the 
network as a whole every success in achieving ever greater impact in the months and years ahead. 
Eliot T. Putnam, Jr. 
Jean Meyer Capps 
Ann von Briesen Lewis 
June 2005 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ii
MID-TERM 
EVALUATION REPORT 
SAVE THE CHILDREN’S CAPACITY BUILDING FOR 
QUALITY HIV/AIDS SERVICES (UMOYO NETWORK) 
ELIOT T. PUTNAM, JR. 
JEAN MEYER CAPPS, RN, MPH 
ANN VON BRIESEN LEWIS 
The information contained in this report is the product of an evaluation conducted by Initiatives Inc. 
The report was prepared under the auspices of the Technical Assistance and Support Contract (TASC2 
Global Health), implemented by Initiatives Inc. under Task Order No. GHS-I-802-03-00040-00 issued by 
the U.S. Agency for International Development. The opinions expressed in this report are those of the 
individual authors and do not necessarily represent the views of USAID or of Initiatives Inc. 
Initiatives Inc. 
376 Boylston Street, Suite 4C 
Boston MA 02116 USA 
TEL (617) 262-0293 
FAX (617) 262-2514 
www.initiativesinc.com 
DISCLAIMER 
The author’s views expressed in this publication do not necessarily reflect the views of the United States 
Agency for International Development or the United States Government. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI iii
CONTENTS 
ACKNOWLEDGEMENTS................................................................................................................................................i 
LIST OF ABBREVIATIONS.............................................................................................................................................iv 
EXECUTIVE SUMMARY.................................................................................................................................................. 1 
I. INTRODUCTION......................................................................................................................................................... 3 
HIV and AIDS in Malawi.............................................................................................................................................. 3 
The Umoyo Network response................................................................................................................................ 3 
Mid-term evaluation in the context of USAID/Malawi strategy ........................................................................ 4 
II. EVALUATION METHODOLOGY........................................................................................................................... 6 
Preparation..................................................................................................................................................................... 6 
Field work....................................................................................................................................................................... 6 
Questionnaire................................................................................................................................................................ 6 
Structure of this report............................................................................................................................................... 7 
III. FINDINGS AND CONCLUSIONS......................................................................................................................... 8 
Improving access, coverage and quality of HIV/AIDS services .......................................................................... 8 
Project management and coordination .................................................................................................................20 
Synergy with other USAID partners......................................................................................................................23 
IV. SUSTAINABILITY......................................................................................................................................................25 
IV. RECOMMENDATIONS ..........................................................................................................................................26 
ANNEXES 
I. PERSONS CONTACTED BY THE MID-TERM EVALUATION TEAM 
II. REFERENCE MATERIALS CONSULTED 
III. IN-COUNTRY EVALUTION SCHEDULE 
IV. MAP OF UMOYO NETWORK NGOs IN 18 USAID TARGET DISTRICTS 
V. PROFILE MATRIX: CURRENT AND PROSPECTIVE NGO MEMBERS OF UMOYO 
NETWORK 
VI. PROGRESS AGAINST YEAR 2 TARGETS 
VII. STATEMENT OF WORK FOR EVALUATION 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI iv
LIST OF ABBREVIATIONS 
NOTE: See Annex 5 for full names and acronyms for all Umoyo Network NGOs 
ADRA .................Adventist Development and Relief Agency 
AED.....................Academy for Educational Development 
ANC....................Ante-natal care 
ARV.....................Anti-retrovral (drugs) 
BCC ....................Behavior change communication 
CACC.................Community AIDS Coordinating Committee 
CBO....................Community-based organization 
CBQ....................Capacity Building for HIV/AIDS Services project (the Umoyo Network) 
COAG................Cooperative Agreement 
CONGOMA.....Council of Non-governmental Organizations in Malawi 
DACC.................District AIDS Coordinating Committee 
DHO...................District Health Office 
DIP.......................District implementation plan 
FHI.......................Family Health International 
GOM...................Government of Malawi 
HBC ....................Home-based care (of people living with HIV/AIDS) 
HPN ....................Health, population & nutrition office, USAID 
IP..........................Infection prevention 
IPT .......................Intermittent presumptive therapy 
JHU/CCP............Johns Hopkins University Center for Communication Programs 
LQAS ..................Lot quality assurance sampling 
M&E.....................Monitoring and evaluation 
MCH ...................Maternal and child health 
MIS.......................Management information system 
MOH...................Ministry of Health 
NAC....................National AIDS Commission 
NGO...................Non-governmental organization 
OA.......................Organizational assessment 
OD ......................Organizational development 
OVC....................Orphans and vulnerable children 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI v
PLWHA..............People living with HIV and AIDS 
PMP .....................Performance monitoring plan 
PMTCT...............Prevention of mother-to-child transmission (of HIV) 
QA.......................Quality assurance 
QI.........................Quality improvement 
RH .......................Reproductive health 
SC/US..................Save the Children/US 
STI .......................Sexually transmitted infections 
TA........................Technical assistance 
ToT .....................Training of trainers 
UPMP..................Umoyo performance monitoring plan 
VACC .................Village AIDS Coordinating Committee 
VCT.....................Voluntary counseling and testing 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 1
EXECUTIVE SUMMARY 
In 1999, Save the Children/US (SC/US), with 
USAID support, established the Umoyo 
Network in Malawi as a mechanism for 
strengthening the capacity of non-governmental 
organizations (NGOs) to deliver reproductive 
health, family planning and HIV/AIDS services. In 
2003, USAID/Malawi awarded SC/US and three 
partners a new Cooperative Agreement 
(COAG) to continue this work under the 
Capacity Building for Quality HIV/AIDS Services 
(or CBQ) project. The focus of the Umoyo 
Network was now to be exclusively on building 
capacity of NGOs to ensure quality, access and 
coverage in the delivery of HIV/AIDS services, 
in recognition of the crushing burden of the 
epidemic on Malawian health systems and all 
other aspects of national life. Funding was 
approved for two years, with two additional 
"option years" subject to a performance review. 
This report summarizes findings of a team 
recruited to conduct a mid-term evaluation of 
the Umoyo/CBQ project, and to make 
recommendations as to its future. 
The evaluation team determined that the 
Umoyo Network/CBQ project is achieving its 
primary purpose of making a significantly 
positive contribution to the national effort to 
prevent HIV transmission and help care for 
those afflicted with AIDS. The project did not 
meet one of its principal numerical targets of 
approving 15 NGOs for formal membership in 
the Umoyo Network before the end of project 
Year 2. But by May 2005, with ten members in 
good standing and four other NGOs projected 
for membership early in Year 3, the project had 
succeeded in expanding access and quality in 
HIV/AIDS services in all regions of the country. 
In particular, it realized substantial improvement 
in USAID indicators for voluntary counseling 
and testing (VCT), prevention of mother-to￾child transmission of HIV (PMTCT), and 
infection prevention (IP). 
The Umoyo Network, through a pragmatic, 
flexible, "hands on" approach to training and 
mentoring, has succeeded in demonstrably 
increasing the professionalism and reach of a 
key group of Malawian NGOs. It has generated 
enthusiasm, commitment and a shared sense of 
mission among its NGO partners, which has in 
turn made them central players in the national 
HIV/AIDS prevention effort. The project's 
technical team is highly regarded by the 
Malawian Ministry of Health (MOH) and 
National AIDS Commission (NAC). It regularly 
participates in a senior advisory role in national 
dialogue on technical issues and policy. To a 
degree not found in many countries, the 
productivity of the Network has led to 
enthusiastic acceptance by the public sector of 
NGOs as essential partners in the national 
HIV/AIDS prevention and treatment effort. 
The growth of the Network has not been 
trouble free. As noted, the pace of bringing new 
NGOs on line was too slow to meet the Year 2 
target of 15 members. This report comments 
on ways in which the careful, deliberate process 
followed by Umoyo in preparing NGOs for 
acceptance into the Network at times has 
resulted in overly lengthy delays in application 
review and final approval. On the other hand, 
once accepted, NGOs speak highly of their 
preparedness and of Umoyo's on-going 
mentoring. Even before their membership and 
accompanying financial support is finally 
approved, Umoyo makes it possible for 
applicant NGOs to take advantage of training, 
technical support and other capacity-building 
resources that they provide all Network 
members. 
Other issues observed by the evaluation team, 
and noted by Umoyo member NGOs, include 
what is felt to be an excessive burden of 
reporting, between NGOs and Umoyo and 
between Umoyo and USAID. Reasons for this 
are rooted in different interpretations of 
reporting obligations, and of the relative 
importance of different indicators of 
performance. The team suggests ways of 
streamlining the reporting process that will 
more effectively serve the project's monitoring 
and evaluation (M&E) requirements, while 
allowing more time for the mentoring and 
capacity building activities that are so 
productive. The team also comments on NGO 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 2
member concerns about other management 
issues, notably the burdensome shift from 
quarterly to monthly disbursements of project 
funds, with the concomitant substantial increase 
in administrative paperwork that detracts from 
time spent on service activities. 
With respect to overall Umoyo Network/CBQ 
project management, the mid-term evaluation 
report addresses the constraints on operations 
and decision-making imposed by maintaining 
two "central" offices, one in Blantyre and one in 
Lilongwe. It also suggests ways in which an 
already highly skilled and motivated staff might 
be made more effective still through a team 
building exercise and training in supportive 
supervision. Recommendations on these and all 
other issues are dispersed throughout the 
following report, and summarized at the end. 
The principal purpose of this evaluation was to 
advise USAID/Malawi as to whether the Umoyo 
Network/CBQ project should be extended 
beyond the two years for which funding was 
originally approved. Given Umoyo's admirable 
record of accomplishment and obvious 
appreciation at many levels, and notwithstanding 
the need to address certain M&E, grants 
management and program management issues, 
the mid-term evaluation team urges approval of 
all funding authorized under the COAG 
between USAID and SC/US. It further urges 
USAID to amend the COAG in order to permit 
approval now of both option years projected 
under the performance-based agreement. 
The team stresses that approving both option 
years now is justified because: 
• Umoyo Network staff needs to devote full 
attention to their mission of NGO capacity 
building, especially with new members as 
they are accepted, without the distraction 
of uncertainty over future funding. 
• Staff also need to be able to focus on 
internal strengthening of management and 
M&E systems without being diverted by 
the need to justify and worry about future 
funding. 
• The COAG 4-year budget already foresees 
a steep reduction in funding for the second 
option year of the project - only 15% of 
overall project funding. This means the 
Network will, of necessity, already be in 
phase-out mode in Year 4. Leaving the 
question hanging as to whether even this 
reduced funding level is certain seems 
manifestly unfair to project managers. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 3
I. INTRODUCTION 
HIV AND AIDS IN MALAWI 
In 1998, in their long-range Vision for the 
Health Sector in Malawi, planners from the 
Ministry of Health (MOH) wrote that 
“HIV/AIDS is slowly eating away at Malawi’s 
social fabric” . In 2005 that scenario is, if 
anything, more dire. It is not an exaggeration to 
say that the reality of HIV and AIDS pervades 
Malawian society, and that there is no-one, in 
the words of one hospital administrator, “who 
is not infected or affected”. It is far more than 
an issue of statistics, although those are startling 
enough – 10 Malawians die every hour from 
AIDS, more than 80,000 every year, and more 
than 800,000 people are living with HIV. The 
words of a senior MOH official at a recent 
conference are especially evocative of the depth 
of the factual and psychological impact of the 
epidemic: “We have lost this generation. If we 
are not careful we will lose the next”. 
In the face of this challenge to its national well￾being, the Government of Malawi (GOM) has 
responded vigorously and comprehensively, 
enlisting an array of national and international 
technical and financial resources. In 1999 a 
Strategic Framework for HIV/AIDS Prevention 
and Care was launched within the Ministry of 
Health’s National Health Plan. Its goal was “to 
reduce the incidence of HIV/AIDS and other 
sexually transmitted infections and improve the 
quality of life of those living with HIV and 
AIDS”, by focusing on improving HIV-related 
services and provider capacity. 
Understanding that the national response could 
not be handled by the health sector alone, in 
2001 the GOM established the National AIDS 
Commission (NAC) to coordinate the national 
effort from a multi-sectoral perspective. NAC’s 
efforts are guided by its newly adopted “2005-
2009 Action Framework”, and are in large 
measure responsible for a situation whereby 
awareness of HIV and AIDS among the general 
population, as well as knowledge of modes of 
transmission and prevention, are nearly 
universal. It has attracted funding from a wide 
range of international donors, and has received 
two installments of funds from the Global Fund 
for HIV and AIDS, with voting expected soon 
on another Global Fund award. Working closely 
with the MOH HIV/AIDS Unit, NAC seeks to 
develop the capacity to deal with the epidemic 
in all areas of Malawian society. This has 
included embracing and supporting the 
country’s vigorous non-governmental 
organization (NGO) sector to an extent often 
not seen in other countries. 
THE UMOYO NETWORK RESPONSE 
To complement government support for 
NGOs, in 1999 Save the Children/US (SC/US), 
with central USAID/Washington funding 
through the PVO/NGO Networks for Health, 
established the Umoyo Network (“umoyo” is 
the Chichewa word for health or well-being.) 
The Network was conceived as a means of 
strengthening and linking Malawian NGOs for 
the purpose of creating a more effective 
delivery system for reproductive health, family 
planning and HIV/AIDS services. Its approach to 
capacity building included technical assistance, 
training, support for proposal writing and 
project management, and development of 
monitoring and evaluation (M&E) capability. 
In May 2003, USAID/Malawi awarded Save the 
Children/US and three partners – ADRA, 
AED/Linkages, and JHPIEGO – a $13 million 
Cooperative Agreement (COAG) to maintain 
support for the Umoyo Network and continue 
its work under a new project aimed at 
“Capacity Building for Quality HIV/AIDS 
Services” or CBQ. The Network's focus was 
now entirely on HIV/AIDS, and on holistic 
development of the organizational and technical 
capacity of Malawian NGOs to ensure quality, 
access and coverage in the delivery of services. 
Its entire purpose was to ease the burden of 
the epidemic on national health systems. 
SC/US is responsible for overall management of 
the Umoyo Network and of its grants to 
member NGOs, drawing on its extensive 
experience in supporting community and 
institutional responses to HIV/AIDS. It 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 4
coordinates all capacity building inputs, provides 
TA to NGOs for financial management, 
voluntary counseling and testing (VCT) and 
other clinical and programmatic services, 
supports community outreach, and monitors 
impact. As noted, it is helped in this endeavor 
by three partners: 
(1) ADRA provides inputs on overcoming 
religious barriers to care seeking through 
support of activities of a Faith-based 
Coordinator. 
(2) Through the Reproductive Heath Advisor, 
AED/Linkages provides technical assistance, 
training and mentoring in services to prevent 
mother-to-child transmission of HIV (PMTCT). 
(3) JHPIEGO has responsibility for service 
delivery assessment and quality assurance, 
primarily in monitoring and TA for infection 
prevention, counseling and testing, provided by 
the project’s QA Specialist. (The Umoyo 
Network also recently added an Advocacy 
Officer, supported by the centrally awarded, 
mission-funded POLICY Project.) 
NGOs that provide HIV-related services 
become members of the Umoyo Network 
through a competitive sub-grant application 
process, featuring pre-award assessment, 
intensive training and other preparations, and 
regular mentoring and technical and 
management assistance once funding is 
approved. Awards are generally for an 18-
month period, with an option to renew if a 
project has proved its worth. The project set 
itself a goal of signing agreements with 15 
NGOs in its first two years. As of the time of 
the mid-term evaluation, ten NGOs were 
approved members of the network with up to 
six more in different stages of membership 
approval. Annex 4 shows locations of current 
and prospective Umoyo Network NGOs, and 
outreach sites, on the map of Malawi. The 
matrix in Annex 5 provides brief profiles of 
current and prospective member NGOs. 
MID-TERM EVALUATION IN THE 
CONTEXT OF USAID/MALAWI 
STRATEGY 
The Umoyo Network/CBQ project is integral 
to USAID/Malawi’s achievement of its Strategic 
Objective (SO) 8, Increased Use of Improved 
Health Behaviors and Services, and of its 
intermediate results (IR): 
• IR 8.2: Quality of services improved 
• IR 8.3: Access to services increased 
• IR 8.4 Health sector capacity strengthened 
Mission-funded activities are to be found in the 
18 districts that were highlighted in the CBQ 
project RFA, nine of which are in the Southern 
Region, eight in the Central and one in the 
Northern. 
The COAG under which the CBQ is funded by 
USAID/Malawi is a “performance based/results 
oriented” agreement, structured in a “2+1+1” 
format. While the first two years were 
approved, funding for up to two additional, one￾year option periods is contingent on assessment 
of achievement of Year 2 targets and overall 
project impact. This mid-term evaluation is 
intended to make it possible for USAID/Malawi 
to determine the extent to which the project 
has contributed to the achievement of Mission 
IRs, by: 
• assessing the progress of the Umoyo 
Network/CBQ project towards achieving 
its intended results; 
• determining whether USAID should 
exercise the option(s) for the one-year 
extensions provided for in its performance 
based agreement; and, 
• determining (in the event that an extension 
is recommended), what modifications to 
the Network’s approach to project 
implementation are in order to help it 
realize even greater impact than it may 
have had to date. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 5
The other components of USAID’s core 
HIV/AIDS portfolio for Malawi are: (1) Family 
Health International’s (FHI) support for home￾based care (HBC) and care for orphans and 
vulnerable children (OVC) through partner 
NGOs and CBOs in five districts; and (2) the 
BRIDGE behavior change communication 
(BCC) project being implemented by the Johns 
Hopkins Center for Communication Programs 
(JHU/CCP). USAID conceived the three 
projects in a somewhat vertical manner, 
intending for them to complement each other 
in providing a continuum of care, while avoiding 
overlap and duplication. Thus, for example, 
Umoyo Network NGOs can use project funds 
to provide VCT and PMTCT services, but not 
HBC, which is provided through FHI grantees. 
The impact of this differentiation between 
activities of implementing agencies, as well as 
synergies achieved and suggestions for their 
expansion, are discussed in Chapter 3 of this 
report (SYNERGY WITH OTHER USAID 
PARTNERS). 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 6
II. EVALUATION 
METHODOLOGY 
PREPARATION 
At the request of USAID/Malawi, a three￾person team was recruited by Initiatives, Inc., a 
Boston-based consulting firm, to undertake the 
mid-term evaluation of the Umoyo 
Network/CBQ project. The three expatriate 
members of the team brought to the 
assignment technical skills and experience in 
clinical HIV/AIDS programming, including VCT, 
PMTCT and infection prevention; NGO 
capacity building and management; and 
implementation of HIV/AIDS and other 
reproductive health and primary health 
programs. Two senior GOM officials, 
representing NAC and the MOH, also 
participated as members of the team for 
significant portions of the assignment, adding a 
key public sector perspective to the team’s 
analysis. (See Acknowledgements at the 
beginning of this report.) Due to delayed 
scheduling of the assignment, the team had 
limited opportunity to review project 
documentation ahead of time, but on arrival in 
Malawi was provided with extensive materials 
by Umoyo and USAID. These included GOM 
and USAID strategic plans, program reports, 
NGO proposals, previous evaluations and 
analyses, quarterly reports, communications 
materials and the like. (See Annex 2 for a list of 
references.) 
FIELD WORK 
The assessment team first met with staff of the 
USAID HPN office for a briefing on the key 
issues to be explored, and then on frequent 
occasions with Umoyo staff of its Lilongwe 
office. Thereafter, through trips to the 
Northern and Southern Regions of Malawi, as 
well as day trips around Lilongwe, the team 
visited offices and static and outreach sites of all 
current NGO members of the Umoyo 
Network, as well as some in process of applying 
for admission. It also met with NAC, the MOH, 
major donors and international NGOs and 
numerous other stakeholders. In its three-day 
visit to the Southern region, the team met at 
length with the Chief of Party/Program Manager 
and her Umoyo Blantyre office staff. (See Annex 
1 for a complete list of contacts.) Finally, it 
scheduled a formal interview with USAID HPN 
staff to gain their perspectives on the history 
and performance of the project. The team’s full 
travel and interview schedule for the assignment 
is attached as Annex 3. 
QUESTIONNAIRE 
Midway through the assignment the team had 
the good fortune to be invited to attend a Save 
the Children/Umoyo Network “Best Practices 
Conference” at the Malawi Institute of 
Management in Lilongwe. In addition to making 
contact with many partner NGO 
representatives, the team took advantage of this 
opportunity to design and circulate a brief, 
informal questionnaire to all attendees. The 
purpose was to give them a chance to 
participate in the evaluation by anonymously 
expressing their views about the work of the 
Network and their ideas as to how it might be 
strengthened. 
Completed questionnaires were received from 
about 60 NGO representatives. As had been 
hoped, they provided the mid-term evaluation 
team with a snapshot of feelings and 
observations on the work of the Umoyo 
Network from those most closely involved, 
which complemented the information that the 
team gathered in other ways. In general, the 
responses bespoke an energized and motivated 
group of people, appreciative of Umoyo 
assistance and impatient to make the most of it 
in serving their communities. 
There were words of praise for Umoyo's 
comprehensive approach to NGO capacity 
building. Respondents found this reflected in 
strengthened NGO financial management, 
improved quality and expanded output of 
services, and new appreciation for careful 
planning and development of monitoring and 
evaluation systems. Respondents spoke, often 
with wonder, of a newfound confidence in 
pursuing their mission, of positive, lasting 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 7
changes in their communities, and of their pride 
in being able to speak out about their work. At 
the same time, they expressed concerns about 
such things as delays in funding approvals, the 
heavy burden of reporting, and inability to 
provide all of the services that their clients 
need. References to survey responses will be 
found throughout this report. Many, if not 
most, of the issues raised were echoed in the 
evaluation team's contacts around the country. 
The accompanying box also presents a selection 
of relevant quotes, from NGO personnel and 
other stakeholders. 
STRUCTURE OF THIS REPORT 
The report that follows is keyed to the 
questions posed in the mid-term evaluation 
Statement of Work (Annex 7), as well as to 
others that the evaluation team felt to be 
important. It first presents the team's findings as 
to Umoyo/CBQ's success in meeting the 
project's principle purpose: helping member 
NGOs improve access, coverage and quality of 
HIV/AIDS services in Malawi. It assesses the 
project's progress in developing NGO technical 
and organizational capacity, reviews its success 
in achieving designated Year 2 results, and, in 
the process, tests the validity of the 
assumptions on which the project was based. It 
then looks at overall Umoyo/CBQ project 
management and coordination, where they have 
contributed to project progress and where they 
might be strengthened. It looks at the important 
issue of synergy between the Umoyo Network 
and other projects, notably HIV/AIDS initiatives 
funded by USAID/Malawi. Finally, it offers 
recommendations on future support for, and 
enhancement of, this initiative. 
Sampling of comments made to Mid-Term Evaluation Team 
during field visits and interviews and in survey questionnaire 
"I could go on the whole day about what Umoyo has done for us."
Senior staff member, NGO hospital 
"Umoyo is the only umbrella body that responds to our needs."
Senior Administrator, National AIDS Council 
"Our monitoring and evaluation system was developed with great assistance from 
Umoyo. We never had one before their coming."
Respondent to NGO survey questionnaire 
"We have accessed other funding as a result of the capacity building of Umoyo."
Director of an Umoyo Network NGO 
"With Umoyo help, we now have the confidence of our clients."
NGO staff person 
"What does the Umoyo Network do best? Build up capacity to perform better."
Respondent to questionnaire. 
"Even if we are weaned away from Umoyo, the support will still help us."
NGO official 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 8
III. FINDINGS AND 
CONCLUSIONS 
IMPROVING ACCESS, COVERAGE 
AND QUALITY OF HIV/AIDS SERVICES 
DEVELOPMENT OF NGO TECHNICAL 
CAPACITY 
Both Umoyo Network member NGOs and key 
government bodies, notably the MOH and the 
NAC, are enthusiastic in their appreciation of 
the technical assistance provided by Umoyo, 
and of the fact that the program is showing 
significant results in VCT, PMTCT, infection 
prevention, quality assurance and stigma 
reduction. Impact of the Network's 
interventions in each of these areas is discussed 
below. 
Umoyo’s technical expertise is contributing 
significantly to moving implementation of key 
HIV/AIDS interventions forward at the national 
level and, through its member NGOs, down to 
community and individual levels. Senior Umoyo 
Technical Advisors, notably those for HIV/AIDS 
and Reproductive Health, participate in most of 
the major HIV/AIDS decision-making bodies at 
the national level, and are equally influential 
with other programs, such as those 
implemented by other USAID/Malawi SO8 
partners. The value added of this expertise is 
significant and should be continued as long as is 
financially and programmatically feasible. It 
represents a substantial USAID contribution to 
the development of technically sound and 
logistically feasible HIV/AIDS interventions at all 
levels in Malawi. The need for such expertise 
will extend well beyond the projected 2007 end 
date of the Umoyo Network/CBQ project. 
Voluntary Counseling and Testing (VCT) 
When the current Umoyo Network project 
started in May of 2003, only MACRO, among 
then-member NGOs, was delivering VCT 
services. Through its three static sites, MACRO 
was providing about half of all of the VCT 
services in Malawi. Since Umoyo began training 
VCT counselors and expanding services in 
2004, the number of NGOs offering VCT 
services has expanded significantly. MACRO 
and other network NGOs are now offering 
services through 14 static and 26 outreach sites, 
with additional sites due to come on line as 
newer NGOs are funded. One member NGO, 
Word Alive, provides VCT services within 
government health facilities, including the 
Queen Elizabeth Hospital in Blantyre and a 
DHO health center in South Lunzu. 
Umoyo has trained large numbers of VCT 
counselors and site managers, and established 
quality standards for VCT services. Client 
confidentiality is guarded assiduously. Member 
NGOs encourage their clients, once tested, to 
join PLWHA support groups or “Post-test 
Clubs”. (A club member's sero-status is not 
known unless he or she chooses to reveal it.) 
Post-test Clubs are often very youth-oriented, 
and serve several purposes: 
• through dramatic and musical 
performances, club members mobilize 
community residents to go for testing; 
• the growth of such clubs tends to reduce 
stigma, because members know that some 
of them are positive, without knowing 
who; 
• clubs serve as an important social support 
network for individuals and communities 
trying to confront the devastating effects of 
AIDS on Malawian society. 
While regular availability of VCT test kits was a 
problem in the past, according to informants at 
NGO sites visited by the team the supply of 
test kits from GOM Central Medical Stores is 
now generally reliable. Umoyo and MACRO do 
maintain buffer stocks of kits in case of supply 
rupture. Some NGOs also provide STI services, 
through syndromic care (as is the case with 
MACRO) or referral for STI screening 
elsewhere. NGOs acknowledged to the 
evaluation team the limitations of the syndromic 
approach, especially in identifying STIs in 
women, but cite GOM policy supporting this 
approach. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 9
Coverage. The current breakdown of Umoyo 
NGO VCT clients is 75% male and 25% female, 
in large measure because of statistics from the 
urban static sites operated by MACRO (which 
still delivers by far the largest proportion of 
VCT services of Umoyo NGOs). Concerned by 
this imbalance, MACRO conducted qualitative 
research to understand the reasons for the 
disparity. They found, not surprisingly, that rural 
women have difficulty getting to urban clinics. 
Even when that is not a problem, women, 
especially married women, are reluctant to go 
to single purpose VCT clinics, such as those of 
MACRO, since the reason for doing so would 
be obvious. Rather, women are more likely to 
seek VCT if co-located with other services, e.g. 
antenatal care (ANC), child health, or family 
planning. They can do so without asking their 
husbands' permission, since the real reason for 
the visit is not obvious to observers. 
Spurred by these findings, MACRO and other 
NGOs have opened outreach VCT clinics, 
usually in space provided in MOH health 
centers, many of these in rural areas. Since 
opening these sites, approximately 44% of 
clients coming forward for testing in these 
settings are women, a significantly higher 
proportion than that at static urban sites. 
Other lessons learned in early stages of 
implementing VCT in Umoyo Network NGOs: 
• Clients at outreach sites are generally 
slightly older than those at static sites. 
• Outreach sites decrease male/female 
disparity. Women go if other health 
services are available (e.g., ANC, MCH, 
family planning.) 
• Urban static sites attract both adolescent 
and adult males. 
• The one group largely unrepresented in 
VCT services is female adolescents. DAPP 
has discovered that one of its outreach 
sites is attracting a large number of 
adolescent girls, but so far they have not 
determined why. 
• There is encouraging evidence of VCT 
being used as an entry point for other 
HIV/AIDS services, through referrals from 
VCT centers to NAPHAM and other 
PLWHA support groups, youth groups and 
Post-test Clubs. 
• Increasingly, VCT is serving as the starting 
point for accessing PMTCT services, ARVs, 
and STI and family planning services. 
MACRO. A further word about MACRO is in 
order, since it has been the lead Malawian NGO 
in providing VCT services and was the only 
"mandated" member of the Umoyo Network 
from the inception of the CBQ project. 
MACRO has received significant technical 
assistance from both Umoyo and the CDC, 
primarily in VCT training and monitoring and 
evaluation, although this has not been well 
coordinated. CDC says that they have 
reasonably frequent interaction with Umoyo at 
the level of M&E staff, usually via telephone 
contact. There has been no regular contact at a 
higher level, although the Umoyo senior 
HIV/AIDS Advisor does meet with CDC about 
overall VCT issues. 
NOTE: It is CDC's understanding that the U.S. 
Government is encouraging all U.S. organizations 
working in HIV/AIDS to coordinate more effectively 
than has been the case until now. CDC staff told 
the team that they can appreciate why coordination 
is desirable, and they would welcome an invitation, 
for example, to attend an SO8 team meeting. The 
team feels that this could provide USAID/Malawi 
with a good opportunity to assert a lead 
coordinating role. 
In principle, MACRO is transitioning the 
majority of its funding to NAC sources. This 
process has not been smooth. NAC funding 
announced in 2003 did not arrive until 2005. 
Nonetheless, MACRO leadership indicated to 
the evaluation team they feel ready to 
"graduate" from Umoyo’s intensive TA to 
enable newer NGOs to benefit. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 10
Prevention of Mother to Child Transmission of HIV 
(PMTCT) 
PMTCT has only recently been introduced in 
Malawi. In fact, services are so new that many of 
the women who have enrolled in PMTCT 
services have not yet delivered their babies. The 
number of PMTCT sites within the Umoyo 
Network has increased from 2 in 2003 to 7 in 
2005. More sites will be included as existing 
Umoyo NGOs add PMTCT services and new 
NGOs are funded (Nkhoma Hospital is a good 
potential example.) Most PMTCT services 
include VCT, and offer Nevirapine for mother 
and infant. 
Some NGOs also have PMTCT support groups 
that offer benefits beyond simply receiving 
Nevirapine. Ekwendeni Hospital's PMTCT 
support group includes women who are both 
HIV+ and HIV –, with differentiation not known 
unless a woman voluntarily discloses her status. 
A small number of grandmothers also attend 
support groups, saying that they want to learn 
about PMTCT and what to do about it. Topics 
addressed in support groups include exclusive 
breastfeeding, infant feeding, and enhancing the 
ability of mothers living with HIV/AIDS to live 
positively for the benefit of both themselves and 
their infants. 
Issues that have arisen in PMTCT service 
delivery by Umoyo NGOs include: 
• Follow-up of infants to ensure that they 
receive Nevirapine is a challenge. 
• The link to other PMTCT services, 
especially intermittent presumptive therapy 
(IPT) for malaria, is through ANC, but this 
is not systematic. (There are soon to be 
global recommendations to change IPT 
guidelines for HIV+ women.) 
• HIV and malaria programs in the MOH are 
not well linked, despite the fact that each 
disease has severe detrimental effects on 
the other. 
• Low utilization of health services is an issue 
throughout Malawi. But with the arrival of 
ARVs, community mobilization efforts are 
attempting to de-stigmatize testing and 
encourage pregnant women to be tested 
and seek referral for PMTCT services as 
they become available. 
• Even as services are being rolled out, 
global PMTCT guidelines are evolving and 
protocols will require changing, with 
additional capacity building implications. 
Continued USAID support for PMTCT in 
Malawi will be extremely important. 
PMTCT advisor. The Umoyo Network's 
Reproductive Health Advisor oversees all 
PMTCT activities, and is well respected by 
colleagues and NGO staff for the global level of 
expertise in this area that she brings to Malawi. 
She has trained trainers at the national level, 
although PMTCT trainers she has trained will 
need more mentoring before they are ready to 
function independently. Umoyo also has a 
PMTCT Officer in its Blantyre office, whom the 
RH Advisor is grooming to take a lead role. 
Challenges. The major challenge facing PMTCT 
in the near future will be the global changes in 
the PMTCT drug regimen that are forthcoming. 
Currently, the single dose of Nevirapine for the 
mother at time of delivery and for the baby 
within 48 hours of birth is logistically and 
economically feasible. This regimen is supposed 
to change to: 
Mother: Nevirapine + 5 days Combivir (or 
equivalent) at the time of delivery. 
Baby: Nevirapine + 5 days Combivir (or 
equivalent) right after birth 
This is likely to exacerbate challenges in 
following up babies after delivery. It only serves 
to emphasize the importance of having a 
PMTCT Technical Advisor in place who can 
adapt to these changes and provide the 
necessary guidance to service providers. 
Quality Assurance and Infection Prevention 
The quality of Umoyo technical assistance for 
infection prevention (IP) was cited in the NGO 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 11
survey conducted by the evaluation team, and 
during site visits, as one of the project's best 
elements of capacity building and a key way in 
which Umoyo helps NGOs to professionalize 
their services. The Umoyo Quality Assurance 
Specialist (JHPIEGO- supported) was 
extensively involved in implementing national IP 
standards, and work he is doing with Umoyo 
NGOs complements similar IP activities of 
JHPIEGO in public hospitals. JHPIEGO has also 
been working with Management Sciences for 
Health (MSH) to ensure they follow the IP 
model in focus districts and hospitals where 
they are active. 
IP self-assessments were conducted on services 
in Ekwendeni, Malamulo, and Nkhoma hospitals. 
Two of three improved at the second 
assessment, and the two hospitals that have had 
a third round showed significant improvements, 
although the Year 2 target of achieving 80% of 
QI indicators has not yet been reached. In the 
case of Nkhoma hospital, improvements were 
made using its own resources. Further 
improvements will depend on extended funding 
support (starting, in Nkhoma's case, with formal 
entry into the Network), but there is reason to 
believe that the Umoyo NGO hospitals will 
achieve the target by the end of the program.
0
10
20
30
40
50
60
70
Base 1st 2nd
Ekwendeni
Malamulo
Nkhoma
Behavior Change Communication (BCC) 
While not specifically required by the RFA, to 
one extent or another all Umoyo Network 
NGOs work to change behavior of those at risk 
of HIV transmission at community and individual 
levels. Examples of their approaches include: 
• Community mobilization, through drama, 
song and speeches, of at-risk women and 
men to seek VCT services 
• Post-test clubs and PLWHA groups to 
decrease stigma and encourage VCT 
• Distribution of IEC materials in English and 
local languages 
• Partnership with BRIDGE, by providing TA 
to NGOs to develop behavior change 
action plans and messages and distributing 
“HOPE Kits” when available 
• Distribution of condoms and 
encouragement of their use, complete with 
demonstrations of proper usage, with 
models, during VCT 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 12
• Counseling messages containing specific 
recommendations on partner reduction 
and fidelity 
Umoyo has based its BCC work on the 
National Behavior Change Interventions 
Strategy for HIV/AIDS and Sexual and 
Reproductive Health (NAC, April 2003). There 
was no intention for the project to develop its 
own overall strategy. BCC strategies are 
developed and assessed at the individual NGO 
level, and impact is not captured in the M&E 
system. In the view of the mid-term evaluation 
team, this represents a missed opportunity, 
because many activities of individual NGOs 
make positive contributions toward 
achievement of USAID PMP indicators for 
behavior change. When results are reflected 
only in written NGO reports, they are unlikely 
to be captured in the overall Umoyo M&E data 
system, and the project does not receive due 
credit for furthering progress towards achieving 
USAID objectives in this area. If the M&E 
system could capture these efforts, such as 
promoting fidelity, abstinence until marriage or 
committed relationships, USAID could report 
on these activities in its PMP. 
Links to USAID/ Malawi SO8 
Umoyo Network activities have positive cross￾cutting impacts on other SO8 efforts: 
• IP QA also helps decrease sepsis in 
maternity cases and newborns—very 
important causes of maternal and newborn 
deaths! 
• Emphasis on exclusive breastfeeding in 
PMTCT supports breastfeeding and infant 
feeding practices in the general population. 
• VCT, PMTCT and STI programs refer 
clients to FP services and vice versa. 
• Umoyo NGOs distribute PSI condoms, 
Youth Alert and Pakechere IEC materials. 
• Umoyo NGOs will distribute BRIDGE 
“Hope Kits” when they become available. 
Other SO8 partners (FHI, JHU/CCP) are 
responsible for other aspects of the HIV/AIDS 
continuum of care in the USAID portfolio. To 
date, collaboration between them and Umoyo 
has been cordial, but not formalized or 
strategic. Collaboration is not specified in 
annual work plans and therefore not given the 
priority of activities that are. The issue of 
synergy among SO8 partners is discussed at 
greater length later in this report. 
Collaboration with the Government of Malawi 
At the national level, as noted elsewhere, 
Umoyo Network technical experts are highly 
respected and regularly consulted by NAC and 
the MOH. At the district level, Umoyo NGOs 
are required to coordinate with District Health 
Offices (DHO) in districts where they are 
active. Primarily, this takes the form of a letter 
of endorsement from the DHO at the time of 
an NGO's application for funding. In addition, 
NGO activities are supposed to become part of 
the District Implementation Plan (DIP). Many 
Umoyo Network NGOs say that they work 
well at the district level and are included in 
DHO planning processes. Others have had less 
success in achieving this level of access. In one 
district visited by the team the Umoyo NGO 
noted that it has not been included in planning 
meetings and requests for appointments were 
not answered. 
In addition to the DHO, District Assemblies, 
District AIDS Coordinating Committees 
(DACCs), Village AIDS Coordinating 
Committees (VACCs) and Community AIDS 
Coordinating Committees (CACCs) are 
important partners in the areas where NGOs 
are working. The evaluation team observed 
activities where Umoyo NGOs work closely 
with these cross-cutting civil society 
organizations. In short, it appeared to the mid￾term evaluation team that, on balance, 
collaboration between Umoyo Network NGOs 
and the public sector has been constructive. 
Conclusion 
The Umoyo Network has contributed 
significantly to the national effort to prevent 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 13
HIV transmission by measurably expanding 
access, quality and coverage in the delivery of 
HIV/AIDS services, and realizing substantial 
improvement in USAID indicators for VCT, 
PMTCT and infection prevention. 
Recommendations for furthering impact: 
• Continue to develop VCT outreach sites, while 
also increasing static urban sites as much as 
possible. 
• Develop specific strategies to reach adolescent 
girls with VCT, PMTCT services. 
• Encourage Umoyo/CBQ technical advisors to 
mentor Malawian nationals, but don’t require 
Umoyo necessarily to fund those positions 
indefinitely. 
• Encourage Umoyo to develop the capacity to 
capture results of member NGOs' community 
oriented BCC initiatives in its M&E data 
system. 
• Track behavior change indicators as part of 
the Umoyo M&E plan, so they can be 
reported against the PMP. (See Monitoring 
and Evaluation.) 
• USAID should continue its leadership support 
of PMTCT in Malawi, through its support to 
Umoyo Network services and community 
mobilization, and to policy development and 
refinement at a national level. Plans after 
2007 should include PMTCT TA to the GOM, 
not necessarily through an NGO grants 
program. 
• USAID/Malawi is urged to invite CDC to SO8 
team meetings, as a means of opening up 
more comprehensive dialogue and sharing of 
program goals and tools, and engendering 
better coordination of technical assistance. 
DEVELOPMENT OF NGO ORGANIZATIONAL 
CAPACITY 
Save the Children/US and the Umoyo Network 
identified several key strategies for improving 
capacity of the NGO sector to play a vigorous 
role in confronting the HIV/AIDS epidemic in 
Malawi: 
1. Provide sub-grants to MACRO and other 
NGOs to expand provision of VCT and 
other HIV/AIDS related services; 
2. Strengthen institutional capacity (leadership, 
managerial and administrative) of NGOs 
through training, hands-on support, 
mentoring and monitoring; 
3. Improve the quality of NGO management 
information systems (MIS); 
4. Support resource mobilization for 
leveraging other sources of financial 
assistance. 
The Network first conducted assessments of 
existing service delivery, management and MIS 
capacity of member or applicant NGOs. The 
purpose was to establish baselines and define 
specific capacity-building needs in order to 
better target training and other support. Needs 
identified by the assessments included improved 
NGO governance, management and 
accountability; development of a large enough 
cadre of skilled personnel to meet the challenge 
of ensuring access to high quality services; 
improvements in NGO grantees' infrastructure, 
transport, and logistics; and new approaches to 
community mobilization. 
The evaluation team found that significant 
progress has been made in all areas, although 
this has often happened in unexpected ways and 
despite a number of challenges unique to the 
project and/or the Malawian context. These 
included managerial complications resulting 
from the project's having offices of more or less 
equal size and strength in both Lilongwe and 
Blantyre; the shift in activity emphasis in the 
new Umoyo as compared to the old; difficulties 
in training and retaining qualified staff when the 
national talent pool is of modest size; and the 
rapidly changing technical environment of 
HIV/AIDS. 
Effectiveness of the NGO Grant-Making Process in 
Expanding Services 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 14
Although, as previously noted, Umoyo funding 
of MACRO was predetermined, other NGOs, 
including those that were previous members of 
the network, were required to take part in an 
open competition for grant funding. The 
process of soliciting and vetting grant proposals 
was lengthy and detailed. The steps, from 
request for concept papers through preliminary 
review, organizational assessments, and ultimate 
approval, are illustrated by the timeline in the 
accompanying box. Despite the fact that several 
applicant NGOs had been part of the previous 
Umoyo Network, the process whereby 9 
NGOs were accepted into the new network 
took most of the first year (May 03-Mar 04). 
One additional NGO received a grant in April 
2005, and several proposals were pending at the 
time of this evaluation. Because the review 
process took as long as it did, Umoyo early on 
took the practical and wise decision to allow 
“candidate” NGOs to avail themselves of 
Umoyo training, technical support and 
mentoring while awaiting funding decisions. 
Despite delays, grants awarded enabled 
member NGOs to expand VCT and related 
services by establishing outreach sites, opening 
new static sites, increasing the range of services 
they provide and reaching out to new 
demographics. While the target of 15 member 
NGOs was not reached at the end of Year 2, 
those members providing VCT and other 
services expanded delivery points from three 
static sites in 2003 to 14 static and 26 outreach 
sites in 2005, facts which the limited nature of 
this indicator fails to capture. The range of 
services provided by member NGOs also 
expanded. PMTCT services are now offered 
from seven entirely new sites, and many NGO 
service centers have expanded into STI 
treatment and infection prevention. Support for 
PLWHAs, youth and Post-test Clubs has also 
taken root and is steadily expanding. 
May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar . . . Dec Jan Feb Mar Apr . . .
Advertise
Tovwirane admitted
2003 2004 2005
Concept papers [56]
Proposal development support for 5 new NGOs continues . . . 
UMOYO NETWORK NGO APPLICATION/ADMISSION TIMELINE
Umoyo staff visits (through Mar 2004)
Conduct OA (through Jan 2005)
Service delivery assessment
Nine NGOs admitted into network
(DAPP, MANASO, MANET+, AHS, Ekwendeni,
WAMI, NAPHAM, MACRO, Malamulo)
Pre-award assessment of short list [30]
External review committee
Develop organizational assessment tool
Training of OA facilitators
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 15
Success in Strengthening Leadership, Managerial 
and Administrative Capacity 
To examine, understand, and record changes in 
institutional capacity, the Umoyo Network 
contracted INTRAC’s Rick James to develop a 
system for monitoring its capacity building 
efforts, one that was more comprehensive than 
the pre-award and service delivery assessments 
that were already part of the subgranting 
process. An organizational assessment (OA) 
tool was developed with Umoyo, and an 
assessment conducted by trained facilitators in 
late 2003. The purpose of the OA was to give 
NGO partners information to guide their own 
efforts at capacity building, but the process also 
helped other stakeholders understand the 
elements of organizational development (OD). 
Both the quantity and quality of capacity 
building activities could be planned and 
assessed, and NGOs could learn from the 
experience while improving program quality. 
The OA tool assessed strengths and 
weaknesses of applicant NGOs in 19 functional 
areas (examples: "clear and shared vision", 
"learning and adaptive capacity of staff", 
"sources and adequacy of financial resources", 
etc.) These were numerically scored, using 
simple assessment forms developed for the 
NGOs' use, and averaged into overall OD 
scores. Most NGOs viewed the OA process as 
a useful and informative guide to the way 
forward, and its results were used by Umoyo in 
determining training priorities and schedules. 
However, it is important to note that the OA 
tool has only been administered once, and thus 
only baseline data was established. Further 
assessments were scheduled, notably for March 
2005, but so far have not taken place. 
Training. The training offered by Umoyo is a 
major strength of the program, as evidenced 
from both the NGO survey described earlier 
and interviews with staff, NGO trainees and 
other stakeholders. The efficacy of the 
Network's multi-faceted approach to training is 
evident in the measurable increase in service 
delivery quality and reported improvements in 
overall capacity. The breadth of the training 
program and approach is illustrated by a listing 
of offerings of 35 training sessions and other 
workshops held by Umoyo between May 2003 
and April 2005: 
• Monitoring and Evaluation training 
• Training in finance for non-financial 
managers 
• Training in USAID financial regulations 
• Training in organizational assessments 
• Management of human resources 
• Computer training and orientation to MIS 
• Governance and leadership 
• Training of trainers in VCT 
• Training in VCT site management 
• Training of trainers in psychosocial 
counseling and positive living 
• Training in whole blood rapid testing 
Some training sessions included participants 
from several or all member NGOs; others were 
specifically designed to meet an identified need 
of a few members. NGOs applying for Umoyo 
Network membership have also benefited from 
these trainings, in some cases for as long as two 
years before joining the network. The volume 
of training provided by the Network has by this 
time clearly created within member NGOs a 
number of skilled, motivated individuals who 
can themselves be developed into a cadre of 
Master Trainers that can take on training 
responsibilities among member and applicant 
NGOs. This would have the effect of reducing 
dependence on SC/Umoyo staff to meet 
training needs, and promote more vigorous 
intra-network communication and growth. 
A large, unmeasured feature of this part of the 
Network's capacity building strategy consists of 
frequent mentoring visits to individual NGOs by 
Umoyo technical and administrative staff, before 
and, especially, after training has taken place. 
Over and over, respondents emphasized to the 
team the value of this personal support and 
mentoring to developing specific skills and 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 16
confidence. All in all, in the view of the 
evaluation team, the Umoyo Network has 
demonstrated a pragmatic and flexible approach 
to training that is reaping significant positive 
dividends in the form of a larger, better-trained 
work force. 
Other indicators of increased capacity include 
the expansion of sites and services, the 
improvement in quality of financial reporting 
and work plans, and successful registration of 
most Network NGOs with the NGO Board 
and with CONGOMA, the Council of Non￾governmental Organizations in Malawi. Yet 
another indicator was the April 2005 Umoyo 
Best Practices Conference, which convened 
over 100 members and stakeholders and 
attracted significant participation from national 
government officials. Member NGOs submitted 
concept papers and were competitively chosen 
to speak on best practices and lessons learned 
from the project. Each prepared and delivered a 
professional quality PowerPoint presentation. It 
could fairly be said that this conference was a 
true "coming of age" moment for the Umoyo 
Network, one that indelibly affirmed its 
important role in combating HIV and AIDS in 
Malawi. 
Improvement in NGO Management Information 
Systems (MIS) 
Ideally, a management information system (MIS) 
for Umoyo member NGOs should enable them 
to collect and provide accurate, comparable 
data that helps them achieve their 
organizational goals and at the same time meet 
GOM and donor requirements. But progress in 
developing a common, user-friendly MIS has 
been slow. The March 2003 final evaluation of 
the first Umoyo Network project 
recommended that the “Network should 
develop an electronic database of information 
on its local partners which can be accessed by 
all staff. This should provide key data on all 
NGOs and be regularly updated by all.” To this 
end, Umoyo has conducted a documentation 
exercise to assess the systems of the NGOs it 
supports, and whether they are helping or 
hindering member NGOs to reach their desired 
goals. It now has baseline MIS scores, but 
follow-up has not been undertaken. 
Success in Resource Mobilization 
Although formal training in resource 
mobilization was offered in 2002, it has not 
been repeated during Umoyo II. Rather, 
through direct contacts and mentoring, Umoyo 
has encouraged and tried to equip NGOs to 
identify alternative funding sources and apply for 
other donor funds, such as through grants 
funded by the Global Fund for HIV and AIDS 
that are offered through the National AIDS 
Commission. To some extent, this has born 
fruit. An official of NAC reports that “It’s easy 
to identify the Umoyo Network participants” 
among the applicants for support from the 
Global Fund by the quality and detail of their 
proposals. To date, four Umoyo NGO 
members have successfully accessed funding 
from the Global Fund, directly applying newly 
learned resource mobilization, proposal writing 
and strategic planning skills. These four have 
significantly increased the non-USAID 
percentage of their funding portfolios. On the 
other hand, for other Umoyo member NGOs 
the percentage of non-USAID funding has 
decreased. So the picture is mixed, but it is 
clear that, with training and motivation, there is 
ample opportunity for NGOs to diversify their 
funding base. 
Conclusion 
The Umoyo Network has developed a grant￾making process that, while lengthy, has 
increased professionalism and effectiveness of 
the NGOs accepted or considered for 
Network membership, and generated 
enthusiasm, commitment and a shared sense of 
mission among NGO partners. Its approach to 
training and mentoring is particularly effective 
and appreciated. 
Recommendations for furthering impact: 
• Apply already designed self-assessment tools 
at six-month intervals, rather than incurring 
the expense and delay of external 
assessments. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 17
• Focus resources and time on establishing a 
computerized, user-friendly MIS that informs 
and better aligns the Umoyo M&E system with 
data. 
• Focus time and resources on development of a 
cadre of Master Trainers for the network, 
drawn from its membership. This will begin to 
reduce dependence on project trainers, 
promote cross-training and cooperation among 
members, and contribute to sustaining project 
impact indefinitely. 
• In terms of resource mobilization, review the 
current funding environment and assist 
members to target and apply for alternative 
funding support. Include private sector 
partnerships, local resources and income 
generating activities. Consider occasional 
resource mobilization training seminars. 
MONITORING/EVALUATING ACHIEVEMENT 
OF UMOYO/CBQ TARGETS 
Umoyo’s Performance Monitoring Plan (UPMP) 
and Indicators 
Please see Annex 6 for a full summary of the 
status of indicators in the UPMP (so named to 
differentiate it from USAID/Malawi's PMP). 
Commentary on indicators is contained in 
footnotes at the bottom of each page of Annex
6. 
Performance of selected indicators. The first 
indicator, number of NGOs funded, is the most 
prominent. The fact that the Year 2 target of 
enrolling 15 NGOs as full-fledged members of 
the Umoyo Network was not achieved, and its 
implications, are discussed elsewhere in this 
report. On the other hand, the second, equally 
significant indicator (numbers of people served) 
would be considered met, and exceeded, if the 
indicator definition was not limited to increasing 
geographic coverage, but instead captured 
overall increases in clients. Some NGOs, such 
as Malamulo Hospital, have defined geographic 
catchment areas beyond which they cannot 
expand. But client numbers have definitely 
increased, a fact not captured by this 
measurement method. Also worthy of note is 
the fact that the project substantially exceeded 
its target for overall numbers of clients seen in 
VCT centers, which speaks to the Network's 
success in achieving a primary goal of expanding 
service access and coverage. 
As noted in Annex 6, several indicators 
originated in Washington rather than with 
USAID/Malawi. Among them are four at the end 
of the UPMP that deal with behavior change. 
These indicators could capture Umoyo’s 
contributions if it were able to report on 
intermediate contributions to achieving the 
overall indicators, such as: 
1. numbers of new members of PLWHA 
groups, as a response to the stigma 
indicator; 
2. numbers of counseling sessions that 
advocated limiting sex only to committed 
relationships; 
3. numbers of youth group community 
outreach sessions advocating delaying sex 
until marriage, or until in a committed 
relationship; 
4. numbers of counseling and outreach 
sessions that promote condoms with risky 
sex. 
While these are output rather than outcome 
indicators, reporting against them would 
capture the considerable efforts of Umoyo in 
these areas, without requiring the project to 
measure overall behavior changes where 
attribution to only one program would be 
questionable. Umoyo Network programs do 
not operate in isolation, and many other 
HIV/AIDs related activities are being carried out 
in areas where Umoyo NGOs are active. 
USAID/Washington also mandated other 
indicators for USAID/Malawi to report on, 
which the Mission has passed on to its partners. 
As indicators were added to the UPMP, no 
clear distinction was made between those 
against which “performance” requirements in 
the COAG would be measured and those, 
mandated by Washington, which needed only to 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 18
be “tracked” by Umoyo. In principle, the 
project would not be held accountable for the 
latter. This makes it difficult for the evaluation 
team to state definitively whether or not the 
project actually achieved its Year 2 targets, 
because these “tracking” indicators also had 
targets indicated in the UPMP. Even after 
clarification by USAID, it was apparent that 
there was confusion at the project level about 
the importance and relevance of the UPMP for 
evaluating performance. 
In general, the mid-term evaluation team felt 
that a considerable degree of "fuzziness" 
surrounded the issue of indicators, something 
that is not unusual in projects of this nature. 
There is confusion on the part of Umoyo as to 
the priority of individual indicators vis à vis 
USAID/Malawi's reporting requirements, as well 
as the relative importance of indicators dictated 
by Washington. Furthermore, the list of 
indicators in the UPMP seems to the team to be 
overlong and repetitive. The team urges Umoyo 
and the USAID SO8 team to get together to 
clarify priorities and expectations where 
indicators and reporting against them are 
concerned. Hopefully this can result in a pared 
down, refined list of "key" indicators on which 
Umoyo can concentrate as the best means of 
measuring project impact. Reaching such 
decisions will, in the team's view, put Umoyo 
and USAID/Malawi on the same page as regards 
indicators, relieving them of a distraction from 
the smooth functioning of their working 
relationship. 
Other performance issues. That shifting reporting 
requirements from Washington resulted in 
agreed-upon indicators being adjusted over time 
is not the only reason that makes judging 
progress toward targets a challenge. There 
were also few clear baseline values established, 
making comparisons difficult. LQAS (lot quality 
assurance sampling) studies have been done for 
member NGOs, but the evaluation team had 
difficulty understanding when the baseline 
studies occurred and whether all of the 
indicators in the latest UPMP were included in 
these baselines. Some LQAS studies took place 
in the previous Umoyo Networks project. This 
should not, in itself, pose a problem, but some 
indicators in the current UPMP were not 
measured in the earlier LQAS. The program’s 
baseline LQAS study was still under analysis at 
the time of this evaluation, and the consolidated 
results were not readily available to the 
evaluation team. 
On the other hand, NGOs cite LQAS skills as 
extremely empowering for their program 
management and supervision, in that they have 
given them the ability to distinguish strong 
service areas from weak ones. These skills are 
very important for strengthening individual 
NGOs' ability to manage health programs. 
Effectiveness of Umoyo Network Monitoring and 
Evaluation (M&E) System 
Data gathering and reporting. The excellent data 
collection sheet designed by CDC for MACRO 
has been adopted by several Umoyo NGOs and 
simplifies VCT and other client data collection. 
Data is provided to Umoyo by NGO members 
in the form of quarterly and annual reports. 
These are analyzed by Umoyo M&E staff, with 
detailed feedback provided to the individual 
NGO. There is evidence that this process is 
both intensive and time consuming, but that it 
has resulted in improvements in both the data 
collection process and in the use of data for 
program decision-making. 
All Umoyo Network NGOs are computerized 
(largely thanks to project support), and submit 
reports to Umoyo electronically and in hard 
copy. The data is then manually entered into 
the Network's computer system, with 
combined reports generated by aggregating the 
data from individual reports. Umoyo staff says 
the uneven quality of NGO reports causes 
delays while clarifications are requested. They 
cite this as one reason that compiling 
information is slow, and reports may be 
submitted late to USAID. 
There is no centralized Umoyo Networks 
project database that is readily accessible to 
both the Blantyre and Lilongwe offices, not to 
mention to the NGOs. There are plans 
underway to rectify this, but inability to track 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 19
up-to-date project progress is a definite 
hindrance to management staff. For example, 
the Network's Deputy Chief of Party, who is 
based in Lilongwe and is responsible for overall 
oversight of field operations, had difficulty 
accessing status reports on new NGO funding 
applications from Blantyre for the evaluation 
team. Quarterly meetings of technical partners 
do not always have access to monitoring 
updates on indicators. 
Because reporting stays at the level of NGO to 
Umoyo, the project does not adequately 
capture the significant amount of on-the-ground 
program progress (as an aggregate) at the NGO 
level against the USAID/Malawi PMP (which is 
where USAID needs data to justify funding from 
Washington.) Umoyo produces lengthy reports, 
both quarterly and annually, with detailed 
descriptions of capacity building activities, but 
these reports do not provide sufficient 
commentary on the data contained to enable 
the reader to understand how this data is used 
to monitor progress towards targets. In short, 
they are heavy on statistics and lists of activities, 
but light on analysis. Were there more of the 
latter, Umoyo would receive more credit for 
the significant contributions it is making towards 
combating the AIDS epidemic in Malawi. (See 
below for further discussion and 
recommendations related to project reporting.) 
Conversations with the new Umoyo M&E 
Manager suggest that he fully understands the 
value of better aligning Umoyo’s reporting with 
USAID’s information needs. He suggests that an 
early meeting with USAID/Malawi would be 
helpful in determining the adjustments 
necessary to make reporting from Umoyo to 
USAID smoother. This would be an excellent 
opportunity for the project and USAID to 
clarify how they can work more effectively as 
partners to measure impact. 
Finally, Umoyo Network indicators are aligned 
with GOM HIV/AIDS data collection 
requirements, although it is not clear to what 
extent the GOM incorporates this data into the 
national reporting system. NGOs submit copies 
of their reports to their respective DHOs as 
well as Umoyo. How the data is used at that 
level varies from district to district. Some 
NGOs are invited to discuss results with the 
DHO, while others are not included in district 
level discussions. NGOs also submit Monthly 
Activity Reports to NAC. 
Conclusion 
Umoyo Network M&E systems do not yet 
adequately capture project impact, due in part 
to an excessive amount of reporting that limits 
analysis, and to a lack of clarity where reporting 
against indicators is concerned. 
Recommendations for strengthening M&E systems: 
• Provide TA to Umoyo to streamline and 
automate its monitoring and evaluation 
processes to efficiently capture program 
activity from the client and make it readily 
available to management and for the 
USAID/Malawi PMP. (This recommendation 
was first made in the March 2003 Final 
Evaluation of the first Umoyo Network.) 
Eliminate manual data transfer unless 
absolutely unavoidable. 
• Limit routine reporting to minimum necessary 
to accomplish program objectives, with more 
focus on analysis. 
• Umoyo and the USAID SO8 team are urged to 
clarify together priorities and expectations 
where indicators and reporting against them 
are concerned, hopefully leading to a refined 
list of indicators and simplification of reporting 
requirements. USAID is further urged to 
provide prompt feedback on submitted 
reports. 
• Encourage Umoyo to report monitoring of 
behavioral indicators at the end of the UPMP 
at the IR level. (Example: For measuring 
reduced stigma linked to revealing HIV status, 
report on “numbers of new members of 
PLWHA clubs”.) 
• The LQAS process needs to be completed so 
as to clarify project baselines against which 
assessments of project impact are to be made 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 20
in future. The team recommends that outside 
TA be engaged to help see it through 
expeditiously. 
PROJECT MANAGEMENT AND 
COORDINATION 
EFFECTIVENESS OF NGO GRANTS 
MANAGEMENT 
Grants Approval Process 
The Umoyo Network/CBQ project was built 
on the structure established under the previous 
Umoyo Network ("Umoyo I"), and focused its 
technical and organizational support on 
strengthening HIV/AIDS related services offered 
by various Malawian NGOs. The lead indicator 
of success of this follow-on project was 
expansion of network membership from a base 
of 10 NGOs that belonged to the previous 
network to “at least” 15 by May 2005. All 
NGOs, whether former members or new 
applicants, were required to participate in a 
lengthy application process, developed by 
SC/US, involving concept papers, preliminary 
reviews and assessments, and submission of 
detailed proposals. 
Of the "original" Umoyo NGOs, one was 
dropped in 2003, and nine were formally 
admitted (in effect, re-admitted) into the 
network in early 2004. Only one entirely new 
NGO has so far been admitted (Tovwirane), in 
April 2005. At least four new candidate NGOs 
that submitted concept papers in August 2003 
are still actively pursuing membership in the 
Network. Two others are in a much earlier 
stage of proposal development. (Annex 5 
profiles the full list of 16 actual and prospective 
members.) 
Clearly, the process of soliciting, reviewing, 
revising and approving grant proposals has 
proven sufficiently time-consuming to limit 
desired expansion of the network. The May 
2005 target of 15 member NGOs has not been 
met, although there is a reasonable expectation 
that, assuming continuation of the project, 
membership could swell to at least 14 later in 
2005. As noted earlier, Umoyo has worked 
intensively with candidate NGOs, imparting 
invaluable (by the NGOs' own admission) 
training, mentoring, and advice, along with 
assistance in proposal preparation. But without 
benefit of formal membership the NGOs do not 
receive funding, which limits their ability to 
provide services and contribute to the overall 
goal of USAID's SO 8. 
Many NGO respondents to the questionnaire 
circulated by the evaluation team, as well as 
those directly interviewed, expressed 
frustration with the long delays in proposal 
review and funding approval, as well as the 
time-intensive process of accessing grant funds 
once approved. Several stressed the need for 
improved communications and more timely 
feedback. All complained that the system now 
imposed on grantees of monthly work plan 
reviews and financial disbursements, rather than 
the traditional quarterly process, takes valuable 
time from service activities. (See below for 
further discussion.) 
The evaluation team agrees that the NGO grant 
approval process is too lengthy and onerous. In 
its effort to build up the capacity of NGOs to 
conceive, plan and implement worthwhile 
activities, Umoyo has, in the team's view, tried 
too hard to achieve perfection before making 
funding decisions. This has led to numerous, 
time-consuming exchanges between Umoyo and 
prospective grantees. To this must be added the 
requirement that USAID review all NGO grant 
applications, and the Mission's tendency to 
respond with highly detailed feedback, to which 
UMOYO feels constrained to reply in similar 
detail, also a time consuming process. 
All of this brings to mind the old adage about 
"letting the perfect be the enemy of the good". 
At a certain point, if it is felt that an NGO will 
be a worthy grant recipient, Umoyo and USAID 
should have the confidence to give it a go-ahead 
and approve funding. It is a given that the NGO 
will falter from time to time, but one of the 
Umoyo Network's great and acknowledged 
strengths is its readiness to help the NGO over 
the rough spots. In short, the process of NGO 
entry into the Umoyo Network should be 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 21
simplified and expedited. Three months should 
be ample time for a "go/no go" decision on a 
particular grant application, from the beginning 
of the process to the end. The team also 
suggests that making a senior Umoyo staff 
member the point person for each NGO 
application, responsible for coordinating all 
inputs and exchanges and monitoring progress 
from beginning to end, would facilitate this 
streamlining. 
In a real sense, this is an issue of control. To 
move more quickly to a point where a grantee 
NGO is entrusted with responsibility for 
program successes and failures will be to 
transfer “ownership” of the work from Umoyo 
and USAID/Malawi to where it belongs. 
Reducing external control should facilitate more 
horizontal cooperation and more quickly lead 
to organizational maturity on the part of the 
recipient. 
Grants Management 
Respondents to the evaluation questionnaire, 
asked to comment on the most positive aspects 
of Umoyo grants implementation and 
administration, focused primarily on the 
project's practical inputs and its consistent 
mentoring for organizational strengthening. 
Close behind was appreciation for the 
network's technical and financial support. 
Project managers were praised for "effective 
communication and follow-up”, their ready 
"encouragement to work hard and evaluate our 
work", their “mentoring and training”, and 
sharing their “technical skills in HIV/AIDS 
fields”. Special praise was offered for the 
quarterly meetings that Umoyo holds with 
NGO grantees, which by all accounts are 
greatly appreciated as opportunities to share 
ideas and lessons learned, troubleshoot 
problems, and build overall NGO management 
confidence. 
On the other hand, as mentioned above, 
frustration was expressed over the arduous 
process of accessing grant funds once 
membership in the network has been approved. 
Under Umoyo I, USAID funds were disbursed 
to member NGOs on a quarterly basis. For 
reasons that no one could fully explain to the 
evaluation team, rules for the new project were 
changed early in its existence, whereby NGOs 
were now required to prepare monthly 
workplans as a prerequisite for "vouching" for 
monthly cash disbursements. This led to a 
major increase in bureaucratic paperwork. 
USAID/Malawi said it was not a requirement 
that they had imposed. In response to a recent 
inquiry from the Umoyo financial manager's 
office, the U.S. office of Save the Children said 
the monthly workplan/disbursement system was 
a USAID/Washington requirement, and that a 
special waiver would be necessary to change it. 
Since such a waiver was apparently obtained for 
Umoyo I, project management is urged 
forthwith to request one for the current 
project. The present time consuming, labor 
intensive process seems nonsensical. 
Another concern/complaint, on the part of both 
NGOs and Umoyo staff, is the project's heavy 
burden of reporting. As noted above, Umoyo 
produces lengthy reports for USAID, both 
quarterly and annually, with detailed 
descriptions of capacity building activities. Add 
to this staff field visit reports, capacity building 
plans, training plans, summaries of NGO 
partner desk reviews and the like, and one is 
struck by how much time has to be spent 
compiling and writing reports that might 
otherwise be spent working with NGOs. 
Without making a judgement on the importance 
of one report over another, or of their quality, 
the evaluation team feels that things can be 
done to ease this burden. Looking specifically at 
quarterly and annual reports, which, as noted 
previously, are heavy on listings of statistics and 
activities and light on forward-looking analysis, 
the project is urged to take steps to make them 
shorter and less repetitive. (This 
recommendation was also made in the March 
2003 Final Evaluation of Umoyo I.) This can be 
done by exacting a page limit, by not repeating 
routine boilerplate, and/or by reducing 
appendices. It is also important to work closely 
with the USAID HPN office to determine what 
information it requires and what it finds 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 22
unnecessary. Less quantity will lead to more 
quality. 
Conclusion 
The Umoyo Network is rightly praised for the 
perceptiveness and attention to detail of its 
grants approval process and for its mentoring of 
member and applicant NGOs. At the same 
time, this has led to an exceedingly slow pace of 
approving new members, and certain 
management requirements have at times 
hindered operations. 
Recommendations for strengthening NGO grants 
management: 
• Simplify and expedite process of NGO 
acceptance into the Umoyo Network, by 
setting a three-month time limit for a go/no go 
funding decision and assigning a senior staff 
person to monitor entire process for each 
NGO. 
• Under these guidelines, expedite applications 
for Umoyo membership currently pending, 
notably from NASO, SASO, MAICC, and 
Nkhoma Hospital. 
• Obtain waiver to enable NGO partners to 
prepare workplans, as well as vouching for 
funding disbursements, on a quarterly rather 
than monthly basis. 
• Reduce reporting burden by clarifying 
USAID/HPN needs, setting page limits on 
quarterly and annual reports, eliminating 
unnecessary reports, and creating simple, 
accessible electronic data reporting forms. (See 
M&E recommendations.) 
OVERALL MANAGEMENT OF THE UMOYO 
NETWORK 
Staff Quality And Coverage 
Umoyo staff is consistently praised as 
responsive, supportive and available to work 
with member NGOs. Its technical advisors are 
well known and respected, and are called on 
frequently for expert advice at the national 
level. In the interest of long-term sustainability 
of interventions, Umoyo is working hard, and 
successfully, on the transfer of knowledge and 
skills to Malawian professionals within the office 
and the network. Despite challenges inherent 
in identifying and retaining human resources in 
Malawi, the Umoyo office has well-qualified staff 
and, contrary to some reports, has over its life 
undergone no more than a normal level of staff 
turn-over (11% in the past project year). 
Recently added staff with specialized skills in 
M&E and capacity building should bring fresh 
approaches and revitalize those activities. The 
staff appears to be the right size for the tasks 
undertaken, although, as has been discussed, 
time-consuming involvement with work plan 
preparation and “vouching” must be reduced to 
allow for more time for creative work with 
NGOs and a reduction of central control. 
Staff Cohesion 
At the same time, the evaluation team felt that 
there are weaknesses in terms of cohesion and 
empowerment of staff, especially at the senior 
management level. This was reflected in the fact 
that senior management and technical staff did 
not always appear aware of the status of key 
program elements, nor sufficiently involved in 
day-to-day decision making. The Deputy Chief 
of Party, for example, who has designated 
responsibility for all NGO capacity building 
activities, should at any given moment have 
access to information that updates the status of 
ongoing NGO applications for membership in 
the network. That he may not always is in part 
a reflection of the functional need to upgrade 
systems for data gathering and retrieval, on 
which the evaluation team makes specific 
recommendations. But it also bespeaks an 
organizational culture in which individuals are 
not, or at least do not feel, sufficiently 
empowered to be entrusted with information 
and to make decisions on their own. Work 
needs to be done on team building and 
supportive supervision that will make an already 
good and dedicated staff more confident in their 
roles and in their ability to look and move 
ahead. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 23
The "Two Office" Conundrum 
In large measure, these issues are a reflection of 
the communication challenges inherent in the 
two-office structure of Umoyo Network 
project implementation. Geographic separation 
between the Lilongwe and Blantyre offices, each 
of which is, in its way, a "central" office - 
Blantyre because it is where the Chief of Party 
and chief financial officer are located, Lilongwe 
because it has closest access to USAID and key 
GOM offices - inevitably leads to gaps in 
communication and information sharing. This 
separation, for example, has made it impractical 
for senior technical and management personnel 
to meet on a regular, informal basis as a core 
team to share information, update each other 
on the status of key program issues, and 
"troubleshoot". Telephone calls and e-mail 
simply cannot take the place of this sort of 
ready access. 
It is not inconceivable that such gaps can be 
bridged while maintaining the present structure. 
Regular core team meetings could be possible 
with a considerably increased level of travel 
back and forth. Organizational consultant 
assistance could be brought in to help project 
leadership create both greater team cohesion 
and a stronger sense of empowerment on the 
part of individual managers and advisors. But it 
is impossible to escape the conclusion that all of 
this would be made measurably easier if overall 
Umoyo Network management were centered 
in one location. Given the realities at play, that 
location would have to be Lilongwe. On 
balance, this makes the most sense to the 
evaluation team, assuming of course that the 
changeover could be made efficiently and not be 
a lengthy distraction for a project that at this 
point will have a remaining life span, at most, of 
slightly less than two years. 
Conclusion 
The Umoyo Network has a skilled, highly 
motivated staff, whose work can only be 
enhanced by attention to issues of team building 
and empowerment, as well as by consideration 
of a key structural shift. 
Recommendations for overall management of the 
Umoyo Network: 
• We recommend that Lilongwe be designated 
the main Umoyo Network office, housing the 
core senior project management and technical 
team. Blantyre should be retained as a 
regional office, overseeing the work of the 
numerous NGOs in its area. Support officers 
should be assigned to the office nearest their 
NGOs. 
• We recommend that Umoyo engage the 
services of a local consultant in organizational 
development to work with the staff to help 
them refresh their understanding of their roles, 
and develop a culture of supportive and 
empowering supervision. Strengthening the 
cohesiveness of the Umoyo team in this way 
will enable an effective organization to sustain 
an even higher level of effort in the years 
ahead. 
SYNERGY WITH OTHER USAID 
PARTNERS 
ACHIEVING THE "CONTINUUM OF CARE" 
In designing the three programs and choosing 
the implementers for its SO 8 HIV/AIDS 
portfolio, USAID/Malawi sought to ensure that 
it could provide a "continuum of care" for those 
touched by or afflicted with HIV/AIDS in its 
focus districts. The Umoyo Network, under 
leadership of SC/US, would work on building 
internal capacity of Malawian NGOs to deliver 
services. FHI would build the capacity of NGOs 
to provide home-based care for afflicted 
individuals and their families, and care to 
orphans and vulnerable children, when referred 
from Umoyo NGOs. The BRIDGE project 
under JHU/CCP would lead a BCC initiative 
that would support all HIV/AIDS related 
prevention and care efforts. The projects would 
be complementary, while avoiding overlap. 
In spite of the strong desire on the part of 
USAID for partnership between projects, and 
notwithstanding everyone's desire to make the 
most of available resources, the hoped-for 
synergies have not been fully realized. Each 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 24
project has its own geographic and 
programmatic priorities and limitations, and the 
press of business and demand for results has 
made collaboration inconsistent at best. The 
evaluation team feels that synergy could be 
strengthened if the partners' meetings currently 
convened by USAID could go beyond reporting 
on what each partner is doing, to determining 
how each partner can link with and support the 
work of others, especially in districts where 
more than one is active. Partners would be 
pleased if these meetings, which they feel are 
now primarily "show and tell" sessions, could in 
fact be used to build effective partnering 
strategies. 
If the "continuum of care" has not yet been fully 
realized, there are nonetheless examples of 
how partners are seeking ways to work 
together, and specific opportunities to do more. 
Recently, Umoyo and JHU agreed to formalize 
collaboration between their two projects, 
whereby BRIDGE provides technical assistance 
to Umoyo NGOs in developing behavior change 
intervention strategies. BRIDGE has invited 
Umoyo participation in its ToT and BCC 
workshops, and has designated MANASO, an 
Umoyo member NGO, to be its distribution 
agent and partner in the rollout of its "Hope 
Kits" in coming months. BRIDGE and two other 
Umoyo NGOs, MANET+ and NAPHAM, are 
also collaborating to produce local radio shows. 
The FHI HBC project works through nine 
NGOs and other implementing agencies in five 
districts. In two cases they have partner NGOs 
in common: Word Alive Ministries in Blantyre, 
which has been an Umoyo member for some 
time, and the Mponela AIDS Information and 
Counselling Centre (MAICC), whose Umoyo 
membership application is pending. These would 
appear to present opportunities for the two 
projects to work closely together in developing 
models that do indeed insure the continuum of 
care for those afflicted with HIV/AIDS. 
Recommendations for strengthening synergies 
among USAID partners: 
• The USAID/Malawi HPN office is urged to use 
its regular HPN partners meetings, now 
devoted primarily to reporting on activities, to 
more proactively develop strategies for partner 
collaboration that will enhance and expand the 
continuum of care for HIV/AIDS patients in 
focus districts, and to follow up on 
implementation of these strategies. 
• Umoyo should itself maximize its working 
relationships with FHI and BRIDGE to develop 
partnership models, and expand those already 
in existence.
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 25
IV. SUSTAINABILITY 
As this is the midpoint of what will be, at most, 
a four-year project, and additional funds are 
unlikely to be available at present levels after 
2007, Umoyo needs to develop an overall exit 
strategy and transition plan, beginning with its 
Year 3 Work Plan. Such a strategy can include 
transitioning funding to other donors and 
functions, and activities to indigenous 
organizations. 
Umoyo is also serving other vital functions for 
the Malawi National Strategic Plan for HIV/AIDS 
that go beyond NGO capacity building. The 
technical advisor functions, for example, are 
covered in two crucial areas, VCT and PMTCT, 
by highly qualified expatriates. It is unlikely that 
Malawi would be ready to see either of these 
specialists leave the country in the forseeable 
future. Certainly their continued technical 
assistance, at the national level and as trainers 
of trainers, will be needed well after the time 
that the Umoyo Network in its present form is 
discontinued. However, in terms of national 
technical capacity that can be sustained over the 
long run, talented Malawians need to enter the 
mainstream of the HIV/AIDS prevention and 
treatment efforts. 
Recommendation for technical sustainability: 
• It is recommended that the Umoyo Senior 
Technical Advisors for VCT and PMTCT each 
be assigned at least one Malawian health 
professional, to be closely mentored for the 
duration of the project. Resources for this do 
not necessarily have to come from the Umoyo 
Network project budget. These individuals 
should have demonstrated personal and 
professional leadership qualities and the 
necessary academic preparation to fill an 
important public health position. It will require 
capacity building in management and planning 
as well as the technical specialty area itself, if 
these individuals are eventually to take their 
place around the tables of national policy￾making bodies. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 26
IV. RECOMMENDATIONS 
Umoyo NGOs have expanded coverage of 
HIV/AIDS services through outreach sites, 
diversification of services, and/or extension of 
services to new demographic groups, while at 
the same time markedly improving service 
quality. All NGOs report satisfaction with their 
interaction with the Umoyo Network, 
particularly in terms of managerial capacity 
building and technical training. Nearly half have 
successfully accessed funding through NAC and 
the Global Fund, and others are seeking to 
diversify funding support, from other donors 
and through income generation activities. All 
report that the Umoyo partnership has 
improved their ability to plan strategically, 
prepare and present proposals, budget and 
monitor expenditures, and improve their 
competitive position for donor, government 
and private sector funding. 
At the same time, GOM officials, other donors 
and stakeholders consistently praise the impact 
of Umoyo in increasing quality and coverage of 
services while strengthening the NGO 
community. Members often participate actively 
in development of district level health plans, and 
with AIDS Coordinating Committees at district 
and community levels. A vivid demonstration of 
the national-level impact of the Umoyo 
Network was the enthusiastic response to the 
Umoyo Best Practices Workshop, April 21 and 
22, 2005. 
Given this record of accomplishment and 
appreciation, and notwithstanding the need to 
address certain M&E, grants management and 
program management issues, the mid-term 
evaluation team urges approval of all funding 
awarded under the COAG between USAID and 
SC/US for the Umoyo Network/CBQ project. 
Further, the team urges USAID to amend the 
COAG in order to permit the approval of 
funding now both option years projected under 
the 2+1+1 structure of the performance based 
agreement. 
The team feels that approving both option years 
now is justified for several reasons: 
1. With only two years left to run in the 
project, Umoyo Network staff need to 
devote full attention to their mission of 
NGO capacity building, especially with new 
members as they are accepted, without the 
distraction of uncertainty over future 
funding. 
2. In terms of internal strengthening of 
management and M&E systems, this too 
deserves the concentrated attention of the 
staff, without being diverted by the need to 
justify and worry about future funding. 
3. The COAG budget already foresees a steep 
reduction in funding for the second option 
year, i.e., the fourth and final year of the 
project - only 15% of overall project 
funding. This means the Network will, of 
necessity, be in phase-out mode anyway. 
Leaving the question hanging as to whether 
even this reduced funding level is certain 
seems manifestly unfair to project 
managers. 
Principal recommendation of this 
evaluation: 
• Approve continued funding of the 
Umoyo Network/CBQ project. Adjust 
terms of project COAG to enable full 
funding for both project option years to 
be awarded at this time, so as to 
remove funding distractions from the 
Network's pursuit of its mission over the 
remaining life of the project. 
Summary of other key recommendations: 
(See body of report for details.) 
• Seek consultant assistance in team building 
and supportive supervision, so as to increase 
cohesion and empowerment of senior project 
managers. 
• Designate the Lilongwe office as the main 
Umoyo Network office, housing the core senior 
project management and technical team. 
• Simplify and expedite the process of NGO 
entry into the Umoyo Network, setting a firm 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI 27
limit on the length of time allotted to make a 
decision. 
• Simplify and streamline program reporting 
requirements for both NGOs and Umoyo 
network staff. 
• Streamline and automate monitoring and 
evaluation processes. 
• As a key element in giving NGO partners more 
control of project implementation, obtain a 
waiver to enable them to prepare workplans 
and receive project disbursements on a 
quarterly rather than a monthly basis.
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEXES
ANNEXES 
I. PERSONS CONTACTED BY THE MID-TERM EVALUATION TEAM 
II. REFERENCE MATERIALS CONSULTED 
III. IN-COUNTRY EVALUTION SCHEDULE 
IV. MAP OF UMOYO NETWORK NGOs IN 18 USAID TARGET DISTRICTS 
V. PROFILE MATRIX: CURRENT AND PROSPECTIVE NGO MEMBERS OF 
UMOYO NETWORK 
VI. PROGRESS AGAINST YEAR 2 TARGETS 
VII. STATEMENT OF WORK FOR EVALUATION 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX I 
ANNEX I 
PERSONS CONTACTED BY THE MID-TERM EVALUATION TEAM 
GOVERNMENT OF MALAWI, MINISTRY OF HEALTH 
Chris Moyo, HMIS Unit 
Dr. Jane Namasasu, Head, Reproductive Health Unit 
Dr Erik Schouten, HIV/AIDS Coordinator 
NATIONAL AIDS COMMISSION 
Roy Hauya, Director of Programs 
Dr. Andrew Agabu, Head, Policy Support and Development 
Cosby Nkwazi, Planning and M&E 
U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT 
Mexon Nyirongo, HPN Team Leader 
Elise Jensen, Senior HIV/AIDS Advisor 
Abel Kawonga, HIV/AIDS Specialist 
Lilly Banda-Maliro, Reproductive Health Specialist 
UMOYO NETWORK/CBQ PROJECT PARTNERS 
SAVE THE CHILDREN/US 
Jennifer Froistad, Field Office Director 
UMOYO NETWORK/SAVE THE CHILDREN 
Carrie Osborne, Program Manager / Chief of Party 
Express Moyo, Deputy Chief of Party / Capacity Building Manager 
Isaac Chipofya, Finance and Grants Manager 
Philip Moses, HIV/AIDS Advisor 
Jonathan Mbuna, Office Manager 
Amanda Manjolo, Capacity Building Coordinator 
Gibson Manda, Monitoring and Evaluation Specialist (former) 
Rolex Tolani, M&E Manager 
Joyce Wachepa, HIV/AIDS Officer 
Dennis Chiombeza, PMTCT Officer 
Gift Kamanga, HIV/AIDS Coordinator 
AED/LINKAGES 
Mwate Chintu, PMTCT/RH Advisor, Umoyo Network 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX I 
ADRA 
Hewton Samuel, Acting Country Director 
Thoko Mwapasa, Faith-based Coordinator, Umoyo Network 
JHPIEGO 
Mary Jane Lacoste, Country Director 
Eneud Gumbo, Quality Assurance Specialist, Umoyo Network 
NGO MEMBERS OF UMOYO NETWORK 
EKWENDENI HOSPITAL 
Kistone A. C. Mhango, PHC Director 
Yonah Gondwe, Project Manager 
Esther Lubafya, HIV/AIDS Coordinator 
Mary Mkandawire, VCT Supervisor 
Milliam Nyirenda, PMTCT Provider 
Mary Chande, R.H.S. Provider, VCT Counsellor 
Esther Kawerama, Hospital Matron 
Grace Chunda, PMTCT Coordinator 
Ms. Mzama, Faith-based Coordinator 
Stalin Mughandira, Resource Supervisor 
MALAMULO HOSPITAL 
Fyson Kasenga, Project Manager 
Mary Panulo, PMTCT Coordinator 
Fanny Mhango, PMTCT Provider 
Hilda Petani, Project Coordinator 
Jacobs Pidini, CO / IEC + Youth Coordinator 
Peterson Katumbi, Human Resource Officer 
ADVENTIST HEALTH SERVICES 
Florence Chipungu, Director 
Elisha Muloza, Namasalima Health Center 
MANET+ 
Anock L. R. Kapira, Executive Director 
Victor Kamanga, Programs Manager 
NAPHAM 
Tiwonge Loga, Executive Director 
Leonard Kalasa, Mzuzu Branch Manager 
Adrienne Rathert, Mzuzu Branch (Peace Corps) 
MANASO 
Francina Nyirenda, National Coordinator 
Michael Jere, Finance & Admin Officer 
Donald Makwakwa, Grants Management Officer 
Johnny Della, Office Assistant, Mzuzu 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX I 
Bornface Chaula, Mbulunji Home Based Care CBO (Rumphi District) 
MACRO 
Wellington E. Limbe, Director 
Gift A.M. Mwalwanda Gumbo, Branch Manager, Mzuzu 
Mr. Komenda, Coordinator, Mzuzu 
Dr. Katawa Msowoya, Branch Manager, Blantyre 
DAPP 
Molly Chirambo, Program Manager 
Veronica Chimera, PMTCT Nurse Provider 
Boston Kayange, Health Service Manager 
Diston Chapita, Counsellor 
WORD ALIVE MINISTRIES INTERNATIONAL (WAMI) 
Phoebe Nyasulu, Program Manager 
George Kukhala, VCT Coordinator 
Esther Mgoli, VCT Site Coordinator, Queen Elizabeth Central Hospital 
Pheona Kutinyu, Counsellor 
TOVWIRANE HIV/AIDS ORGANISATION 
Helen Munthali, Executive Director 
Mr. Kachali, staff 
PROSPECTIVE NGO MEMBERS OF UMOYO NETWORK 
NKHOMA HOSPITAL 
Project Director 
Medical Director 
NASO 
Dan Nthara, Project Director 
MAICC 
Carmen Aspinall (World University Services, Canada Volunteer) 
OTHERS 
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) 
Wm. Perry Killam, VCT Specialist 
Mindy Hochgesang ,Monitoring and Evaluation Field Officer 
CHRISTIAN HEALTH ASSOCIATION OF MALAWI (CHAM) 
Desiree Mhango, Health Coordinator 
COUNCIL OF NON-GOVERNMENTAL ORGANIZATIONS IN MALAWI (CONGOMA) 
Ronald Mtonga, Program Manager 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX I 
FAMILY HEALTH INTERNATIONAL (FHI) 
Margaret Kaseje, Country Director 
McPherson Gondwe, Senior Technical Officer (HBC) 
JHU/CCP BRIDGE PROJECT 
Kirsten P. Böse, Chief of Party 
Glory Mkandawire 
MANAGEMENT SCIENCES FOR HEALTH (MSH) 
Dr. Rudi Thetard, Country Director 
Wayne Stinson, Senior Technical Advisor 
POPULATION SERVICES INTERNATIONAL (PSI) 
John Justino, Resident Director 
Jones A. Katangwe, Deputy Director 
UNAIDS 
Dr. Erasmus Morah, Country Coordinator 
INTRAC 
Rick James, NGO Capacity Building Consultant/Advisor 
WORLD FOOD PROGRAM (WFP) 
Robin Landis, Programme Advisor, HIV/AIDS Unit 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX II 
ANNEX II 
REFERENCE MATERIALS CONSULTED (a non-exhaustive list) 
Adventist Health Services. Integrated Clinic and Community Based HIV/AIDS/STI Prevention Project. March 
2004. 
Chiphangwi, J. D., Dallabetta, G.A., Liomba, G., Miotti, P.G., Saah, A.J. “A Retrospective Study Of 
Childhood Mortality and Spontaneous Abortion in HIV-1 Infected Women in Urban Malawi.” In
International Epidemiology. 1992. 
College of Medicine and Medical Association of Malawi. Malawi Medical Journal. Volume 14, No.2. 2002 
DAPP. DAPP HIV/AIDS Program – Capacity Building for a Community Response. Proposal for Submission to 
Umoyo Network for USAID Funding. 2003. 
Ekwendeni Hospital. Organisational Development Assessment for Capacity Building for HIV/AIDS Services. Aug 
2004.
INTRAC. Developing a System for Monitoring and Evaluation of Capacity Building. June 2003. 
James, R. "People and Change. Exploring Capacity-Building NGOs". INTRAC NGO Management & Policy 
Series. No. 15. 
JHPIEGO. A Performance and Quality Improvement Process to Improve Infection Prevention: Malawi Case Study. 
JHP-26. March 2004. 
MACRO. “Prevention of HIV/ Transmission through Intensifying and Improving IEC and Anonymous 
Counselling and HIV Testing.” Quarterly Progress Report. Jan-March 2005. 
Malamulo SDA Hospital. Integrated HIV/AIDS Prevention and Family Planning (FP) Promotion Project. 2003. 
Malawi National HIV/AIDS Action Framework (2005 – 2009). 
Malawi Demographic and Health Survey 2000. Measure DHS +. August 2001 
MANASO. Building Capacity of CBOs in HIV/AIDS Networking and Grants Management. Oct 2003. 
MANET. Capacity Building and Support for MANET+ and PLWHA Support Groups. Sept 2003, March 2004. 
MANET. “Overcoming.” MANET Occasional Paper. April 2005. 
Measure Evaluation. Aids in Africa during the Nineties, Malawi. A Review and Analysis of Surveys. 2004 
Ministry of Health. Information, Education and Communication Implementation Plan for working with Six Key 
Social Groups in Malawi on Behaviour Change. Undated. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX II 
Ministry of Health. Measuring Health Sector Performance, a Handbook of Indicators. Dec 2003 
Ministry of Health. Performance and Quality Improvement Process for Infection Prevention in Hospitals in 
Malawi. 
Ministry of Health. Planning Department. Health Management Information Bulletin. June 2003. 
Ministry of Health. Prevention of Mother-to-Child Transmission of HIV in Malawi. Guidelines for 
Implementers. March 2004 
Ministry of Health. National Infection Prevention Standards - Consolidation of the Results of the Assessment 
Tool. April 2005 
Ministry of Health. Social Mobilization Implementation Plan for Working with Six Key Social Groups in Malawi 
on Behaviour Change. Undated 
Ministry of Health. Treatment of Aids, Guidelines for the Use of Antiretroviral Therapy in Malawi. Oct 2003. 
(1st Edition) 
Ministry of Health, UNICEF, NAC. Prevention of Mother-to-Child Transmission HIV in Malawi. 2003 
National Aids Commission, Malawi. Newsletter. Nov 2004. 
National Aids Commission. HIV and AIDS in Malawi. 2003 Estimates and Implications. Jan 2004 
National Aids Commission. Malawi National HIV/AIDS Estimates 2003, Technical Report. Jan 2004 
NAPHAM. Improving Care and Support and Reduction of Stigma and Discrimination for PLWHAs. Oct 2003. 
NGO Networks for Health, Umoyo Network Malawi. Evaluation Survey Results for Eight Partner 
Organisations. June 2003 
Population Services International. “Measurable Health Impact Drives Everything That We Do”. Biennial 
Report. 2003 –2004 
Population Services International. PAKACHERE Health and Development Communications. Living 
Positively with HIV and AIDS. Undated 
Save The Children, Umoyo Network. Capacity Building for Quality HIV/AIDS Services Project. Nov 2004. 
Save The Children, Umoyo Network. Capacity Building for quality HIV/AIDS Services. Request for Proposals. 
Guidelines for Competitive Sub-Grants. 
Save The Children, Umoyo Network. Capacity Building for Quality HIV/AIDS Services Project. Quarterly 
Reports Oct 2003 – Feb 2005. 
Save the Children, Umoyo Network. Integrated Clinic and Community Based HIV/AIDS/STI Project. Feb 
2004. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX II 
Save The Children, Umoyo Network. NGO’s Management Information Systems. Documentation 
Report. April 2004. 
Save The Children, Umoyo Network. Organization Assessments for Local Partner NGOs. Facilitators 
Guide 2004. 
Save The Children, Umoyo Network. Performance Management Plan. Strategic Objective 8. Feb 2005. 
(Final Draft). 
Save The Children, Umoyo Network. Treasuring the Gift, How To Handle God’s Gift Of Sex. 
Save the Children, Umoyo Network. Year Two Work Plan and Revised Performance Monitoring Plan, May 
2004-May 2005.
Synod of Livingstonia. Integrated Services for Voluntary Counselling and Testing, Prevention of Mother to Child 
Transmission and Syndromic Management of Sexually Transmitted Infections. 2003. 
UMOYO Capacity Building for Quality HIV Services Project. Performance Standards for Counselling and Testing 
(CT). Sept 2004 
UNAIDS, UNICEF, WHO. Epidemiological Fact Sheets on HIV/AIDS and STDs. Update 2004. 
U.S Agency for International Development. Co-Operative Agreement No. 690-A-00-03-00185-00 
Capacity Building for Quality HIV/AIDS Services Project. May 2003. 
U.S Agency for International Development. SO 8, Health Services Improved. 
U.S Agency for International Development. HIV/AIDS Strategy, 2002-2006, Malawi and Neighbouring States.
USAID/Malawi: Nov 2003. 
WHO. HIV/AIDS Epidemiological Surveillance Update for the African Region 2002. Harare, Zimbabwe: 2003. 
Word Alive Ministries. Capacity Building for VCT and Other HIV Related Services Project. 2003-2006. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX III 
ANNEX III 
IN-COUNTRY EVALUTION SCHEDULE 
DATE TIME VENUE ORGANISATION CONTACT PHONE #S COMMENTS 
WEEK 1 
Thurs, April 14th AM Cresta Hotel 1st Team Mtg. w. 
Elise Jensen 
 14.00 USAID/Malawi USAID Elise Jensen, Mexon 
Nyirongo 
01 772 455 
09 960 037 
Briefing w. HPN team 
Fri 15th 
(transferred to 
Capital Hotel) 
10.00 USAID Office HPN Team 
Umoyo & Save the 
Children 
Elise Jensen 
Express Moyo, Philip 
Moses, J. Froistad, et 
al 
01 772 455 
08841 460 
Briefing w. HPN, 
Save/US and Umoyo 
staff 
 PM Save the Children/US and 
Umoyo Offices, Amina 
House 
Umoyo Network Express Moyo, Philip 
Moses, et al 
01 753 888 1st full team meetings 
with Umoyo staff 
Sat 16th 09.00-
16.00 
Capital Hotel & Amina 
House 
Umoyo Network Umoyo senior staff Wide ranging 
discussions 
 09.00 Capital Hotel JHPIEGO/Umoyo M..J. LaCoste, E. 
Gumbo 
 11.00 Capital Hotel Gibson Manda 08838 181 Telephone mtg. 
Sun 17th 11.00 TEAM DEPARTS LILONGWE FOR MZUZU 
Mon 18th 09.00 Mzuzu Mzuzu Branch of MACRO Gift Gumbo Begin NGO contacts 
 13.30 Mzuzu NAPHAM, MANASO 
Branch Offices; also 
Central Hospital 
Leonard Kalasa and 
others 
 Continue NGO 
contacts 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX III 
DATE TIME VENUE ORGANISATION CONTACT PHONE #S COMMENTS 
Tues 19th all day Ekwendeni Hospital and 
Ekweni Hlth. Ctr. 
Ekwendeni Kistone Mhango and 
team 
Wed 20th 08:00 TEAM DEPARTS MZUZU FOR LILONGWE 
 13:30 Lilongwe MANET Anock Kapira NGO contact 
 15:30 Lilongwe MACRO HQ W. Limbe, K. 
Msowoya 
WEEK 2 
Thurs 21st 08.00 Malawi Institutue of 
Management 
Umoyo Network Best 
Practices Conference 
 Team attend sconf., 
holds indiv. NGO 
meetings 
Fri 22nd 08.00 Nat'l AIDS Commission NAC M&E Unit Cosbi Nkwesi 01 770 022 
 09.00 MOH Repro. Health Unit Jane Namasasu 01 751 552 
 10.30 MOH HIV/AIDS Div. Dr Erik Schouten 01 788 414 
 14.00 NAC Policy Support and 
Development 
Dr. Andrew Agabu, 
Head 
Sat 23rd 12.00 Jennifer Froistad – Private 
Residence 
Save The Children Jennifer Froistad 08 831 710 wide-ranging 
discussion 
Sun 24th 10.00 Capital Hotel AED/Umoyo Network Mwate Chintu 01751 201 
Mon 25th 09.00 Lilongwe NAPHAM Tiwonge Loga NGO 
 10.00 – 
13.00 
USAID Mission USAID Elise Jensen 01772 455 Team interviews 
HPN team 
 14.00 JHU / CCP Office BRIDGE project Kirsten Böse 01 750 333 
 15.30 CHAM Office – off 
Presidential Way 
CHAM Desiree Mhango, 
Health Coord. 
09939 333 Eliot 
 17.30 TEAM DEPARTS LILONGWE FOR BLANTYRE 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX III 
DATE TIME VENUE ORGANISATION CONTACT PHONE #S COMMENTS 
Tues 26th 09.00 Umoyo Blantyre 
Headquarters 
Umoyo Network Carrie Osborne and 
staff 
 joined by Roy 
Hauya, C. Moyo 
 13.30 Blantyre MANASO NGO staff NGO 
 15.00 Blantyre Word Alive, Queens 
Hospital 
NGO staff 01 674 451 NGO 
 15.45 Umoyo HQ INTRAC Rick James CB discussion 
Wed 27th 09.00 Thyolo DHO Jean, Chris Moyo 
 09.00 on Namasalima Adventist Health Services 
(NGO) Clinic 
Florence Chipingu & 
staff 
01621 688 Ann, Eliot, Roy 
Hauya 
 11.00 on Malamulo Hospital Jean, Chris 
WEEK 3 
Thurs 28th 08.00-
10.00 
South Lunzu DAPP NGO staff 01 672 706 
 11.00 South Lunzu Word Alive and MOH 
clinics 
NGO staff followed by more 
mtgs. Umoyo HQ 
 14.00 Blantyre PSI John Justino 01675 344 Ann 
 14.00 Blantyre ADRA Hewton Samuel 01 622 693 Eliot 
 17.30 TEAM DEPARTS BLANTYRE FOR LILONGWE 
Fri 29th 08.15 Lilongwe MSH Rudi Thetard 01 756 111 Jean 
 09.30 Lilongwe UNAIDS Erasmus Morah 01772 603 Ann 
 09.30 Lilongwe, Arwa House 
City Centre 
FHI Dr. Margaret Kaseje 01 775 106 
09 510 111 
Eliot 
 11.00 Lilongwe Kangombe 
House 
CDC - Global Aids 
Program 
Perry Killam and 
M. Hochgesang 
01 775 188 
09 960 389 
Jean 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX III 
DATE TIME VENUE ORGANISATION CONTACT PHONE #S COMMENTS 
 13.00 - 
17.00 
Nkhoma Nkhoma Hospital, 
prospective Umoyo 
Network NGO 
NGO staff 09 960 037 Jean, w. Eneud 
Gumbo 
Sat 30th 09.00-
17.00 
Capital Hotel Team working mtgs, 
incl. with Umoyo 
staff 
Sun. May 1st 10.00+ Capital Hotel Report drafting 
Mon 2nd all day Capital Hotel Working session with 
R. Hauya; plan and 
prepare USAID 
briefing 
Tues 3rd 10.00 – 
13.00 
USAID Mission USAID HPN team Elise, Mexon et al 01772 455 Formal team 
debriefing; report 
drafting 
Wed 4th 10.00 Capital Hotel Umoyo/ Save the Children Express Moyo, Philip 
Moses, Jennifer 
Froistad, Carrie 
Osborne et al 
 Informal debriefing 
J. Capps departs 
Thurs 5th AM Lewis, Putnam depart 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX IV 
ANNEX IV 
MAP OF UMOYO NETWORK NGOs IN 
18 USAID TARGET DISTRICTS (version 4.1) 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX V 
ANNEX V 
PROFILE MATRIX 
CURRENT AND PROSPECTIVE NGO MEMBERS OF UMOYO NETWORK 
UMOYO NGO TITLE OBJECTIVES ACTIVITIES BENEFICIARIES SITES/ AREA JOINED UMOYO * PROJECTED 4 YR FUNDING 
1.Ekwendeni 
CCAP Hospital 
Prevention of HIV 
transmission through 
intensifying and 
improving IEC and 
VCT 
Increase acceptance, 
reduce transmission, 
integrate STI into FP 
services 
PMTCT, integrated 
FP services, health ed 
messages, training for 
CBDAs, safe 
motherhood, STI 
management, bicycles 
for volunteers 
Reproductive age 
(15-49) 
Mzuzu and 13 
villages in Mzimba 
District 
2003 568,678 
2. Malamulo 
SDA Hospital 
Integrated HIV/AIDS 
prevention and FP 
Provide HIV 
prevention and FP 
services 
IEC, condoms, VCT, 
STI mgmt., PMTCT, 
training teachers, vol. 
counselors 
Reproductive age 
(15-49) 
Malamulo, Ngabo, 3 
outreach sites 
2003 431,477 
3.Adventist 
Health Services 
(AHS) 
Integrated clinic and 
community based 
HIV/AIDS/STI 
Provide FP, VCT, 
HIV/AIDS/STI 
management services 
Train CBDs, PMTCT 
nurses, manage STI 
patients, condom 
distribution, VHC 
meetings, ToT on 
HBC, VCT, youth 
Reproductive age 
(15-49) 
Sites in 11 districts; 
national office in 
Blantyre 
2003 $445,523 
4. MANET+ 
Malawi Network 
of People Living 
w. HIV/AIDS 
Capacity bldg., inst. 
support for quality 
HIV/AIDS services 
Improve systems, 
advocacy for 
PLWHAS 
PLWHA services. 
Improve fin. systems, 
staff development, 
advocacy, policy 
planning 
PLWHAs, Board 
members and staff 
National office 
Lilongwe 
2003 $428,469 
5. NAPHAM 
National Assn of 
People Living with 
HIV/AIDS in 
Malawi 
Improving care and 
support, reduction of 
stigma and 
discrimination 
Promote VCT, HBC 
services, 
outreach/behavior 
change, psycho-social 
support, cap. building 
Group therapy, 
pastoral counseling, 
medical support to 
PLWHAS, training 
PLWHAs, youth 
w/in catchment area 
Lilongwe (HQ), 
Salima, Mzuzu, 
Nkhatabay, Blantyre, 
Mulanje 
2003 $667,989 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX V 
6. MACRO 
Malawi AIDS 
Counselling and 
Resource 
Organization 
Prevention by 
strengthening VCT 
services 
Improve VCT 
services, increase 
access and demand, 
IEC materials 
Anonymous and 
confidential CT, 
provide info, 
behavior skills, STD 
prevention, 
detection, mgmt., FP 
Youth, reproductive 
age group, PLWHAs 
Static and outreach 
sites in Blantyre, 
Lilongwe, Mzuzu 
2001 $2,029,650 
7. DAPP 
Development Aid 
from People to 
People
Capacity building for 
a community 
response 
Reduce spread of 
AIDS, expand 
capacity, HOPE 
stations 
Training out-of￾school youth, youth 
clubs, peer 
educators, HBC trng, 
cap. bldg., income 
gen, OVC, PMTCT 
Youth and 
reproductive age 
group (15-49) 
Blantyre, 
Chiradzulu, 
Lilongwe 
2003 $544,007 
8. Word Alive 
Ministries 
International 
(WAMI) 
Intervention, 
counseling and care 
program 
To provide 
counseling, care and 
support, protect 
rights of widows and 
orphans, support 
community care 
VCT, community 
based care, orphan 
care, HIV prevention, 
inpatient VCT, 
PLWHA groups 
HIV/AIDS infected 
and affected 
communities in 
Blantyre, 
reproductive age 
group 
Blantyre 2003 $312,046 
9. MANASO 
Malawi Network 
of AIDS Service 
Organizations
Build capacity of 
CBOs in HIV/AIDS 
networking, grants 
mgmt. 
Coordinate 
HIV/AIDS activities 
among AIDS CBOs, 
others 
Provide mini-grants 
to CBOs, also TA, 
training, capacity 
building 
Community based 
HIV/AIDS service 
organizations 
Based in Blantyre, 
branches in 
Lilongwe, Mzuzu 
2003 $524,038 
(100%US for 
overhead) 
10. Tovwirane HIV/AIDS 
Organization 
Community based 
NGO 
Support groups, 
positive living 
Communities Mzimba District 2005 $232,099 
11. Nkhoma 
CCAP Synod 
Hospital
Clinic-based 
HIV/AIDS services 
Increase utilization of 
HIV/AIDS/STI 
services, improving 
service quality at 
clinic/comm. level 
VCT,PMTCT and STI 
activities 
15 to 49 
reproductive age 
group 
5 Clinics Working on 
proposal, 
capacity 
building 
since 8/03 
$421,146 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX V 
12. MAICC 
Mponela 
Mponela AIDS 
Information and 
Counseling Ctr. 
Behaviour change 
interventions 
Received 
concept 
paper 8/03, 
still 
develop-ing 
plans. 
13. SASO 
Salima AIDS 
Support Org. 
Advocacy, help to 
PLWHAs 
Rec'd 
concept 
paper 8/03, 
still dev. 
plans 
est. $370K 
14. NASO 
 Nkhota Kota 
AIDS Support 
Advocacy, help to 
PLWHAs 
Rec'd 
concept 
paper 8/03, 
still dev. 
plans 
est. $430K 
15. Southern 
Bottlers (SOBO) 
Potential workplace 
HIV/AIDS initiative 
Initial 
contact 
10/04. 
$154,400 
16. Partners in 
Hope 
Rec'd 1st
submission 
8/03;re￾submitted 
2/05. 
 $91,297 
*This date reflects when NGOs began process of admission to new Umoyo Network/CBQ. NGOs 1-9 were also members of the previous network, Umoyo I, beginning in 1999, 
2000 or 2001. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
ANNEX VI 
PROGRESS AGAINST YEAR 2 TARGETS 
NOTE: Shaded areas are for tracking only. See UPMP for full indicator descriptions. See footnotes for commentary on individual indicators. 
RESULT Y2 TARGET ACHIEVEMENT BY DEC ‘04 ACHIEVEMENT BY MAR ‘05 WILL MEET Y2 TARGET? COMMENTS 
Result 1: Improved Capacity of the NGO Sector to sustain provision of HIV-related services 
Number of NGOs funded 15 9 10 NO Includes Tovirane funded April ‘05 
Increased numbers of 
people served (defined in 
geographic coverage) 
100%1 77.8% 85%2 NO 
Updated 04/05 UN report changed 
indicator definition2
# of districts with HIV 
related systems 
strengthened 
18 83 8 NO (see comment) Policy work at national level impacts all 18 districts 
# of NGOs with capacity 
strengthened No Y2 target n/a n/a n/a Baselines only completed on old NGOs late 20044
% of NGOs with 
measurable increase in 
USAID HIV/AIDS related 
funding 
70% Not measured 
33%5
(MTE team analysis 
shows 4/9 or 44%) 
1Applies to 7 NGOS with geographic coverage area and excludes NAPHAM, MANASO AND MANET. This was not explained in the original PMP. Malamulo has a fixed geographic 
coverage area, but indicator definition did not explain that Malamulo would not be included. Malamulo has increased number of sites from 1 to 2. Overall numbers of sites have increased 
from 13 to 42. 
2Figure represents 6 out of 7 NGOs with increased geographic coverage. Malamulo was not counted because of their fixed geographic coverage. Umoyo responsible for reporting, but not 
achieving targets for this indicator. 
3 Does not include MANASO & MANET. Indicator definitions limited to NGO implementation areas, but overall program activities satisfy USAID HPN Indicator 4 It would not be reasonable to repeat OD assessment over such a short period of time. There is confusion about what successful OA outcome would be. Some “baselines” were done as 
early as 2000 and have not been repeated. The OA self assessment tool was designed to be done without technical assistance by March 2005, and periodically thereafter 5 NGO applications are with donors and indicator will not be measured until funding is secured. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
RESULT Y2 TARGET ACHIEVEMENT BY DEC ‘04 ACHIEVEMENT BY MAR ‘05 WILL MEET Y2 TARGET? COMMENTS 
Result 2: Increased availability of VCT and other HIV-related services provided by the NGO sector 
# of USAID supported 
VCT sites 19 static, 
20 outreach 
14 static, 
24 outreach 
14 static, 
24 outreach6 No7
HPN Indicator. Umoyo tracking 
for Mission. NAC funds for 
additional sites were not received 
until April 05. 
# of USAID assisted STI 
clinics 24 16 168 No HPN Indicator
# of clients seen in USAID 
VCT centers 70,000 69,934 
85,9463 
(32,963 female) 
(52,500 male) 
Yes 
(Exceeds targets) 
USAID/Washington Indicator 
# of clients seen in 
USAID-assisted STI clinics 12,200 6,010 9,630 No USAID/Washington Indicator 
# of USAID supported 
PMTCT sites 5 5 5 Yes 
USAID /W Indicator. Additional 
NGOS requesting to start PMTCT 
services 
Total # of women 
receiving PMTCT services 
(including counseling) 1,310 2,022 2,02210 Yes 
USAID/W Indicator. (Due to delays 
in national PMTCT policy, Umoyo 
is not responsible for achieving 
targets.) 
6 Tovirane’s funding will increase these numbers. Would be higher at this stage if anticipated NAC funding to Umoyo NGOs (especially MACRO) had been received. 7 Outreach sites exceed targets, MACRO NAC funding for increasing static sites not received until April 2005. 
8 Umoyo is tracking these figures for the USAID Missions HPN indicators. Although not held accountable for reaching target figures, funding Nkhoma and some of the other pending NGOs 
should raise this figure to 24 by the end of Year 3. 
9 Preponderance of males attributed to overrepresentation by MACROs data. Programmatic efforts at MACRO and increased numbers of outreach VCT centers in several NGOS that are 
now co-located with other health services are starting to address the gender imbalance in VCT services accessed by clients. 
10 Actual number probably higher. Data still being collected. Target for year 3 will be 5,000. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
Total # of HIV+ women 
receiving a complete 
course of antiretroviral 
prophylaxis in PMTCT 
setting11
n/a 53 500 n/a 
USAID/W indicator. Few Network 
NGOs give ARVs. Not clear if 
referrals can be counted in this 
indicator. 
# of USAID-assisted health 
facilities offering ARV 
treatment programs12
3 2 213 n/a 
MACRO would like to become 
ARV distribution sites. 
# of people receiving ARV 
treatment from USAID￾assisted health facilities 3 2 
Ekwendene 
154 women 
115 men since 
07/04 
n/a 
Numbers limited by government 
supply to 25 new patients/month. 
Maximum @ 04/05 could be 300 at 
Ekwendene 
# of condoms distributed 
by USAID-assisted HIV￾related services n/a 1,185,078 1,185,07814 n/a 
USAID/W indicator. No specific 
targets. Umoyo tracking only, but 
reporting is required. 
11 Complete course is not defined. Not clear if this refers only to Nevirapine at time of delivery. 
12 USAID supports OD and TA to the NGO, not drug procurement and supervision 
13 AHS and Malamulo plans are being finalized 
14 Numbers will probably be higher, data still coming in. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
RESULT Y2 TARGET ACHIEVEMENT BY DEC ‘04 ACHIEVEMENT BY MAR ‘05 WILL MEET Y2 TARGET? COMMENTS 
RESULT 3: Improved Quality of HIV-related Services 
% of USAID supported 
with Quality Improvement 
in Quality Improvement 
Scores15
% of health facilities that 
achieve 80% of national 
standards for infection 
prevention16 n/a 
Malamulo 
29.5%-52% 
Ekwendeni 
42-39% 
Nkhoma 
25.1-55.1% 
Malamulo 
3rd 64 
Ekwendeni 
3rd 65.3 
n/a 
No targets set. Shows promise for 
2007. 
# of facilities that achieve 
80% of national standards 
for counseling and testing 
n/a 
MACRO17 BL 
61% 
MACRO LL-60% 
MACRO MZ-41.6% 
Ngabu-27% 
AHS Lakeview 
27% 
AHS Namasalima 
37% 
n/a n/a 
No targets set. Shows promise in 
some facilities for 2007. Reports on 
VCT quality not yet finished. 
National standards not yet 
established. NGOs would not be 
expected to know what they are 
and meet them. 
% of VCT sites meeting 
quality control standards 
for rapid blood testing 80% 0 0 No18
National standards not yet 
approved as of April 2005. In draft 
now. Umoyo can not meet 
standards not yet established. 
15Data not provided by Umoyo. Referred to JHPEIGO for data. This is supposed to come from the Service Delivery Assessments. 
16 JHPIEGO M&E for IP activities were not incorporated into the December 2005 UPMP update. Umoyo should assure that it is included in the next UPMP update. 
17 Based on the individual NGO start of service date. 
18 See comment. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
% of health facilities in 
targeted districts with no 
stock out of HIV test kits 
in past 3 months 
100% 78.6% 78.6%19 No 
Kits come from Central Medical 
Stores and FHI has buffer stocks, 
thus kits are available. 
USAID/Malawi PHN indicator 
% of health facilities in 
targeted districts with no 
stock out of STI drugs in 
the past 12 months. 
100% 93.8% 93.8% 100% 
USAID/Malawi PHN indicator. 
Tracked for the RH portfolio 
% of adults in stable 
relationship having sex 
with non-cohabitating non￾marital partners 12% (definition of “sex” not 
specified) 
Baseline data ?date 
7.7% females 
12.61% of males 
USAID/W indicator 
No clear plans described how 
Umoyo will collect information on 
this indicator. 
Message is included in counseling 
sessions and community outreach 
activities. Data on counseling of this 
topic included on data sheets. 
% of sexually active adults 
not in stable relationship 
who had sex with more 
than one partner 
20% 
Baseline data 
14 % female 
26.8% male 
Not measured 
USAID/W Indicator 
% of respondents who 
report condom use at last 
risky sex 
39% women 
55% men 
[USAID target 
35% women, 
45% men] 
Baseline 02/04 
64.2% women 
75.6% men 
19 No updated data provided. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VI 
Median age at first sex 
among young men and 
women 
18 
[USAID F: 18.3 
M: 18.0] 
% of people who fear 
disclosing HIV status 
because of negative 
reaction 
[USAID target 
70%} 
Baseline 
64.2% females20
44.3% males 
Umoyo Network NGOs have 
several PLWHA groups. 
Membership by definition 
demonstrates willingness to 
disclose status. 
20Question was posed as “% of men and women who would not tell others about the partner’s cause of death at the funeral if partner died of AIDS. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
ANNEX VII 
STATEMENT OF WORK FOR EVALUATION 
USAID/Malawi Evaluation of Save the Children’s Capacity Building for 
Quality HIV/AIDS Services Project 
I. PURPOSE 
The purpose of this evaluation is to provide USAID/Malawi with an independent mid-term evaluation of 
its Cooperative Agreement #690-A-00-03-00185-00: Save the Children’s (with its partners ADRA, AED 
and JHPIEGO) Capacity Building for Quality (CBQ) HIV/AIDS Services Project (hereafter referred to as 
Umoyo Network). Umoyo Network, which is managed by the USAID/Malawi’s Office of Population, 
Health, and Nutrition (PHN), is a performance based award. HPN will utilize the findings of the 
evaluation in its determination as to whether to continue funding this activity for years 3 and 4. 
When this project was originally conceptualized, USAID/Malawi PHN Strategic Objective (SO) 8 was to 
facilitate Healthier Malawian Families. The Umoyo Network was designed to support SO8 KIR8.2 
Reduced New HIV Infections Illustrative Results (IR): 
 IR 8.2.3: Increased availability of HIV-related support services 
 IR 8.2.4: Improved quality of HIV-related support services 
 IR 8.2.5: Increased use of quality voluntary counseling and testing services 
However, in 2004 USAID/Malawi’s strategic framework was updated. USAID/Malawi HPN SO 8 
Healthier Malawian Families is now a Mission Goal. In order to achieve this Goal, SO 8 was modified 
and is now Increased Use of Improved Health Behaviors and Services. Consequently, SO 8 IRs were 
also restructured and the Umoyo Network now supports newly designed: 
 IR 8.2: Quality of Services Improved 
 IR 8.3: Access to Services Increased 
 IR 8.4: Health Sector Capacity Strengthened 
Umoyo Network is currently in its second year of implementation. In the Performance Based/Results 
Oriented agreement it was determined that additional one-year option periods (up to 2) could be 
awarded. The decision to exercise the options is contingent upon the successful completion of Year 2 
targets, as agreed upon prior to the commencement of the award. This evaluation is a required action 
under the Performance Based/Results Oriented agreement and it will provide the information necessary 
to decide to exercise additional an one-year option. 
Specifically, this evaluation will provide the basis for USAID/Malawi to: 
• Assess the progress of Umoyo Network towards achieving the results outlined in their 
workplan; 
• Decide whether or not to exercise the option to extend the project into a third year; and, if so, 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
• Determine whether it would be advantageous to modify approaches to implementing this 
project, given the resources, time and staff available, in order to better ensure that project 
results meet USAID/Malawi SO 8 targets. 
As a monitoring tool, this mid-term evaluation should be used to evaluate project strengths, weakness 
and opportunities and to make specific recommendations for future programming/management options 
to ensure desired results are achieved by the project’s end. 
II. BACKGROUND 
Malawi is rated among the world’s ten countries most affected by the AIDS epidemic. It is estimated 
that 800,000 Malawians are now living with HIV and more than 80,000 of them are dying each year. 
According to NAC approximately 14% of adults aged 15-49 are infected, translating into a 50% lifetime 
risk of contracting the virus. Factors such as a lack of quality services and limited availability of voluntary 
counseling and testing services have prevented many Malawians from receiving the information and 
treatment necessary to respond to the disease and to protect their partners. 
In order to stem this epidemic, the Government of Malawi developed a National Health Plan in 
conjunction with the National AIDS Commission’s Agenda for Action. These strategies focus on 
improving HIV-related services and provider capacity. This strategy is supported by USAID/Malawi SO 
8. 
In 1999 Save the Children (SC/US) began developing the Umoyo Network through NGO Networks for 
Health. The Umoyo Network linked NGOs together to create a more effective service delivery system 
that facilitated reproductive health and family planning and HIV/AIDS services. By offering participating 
NGOs technical assistance, access to a grant management program and monitoring and evaluation 
activities, Umoyo Network also sought to build their capacity. In 2003, SC/US was awarded funding by 
USAID/Malawi to continue the Umoyo Network as the Umoyo Network for Capacity Building for 
Quality (CBQ) HIV/AIDS Services Project. 
The Umoyo Network’s focus is now solely on HIV/AIDS. In order to address the shortage of HIV￾related support services, the Project’s objective is to develop the organizational and service delivery 
capacity of Malawian NGOs to meet the demands of this epidemic on HIV/AIDS health systems and 
service delivery. By providing networking and partnership opportunities which support organizational 
and service delivery capacity building, Umoyo Network links NGOs to each other. In doing so, the 
Project’s goal is to facilitate a more comprehensive system of HIV prevention, care and treatment 
services and maximize access to resources and technical expertise. The Umoyo Network also works in 
collaboration with the MoH and NAC. This ensures that all NGOs are compliant with national policies 
and working within GoM HIV/AIDS National Strategic Framework. Ultimately, Umoyo Network hopes 
to reduce new HIV infections through these capacity building activities. 
The Umoyo Network, with partners operating in 18 districts, has offices in Blantyre (responsible for 
NGO mentoring in the southern region and for Project finance, grants management and administration) 
and Lilongwe (responsible for NGO mentoring in the central and northern region and for Project policy, 
advocacy at the national level and ministerial relationships). SC/US Chief of Party manages both offices 
and makes all management decisions regarding the fulfillment of the cooperative agreement. Policy and 
programmatic decisions are made in cooperation with the other three partners (ADRA, AED, 
JHPIEGO). 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
III. CONSULTANCY OBJECTIVES 
The evaluation team will asses and document the progress made to-date in achieving the specific 
objectives in the agreement and review the programmatic, technical and managerial strengths and 
weaknesses of all major Umoyo Network components by addressing the following evaluation objectives. 
Based on the findings, the team will present results achieved to-date, document lessons learned and 
present justified recommends for improved performance. 
OBJECTIVE 1 
Assess progress made in implementing the project and achieving yearly targets and estimate if project 
implementation is likely to achieve the end of project objectives. Review the suitability of the project 
design and effectiveness of Umoyo Network program in helping NGOs improve access, coverage, and 
quality of HIV/AIDS services. 
Overall Aim: To establish whether the program activities of the Umoyo Network are appropriate and 
effective in meeting the stated objectives. 
1. Review the original assumptions in the project design and assess their validity. 
a. Are the original assumptions valid? 
b. Will the original assumptions provide sufficient guidance for appropriate programmatic and 
technical assistance decisions? 
2. Assess whether the Umoyo Network is meeting anticipated Year 2 results, as negotiated in the 
original agreement. 
a. Has the project established reasonable methods for gathering data necessary to monitor and 
evaluate progress and indicator data? Is gathered data useful and applicable? Does the M&E 
Plan facilitate the utilization of data for improved performance? 
b. How effectively and efficiently does project performance contribute to USAID/Malawi SO 8 
desired results? 
3. Assess and analyze the effectiveness of Umoyo Network potential to build NGO technical capacity. 
a. Do participant NGOs show measurable signs of increasing access to and improving quality of 
HIV-related support services (including VCT services)? Are services being strengthened (in 
quality, availability and scope)? 
b. How is Umoyo Network technical assistance (TA) guiding positive changes in the services 
provided by participant NGOs? 
c. How is Umoyo Network TA affecting participant NGOs ability to link preventative and support 
services? Is technical competence sustainable? 
d. Does the TA reflect quality international and local standards and utilize state-of-the-art 
technologies? 
4. Assess and analyze the effectiveness of Umoyo Network’s to build NGO organizational capacity. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
a. Do participant NGOs show signs of improving their ability to manage services and operations 
(managerial, financial, etc.)? 
b. How is Umoyo Network technical assistance (TA) guiding changes in the services provided by 
participant NGOs? 
c. Are participant NGOs moving towards sustainability? Are they diversifying their funding? 
d. Is coverage increasing as a result of Umoyo Network TA? 
e. Are networking and partnerships between NGOs being built? What are the results of these 
relationships? Are they sustainable relationships? 
5. Assess and analyze the effectiveness of Umoyo Network’s ability to operate a grants management 
program. 
a. Are NGOs accessing the grants mechanism? If so, how? 
b. Has the grants mechanism facilitated NGO’s ability to provide increased access to quality HIV￾related support services? How has this been measured? Are measurement tools applicable and 
appropriate? 
6. Assess and analyze Umoyo Network TA from the viewpoint of participant NGOs. 
a. Is Umoyo Network TA useful and well-timed? Are partner NGOs satisfied with their 
relationship with Umoyo CBQ? Explain why or why not. 
b. Is the grants mechanism useful? Accessible? 
c. Which has more impact on the capacity of NGOs: the grants mechanism or capacity building 
TA? How? Why? Does funding reflect this? 
OBJECTIVE 2 
Assess the management and coordination of Umoyo Network. 
Overall Aim: To establish the strengths and weaknesses of the Umoyo Network’s management, 
coordination and communication. 
1. Assess and analyze the effectiveness of the Umoyo Network system of managing the NGO network 
(i.e. administering grants, providing TA, building capacity). 
a. Has the contractor’s staff composition (in the field and at the headquarters), duties and level of 
effort been sufficient to meet project requirements? 
b. Are Umoyo Network staff equipped to provide state-of-the art, timely TA? 
c. Are Umoyo Network systems and procedures adequate for responding to NGO needs? 
d. How have Umoyo Network coordination and systems affected the NGO network’s ability to 
operate as a system to provide linked HIV-related support services? 
e. Assess the effectiveness of Umoyo Network to coordinate with sub-partners (ADRA, AED, 
JHPIEGO). 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
f. Are sub-partners engaged? Do they provide value-added contributions in building NGO 
capacity? If so or not, explain. 
2. Assess whether Umoyo Network is facilitating synergy among: 
• USAID/Malawi Health Team 
• NGOs 
• Sub-partners 
• Other USAID/Malawi SO8 partners 
• Other donors/Government of Malawi 
a. Is Umoyo Network linking with these groups? Is there coherence and/or integration between 
services? 
b. Has coordination and communication between these groups been effective? 
c. Are there opportunities for these groups to obtain information from SC/US and to provide 
feedback on activity implementation? 
3. Assess and document NGO compliance with MoH and NAC regulations. 
a. Are NGOs coordinating with MoH at a district level when implementing services? Are they 
effective? 
b. Is Umoyo Network contributing to MoH and NAC HIV/AIDS prevention and care strategies? 
OBJECTIVE 3: 
Provide recommendations for improved performance 
Overall Aim: To document challenges, weaknesses, and progress made to date. Provide 
management/administrative and technical recommendations based on evaluation findings. 
1. Identify inadequacies, gaps or areas that need strengthening, if any, in Umoyo Network methodology 
and programming. 
2. Identify performance delays against indicators and articulate causes for these delays, and recommend 
remedial action. 
3. What changes, if any, should be considered by USAID/Malawi and/or Umoyo Network to make the 
project more responsive in reducing new HIV infections and improving quality and access to HIV￾related support services in Year 3? 
IV. METHODOLOGY 
IV.I Evaluation Methodology 
The evaluation team is expected, in its proposal, to describe in detail a methodology for collecting the 
necessary information and data. The proposal should include a description of how the methodology 
responds to the above tasks and questions; from whom (and what) and how data will be collected; and 
how the data will be analyzed. The methodology should be collaborative and participatory, including 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
partners and key stakeholders (including USAID staff) as much as possible in planning and conducting the 
evaluation. 
IV.II Arrangement of Meetings: 
The Evaluation Team will work under the supervision and guidance of the USAID Cognizant Technical 
Officer (CTO) for the Umoyo Network. The CTO will organize all internal USAID meetings. 
The CTO will arrange for an initial introductory meeting with Umoyo Network Directors and MoH and 
NAC officials. Where necessary the CTO may participate in meetings with the Umoyo Network 
Directors and MoH and NAC officials. A general list of stakeholders and key partners will be provided 
to the Evaluation Team by the CTO at the time of arrival. The Evaluation Team, however, will be 
responsible for expanding this list as appropriate and arranging the meetings and appointments so as to 
develop a comprehensive understanding of the program and services offered through the Umoyo 
Network. 
The CTO will arrange, at a minimum, the following internal meetings: 
1. Pre-evaluation meeting. The evaluation team will hold a pre-evaluation meeting with USAID/Malawi 
SO 8 team in Lilongwe, Malawi upon arrival. The purpose of this meeting is to review the scope of 
the mid-term evaluation and finalize evaluation methodology, key research questions and the 
schedule. 
The evaluation team will then meet periodically (as necessary) with USAID/Malawi, SO8 to provide 
updates on their progress. 
2. Mid-evaluation meeting. The evaluation team will hold a mid-evaluation meeting with USAID/Malawi 
SO 8 team to review progress and to troubleshoot possible obstacles in completing the evaluation 
as planned. A proposed outline of the report, including draft evaluation findings and 
recommendations as developed to date, will be presented. 
3. Debrief meeting. A debrief meeting will be held at the conclusion of the evaluation. In this meeting 
the evaluation team will present preliminary findings and recommendations in the format of a draft 
report that includes all the components of the final assessment report. At this meeting, 
USAID/Malawi SO 8 team will offer initial feedback. (See “Deliverables” section for further details.) 
An additional meeting may be requested by USAID/Malawi to debrief stakeholders and solicit feedback. 
The Evaluation Team is responsible for identifying and organizing any other appointments and meetings 
that may be required. Where necessary, especially with regards to meetings with government officials, 
the CTO may assist in arranging some of these meetings. The HPN Team Leader may participate in 
meetings with the government. 
IV.III Background Documents: 
Annex 1 provides a detailed list of reports, studies and other documents that the team should review 
and take into consideration when preparing for the evaluation and while conducting the evaluation. 
These reports will be collected by the CTO. The evaluation team is expected to collect and annotate 
additional documents and materials. 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
IV.IV Field Visits and Stakeholder Interviews: 
The program is being implemented in 18 Malawian districts. The team will arrange to visit selected sites 
in consultation with the CTO. Wherever possible, the Evaluation Team will be accompanied by a 
member of the staff from USAID or Umoyo Network. 
A list of key stakeholders and partners that the evaluation team should interview is included in Annex 2. 
These interviews should be conducted in-person whenever possible. 
V. TEAM COMPOSITION AND DESIRED QUALIFICATIONS 
The evaluation team will consist of a team leader and 2 technical experts. A representative from the 
MoH and/or NAC may be asked to participate as well. 
1. Team Leader/ Senior Evaluation Specialist should have a post graduate degree in health or an 
applicable social sciences field. S/he should have at least 5 years senior level experience working in 
HIV/AIDS prevention and care and health/population programs in a developing country (preferably 
in countries with high HIV prevalence). S/he should have extensive experience in conducting 
qualitative evaluations/assessments and strong familiarity with the NGO sector. Excellent oral and 
written skills are required. The Team Leader should also have experience in leading evaluation 
teams and preparing high quality documents. 
The Team Leader will take specific responsibility for assessing and analyzing the organization’s 
progress towards targets, factors for such performance, benefits/impact of the strategies, and 
compare with other possible options. S/he will also suggest ways of improving the present 
performance, if any. 
S/he will provide leadership for the team, finalize the evaluation design, coordinate activities, arrange 
periodic meetings, consolidate individual input from team members, and coordinate the process of 
assembling the final findings and recommendations into a high quality document. S/he will write the 
final report. S/he will also lead the preparation and presentation of the key evaluation findings and 
recommendations to the USAID/Malawi team and other major partners. 
2. HIV/AIDS Technical Advisor should have a post graduate degree in public health or related subject. 
S/he should have at least 10 years experience with HIV/AIDS prevention and care design and 
implementation in developing countries (preferably in countries with high HIV prevalence). S/he 
should be knowledgeable in program assessment and evaluation methodologies in HIV/AIDS 
prevention/care programming, organizational and institutional capacity building. S/he should have 
extensive experience in conducting qualitative evaluations/assessments around HIV/AIDS service 
development and delivery by the NGO sector. S/he should have experience developing services and 
demonstrated knowledge of state-of –the-art strategies for evidenced-based HIV/AIDS 
programming. 
3. Capacity Building Technical Advisor should have a post graduate degree in organizational 
development or health systems. S/he should have at least 5 years experience with NGO capacity 
building and organizational development in developing countries (preferably in countries with high 
HIV prevalence). S/he should be knowledgeable in program assessment and evaluation 
methodologies in capacity building, HIV/AIDS, organizational and institutional development. S/he 
MID-TERM EVALUATION, THE UMOYO NETWORK, MALAWI ANNEX VII 
should have extensive experience, and demonstrate state-of-the-art knowledge, in conducting 
qualitative evaluations/assessments around improving capacity for service delivery. 
ANNEX 1 – Selected list of background materials 
1. Umoyo Network Cooperative Agreement proposal 
2. Umoyo Network Workplan 
3. Umoyo Network quarterly reports 
4. Umoyo Network participant NGO organizational assessments 
5. USAID/Malawi Country Strategic Plan 2000-2005 
6. USAID/GoM Strategic Objective Agreement 
7. USAID/Malawi Performance Monitoring Plan 
8. USAID/Malawi HIV/AIDS Strategic Framework 
9. Project Request for Applications 
10. 2000 Malawi DHS 
11. GoM National Health Plan 
12. HIV/AIDS National Strategic Framework 
ANNEX 2 – List of Key Stakeholders and Partners 
1. National AIDS Commission 
2. Ministry of Health 
3. Umoyo Sub-Grantees 
4. ADRA 
5. JHPIEGO 
6. AED 
7. other USAID implementing partners as relevant 
8. USAID 
9. Members of District Health Management Teams