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German Institute for Development Evaluation

Evaluation of German-Rwandan Development Cooperation in the Health Sector (concluded)

In 2010, the German Federal Government agreed to the request of the Government of Rwanda to discontinue its support to the health sector by the end of 2012. This mutual agreement underscores the commitment of the Government of Rwanda to improve the division of labour between development partners in accordance with the Paris Declaration on Aid Effectiveness and the Accra Agenda for Action.

This historic moment has provided a unique opportunity to review and assess 30 years of cooperation in the Rwandan health sector by means of a summative evaluation. Due to the fact that nearly the entire spectrum of aid modalities and instruments of German Development Cooperation had been employed, there was an overall interest in striking a balance after so many years of cooperation. DEval conducted the evaluation between July 2012 and October 2013 and published the final report in 2014.

Objectives of the evaluation

The specific objectives of the evaluation were to provide evidence and an assessment of the following:

1. How Rwandan-German cooperation has developed in the health sector.

2. The relevance, effectiveness, efficiency, impact, sustainability, coherence, coordination, complementarity, and harmonisation of Rwandan-German cooperation in the health sector.

3. Successful and less successful aid modalities and instruments, as well as their interaction and adaptability to changing conditions within the sector and with regard to socioeconomic and political developments.

4. The phasing out strategy of German development cooperation in the health sector.

Object of the evaluation: Cooperation in the midst of change

The time since 1980 has been distinguished along three phases according to historical periods of Rwanda and milestones of German and international development cooperation: The phase between 1980 and the Genocide of 1994, the post-conflict and reconstruction phase until 2003, and the phase until 2012 which is characterised by the integration of the Rwandan-German health program into the Rwandan Sector-wide approach (SWAp) including Sector Budget Support.

An analysis of the most important social, political, and economic trends over the whole period from 1980 to 2012 forms the background for the critical revision of Rwandan-German cooperation since 1980. An overview on the alterations in the health sector as well as on the evolution of the health status of the Rwandan population form part of this context analysis.

The phase between 2003 and 2012 constitutes the centerpiece of the evaluation. The extensive documentation of the more recent development interventions in comparison to the earlier phases allows an in-depth analysis. Furthermore, the strategic re-orientation of the Rwandan-German cooperation since 2003 provides an additional, interesting object of investigation.