Report Details Year Published 2025 Type Project/Programme Joint No Partner/s N/A Country/ies Kenya

Introduction: The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. Objective: This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilisation of CBHIS data, community accessibility to the data and use of the data to empower communities. Methods: We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesised findings using a thematic approach. Results: Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. Conclusion: CBHIS utilises both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on digitisation and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.

Objective To perform critical methodological assessments on designs, outcomes, quality and implementation limitations of studies evaluating the impact of malaria rapid diagnostic tests (mRDTs) on patient-important outcomes in sub-Saharan Africa.Design A systematic review of study methods.Data sources MEDLINE, EMBASE, Cochrane Library, African Index Medicus and clinical trial registries were searched up to May 2022.Eligibility criteria Primary quantitative studies that compared mRDTs to alternative diagnostic tests for malaria on patient-important outcomes within sub-Sahara Africa.Data extraction and synthesis Studies were sought by an information specialist and two independent reviewers screened for eligible records and extracted data using a predesigned form using Covidence. Methodological quality was assessed using the National Institutes of Health tools. Descriptive statistics and thematic analysis guided by the Supporting the Use of Research Evidence framework were used for analysis. Findings were presented narratively, graphically and by quality ratings.Results Our search yielded 4717 studies, of which we included 24 quantitative studies; (15, 62.5%) experimental, (5, 20.8%) quasi-experimental and (4, 16.7%) observational studies. Most studies (17, 70.8%) were conducted within government-owned facilities. Of the 24 included studies, (21, 87.5%) measured the therapeutic impact of mRDTs. Prescription patterns were the most reported outcome (20, 83.3%). Only (13, 54.2%) of all studies reported statistically significant findings, in which (11, 45.8%) demonstrated mRDTs' potential to reduce over-prescription of antimalarials. Most studies (17, 70.8%) were of good methodological quality; however, reporting sample size justification needs improvement. Implementation limitations reported were mostly about health system constraints, the unacceptability of the test by the patients and low trust among health providers.Conclusion Impact evaluations of mRDTs in sub-Saharan Africa are mostly randomised trials measuring mRDTs' effect on therapeutic outcomes in real-life settings. Though their methodological quality remains good, process evaluations can be incorporated to assess how contextual concerns influence their interpretation and implementation.PROSPERO registration number CRD42018083816.

Introduction: The suboptimal case notification rates for tuberculosis (TB) globally could partly be due to the poor implementation of TB testing guidelines or policies. We identified, appraised and synthesized qualitative evidence exploring the barriers and facilitators to implementing TB testing guidelines. Methods: We searched electronic databases and grey literature and included studies based on predefined inclusion criteria (PROSPERO registered protocol CRD42016039790) until 9th February 2023. We used the Critical Appraisal Skills Programme tool to assess the methodological quality of the included studies. Two authors reviewed the search output, extracted data and assessed methodological quality independently, resolving disagreements by consensus. We used the Supporting the Use of Research Evidence framework to identify themes and analyse and synthesize our data. We applied the Confidence in the Evidence from Reviews of Qualitative Research approach to assess the confidence of the review findings. Results: Our search output was 6976 articles, from which we included 25 qualitative studies, mostly from low- and middle-income countries (n=19) and about national guidelines (n=22). All studies were from healthcare settings. Most barriers revolved around health system constraints involving the guidelines (low trust and adherence, ambiguous and poorly developed or adapted guidelines) and poorly resourced and organized health facilities to enable the implementation of the guidelines. Individual-level barriers included low trust and low awareness among recipients and providers of care. Donor dependence was the main socio-political constraint. These barriers were similar across all income settings except poorly resourced health facilities and social and political constraints which were only reported in low- and middle-income settings. The reported facilitators were improved trust and knowledge of guidelines, national leadership support and availability of training tools and opportunities for guidelines across all income settings. We had high confidence in most of the review findings. Conclusion: Limited guideline knowledge, trust and adherence related to poorly developed and disseminated guidelines in all income settings and poorly resourced facilities in low- and middle-income countries hinder the implementation of TB testing guidelines. This could be improved by better guideline training and adaptation and resourcing of health facilities. Trial registration: The protocol of this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016039790, and published in a peer-reviewed journal.

Overview Nutritional Improvements through Cash and Health Education (NICHE) II programme as a multi-sectoral and integrated approach to reduce poverty and vulnerabilities in line with the Sustainable Development Goals (SDG) framework. The programme targets strengthening the capacity of government at the national and county levels to implement complex social assistance schemes sensitive to nutrition and child protection outcomes through three main components of a cash top-up, nutrition interventions, and child protection. The cash transfer component complements existing National SNSNP cash transfer programmes in the country. The cash top-up of Ksh 500 to a maximum of Ksh 1000 per month is paid bi-monthly together with the main NSNP cash transfer to households with pregnant woman or women with a child under the age of two. The nutrition component of counselling and home visits is implemented through the Baby Friendly Community Initiative (BFCI) which is a broader community initiative to improve infant and young child feeding (IYCF). Lastly, the positive parenting under child protection as an additional component is piloted in Kilifi County to draw on challenges or success factors for replication and expansion. This evaluation thus aims to assess the implementation process and document progress, lessons learnt and challenges to inform the subsequent phase of the NICHE programme. NICHE II, started in November 2019, is at an important phase of determining directions for scalability to additional counties in 2024/2025. The evaluation will focus on - i) determining lessons and direction for scalability of next phase; ii) drawing lessons from the positive parenting programme pilot in Kilifi, especially the integration of the child protection component with the other components of NICHE; and iii) assess the costs of rNICHE to inform sustainability and efficiency concerns related to implementation of the programme. Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A Consultant name American Institutes for Research® (AIR®) under UNICEF’s technical assistance. Agency Focal Point Kinlay Penjor Focal Point Email kpenjor@unicef.org Managed by Independent Evaluation Office No Geographic Scope Country Country/ies Kenya

Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A Country/ies Kenya

Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A Country/ies Kenya

Overview The overall HIGHWAY project objective was to increase access to and use of co-designed and sustainable early warning systems to inform regional, national, sub-national, and community-level planning and decision-making in the East African region and to improve early warning services for people living in the Lake Victoria region. Within the scope of this project, WMO has supported the East African countries Kenya, Tanzania, Uganda, and Rwanda to increase the use of weather information to improve resilience and reduce the loss of life and damage to property. The result of the project was the increased number of NMHSs having access to new and improved Early Warning Systems (EWS) for decisionmaking, as well as households and institutions able to access and use the new and improved EWS. Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A SDG/s SDG13 - Climate Action Consultant name Iva Bernhardt Agency Focal Point Alok OJHA Focal Point Email ioo@wmo.int Managed by Independent Evaluation Office Yes Geographic Scope Regional Country/ies KenyaRwandaUganda

Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A SDG/s SDG1 - No PovertySDG16 - Peace, Justice and Strong InstitutionsSDG6 - Clean Water and Sanitation Geographic Scope Country Country/ies Kenya

Overview As country offices and sectors align with operationalizing UNICEF commitment to gender equality and empowerment of women and girls supporting the goal areas of the Strategic Plan 2022-2025 and begin to invest substantial resources in gender transformative programming, it has been decided to conduct a formative evaluation of UNICEF’s efforts that aim both to change overall structures that underpin gender inequality, and to contribute to lasting and positive change in adolescent girls’ lives in the Eastern and Southern Africa region. This evaluation aims to both learn from the implementation of GAP 2018–2021 targeted commitments towards adolescent girls and generate evidence on the current state of UNICEF’s performance in gender transformative programming, identifying key lessons and the most impactful approaches, unpacking what kinds of investments have been made so far, as well as taking into account the specificities of the region (e.g. HIV burden, widespread harmful practices such as FGM and child marriage, high level of adolescent pregnancy rate). Based on such evidence, it is expected that the evaluation will inform implementation of similar commitments from GAP 2022-2025 in ESAR, by identifying the structure and resources needed for advancing a girl-intentional approach in programming to foster gender-transformative approach and results, thus enabling country offices to replicate and scale more ambitious and bolder interventions across sectors and across the region. The evaluation will have a specific focus on girl-intentional programming looking at specific investment made in adolescent girls’ agency, empowerment and leadership in ESAR, and three case study countries will be identified for in-depth exploration and field visits. The evaluation is also expected to engage with and involve adolescents throughout the evaluation process, not only during data collection, but also in the inception and validation phases. Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A Consultant name Social Development Direct Agency Focal Point Emmanuelle Compingt Focal Point Email ecompingt@unicef.org Managed by Independent Evaluation Office No Geographic Scope Country Country/ies Kenya

Overview To help address the challenges facing the immunization program, GAVI provided financial support to Kenya to strengthen its Immunization system to achieve equitable immunization outcomes. UNICEF received programmable amount of US$10,076,904.11 from Gavi to support the implementation of the activities at national level and in counties, as following: non COVID-19 re-programmed amount US$6,864,114.11; COVID19 reprogrammed amount US$1,598,926.00; and enhanced quality assurance activities by UNICEF (US$1,613,864.00). The role of UNICEF is to manage the grant on behalf of the Ministry of Health and the first disbursement was received from GAVI in April 2017, but the implementation fully commenced in November 2017 after the government had addressed most of the issues that had been outlined for action. This GAVI HSS program was designed, from inception, with sustainability as part of the design, and it took into consideration various parameters of sustainability that included political, financial, technical, managerial, and social capital. The programme will conclude by September 2023. The purpose of this summative evaluation is to carry out an end-term assessment of the GAVI HSS program that is ending in September 2023 to assess its contribution in achieving the immunization systems strengthening and coverage and equity objectives with a focus on the relevance, coherence, effectiveness, efficiency, and sustainability of the program. The programme outcomes and other elements of programmatic achievement will be evaluated as part of the effectiveness component of this evaluation. The evaluation is part of donor requirement and was included as part of the results framework for the program at inception. Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A Consultant name Leen Jille (Team Leader, hera) Agency Focal Point Camlus Odhus Focal Point Email coodhus@unicef.org Managed by Independent Evaluation Office No Geographic Scope Country Country/ies Kenya

Report Details Year Published 2024 Type Project/Programme Joint No Partner/s N/A SDG/s SDG16 - Peace, Justice and Strong InstitutionsSDG5 - Gender Equality Geographic Scope Country Country/ies Kenya

Report Details Year Published 2024 Type Strategic/ Thematic Joint No Partner/s N/A SDG/s SDG1 - No PovertySDG10 - Reduced InequalitiesSDG11 - Sustainable Cities and CommunitiesSDG12 - Responsible Consumption and ProductionSDG13 - Climate ActionSDG16 - Peace, Justice and Strong InstitutionsSDG2 - Zero HungerSDG5 - Gender EqualitySDG7 - Affordable and Clean EnergySDG9 - Industry, Innovation and Infrastructure Geographic Scope Country Country/ies Kenya

Report Details Year Published 2023 Type Project/Programme Joint No Partner/s N/A SDG/s SDG16 - Peace, Justice and Strong Institutions Geographic Scope Country Country/ies Kenya

Report Details Year Published 2023 Type Project/Programme Joint No Partner/s N/A SDG/s SDG10 - Reduced Inequalities Geographic Scope Country Country/ies Kenya

Report Details Year Published 2023 Type Project/Programme Joint No Partner/s N/A SDG/s SDG16 - Peace, Justice and Strong Institutions Geographic Scope Country Country/ies Kenya

Overview The evaluation will provide an improved understanding of what works for strengthening child protection systems to protect children on the move. Particularly, how the intervention has strengthened the capacity of child protection systems through the provision of quality integrated services, mental health, psychosocial support as well as the promotion of alternative transitory care options and non-custodial measures to replace immigration detention. The evaluation will contribute to accountability of UNHCR and UNICEF for their current performance and results, as well as inform the design of future initiatives in the realm of protecting children on the move from violence, exploitation, abuse, and child detention. Report Details Year Published 2023 Type Project/Programme Joint No Partner/s N/A Consultant name Plan Eval Agency Focal Point Elena Gariboldi Focal Point Email egariboldi@unicef.org Managed by Independent Evaluation Office No Geographic Scope Country Country/ies KenyaPanama

Report Details Year Published 2023 Type Project/Programme Joint No Partner/s N/A SDG/s SDG15 - Life on Land Geographic Scope Country Country/ies KenyaTanzaniaUganda

Report Details Year Published 2022 Type Project/Programme Joint No Partner/s N/A SDG/s SDG9 - Industry, Innovation and Infrastructure Geographic Scope Country Country/ies Kenya

Overview The second phase of NICHE (NICHE II) in Kenya for integration of UNICEF’s three program areas, nutrition, social policy and chlid protection, representing 3 outcomes in the 2018-2022 Country Programme. This being the first robust integration of these programmatic outcomes in UNICEF Kenya, there is a need to thoroughly investigate this synergy and learn on how best such integration can be maximized in Kenya. Similarly on the part of Government of Kenya - Ministry of Labor and Social Protection, Ministry of Health - NICHE II is a learning platform for multisectoral programming and robust/reliable evidence is required to inform further scale-up to additional counties where Government-led cash transfer programme are in place. Report Details Year Published 2022 Type Project/Programme Joint No Partner/s N/A Consultant name Penjani Kamudoni Agency Focal Point Lucy Maina Focal Point Email lmaina@unicef.org Managed by Independent Evaluation Office No Geographic Scope Country Country/ies Kenya