to substantiate its models of good practice with quantitative and qualitative evidence. If, as recommended, FGAE is to deepen its training and SRH promotion work, and work outside of Ethiopia, it will need to strengthen its monitoring and evaluation systems, improve the documentation of models of good practice and put in place robust internal learning systems to enable the team to connect to international thinking and to share lessons and good practices. The enabling environment for SRH in Ethiopia is generally positive, but it is fast changing, with an increasing number of actors engaging in service provision. This calls for FGAE to keep its market position under regular review. Whilst the GoE Health Extension Package has reduced the scope for FGAE engagement at the community level, clear opportunities in other areas exist for FGAE programme development. Low levels of service coverage make both continued service expansion and innovation necessary, to find ways of reaching larger numbers of people with quality and accessible SRH services. At the same time, there is a clear demand for FGAE to continue playing a leading role in the transformation of the SRH landscape in Ethiopia through its training and capacity building of other service providers as well as its influencing of national policy and standards. The challenge therefore is how to balance these four areas of activity within the organisation, whilst making steps towards achieving greater financial sustainability. Whilst FGAE has been active across all four areas, it is the consultants’ impression that service expansion and innovation dominate activities. This review suggests that, within the current context, some ‘rebalancing’ is appropriate, with more emphasis being given to deepening capacity building and policy influencing activities, whilst continuing to extend services and innovate. This will not be an easy balance to strike as there will be a constant pull towards service expansion. Effective FGAE leadership will be critical to navigate the competing demands and ensure the organisation optimises its market position. The following recommendations set out priority actions to pursue the opportunities that are present and the challenges FGAE face. Many of them echo objectives stated in FGAE’s Strategic Plan 2009-2013. 3.1 Recommendations It is recommended that: Relevance 1. Targeted approaches to reaching the poorest, especially in urban areas, are introduced. For the former, a first step would be to map areas where the poorest live in communities, ensure that HEWs or HDAs follow up with these households and track whether they eventually seek services. This would generate some experience of reaching the poorest, which can be used to inform FGAE’s wider programme. Efficiency and Value for Money 2. IPPF assist the FGAE team to understand how value for money approaches can assist them in achieving their overriding objective of making quality SRH services available to the poor and marginalized. Approaching concepts of efficiency and value for money in this way, with an awareness of the dominant organisational culture, will help ensure they become embedded. 3. IPPF continue to assist FGAE to strengthen monitoring and evaluation systems and enable the team to use M&E data to improve programme performance. This could be achieved by: Scaling up the CMIS to all FGAE clinics and ensuring a standardized approach for data collection and recording across the organization is in place.
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