Client name: UK Department for International Development (DFID)

Duration: 2011-2014

Location: South Africa

Coffey is evaluating a £25 million UK government intervention designed to support the South African government’s actions to increase access to and the quality of health services across the country. 


South Africa is undergoing a major revitalisation of its health systems to combat the main causes of ill health – HIV, tuberculosis, maternal and child mortality, non-communicable diseases, injuries and violence. The government has set targets for health outcomes to improve in relation to other middle income countries.

The DFID-funded Strengthening South Africa’s Response to HIV and Health (SARRAH) program provides funding and technical advice to partners working in the South African health system and the national response to HIV and AIDS. The main focus of the program is support for the Ministry of Health's commitment to improving the health of all South Africans.

Coffey was commissioned to provide evidence of the degree to which the SARRAH program is achieving its objectives and impacting on health and HIV service delivery, and to assess the ‘value for money’ of the DFID contribution.


Theory-based approach – To assess the impact of SARRAH on health and HIV outcomes, Coffey utilised a contribution analysis to assess interventions through a testing of the overall program’s theory of change. This will allow an understanding of the role SARRAH activities and other influencing factors (such as political economy) have played in outcomes and impact level changes on health delivery services. The extent to which this theory of change can be validated will form the basis of SARRAH’s performance as a whole.

Assess value for money – To demonstrate the value for money of SARRAH, Coffey has undertaken detailed qualitative assessments to address the economy, efficiency, effectiveness and equity of its strategic interventions and work-streams.


The impact assessment will:

  • enable the improvement in quality of access to HIV and AIDS and other health services in selected districts
  • strengthen leadership and accountability of the national response to HIV and AIDS
  • support national interventions to improve access to HIV and AIDS and health services
  • strengthen performance management and strategic planning for HIV and AIDS and health services at a national and provincial level
  • strengthen systems to effectively monitor and evaluate national strategic plans for HIV, AIDS and health