This is the second annual review of the second phase of DFID’s grant to HERFON and was commissioned by DFID to review the progress made since August 2010. The review was undertaken 05-16 September 2011.

The report is set out in the following sections:

• Progress against the logframe
• Impact monitoring – answering the “so what” question
• Value for money assessment
• Financial sustainability
• Decentralisation
• Concluding comments and recommendations

Key recommendations for HEFRON in the next 6 months:

• Re-target state advocacy efforts to ensure that the health reform focus takes priority and leads to improved health status
• Re-educate and refocus the membership to HERFON’s Constitution
• Ensure they have a functioning but streamlined organisational structure signed up to by all staff
• Make considerably greater effort to demonstrate the impact of their activities
• Urgently diversify their funding sources
• Strengthen their evidence mandate through a scaled up and responsive resource centre (knowledge management centre) which is recognised as a National centre of excellence