The ATIA project aims to provide the most vulnerable populations in Madagascar, Burkina Faso and Togo with a sustainable social health protection system through the implementation, development and financial, operational and institutional empowerment of three partner mutual insurance companies.
Objectives of the assessment:
The evaluation comes at the end of a 3-year funding cycle from the French Development Agency, under the ATIA-AFD CZZ3564 01 F agreement, which provides for a final evaluation in the last year of the project. The evaluation covers the actions implemented as part of the project since January 2023 in Madagascar, Burkina Faso, and Togo with our three local partners: AFAFi, TOND LAAFI, LAMESIN NYO. Vulnerable populations in Burkina Faso, Togo, and Madagascar benefit from a sustainable social health protection system, in line with the national health policy. The general objectives of the evaluation are:
Objective 1: Evaluate the extent to which the actions of mutual societies have helped to strengthen their visibility and legitimacy in public dynamics linked to Universal Health Coverage
During the period 2023 to 2025, mutual health insurance companies have implemented various actions to increase their visibility among the various stakeholders responsible for implementing Universal Health Coverage, including in Madagascar: 1) a pilot project for universal health coverage in Sainte Marie and 2) a second pilot project testing the capacity of a municipality to facilitate access to health coverage for the poor in the municipality. The objective is to initially evaluate the actions of mutual health insurance companies, identify the obstacles they face, and formulate recommendations for the continuation of this project.
Objective 2: Evaluate how the capacity building mechanisms implemented have enabled mutual societies to take ownership of the proposed tools and methods and to develop autonomous management capacity, including strategic management, team management and a financial autonomy plan.
ATIA has implemented a training program designed to strengthen the financial autonomy and organizational efficiency of its partner mutual insurance companies, while improving the quality of services. These initiatives were designed to meet the specific needs of the partners, while also including common components to harmonize practices and share strategic tools.
Objective 3: To assess the extent to which mutual insurance companies have helped improve prevention of communicable diseases, and more specifically dengue fever, and how membership in a mutual insurance company influences the empowerment of women in managing family health.
Mutual health insurance companies raise awareness among their beneficiaries about high-prevalence diseases and those where simple actions can significantly limit the risk of contracting the disease (e.g., dengue fever). The objective is to measure beneficiaries’ appreciation of awareness-raising actions. Furthermore, the majority of beneficiaries are women and girls for all mutual insurance companies. The impact study carried out by the University of Bordeaux in Burkina Faso between 2020 and 2022 demonstrated that access to a mutual health insurance company (TOND LAAFI) strengthens women’s decision-making power in the household, particularly in decisions related to access to healthcare. The objective is to assess the influence of the LAMESIN NYO and TOND LAAFI mutual health insurance companies on women’s decision-making power in household health matters, as well as to understand the perception of their family environment regarding their membership in these mutual insurance companies.
For more information, the terms of reference can be downloaded from the Coordination Sud website .
How to apply
Please submit your offers by August 15, 2025, to brendan.farrell@atia-ong.org, specifying the subject line “EVAL/AFD/MDS.” The project document sent to the main donor (AFD) can be provided to candidates upon request.