Evaluation of the WACA SP 2021-25
Introduction
This report sets out the findings of an independent evaluation of the MSF West and Central Africa (WaCA) Strategic Plan (2021-2025). As well as reporting on the assessment of the Strategic Plan, the findings from this evaluation will also contribute toward informing the subsequent Strategic Plan 2026-2031.
Data collection followed a mixed methods approach, and took place in 2025, with MSF WaCA staff (HQ, and fields ), and other health workers and local communities receiving MSF services in Nigeria and Cote d’Ivoire. Data analysis focuses on the performance of the Strategic Plan and its associated documents (Operational Plan, Associative Plan, Medical Strategy), and is framed by evaluation objectives, key questions and analysis criteria.
Key Findings
The Strategic Plan played a pivotal role in giving direction and purpose to MSF WaCA’s early growth, offering a bold and visionary roadmap focused on African proximity, equity, reactivity, and innovation. Operationally, MSF WaCA made significant strides, particularly in rapidly expanding its presence across diverse emergency contexts in West and Central Africa and beyond (Pakistan and Ukraine). Respondents highlighted the organisation’s responsiveness, growing reputation, and its success in mobilising staff from the region, and engaging local communities. Programmatic gains in areas such as nutrition and epidemic response were especially noted.
However, the evaluation also surfaced gaps between strategic ambition and implementation capacity. Key challenges included inconsistent communication of the Strategic Plan across different levels of the organisation, limited internal alignment, and a lack of practical tools to guide implementation. Strategic sub-documents, such as the Operational Plan, the Medical Strategy, and the Associative Plan, were viewed by many as underdeveloped, insufficiently disseminated, or disconnected from frontline realities. This lack of cohesion limited ownership and hindered their operational utility.
Resource constraints, particularly in human resources and structural systems, further complicated delivery. Despite notable financial investments, inefficiencies in staffing, planning, and strategic prioritisation were common. Efforts to engage in innovation and localisation were often aspirational rather than systematically embedded. Community health promotion, data integration, and proactive monitoring and evaluation were frequently under-resourced, affecting long-term sustainability and institutional learning.
Importantly, the Strategic Plan showed limited adaptability to unforeseen contexts. Although field teams demonstrated agility in adjusting to crises, the strategic framework lacked mechanisms for iterative learning, mid-course correction, or sustained responsiveness to changing dynamics. The experience underscored the importance of embedding flexibility and feedback loops within future planning.
Conclusions
From these insights, a number of key lessons emerge for the next strategic cycle (2026–2031). These include the need to better align ambition with operational and structural capacity; to co-create the strategy with field-level actors, partners, and communities; and to invest in systems, tools, and leadership that support strategic steering and delivery. A more grounded and inclusive development process, combined with a sharper focus on institutional strengthening, context-specific programming, and clear prioritisation, is essential.
This evaluation calls for the next Strategic Plan to retain MSF WaCA’s ambition and distinctiveness while reinforcing its internal coherence, responsiveness, and sustainability. Strengthened community engagement, clearer performance frameworks, improved resource planning, and enhanced regional and political positioning will be critical as MSF WaCA moves into its next phase of growth and consolidation.
