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Multi-Country Evaluation of the AFFORD Programme by HelpAge International

Elderly people face significant challenges in developing contexts in accessing and benefiting from improved social protection, health and HIV programmes.

Through funding from Irish Aid, Help Age International and its partners implemented the Accountability and Fulfillment for Older People to Raise their Dignity (AFFORD) Programme in Mozambique, Uganda, Tanzania, and South Africa alongside a development education component in Ireland.

AFFORD was a four-year intervention running from 2012-2016 . The programme aimed to enable older men and women to benefit from more accessible social protection programmes, access age-friendly health/HIV programmes, and improve social protection and age-friendly health policy.

HelpAge country offices and their partners have designed and implemented interventions targeting these three outcomes through the establishment of Old Person's Associations (OPAs) and Older Persons Monitoring Groups (OPMGs) at the community level, as well as advocacy strategies at the local, district and national levels.

Scope of Work

After four years of implementation of the AFFORD programme, Help Age International and its stakeholders sought to understand the programme's relevance, its contribution to outcome objectives, its effectiveness and sustainability.

By gathering evidence through mixed-method approaches, this evaluation synthesized lessons learned, critically assessed theories of change, and provided concrete and implementable recommendations at the programme and country-level.


The evaluation was carried out using "Process Tracing" as a means to appraise the programme's contribution. This method offered a means to identify causal pathways underlying the interventions’ logic and achievement of outcomes. It enabled the isolation and categorization of causal inference with the aim of providing a qualitative judgement on pathways leading to project achievements and associated achievements.


  • Through training partners, OPAs and OCMGs in the monitoring of the age-friendliness of social protection schemes, Help Age Mozambique successfully enabled older people to hold their governments to account at the local and national level. Among the most important achievements as identified by stakeholders was the opening of new payment points, the creation of IDs for Older Persons, and an increase of the number of older persons accessing social protection.

  • In Tanzania, whilst age-friendly healthcare guidelines were established by a previous intervention, the AFFORD programme facilitated key curriculum reviews for the specialized training of health service providers in geriatric care, established a geriatric unit within MoHSW, and provided capacity building services to home-based carers and peer educators on the promotion of HIV diagnosis and VCT and ART treatment for older people.

  • On the policy front, in Uganda, Help Age successfully organized and mobilized grass-roots level groups to engage in policy making at the district and national level. This resulted in the passing of the National Council for Older Persons Act (2013) which institutionalized local, district and national level structures to voice the concerns of elderly people.


The AFFORD Programme successfully mobilized partners to deliver a multi-country grassroots level advocacy programme. Help Age empowered Older Peoples Associations at the community level to advocate for their own right to social protection and geriatric healthcare. Through process tracing, the end of programme evaluation was able to infer project contribution to outcome level advocacy changes. Given the deep participatory nature of process tracing, the evaluation served as a focal point for partners and stakeholders to gather and reflect on the most successful strategies to improve advocacy outcomes.

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