1. Introduction
The United Nations Population Fund (UNFPA) is the lead United Nations agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled. The strategic goal of UNFPA is to “achieve universal access to reproductive health, and accelerate progress on the implementation of the Programme of Action of the International Conference on Population and Development (ICPD). With this call to action, UNFPA contributes directly to the 2030 Agenda for Sustainable Development, in line with the Decade of Action to achieve the Sustainable Development Goals”. (https://www.unfpa.org/strategic-plan-2022).
In pursuit of this goal, UNFPA works towards three transformative and people-centered results: (i) end preventable maternal deaths; (ii) end unmet need for family planning; and (iii) end gender-based violence (GBV) and all harmful practices, including female genital mutilation and child, early and forced marriage. These transformative results contribute to the achievement of all the 17 Sustainable Development Goals (SDGs), but directly contribute to the following: (a) ensure healthy lives and promote well-being for all at ages (Goal 3); (b) achieve gender equality and empower all women and girls (Goal 5); (c) reduce inequality within and among countries (Goal 10); take urgent action to combat climate change and its impacts (Goal 13); promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels (Goal 16); and strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development (Goal 17). In line with the vision of the 2030 Agenda for Sustainable Development, UNFPA seeks to ensure increasing focus on “leaving no one behind”, and emphasizing “reaching those furthest behind first”.
UNFPA has been operating in Egypt since 1972. The support that the UNFPA Egypt Country Office (CO) provides to the Government of Egypt under the framework of the 11th Country Programme (CP) (2023-2027) builds on national development needs and priorities articulated in:
● Egypt’s Vision 2030;
● National Structural Reform Programme (Phase II);
● Government Action Programme, 2023-2027;
● National Project for the Development of the Egyptian Family, 2022-2024;
● National Population Strategy, 2015-2030;
● Decent Life/Haya Karima Presidential Initiative;
● National Strategy for the Empowerment of Egyptian Women 2030;
● Egyptian National Youth Strategy, 2022-2026;
● United Nations Common Country Analysis/Assessment (CCA), 2021;
● United Nations Sustainable Development Cooperation Framework (UNSDCF), 2023-2027.
The 2024 UNFPA Evaluation Policy encourages CO to carry out CPEs every programme cycle, and as a minimum every two cycles.(https://www.unfpa.org/admin-resource/unfpa-evaluation-policy-2024). The country programme evaluation (CPE) will provide an independent assessment of the performance of the UNFPA 11th country programme(2023-2027) in Egypt, and offer an analysis of various facilitating and constraining factors influencing programme delivery and the achievement of intended results. The CPE will also draw conclusions and provide a set of actionable recommendations for the next programme cycle.
The evaluation will be implemented in line with the UNFPA Evaluation Handbook. The Handbook provides practical guidance for managing and conducting CPEs to ensure the production of quality evaluations in line with the United Nations Evaluation Group (UNEG) norms and standards and international good practice for evaluation. (UNEG, Norms and Standards for Evaluation (2016). The document is available at https://www.unevaluation.org/document/detail/1914).  It offers step-by-step guidance to prepare methodologically robust evaluations and sets out the roles and responsibilities of key stakeholders at all stages of the evaluation process. The Handbook includes links to a number of tools, resources and templates that provide practical guidance on specific activities and tasks that the evaluators and the CPE manager perform during the different evaluation phases. The evaluators, the CPE manager, CO staff and other engaged stakeholders are required to follow the full guidance of the Handbook throughout the evaluation process.
The main audience and primary intended users of the evaluation are: (i) The UNFPA Egypt CO; (ii) the Government of Egypt; (iii) implementing partners of the UNFPA Egypt CO; (iv) rights-holders involved in UNFPA interventions and the organizations that represent them (in particular women, adolescents and youth); (v) the United Nations Country Team (UNCT); (vi) Arab States Regional Office (ASRO); and (vii) donors. The evaluation results will also be of interest to a wider group of stakeholders, including: (i) UNFPA headquarters divisions, branches and offices; (ii) the UNFPA Executive Board; (iii) academia; and (iv) local civil society organizations and international NGOs. The evaluation results will be disseminated as appropriate, using traditional and digital channels of communication.
The evaluation will be managed by the CPE manager within the UNFPA Egypt CO in close consultation with the Government of Egypt (GoE) that coordinates the country programme, with guidance and support from the regional monitoring and evaluation (M&E) adviser at the ASRO, and in consultation with the evaluation reference group (ERG) throughout the evaluation process. A team of independent external evaluators will conduct the evaluation and prepare an evaluation report in conformity with these terms of reference and the detailed guidance in the Handbook.
 

2. Country Context
Egypt is a lower middle income country, with a total land area of 1.01 million square kilometres, continues to experience demographic pressures that shape its development trajectory and the scope of UNFPA’s support. Although the population has reached approximately 108 million people according to recent national estimates, the population remains heavily concentrated within 8 percent of the territory, primarily along the Nile Valley and Delta. Data from the UNFPA World Population Dashboard and the UNDP Human Development Database confirm the persistence of high population density in these areas and the sustained annual population growth of around 2 million people per year.
Over the last fifteen years, population growth has been driven in part by fluctuating fertility trends: the total fertility rate declined to 3.0 children per woman in 2008, rose to 3.5 in 2014, and has since declined to approximately 2.85, supported by national family-planning initiatives and policies for women’s empowerment. Fertility in rural Upper Egypt remains considerably higher, accounting for 41 percent of births while representing roughly one quarter of the population, and adolescent girls in rural areas tend to marry earlier and experience higher levels of early childbearing.
The demographic structure of the country, with approximately 61 percent of the population below age 29, presents a demographic dividend opportunity that remains only partially realized. According to the World Bank Development Indicators and the United Nations Development Programme Human Development Index (HDI), Egypt is classified within the high human development category, yet persistent socioeconomic disparities continue to constrain inclusive growth. Multidimensional poverty is estimated to affect approximately 30 million people, with poverty rates reaching up to 60 percent in rural Upper Egypt. While Egypt’s income inequality, as measured by the Gini coefficient, reflects moderate levels compared to peer countries, geographic and socioeconomic disparities remain pronounced, particularly between urban and rural areas.
The flagship Presidential initiatives – Haya Karima, a national poverty reduction initiative targeting around 5,000 of the poorest villages; and the National Project for Development of the Egyptian Family, 2022-2024, which provides a holistic response to transform the demographic challenge into an opportunity – have illustrated the country’s investments in human capital development and in realizing the rights of those left furthest behind. Furthermore, the First Lady is championing girls’ empowerment as an integral part of development programmes. Egypt has embarked on the second phase of the National Structural Reform Programme, 2021-2024, focused on diversifying the productive structure of the economy. In parallel, the Government has taken progressive steps toward introducing legislative reforms, including on combating sexual harassment and female genital mutilation (FGM), and adopting important strategies on human rights, women’s empowerment, FGM, youth and adolescents and climate.
Egypt benefits from a relatively strong national statistical system, led by the Central Agency for Public Mobilization and Statistics (CAPMAS), which has demonstrated solid institutional and technical capacity to generate high-quality, nationally representative, and disaggregated data. Through large-scale household surveys and administrative data systems—such as the Egyptian Family Health Survey 2021—CAPMAS provides reliable evidence of disaggregated data.
Despite progress toward the UNFPA transformative results, significant gaps persist. Egypt’s maternal mortality ratio (MMR) declined from 174 per 100,000 live births in 1992 to 54 in 2010 to 42.8 in 2019, but increased to an estimated 49 in 2020 due to COVID-19-related service disruptions. Moreover, the maternal mortality ratio (per 100 000 live births) has improved by decrease to 17 in 2023. Regional inequities persist, with the highest MMR levels recorded in North Sinai and Matrouh.
As per the Egyptian Family Health Survey 2021, the national contraceptive prevalence rate is 66.4 percent and the national rate of unmet need for family planning services is 13.8 percent. Of concern is the contraceptive prevalence rate among younger age groups, which is significantly lower (39 percent for married women aged 15-19 years and 52.3 percent for those aged 20-24 years) as per the Egyptian Family Health Survey 2021. Spacing between pregnancies is less than two years among 69 percent of married women aged 15-19 years and 26 percent for those aged 20-24. Disparities in the maternal mortality rate and unmet need for family planning between rural and urban governorates, and among different age groups, suggest that there are gaps in quality of care, as well as deeply rooted gender and social norms that disempower rural and younger women; these need to be addressed. Therefore, younger age groups fall among the most at risk of unwanted pregnancies, repeated pregnancies with minimal spacing, leading to increased maternal mortality and morbidity.
Private spending on health care represents about 71 percent of the total current health care spending in Egypt, compared to the global average of 41 percent. Within the public sector, there were only 1.2 doctors and 2.2 nurses per 1,000 citizens in 2019, in addition to inadequate geographic distribution of health service providers. This highlights the importance of the Government prioritizing the 2018 roll-out of universal health coverage and enhancing national investments in health care to improve citizens’ access to affordable health care services. Furthermore, there is a need to address health system gaps to ensure adequate local-level coverage, effective monitoring and accountability, and adherence to standard operating procedures and ethical codes to end malpractice that affects the health and well-being of women and girls – for example, 52 percent of deliveries are caesarean (C-sections) while FGM medicalization is as high as 79 percent.
Approximately 7.88 million women face some form of violence every year, according to the Egypt Economic Cost of Gender-based Violence Survey (2015), while less than 1 percent report such incidents and seek support services. According to the Egyptian Family Health Survey 2021, the percentage of girls aged 15-17 years who have undergone FGM was reduced to approximately 36.8 percent compared to 61 percent in 2014; and around 11 percent of girls aged 15-19 years are either currently married or were married before the age of 18. In addition, 46 percent of married women were subjected to spousal violence in their lifetime. These forms of GBV against women and girls lead to disempowerment, limited access to human capital opportunities, agency and decision-making power. All of the above is further amplified among urban refugees and migrants as their socioeconomic conditions place them more at risk of gender-based violence against women and girls and sexual harassment.
 

3. UNFPA Country Programme
UNFPA has been working with the Government of Egypt since 1972 towards enhancing reproductive health (RH), advancing gender equality, realizing rights and choices for young people, and strengthening the generation and use of population data for development. UNFPA is currently implementing the 11th country programme in Egypt.
The 11th country programme (2023-2027) is aligned with Egypt’s Vision 2030; National Structural Reform Programme (Phase II); Government Action Programme, 2023-2027; National Project for the Development of the Egyptian Family, 2022-2024; National Population Strategy, 2015-2030; Decent Life/Haya Karima Presidential Initiative; National Strategy for the Empowerment of Egyptian Women 2030; Egyptian National Youth Strategy, 2022-2026; United Nations CCA, 2021; and UNSDCF, 2023-2027. In 2021, the UNFPA Egypt CO undertook the process of aligning the 11th country programme to the UNFPA Strategic Plan 2022-2025. It was developed in consultation with the Government and civil society.
The UNFPA Egypt CO delivers its country programme through the following modes of engagement: (i) advocacy and policy dialogue, (ii) capacity development, (iii) knowledge management, (iv) partnerships and coordination, and (v) service delivery. The country programme (2023-2027) contributes to the following national priorities, UNSDCF outcomes and UNFPA Strategic Plan 2022-2025 outcomes;
National Priorities:
● Egypt’s Vision 2030;
● National Structural Reform Programme (Phase II);
● Government Action Programme, 2023-2027;
● National Project for the Development of the Egyptian Family, 2022-2024;
● National Population Strategy, 2015-2030;
● Decent Life/Haya Karima Presidential Initiative;
● National Strategy for the Empowerment of Egyptian Women 2030;
● Egyptian National Youth Strategy, 2022-2026;
UNSDCF Outcomes:
1. By 2027, strengthened human capital through equal access to quality services, social protection and social justice ensured for all people.
2. By 2027, enhanced people-centred inclusive sustainable and green economic development driven by industrialization, productivity growth, decent jobs, digitalization and integrating the informal economy.
4. By 2027, people have improved, safe and equal access to information, protection, justice and a peaceful and inclusive society through transparent, accountable, participatory, effective and efficient governance based on the rule of law and international norms and standards.
5. By 2027, women and girls realize their rights in the social, health and livelihood spheres, as laid out in the Egyptian constitution, and their voice and leadership are guaranteed in a society free of all forms of discrimination and violence against women and girls.
UNFPA Strategic Plan 2022-2025 Outcomes:
1. By 2025, the reduction in the unmet need for family planning has accelerated.
2. By 2025, the reduction of preventable maternal deaths has accelerated.
3. By 2025, the reduction in gender-based violence and harmful practices has accelerated.
The UNFPA Egypt 11th country programme (2023-2027) has five thematic areas of programming with four interconnected outputs: (i) policy and accountability; (ii) quality of care and services; (iii) gender and social norms; (iv) population change and data; and (v) adolescents and youth]. All outputs contribute to the achievement of the Strategic Plan 2022-2025 outcomes, UNSDCF outcomes and national priorities; they have a multidimensional, ‘many-to-many’ relationship with these outcomes.
Output 1: [Adolescents and youth]
By 2027, youth’s, in particular girls’, agency and human capital are strengthened to enable them to make informed choices and realize their full potential.
This has been delivered through: (a) leading an advocacy campaign promoting Noura as a central figure in the girls’ empowerment national programme championed by the First Lady to enhance investments in adolescent girls; (b) building social, health and economic assets of adolescent girls and young women in vulnerable situations through the Girls Assets Framework intensive programme; (c) integrating age-appropriate knowledge, attitudes and practices about maternal health, RH and family planning, gender-based violence against women and girls and harmful practices into economic empowerment programmes to develop a comprehensive approach to youth empowerment, in partnership with Government and other United Nations entities; (d) building youth’s skills, knowledge, capacities and capabilities with government entities, youth-led organizations, networks and local civil society organizations; (e) operationalizing innovation frameworks that capitalize on social entrepreneurship that foster locally driven solutions to enhance population characteristics through incubators and accelerators, and facilitating participation of youth in decision-making; (f) advancing Menstrual Hygiene Education; and (g) promoting inclusion and empowerment of youth with disabilities.
Output 2: [Gender and social norms]
By 2027, capabilities and capacities of actors and institutions are strengthened to address gender equality and expand a zero-tolerance environment towards all forms of gender-based violence against women and girls
This has been delivered through: (a) institutionalizing and expanding the capacities and availability of local civil society organizations and community-based organizations (CBOs) and networks to empower youth as agents for the achievement of sustainable development, provide women-friendly and girl-friendly safe spaces and foster social cohesion; (b) expanding engagement with religious and community leaders, media, local community networks, the private sector and service providers to promote gender equality; (c) conducting men and boys engagement programmes to strengthen their roles as positive change agents for gender equality; (d) strengthening knowledge and shifting attitudes of community members through diverse interactive modes of engagement, including sports and edutainment; (e) increasing integration of age-appropriate population education within formal and non-formal education and scaling up of premarital education for couples; (g) expanding multimedia and behavioural change campaigns; (h) expanding refugee support through Women and Girls Safe Spaces; (i) sustaining and expanding safe spaces and economic empowerment units for girls and GBV survivors; and (j) supporting high-level policy dialogues advancing national policies and practices to eliminate harmful practices, promote gender equality, and enhance the rights and well-being of women and girls.
Output 3: [Quality of care and services]
By 2027, national systems, including l