Evaluation Summary
1. Outline of the ProjectCountry: the Kingdom of
Cambodia
Issue/Sector: Maternal and Child
HealthDivision in charge：Deputy
Director, Health Team 3, HealthGroup 2, Human Development
Department
Period of(R/D):
Cooperation Mar/01/2011Feb/28/2015

Project Title: the Project for Improving Maternal andNewborn Care through Midwifery Capacity Development
Cooperation Scheme: Technical Cooperation Project
Total Cost： JPY390 million (as of August 2014)

Partner Country’s Implementing Organization: Ministry of
Health, NMCHC, Kg. Cham Provincial Health Department, Kg. Cham
Provincial Referral Hospital, Kg. Cham Regional Training Center

Supporting Organization in Japan:

Other Related Projects:
Grant Aid
- Construction of National Maternal and Child Health Center (1995-1997)- Improvement of Maternal and Child Health Service (1998)- Improvement of the Kampong Cham Referral Hospital (2006-10)- Expansion of National Maternal and Child Health Center (2013- )Technical Cooperation in Maternal and Child Health-Maternal and Child Health Project Phase I & II (1995-2006)
Improving Maternal and Child Health Services in Rural Areas (2007-10)
Promotion of Medical Equipment Management System Phase I & II (2006- 2015)
Strengthening Human Resources Development System of Co-medicals (2010-2015)

1-1. Background of the Project
In Cambodia, the number of midwives is less than what is required. This is especially so in rural
areas. Furthermore, quality service in delivery care may be questionable as training for midwife
is not satisfactory in quality. To tackle these issues, the Ministry of Health (MOH) in Cambodia
has set up policy to increase numbers of midwives. MOH gives priority to increase in numbers of
midwives in rural areas, and enhancement of the quality of in-service and pre-service training
conducted by regional referral hospitals.
In an effort to accelerate the implementation of the policy of the MOH, the Japan International
Cooperation Agency (JICA) started the “Project for Improving Maternal and Newborn Carethrough Midwifery Capacity Development” in March 2010. The project is aimed at strengthening
midwifery training system so that the quality of midwifery services focused on evidence-based
quality care can be ensured. The midwifery training system is to be developed, building on
experience in the four provinces in Kampong Cham (Kg. Cham) Region as the model region of
the project.
Approaching to an end of the Project in February 2015, the Terminal Evaluation Team (theTeam) was organized in accordance with JICA evaluation guidelines. The Team aims to review
the progress and achievement of the Project as well as to shape clear understanding of the courseof the Project for the remaining project period.
1-2. Project Overview(1) Overall Goal
The utilization of and access to Maternal and Newborn care provided by midwives isincreased.
(2) Project Purpose
The midwifery training system is strengthened for enabling provision of midwifery services
with evidence-based quality care.

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(3) Outputs
1) The capacity of midwifery trainers who are in charge of pre-service and in-service
trainings is strengthened in NMCHC and in the model region.
2)

Training management for Midwifery pre-service and in-service trainings is strengthenedin the Kampong Cham (Kg.Cham) Province.

3)

Training environment for midwifery pre-service and in-service trainings is improved in
NMCHC and in the Kg. Cham Province.

4)

Communication and collaboration for the midwifery capacity development between
NMCHC and/or the model region and other regions are strengthened.

5)

The issues and lessons learned in midwifery capacity development in the model region
are identified and reflected in the national strategies/programs.

(4) Input (as of the terminal evaluation)
Japanese Side:
Long-term expert: 3 posts, 134MMUSD 342,375Equipment:
Short-term expert: 19 persons, 44MM
USD 22,592Equipment (by experts):
Training in Japan:
21 persons, 18MM
USD 586,336Local expenses:
Training in Brazil
5 persons, 2.3MM
Cambodian Side:Counterparts:- Total of 59 persons (w/w NMCHC: 23, RTC 6, Kg. Cham
Provincial Health Department 4, Kg. Cham Provincial
Hospital 26)
Land and Facilities:- Office space in NMCHC (3rd Fl.) and in Training Building of
Kg. Cham Provincial Hospital (PH) (3rd Fl.)- Furniture in the offices (desks, chairs, shelves, etc.)- Parking space adjacent to the buildings- Utilities in offices (electricity, water, sewage)- Nine (9) air conditioners, thirty two (32) fans amounting to
USD1,500- Maintenance and management fee of the above
2. Mid-term Review Team
Members
Ms.Saeda
LeaderDirector, Health Division 3, Health Group 2,
MAKIMOTO
Human Development Department, JICA
Ms. Kyoko
Cooperation & Program Officer, Health Division 3, Health
SAKURAI
Planning
Group 2, Human Development Department,
JICA
Dr. Tamotsu
Advisor /Director, Technical Cooperation Center, Bureau
NAKASA
Maternal andof International Medical Cooperation, National
Child HealthCenter for Global Health and Medicine
Ms. Yoko
Evaluation
Senior Specialist in International Health, Global
OGAWA
Analysis
Link Management, Inc.
Period of August 27 to September 12, 2014
Study Type: Terminal Evaluation
Evaluation
3. Summary of Evaluation Results
3-1. Achievements(1) Output 1
Output 1 is considered sufficiently achieved, as all the Output indicators shows optimal levelsof achievements. Core Trainers at NMCHC together with Japanese Experts had created a
training curriculum of “Woman and Baby Friendly Childbirth Care based on Evidence” andcompiled its teaching material, “Guide to Individualized Midwifery Care for Normal Pregnancy
and Birth.” The curriculum and the training materials are then utilized to foster further Core
Trainers at NMCHC as well as at the Kg. Cham Region through a coaching program. To date,these Core Trainers trained all the Midwifery trainers, preceptors in NMCHC and in Kg. Cham
Region, as well as all the midwifery trainers at the Kg. Cham Regional Training Center (RTC)xiv

and one each from 3 other RTCs in the country.
With the increase of the average test results of Pre- and Post-test from 75 to 91/100, one could
say that the midwifery trainers' knowledge on evidence-based midwifery care is increased.
Furthermore, the training workshops by the Kg. Cham Core Trainer team produced equallystable results in pre-/post-test scores as ones by the NMCHC Trainer team, indicating theinvariable quality of teaching by the Kg. Cham Core Trainers.
(2) Output 2
Output 2 is moderately achieved, as a good foundation has been built for “strengthening themanagement of pre-service and in-service training.” The establishment of TU at Kg. Cham
Hospital in April 2013 itself was a breakthrough, and the Kg. Cham PH became the first PH
recognized by the MOH as a training institution that could serve region-wide. The guidelines inestablishing TU has been approved by the Kg. Cham Provincial Health Department (PHD), TU
members have been nominated, and TU now has a Training Building with a dormitory, thanks
to the Grant Assistance for Grass-roots Human Security Projects.
As for TU’s capacity in managing the midwifery in-service training, it has so far provided a full
administrative support to three (3) in-service training, including the JICA-supported “Woman
and Baby Friendly Childbirth Care Based on Evidence” and one-month BEmONC training;
becoming the first provincial-level institution in the country to host a long-term midwifery
in-service training. With regards to the midwifery pre-service training, TU has yet to make any
substantial contribution. It has not yet formulated an annual plan of training, a step required tosecure the budget for its activities. TU could at the same time benefit further from stronger
leadership and institutional support.
This limited level of achievement is mostly explained by the strategic shift towards theestablishment and strengthening of TU at Kg. Cham Provincial Hospital, which only occurredin December 2013.
(3) Output 3
The level of achievement of Output 3 is moderate. The Project conducted mainly three sets ofactivities in order to improve environment where evidence-based midwifery care were to betaught in pre-service and in-service training. They were 1) distribution of delivery kits and otherequipment for training to training sites in the model region, 2) facility improvement at thedemonstration site (NMCHC) and, 3) provision of training to all the co-workers of midwifery
trainers in the model region.
For the first aspect, one-hundred and fifty (150) delivery kits and Sphygmomanometer/
Stethoscope for evidence-based midwifery care was procured and distributed to fifty-three (53)
facilities in the model region at the beginning of the Project. Of these 53 facilities, some are notdirect providers of midwifery training. Of 22 facilities where midwifery training is offered,some are not included in the initial 53 facilities. Equipment related to training, mainly LCD
projectors, computers and printers, are also provided each fiscal year for NMCHC, Kg. Cham
Mother and Child Health (MCH) unit at PHD and all the PHs, RHs, MCH Unit at Operational
Districts in the model region. The level of utilization of the above equipment could not be
confirmed in a comprehensive manner during this study.
For the second, partitions and curtains at the labor room and in the Maternity Ward for privacy
were installed at NMCHC, for improved privacy. In addition, the Neonatal Care Unit wasrenovated in 2012, which resulted in effective control and prevention of nosocomial infections.
The third sets of activities seem to have been essential in creating woman and family friendly
environment: the concept/contents of the training reportedly touched and promoted attitudinalchanges of service providers.
(4) Output 4
The Output 4 is moderately achieved. Project has made presentations on the project activities invarious occasions, part of which has yielded substantive actions to expand trainingxv

opportunities for non-project partners.
The Project took a strategy to communicate its concept/contents in a form of presentations
through five (5) channels: 1) periodical events on MCH, 2) academic forums/publications, 3) a
professional association of midwives, 4) a potential promoter/collaborator, and 5) three (3)Regional Training Centers from non-model areas (RTC: Battambang, Kampot, Stung Treng).
Out of these channels, the third and the forth channels yielded an invitation to NMCHC toprovide: 1) One-day workshop for the Battambang Chapter of the Cambodia Midwives
Association (CMA) (membership of about 300); and, 2) Two-day training of maternity staff at
the Phnom Penh Municipal Hospital, the Technical School for Medical Care (TMSC), theKhumer-Soviet Friendship Hospital (some planned in October 2014) funded by the Australian
Volunteer International.
These positive reactions and acceptances of Project’s approach are in themselves theachievement. Nevertheless, the nature of the diffusion remains ad-hoc. More strategic approachin engaging with other regions could have been beneficial.
(5) Output 5
The Project is highly likely to achieve this Output by the end of the Project, as the two major
ideas that the Project intended to introduce in the midwifery training system in Cambodia wereincorporated into either the national guidelines or the national curricula for in-service training.
One is the concept and contents represented in “Guide to Individualized Midwifery Care forNormal Pregnancy and Birth,” which has been introduced from the core trainers to midwifery
trainers in four Provinces during the Project. The other is a model or mechanism to spread suchconcept/contents to regional and provincial levels in order to strengthen the midwifery training
capacity at sub-national levels. For the former, the Project Counterparts and Experts at NMCHC
are currently working on integrating these ideas and elements into training curricula/materials.
For the latter, the establishment of TU at the Provincial Hospitals has already been incorporated
into the National Guidelines on Complementary Package of Activities for Referral Hospital(a.k.a. the CPA Guidelines), which is currently in printing.
(6) Project Purpose
Achievements of Project Purpose (As of August 2014)
Objectively Verifiable Indicators (OVIs)
1. Practice of evidence-based
midwifery care which is useful andshould be encouraged is increased**.
2. Practice of evidence-based
midwifery care which is harmful andineffective is decreased**.

Achievements
Number of "useful" practices increased
NMCHC
Kg. Cham PH
8/8*
8/8*
Number of "harmful" practices decreased
NMCHC
Kg. Cham PH
8/12***
9/12***

3. Proportion of women who felt
themselves treated client-centered careis increased.

4. Students' knowledge on
n=57 (2014)# of questions that had
evidence-based MW care is increased.
right responses of >70%
9/12
5. Number of Midwifery training
Kg. Cham PH conducted 35 training on midwifery
conducted in Kg. Chamcare; w/w three (3) was fully supported by TU.
* Out of 9 practices, end-line data on one indicator is missing.
** Evidence-based quality care implies current best practices that are recommended by “WHO Care inNormal Birth,” WHO Reproductive Health Library, or other relevant references. The words of useful andharmful and ineffective are referred to the documents as above.
*** Out of 15 practices, end-line data on one indicator is missing and two were irrelevant.

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From the improvements seen in the indicators, it is clear that much improvement has been madein strengthening the capacity of midwifery training system, except the part in strengthening TU
at the Kg. Cham PH. Parts of these improvements are however confirmed especially at
NMCHC and at the Kg. Cham PH, but not in the entire model region of the Project due to thelack of data.
From the OVI 1 ~ 3, one could say that the ability to demonstrate exemplary “midwifery
services with evidence-based quality care” at NMCHC and at Kg. Cham PH have improved;with the increase in all the “useful practices” and decrease in all the “harmful practices” and inpositive feedback of the women who received care. Frequency of fetal heart beat monitoring
has also increased and midwives are also reported to stay longer with clients during childbirth,
indicating that more proper assessment of clients is performed by the midwives.
As for the OVI 4 regarding student’s knowledge, more than 70% of students answered correctly
for nine (9) out of twelve (12) questions asked. One could say that these evidence-based
practices have been communicated and understood well by pre-service students.
From OVI 5, the capacity of provincial-level institution to conduct midwifery training has beenstrengthened with thirty-five (35) midwifery training, nineteen (19) out of which after theestablishment of TU. However, ones with substantive support by TU are so far limited to three(3).
(7) Overall Goal
Cambodia has made a spectacular performance in improving the access to maternal services in
the past decade. The Project has commenced its activities on March 2010 in the midst of an
expansive trend in access to and usage of delivery services. As such, the National Health
Statistics between 2008 and 2013 shows the percentage of deliveries attended by trained healthpersonnel have increased from 53% in 2008 to 84% in 2013, and of deliveries performed athealth facilities from 35% in 2008 to 80% in 2013. Project’s Overall Goal is therefore
considered as already achieved at this point in 2013.
The logic model behind the PDM is that if the quality of care and services is improved, thatwould contribute to the retention and/or increase in utilization of maternal services. The scope
and the type of intervention under the Project have nevertheless been limited to have an impact
at national level.
This expansion in access could rather be explained by many changes brought to the Cambodia
maternal and child health sector over the past decade. Among them, major contributing factors
include 1) promotion of facility-based deliveries through midwife incentives, 2) allocation of
more midwives to health facilities, 3) improved physical access to health facilities, both innumber of functional health facilities and in availability of transportation, 4) improvement incapacity to provide EmONC services at public hospitals, and 5) mass media campaign
promoting safe deliveries.

3-2. Summary of Evaluation Results(1) RelevanceOverall, the relevance of the Project is considered to be high. The Overall Goal and the Project
Purpose remained as a priority agenda in the Health Strategic Plan 2008 -2015 and also
coherent with the cooperation policy of the Japanese Government. With regards to the needs ofthe target group, strengthening the training system at provincial level was the priority at thetime the Project has commenced, and the revised CPA Guidelines reiterated the importance of
establishing TU at Provincial Hospital.
As for the Project’s focus on quality of midwifery care in normal delivery and promotion of thepatient value, it matches the needs of the beneficiaries as well as the midwifery trainers.
Through efforts to diffuse the “Guide to Individualized Midwifery Care for Normal Pregnancy

xviiand Birth,” this Project stimulated the latent needs of the service providers and satisfies theneeds of the beneficiaries, as suggested by the positive response by both the service providers
and clients. Its positive reception is evident from NMCHC’s decision to incorporate its
concept/contents into the standard 4-week midwifery in-service training as well as in the
curriculum of BEmONC.
(2) EffectivenessOverall, effectiveness is considered to be high, with successful promotion of “evidence-based
quality midwifery care,” and good level of achievements in “strengthening training system”
especially at regional and provincial levels.
In the former, the Project has been very effective in bringing about a positive attitudinal andbehavior changes among midwifery trainers. In the latter, the Project has established a goodfoundation at the provincial level to start playing substantial roles in in-service training.
The degree to which each Outputs has contributed to this achievement varies, with strong
contribution of Output 1, Output 3 and Output 5. Output 1 and 3 enhanced one another toensure improved quality care is in place at where midwifery trainers work. Output 2 suffered by
the influence caused by important assumptions: change in direction of the in-service training
system. As a result, the strategy of the Output 2 had to be shifted to the establishment anddevelopment of TU, which requires further development. For Output 4, extent to which thesecontributed to the Project Purpose was not as direct as other Outputs.
(3) Efficiency
Efficiency of the Project is considered to be moderate, as the Project required shifting its
strategies and diverting resources to additional/alternative sets of activities due to an influenceby external factors. Project has however adjusted its strategies and activities fairly well toensure attainment of Outputs.
(4) Impact
Impact of the Project is expected to be moderate, with its limited contribution to the Overall
Goal and with continued benefits to the model areas to be expected. However, it is uncertain if
the similar effects could be effectuated to much larger beneficiaries across the country in thenear future.
Some of expected diffusive effects include: 1) establishment of Tus in other provincial hospitals
following the example of the Kg. Cham PH, 2) contribution/benefits to expanded/improved
training in areas other than mother and newborn care by TU at Kg. Cham PH, 3) benefits to thestudents and trainees as well as to mothers and babies each year by the skilled midwifery
trainers and preceptors in 22 health facilities in Kg. Cham Region and NMCHC, 4) benefits to
midwifery and OB/GY students in public and private medical schools by the Core Trainers in
NMCHC and in Kg. Cham PH and, 5) benefits to members of CMA nation-wide (about 3,000
members).
(5) Sustainability
The sustainability of the Project is not ensured, as some of the essential factors, namely thefinancial and organizational aspects that require provincial-level institutions to sustain the
training activities are found to be weak. However, in terms of policy support, institutionalarrangement and technical capacity, the Project had achieved sufficient level for continue
providing midwifery training at the Provincial level.
[Policy aspect] Maternal and child health will continue to be a high priority in Cambodia’s
health sector. Additionally, with the number of midwives becoming sufficient, the quality ofcare and skills development will become even more important focus in the future program.
[Institutional aspect] There are several factors that support institutional sustainability, namely,
1) incorporation of parts of Project-developed teaching material in updated curricula of
BEmONC as well as standard 4-week in-service training of midwives, 2) the CPA Guidelines
which stipulates the establishment of TU in PHs and, 3) stability of human resources remainingxviii

in their position. Conversely, retirement of Counterparts in higher positions could interrupt the
supportive relationship which this Project has enjoyed and discontinuation of certain activities.
At the same time, TU members still requires concrete skills to strengthen the institutional
capacity in order to function in independent manner.
[Financial aspect] The BEmONC and four-week in-service midwifery training, when finalized,
are expected to be incorporated into the national Annual Operation Plan and continued to be
implemented in a course of national program financed by the HSSP funding. However, otherthan these courses, financial sustainability is uncertain at this moment. At the Kg. Cham PH,
facility user fee of the new Training Building would help the function of TU, although concretearrangements are yet to be made.
[Technical aspect] Thanks to intensive coaching program, Core Trainers have not only
established sufficient knowledge and skills to carry on “woman and baby friendly care”
founded especially on spirit of “Patient Value”, but also willingness to continue training others.
As for updating research evidences on their own for continuous revision of the teachingmaterials at NMCHC, it would be difficult continue these efforts after the Project experts
completed their assignment.
3-3. Factors that promoted the attainment of the Project(1) Concerning the project design
NMCHC is an organization responsible for development and revising national documents
such as guidelines and curricula. Having NMCHC as a partner made it easier for the
Project to suggest revision of existing national documents based on experiences andlessons learned through the Project.
(2) Concerning the implementation process of the Project
Project attempted communicating a “good midwifery care” where “midwives use theirclinical knowledge and skill to provide care and respect patient’s value” throughworkshops employing animated teaching methodologies. This approach and its contents
seemed to have promoted attitudinal and behavior change among service providers andhave motivated midwifery trainers to further communicate to others.
3-4. Factors that impeded the attainment of the Project(1) Concerning the project design
The narrative of the Project Purpose was not necessarily clear and rather new toCounterparts, which necessitated the Project to invest in time and resources (such as
Counterpart training in Japan and in Brazil) to bring out mutual understanding of the core
stakeholders.
Uncertainty in securing budget from JICA caused some delay in launching activities at theprovincial level.
(2) Concerning the implementation process of the Project
Uncertainty in securing budget from JICA at the beginning caused some delay inlaunching activities at the provincial level.
Some of the contents in the “Guide to Individualized Midwifery Care based on
Evidence,” were not completely in line with the protocol, or what is taught in the school.
There are several difficulties in realizing “good midwifery care” that exist in the healthsystem, such as 1) an incentive scheme for 24-hour shift for midwives that could
discourage supportive attitude for birthing woman, 2) the lack of adequate space to enable
active birth, attendance of family members and sufficient privacy and 3) hospital workers
having multiple duties imposed on them.
3-5. Conclusions
Despite several changes in components of the Project, the Project has attained good results inpromoting quality midwifery care and in strengthening training capacity at the provincial level.
The most significant output of this intervention appears to be an attitudinal and behavior
changes among those who are “touched” by this approach. The actual improvement in qualityof services at NMCHC and Kg. Cham PH is confirmed through the increase in the number ofwomen who feel themselves received client centered care. As a result, the concept of woman

xixand baby friendly care is planned to be incorporated into 4 week in-service training and 4 week
BEmOC training. After completion of the Project, this value is expected to be inherited by thein-service training and BEmONC courses and continues to be communicated to the midwives in
the country through these national standardized courses. With the geographic expansion andcontinuation of national standardized training courses, more midwives are expected to be
trained on the concept in NMCHC, Kg. Cham and other regions.
One of the significant achievements of the Project in strengthening the training system was,apart from development of the Core Trainers at the provincial level, the establishment of thefirst TU at the provincial hospital in Cambodia. The construction of the Training Building
within the Kg. Cham PH was made possible with the fund from the Grant Assistance for
Grass-roots Human Security Project. Since TU’s establishment, nineteen (19) midwifery
training including the long-term BEmONC training have been conducted at this facility. This is
an initial step for TU, which has just started its activities in December 2013. TU requires further
strengthening under the leadership of the top management of the PHD and the PH in order toexpand the training capacity at the Provincial level.
After the Project’s intervention at Kg. Cham PH, burden of delivery cases on the hospital has
increased. While this could provide good opportunities for the midwifery students andins-service trainees, the principles and skills presented in the “Guide to Individualized
Midwifery Care for Normal Pregnancy and Birth” could be better applied at the health center
level. It is hoped that in the future, the contents of the Guide will contribute to improvement of
the quality of midwifery care at HC.
3-6. Recommendations
Activities to be completed by the end of the Project：【Output 1】
1) Project to complete the End-line Survey report2) Core Trainers and TU of Kg. Cham PH to prepare refresher training plan for the midwifery
trainers including the funding source(s)【Output 2】3) Kg. Cham PHD to identify the additional support for TU based on the review meeting andlessons learned through one-month BEmONC training.
4) PHD and TU of Kg. Cham PH to formulate the annual training plan including midwifery
training, as well as an action plan to strengthen TU including the funding source(s).
5) NMCHC, in consultation with other MOH Departments, to organize meetings to discussand identify implementation structure in conducting regional training on MCH by Kg.
Cham PH.
【Output 3】6) Project to monitor the usage of the materials and equipment provided at an earlier stage of
the Project to the midwifery training facilities.
【Output 4】7) PHD to share the experiences of TU of the Kg. Cham PH with all the provincial hospitals in
Cambodia (Appendix to the the CPA Guidelines “Guide for Training Unit”). TU to finalizea process document on establishing a training unit for sharing.
【Output 5】8) NMCHC to finalize the curriculum for "Training for Improving Midwifery Skill on ANC,
Delivery and PNC" (4-week in-service training for midwives)
9) Project to assist the revision of the teaching material for the one-month BEmONC training.
Medium to Long-term recommendations:
1) NMCHC to utilize Core Trainers of woman and baby friendly childbirth care based onevidence, where applicable, for four-week in-service midwifery training and one-month
BEmONC training planned to be held in NMCHC and in Kg. Cham PH.
2) In order to put TU on a stable path, Kg. Cham PHD and PH to take managerial measures to,1) clearly delineate roles and responsibilities of each staff, 2) consider utilization of user fee

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3)
4)
5)

6)

from the Training Building for proper function of TU, 3) consider increasing number offull-time staff, and also 4) conduct close monitoring of the operation.
Kg. Cham PH to conduct staff training based on the needs of its staff
NMCHC to continue technical support in training management at the occasion of
MCH-related training for Kg. Cham PH.
The concept of woman and baby friendly childbirth care based on evidence is a core andimportant viewpoint of midwifery. Since the RTCs and the surrounding provincial
hospitals are key institutions of midwifery education, it is recommended for NMCHC to
conduct the midwifery trainer’s training for RTCs and PHs in other three regions.
HRDD and NMCHC to take account of including the basic concept of midwifery care into
the scope of midwifery, core competency of midwives and pre-service training curriculumat the occasion of the next revision.

3-7. Lessons Learnt
When introducing a new idea, it is necessary to carefully assess the feasibility of its
application, based on careful situation analyses and review of existing intuitional andregulatory settings, and with sufficient discussion and understanding among Counterpart
organizations and relevant development partners.

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