Universalia carried out an initial organizational review of AMREF jointly commissioned by CIDA & Sida. Universalia designed the overall approach for this study to include the development of an evaluation framework, to identify data sources, define questions, develop indicators and determine the instrument and methods of analysis. The review used the institutional and organizational (IOA) framework to examine the organization’s performance and factors that affect its performance (internal motivation, capacities and external context). Key sources of data for the review included: interviews in Canada, Sweden and Africa, site visits to four African countries (Kenya, Tanzania, Uganda and South Africa), and review of relevant documents. Descriptive, content and comparative analyses were used to analyze the data, using triangulation of the multiple data sets to ensure validity. Based on the analyses, the evaluation team made assessments, developed recommendations and identified lessons learned. An update of the review was conducted by Universalia in 2005.