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Background:  Programme efficiency is a vital factor in achieving Sustainable Development Goals (SDGs) in an environment of scarce resources. The branch performance tool (BPT) developed by the International Planned Parenthood Federation (IPPF) is an effective tool for continuous monitoring of programme efficiency in the health sector. Objectives:  The aim of this study was to assess the effectiveness of BPT in improving programme efficiencies and provide recommendations for further improvements. Methods:  The service delivery data, collected through an Internet-based Monitoring and Evaluation Information Management System (MEIMS), as well as costing data over a period of three consecutive years (2013–2015), were fed into the BPT. Data on performance against key efficiency indicators (KPI), measured through data envelopment analysis at each service delivery point (SDP), were used to inform the development of an action plan at the end of each year. Lessons learnt on the  best practices  of well-performing SDPs and on the  improvement opportunities  of low-efficient SDPs identified through the BPT were presented during programmatic review workshops and formed the basis of management action. Results:  The organisation met all its efficiency targets in 2013–2015, including increase in number of clients per staff day from 1.9 to 3.0, spike in the cost recovery ratio from 20% to 29%, reduction in cost per SRH service from $3.6 to $2.7 and decrease in overhead cost as a percentage of total organisation level cost from 20.5% to 12.8%. Conclusions:  Branch performance tool is effective for evidence-based decision-making on programme efficiency of service delivery interventions in the health sector. It has potential for further improvement and replication in the health sector, which will contribute to the pursuit of SDG3.

The branch performance tool: A methodological approach for continuous monitoring of programme efficiencies of service delivery interventions