Monitoring and Evaluation of Integrated Campaigns

1
Monitoring and Evaluation of Integrated Campaigns

• Measles-Malaria Partnership Meeting
• Mac W. Otten, Jr., MD MPH
• Global Immunization Division
• Feb. 2007

2
ME Integrated Campaigns

• Campaign itself
• During campaign
• Survey immediate, dry season
• Survey wet season
• Post-campaign ITN use
• Post-campaign routine ITN distribution

3
Six Sigma for Child Survival
Kaizen for ITN Use
Creating 50,000 Conversations for Malaria Control
Improving Measurement and Management for ITN Use
4
Issues

• Great progress 5 to 55
• 45 children not under ITNs
• One-third not using ITN
• How to address?
• Distribution increase to gt90
• ITN use
• Distribution of ITNs at routine antenatal and
  EPI visits

5
ITN Use, lt5 yo children
6
Take-Home Messages

• Reach gt80 ITN use by improving ITN use routine
  ITN distribution
• Modern management paradigm
• Continuous measurement
• De-centralized measurement
• De-centralized problem-solving
• Scale

7
Public health managementminimal information
package

• Minimal package
• Inputs (stock)
• Coverage
• Impact (surveillance)
• Use of data

8
Measurement tools

• Inputs (Stock) ITNs
• Coverage
• Ask about ITN use at EPI contacts
• Impact
• WHO Integrated Disease Surveillance monthly form
• lt5-year-old in-patient malaria cases/deaths

9
De-centralized problem-solving

• Why do we need?
• Behavioral change related to ITN use may be
  complicated
• Fits with known community development and
  behavior change theory
• Reaching Every District meetings between
  community and health facility staff

10
Can this be done?
Monthly measurementat Health Facility District
Levels
11
Measurement itselfas an intervention

• 50,000 conversations per month about ITN use
• Communication, marketing, advocacy tool
• Benin MOH/CDC study

12
Integration

• Building on successful management paradigm
• Polio-Measles-Routine success story
• De-centralized measurement problem-solving
• New anti-malarial drugs (ACTs)
• Child survival interventions

13
Scale

• Small pilots
• Design cost between small pilots and nationwide
  scale are different

14
Impact

• Why do we need impact measurement?
• Cant we just use coverage?

15
For measles, impact does notmatch coverage

• Burkina Faso
• Namibia
• South Africa
• Malawi
• Ethiopia
• Benin
• Niger
• Rwanda

• Uganda
• Kenya
• Zambia
• Angola
• Benin
• DRC
• Sierra Leone
• Tanzania

16
Proposal Achieve gt80 ITN useat scale in 3
countries in 2007

• Example Sierra Leone
• Using all ANC and EPI contacts, mothers
• Train health facility staff to facilitate
  behavior change discussions with community and
  political leaders, especially males
• Link with NGOs
• Red Cross system - 50 chiefdoms
• Measurement of stock and coverage in all health
  facilities and districts every month
• Evaluation

17
Summary

• Address ITN use routine ITN distribution
• Modern management paradigm
• Continuous improvement
• De-centralized problem-solving
• Make progress at scale in 2007
• Attempt to reach gt80 ITN use coverage in 3
  countries in 2007

18
End