Fighting Malaria Together - December 2010

AMP holds workshops on monitoring and evaluation of LLIN scale-up efforts

Experts from 14 countries gathered in Nairobi to identify critical information to be collected during and after LLIN campaigns to improve overall scale-up efforts. By Hana Bilak, PATH.

In May and June 2010, the Alliance for Malaria Prevention (AMP), a workstream of Roll Back Malaria’s (RBM’s) Harmonization Working Group, organized a set of workshops on “Monitoring and evaluation for scaling-up ownership and use of long-lasting insecticide-treated nets (LLINs) for preventing malaria.” The main objective of the workshops was to identify monitoring and evaluation (M&E) strategies in the context of LLIN scale-up efforts, in particular through mass campaigns, but also by using routine delivery systems. Achieving rapid, high, and equitable coverage of populations with LLINs represents an unprecedented planning and logistical challenge which requires a careful M&E strategy. However, countries have given variable attention to developing and advocating for the M&E component of LLIN campaigns, even though the post-campaign window represents an important opportunity to determine the need for targeted “mop-up” efforts, and for understanding reasons for gaps in LLIN ownership and use.

Specific objectives included identifying critical information to be collected during and after LLIN campaigns to improve overall scale-up efforts, describing the methods and strategies to do this, using the data collected to improve LLIN ownership and use, and including LLIN scale-up M&E efforts in the overall national M&E plan. The workshop was based on a shared learning approach; promoting exchange among participants; and combining plenary presentations and discussions, plenary review of country scenario presentations, and country-specific group work.

Although participants may have started the workshop with the idea that their countries were supposed to conduct household surveys after each campaign, discussions emphasized that this should only be considered if no other data sources are available: understanding indicators used in other surveys and using them to answer specific questions, adding specific questions to already-planned data collection activities, and broadening timeframe and indicators can be ways of collecting the necessary information without organizing a stand-alone survey. This highlighted the need for the LLIN M&E strategy to be included in the overall national M&E strategy, using harmonized indicators, detailing data collection schedule and scope, and having a clear plan for interpretation and use of information to improve program strategies. Participants also discussed and reflected upon the importance of carefully planning post-campaign surveys if needed: collecting only appropriate information, using valid statistical methods and correctly interpreting results.

A key outcome of both workshops was the critical need for a clear definition of universal coverage in order to drive development and evaluation of LLIN scale-up strategies. Participants also asked for standard indicators on process and output that can be adapted by countries and a full list of standard Behavior Change and Communication (BCC) indicators. The AMP and its partners took up the challenge of addressing this, and there have been a series of email exchanges and conference calls addressing universal coverage definition, strategies to account for existing nets in determining LLIN quantities to be procured, and development of BCC indicators. The outcomes of these discussions will be presented at the next RBM Monitoring and Evaluation Reference Group meeting in January 2011.

This workshop was held in Nairobi from May 18 to 21 and gathered representatives from 14 countries: Ethiopia, the Gambia, Ghana, Kenya, Liberia, Malawi, Nigeria, Sierra Leone, the Sudan (north and south), the United Republic of Tanzania, Uganda, Zambia, and Zimbabwe. Angola, Burkina Faso, Burundi, the Central African Republic, the Congo, Côte d’Ivoire, the Democratic Republic of the Congo, Madagascar, Mali, the Niger, Senegal, and Togo were represented at the Francophone workshop in Dakar from June 21 to 25.  Funding and technical support for the workshops came from many AMP partners, including the International Federation of the Red Cross/Red Crescent Societies; Malaria No More (with Exxon Mobil); RBM; Global Fund to Fight AIDS, Tuberculosis and Malaria; WHO; UNICEF; President’s Malaria Initiative (PMI), USAID and Centers for Disease Control and Prevention (CDC); Malaria Control and Evaluation Partnership in Africa, a program at PATH; NetWorks; CDRH Senegal; and MACRO International.

The presentations given in Nairobi and Dakar are available on the AMP M&E webpage at the following address: http://www.allianceformalariaprevention.com/working-groups-view.php?id=3.

For more information, please do not hesitate to contact the AMP M&E working group chair, Mr. David Gittelman (CDC/PMI) at dmg1@cdc.gov.