A new project is initiated by UNICEF, in partnership with the Bill & Melinda Gates Foundation (BMGF), a community-based real-time monitoring (RTM) to support the Child-Friendly Communities approach (CFC) in five countries. This initiative includes three countries supported by BMGF grant (Democratic Republic of the Congo, Guinea and Liberia) and two countries (Chad and Togo) supported through other resources. The CFC initiative with its RTM component (CFC-RTM) applies an integrated approach to address the overlapping deprivations of children with routine, evidence-based program monitoring based on key data from the community and facility health systems as well as from social accountability and community engagement mechanisms, all available in real-time to guide local decision-making and action. This initiative will be used as a proof of concept to inform further programming and scale-up in the West and Central Africa region (WCA).
In collaboration with the Global MICS program and close support from the MICS team members in the West and Central Africa Regional Office, household surveys based on MICS methodology and guidelines have been included as the corner stone of the monitoring and evaluation of the initiative. Each of the participating countries will conduct a household survey at the baseline and at the end line period (after two years of programme implementation). The surveys are based on the MICS Programme’s survey methodology and use standard MICS tools. The household surveys will provide an independent and robust data source that will serve two principal functions: 1) providing a valid coverage estimate of key maternal and child health interventions both at baseline and end line to see if coverage increased over the grant period, and 2) providing an opportunity to observe the intervention coverage estimates generated from routine information systems and compare them to those generated from the household survey to determine if any discrepancies in those values are decreased over the grant period.
The surveys will follow a clustered sampling approach at the implementation/control domain level within each country, sampling approximately 2,000 households per country to generate these estimates. The samples will include approximately 1,000 households in implementation (intervention) sites and 1,000 households in control (non-intervention) sites. The surveys have been designed with flexibility, so it can be implemented as a longitudinal survey to generate robust and comparable baseline and end line data for the evaluation of this grant. The sample size estimation has considered a 10% attrition rate to mitigate dropouts. During the implementation of the baseline, basic contact information will be collected from survey respondents to allow the same panel to be re-selected during the implementation of the end line survey.
The baseline surveys cover topics like birth registration, breastfeeding and dietary intake, vitamin A coverage, immunization coverage, care of illness (treatment of diarrhea, care seeking for symptoms of acute respiratory infection (ARI), anthropometry etc.
The surveys are being implemented by the following institutions at the national level:
- In Chad: l’Institut National de la Statistique, des Études Économiques et Démographiques (INSEED)
- In Guinea: l'Institut National de la Statistique (INS)
- In Liberia: the Liberia Institute of Statistics and Geo Information Systems (LISGIS).
- In DRC: A private firm will be identified to be the implementing institution.
- In Togo: Institut national des Etudes Economiques et Demographiques (INSEED)
The coverage data generated from the household surveys at the baseline will be used to inform the rollout of CFC-RTM in intervention districts. The baseline and end line coverage data will be made available to country and district CFC-RTM focal points, but also reported to and managed at the regional and HQ level in a multi-country database where the overall project management and evaluation will be conducted. At the end of the project implementation and evaluation periods, select data may be shared to facilitate further research on the intervention’s effectiveness, scalability, and relevance.
In November 2018 Guinea, Chad and Liberia are in the field collecting data for the baseline study.
This marks an important step for the initiative as after the baseline data has been collected the implementation of the CFC/Real Time Monitoring through routine community health visits and monitoring can really begin.
Congratulations to survey teams in these countries for this great effort.