The document provides select results from KPC surveys for projects that ended in 2011. It includes data on technical intervention areas and levels of effort by country for different NGOs. It then shows KPC indicators with levels of effort moved, indicators included in M&E plans, and targeted indicators for Relief International and Concern Worldwide. Graphs compare results over time for various health indicators like infant and young child feeding practices and newborn postnatal visits. The document concludes by comparing KPC and DHS data for several countries between 2006/2007 and 2011 for indicators like antenatal care, skilled birth attendance and breastfeeding practices.
20. Soap at the Place for Hand Washing (2006/7 – 2011)
100
80
Coverage (%)
60
40
20
0
Nepal Rwanda Niger Tanzania PSI GOAL
(CARE) (Concern) (Relief) (Wellshare) (Malawi) (Ethiopia)
Baseline Endline
20
21. Child ITN use:
A comparison of KPC and DHS data (2006/7 – 2011)
100
80
Coverage (%)
60
40
20
0
Concern Wellshare Relief
(Rwanda) (Tanzania) (Niger)
Baseline DHS Endline DHS Baseline KPC EndlineKPC
21
22. Appropriate fever treatment:
A comparison of KPC and DHS data (2006/7 – 2011)
60
40
Coverage (%)
20
0
Concern Wellshare Relief
(Rwanda) (Tanzania) (Niger)
Baseline DHS Endline DHS Baseline KPC EndlineKPC
22
23. ANY QUESTIONS?
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24. Detailed baseline and endline KPC
survey information
Sampling Endline
PVO BL Den BL Dates EL Den Notes
Method Dates
CARE Cluster 660 3/2008 660 3/2011 30 villages x 11 HHs x 2 districts
BL: 6 dist x 5 SAs x 95 HHs
120 (well)
Concern LQAS 570 2-3/2007 6-7/2011 EL: 6 dist x 20 HH (well), 61-74 HH (sick)
395 (sick) Well-child (0-23 mo); Sick-child (0-59 mo)
GOAL LQAS 114 2/2008 114 8/2011 6 SAs x 19 communities
35 SAs x 19HHs
532 (2 dist) 2/2008 (2 dist) 532 (2 dist) Parsa: 13 SAs=247 (2007 CATCH)
PLAN LQAS 6-7/2011
133 (Bara) 6/2006 (Bara) 133 (Bara) Sunsari: 15 SAs=285 (2007 CATCH)
Bara: 7 SAs=133 (2000+ CATCH)
3-stage stratified cluster sampling
PSI Cluster 300 2-3/2007 391 6-11/2010 Baseline KPC survey in Salima District
Endline data extracted from 2010 DHS in Salima District
BL: 30 clusters x 11HH from 453 villages in target district
Relief Cluster 330 1/2008 358 9/2011
EL: 30 clusters x 12HH from 61 focus villages
BL: 30 Clusters x 10 HHs
EL: 45 Clusters x 10 HHs
Save Cluster 300 2/2007 450 6/2011(?)
Over-sampled 15 clusters in Ekwendeni catchment area
(22 from Ekwendeni area, 23 from non-Ekwendeni area)
BL: 34 clusters x 10HHs
Wellshare Cluster 340 2-3/2007 390 6/2011
EL: 30 clusters x 13HHs
24
25. FE KPC Best Practices
Inclusion of BL and MT (if applicable) data
Denominators and CIs for all %s (including BL and MT – not just EL)
Comparison to baseline
Possible explanations for changes or lack of change
Tabulation tables as an annex
Correct population-weighting
DHS comparison (if applicable/possible)
Dates that data were collected (including BL)
Summary of any changes/recalculations that were made to BL data
since DIP/initial submission
Any differences in sampling methodology (BL vs. EL vs. MT)
25
27. CARE Plan
• CB-NCP (only Doti) • CB-NCP
• BPP/Safe Motherhood Package • FCHV-led Pregnant Women’s Groups (subset
• National c-IMCI strategy of mothers’ groups)
• Birthing center establishment • Strong engagement of VDCs
• FCHV-led mothers’ groups • Birthing center establishment
• Involvement of mothers-in-law and husbands
(decision makers)
• SATH in marginalized communities
• Leveraged other CARE projects
Wellshare Save
• VHC establishment • IMNC training manual
• Long distance drivers – em trans & health ed • CBMNC package
• Health advocates in 2 marginalized tribes • KMC expansion
• AFYA 1-2-3 BCC campaign • ENC promotion (agogo)
(3 key messages / intervention area)
• TBA/CORPs-led community activities
• TBA-led Survive & Thrive
Groups, registers, home visits 27
• TBAs repositioned
28. Concern Relief
• CHW peer support groups • Women’s health groups
• CHW home visits w/ counseling • Home visits
• Community mobilization database • HW & CHW HH/C-IMCI training
• IMCI bulletin • TBAs repositioned as delivery companions
• Infrastructure development
GOAL PSI
• Adapted care groups • Social marketing + behavior change
• CGV home visits • Targeted outreach communications
• CGV referrals & follow-ups • Communication material development
• Worked at health post level – capacity, • Helped with zinc inclusion in EDL
supportive supervision, QOC
28
29. [KU1]Will definitely remove but I think it would be useful to share internally to show what grantees are/aren’t reporting
[OB2]I think you can remove this section.
Summary of information included
in/missing from KPC reports
PVO Information provided in KPC Report
CARE Did not calculate weighted averages/did not explain why; no explanation for change (or lack thereof) in indicators; compared to
baseline; provided tables with denominators; also did capacity assessments of HFs, HWs, and FCHV but didn’t seem to link them all
together
Concern Provided some potential explanations for indicators within intervention areas and also compared them to baseline; did not discuss
other CATCH indicators at all; provided CIs with estimates; denominators in a separate table; pop weighted SAs!
GOAL Provided some potential explanations; provided both denominators and CIs; compared to MTE and BL (but neither had CIs);
reported in database as one area but showed disaggregated results in FE (2 woredas) having small denominators (57 each); did not
pop weight SAs
PLAN Did not provide potential explanations – just #s, decision rule tables, and recommendations by SA for low-performing indicators;
provided tables with estimates compared to MTE & BL but without CIs or Denominators (needed to go into the decision rule table
to figure them out); Did not pop-weight SAs!
PSI Used 2010 DHS data in their final KPC report. The conducted a TRAC survey in 2011 but did not use it in their FE report.
Did not provide explanations for change or lack of change. Did not even include all CATCH indicators in the final KPC report, which
was very short (4 pages?).
Relief Provided some potential explanations; provided tables with denominators; compared to baseline in discussion
Save Did not provide explanations – just #s and summaries; provided tables with denominators and weighted averages with CIs, as well
as baseline % and denominator (would have been nice to see CI also); compared #s to baseline; database can accommodate design
Wellshare Provided Access file with KPC data; Also provided tabulation tables in their final KPC report; Provided BL & EL numerators, denominators, and
CIs in indicator tables; Also compared to 2010 DHS; Did not include possible explanations for changes in the indicators in the KPC report – some
in FE narrative.
29
30. Health Facility Delivery:
A comparison of KPC and DHS data (2006/7 – 2011)
90
Baseline DHS
80 Endline DHS
Baseline KPC
70 EndlineKPC
60
50
40
30
20
10
0
Save CARE Plan Wellshare
Malawi Nepal Nepal Tanzania
30
Hinweis der Redaktion
Most common indicators moved = EBF (4) and Soap (4)
Most common indicators moved = EBF (4) and Soap (4)GOAL: 4 > target, 1 target w/in CI, 1 w/o target
Changes in grayed out indicators are not statistically significant
100%!
100%!
100%!
3 stat sigNepal – PWGs encourage ANC, gov incentives to attend 4+Wellshare – BCCGoal – increased 2+ but not 4+
+ Relief = 2 stat sigGoal – increasing ANC -> increase in MTTRelief – mother & child care through gov
+ Relief = 3 stat sigPlan, Care – Govt incentives for HF deliveries, biggest limitation to HF deliveries = transportCARE – 55 birthing centers, SBA training, delivery kits, newborn deaths within 24h decreasedPlan – local recruitment of ANMs and HWs (gov policy), birth center expansion, social recognition awardsGOAL – worked with TBAs and HEWs to promote safe/clean deliveries. Prior no HEW hands-on experienceRelief – TBAs often perform deliveries in HFs, promoted SBA & companions to delivery esp through CGsWellshare – repositioned TBA role, village level vital event registers feeding into district level HMIS, TBA training on HBLSS, STGs
1 stat sig + maybe Goal + maybe Relief = 1-3 stat sigNo real commentary on this indicatorPlan saw a large increase even though EBF was common
+ Relief = 4 stat sigRelief – a large increase (endline > 2 x the 2010 national nutrition survey)GOAL – CGs and CHPs through SBCC strategy with home visits
1 stat sig Relief – increased in EBF and CF but food insecurity
2 stat sigConcern – CCM/P phased in during 1st two yearsWellshare – ABs not available at HPs until last year of project, but caregivers trained in careseekingCARE – already high
+ Relief = 2 stat sigRelief – could have been better with HH distribution by CGVsConcern – lagged behind DHS & both malaria and pneumo; did improve fluid and food intake thoughGoal – trained HEWsPSI – Thanzi ORS expansion (intro in 1999), CBD by Safe Water and Hygiene Promoters, high cost a worryWellshare – BCCZINCConcern – IRC piloted zinc in 2005 & included in all EIP districts, stockouts at EL thoughGoal – zinc added to EDL in May 2009PSI – helped pilot zinc with a CIDA CCM project after MTE; plan to bundle
3 stat sigGoal – Water Guard distributed monthly by CGVs 2008 – 3/2010 when social marketing began, developed a network of suppliersRelief – BCC local & appropriate methodsPSI – Water Guard safe water solution (SWS) and Wa Ufa (powder)Wellshare – Mostly boil, PUR and Water Guard only available in larger markets, negative perceptions of products (e.g., toxic residue)
4 stat sigRelief – challenging: started after MNC & BF, can’t leave soap by latrines or in a container, costly; soap production trainingPSI – FE recommended research to understand decreaseConcern – tippy taps (practical options) + health promo messages = hand washing stations but soap had to be hidden from goats
**No Ethiopia DHS data – but neither KPC increase was stat sigITN: + Relief = 2 stat sigGoal – endemic in woredas but not in region as a whole, ITN distributions in 2005/06 & 2009/10; not reflected in EL KPC but in a separate survey was found to be 83%, used CGs and CHPs + IRS campaignsRelief – ITN distribution , BCC around peak malaria timesWellshare – national distribution to pregnant women and U5s through PMI & GF
**No Ethiopia DHS data – but neither KPC increase was stat sigFEVER RX: + Relief = 2 stat sigConcern – HBM, RDT intro so def of correct Rx changed (End-line figure is defined by either correct treatment after RDT or presumptive treatment (depending on existing policy in health sector at time of survey)) At time of the KPC survey, 2/6 districts (Kirehe and Ngoma) = near complete RDT implementation while 4 districts were still phasing in RDTs. As a result, the treatment varies considerably by district. At endline, correct Rx is defined as a child with fever who was seen by a trained provider within 24 hours of onset and either given presumptive treatment or tested with and RDT and treated in accordance with the results of the test. When correct treatment is broken down by whether RDTs were used or not, the effect of having RDTs becomes apparent: 89% of children who had access to RDT received correct treatment, compared to just 29% of those who were not tested and treated presumptively. Goal – trained HEWs – HPs had Rx but lacked reliable stocks and were open only sporadically Wellshare – HWs trained in RDTs but ran out of supply.