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Background to the SC4CCM project 
• 
In 2009, SC4CCM set out to improve community-level availability of key products for s...
Over-arching Endline Evaluation Questions 
• 
To what extent (geographic breadth and institutional depth) have the SC4CCM ...
Case selection strategy 
• 
Compare original with scale-up districts 
• 
Learn from extremes: best and worst performing wi...
Multiple, Mixed methods design 
Qualitative case studies 
• 
Purposively selected cases 
• 
In-depth interviews (district,...
Within-case (country) analysis process 
• 
Team discussion and analysis notes after each district; feedback from evaluatio...
Cross-case synthesis process 
• 
Common themes identified from program theory and country-specific analyses 
• 
Codebook d...
Data-based country program theories
Pilot-to-program theory
Acknowledgements 
JSI Research & Training Institute, Inc. (JSI) implemented the Supply Chains for Community Case Managemen...
Using case-based methods to assess scalability and sustainability: Lessons from evaluating innovations of the Supply Chain...
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Using case-based methods to assess scalability and sustainability: Lessons from evaluating innovations of the Supply Chain for Community Case Management (SC4CCM) project in Rwanda, Malawi, and Ethiopia

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Overview of the SC4CCM project and end-line evaluation questions focused on scalability and sustainability. Methodological approaches including case selection strategies, mixed method approaches, within-case and cross-case analysis processes. (Sangeeta Mookherji, GWU)

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Using case-based methods to assess scalability and sustainability: Lessons from evaluating innovations of the Supply Chain for Community Case Management (SC4CCM) project in Rwanda, Malawi, and Ethiopia

  1. 1. Background to the SC4CCM project • In 2009, SC4CCM set out to improve community-level availability of key products for sick child management in 3 countries: Malawi, Rwanda, Ethiopia. • Tasked with demonstrating that tested innovations could be scaled and sustained after project end. • Midline evaluations (2012-13) focused on measuring effects; findings kicked off scale-up process. • Endline evaluation (2014) focused on learning about scalability and sustainability of SC4CCM innovations.
  2. 2. Over-arching Endline Evaluation Questions • To what extent (geographic breadth and institutional depth) have the SC4CCM innovations to support commodity availability at the community level, specific to each country, been scaled up? • To what extent have the program effects of SC4CCM observed at midline been maintained at endline? • To what extent have the country- specific innovations been institutionalized at endline? • What aspects of the SC4CCM design, implementation, and overall project approach contribute to scalability and sustainability of the particular innovation supported in a country?
  3. 3. Case selection strategy • Compare original with scale-up districts • Learn from extremes: best and worst performing with SCM/PA • Management component focus: choose near and far CHWs; high and low QI • Get multiple perspectives – district, HC, CHW
  4. 4. Multiple, Mixed methods design Qualitative case studies • Purposively selected cases • In-depth interviews (district, HC, CHWs) • Structured observations of tool use (HC and CHW) • RSP tool documentation review (HC, CHW) • QI team documentation review (district, HC) • Standard field manual Endline surveys • Representative selection of HCs and CHWs • Comparable to midline LIAT • Structured survey interviews • Physical inventory of key products • Assessment of knowledge and competency using RSPs
  5. 5. Within-case (country) analysis process • Team discussion and analysis notes after each district; feedback from evaluation advisor • One week focused analysis immediately after data collection – whole team, with project management and evaluation advisor participation • Writing of country-specific endline report, integrating LIAT data • Presentation of endline findings to country stakeholders Focused analysis steps: • District-by-district analysis, using notes, original program theory, evaluation questions; ongoing identification of contextual factors • “Deep dives” – RSP procedures: improvements, benefits, challenges; QI teams: functionality, benefits, challenges; PA: perceived improvements, other changes, challenges • Analysis of contextual factors – contributions and barriers; likelihood of affecting scale-up or sustainability; can it be changed? • “Validation” and revision of program theory based on the data
  6. 6. Cross-case synthesis process • Common themes identified from program theory and country-specific analyses • Codebook developed • Qualitative data coded in atlas.ti – to make the data more manageable, and allow for focused cross- theme analysis to understand relationships and non-linearity • One week focused synthesis analysis with whole team participation Synthesis analysis steps: • Data integration - PA: used qual to explain survey findings; RSP: qual- survey validation; QI: used qual findings as lead • Differences and similarities between countries; full range of benefits and challenges (RSP and QI); explaining PA; context • Scale: compared how it is happening across countries; RSP v. QI; partner implementation • Sustainability: Data visibility and use comparisons and mechanisms; evidence of political commitment • Project inputs and implementation strategy contributions
  7. 7. Data-based country program theories
  8. 8. Pilot-to-program theory
  9. 9. Acknowledgements JSI Research & Training Institute, Inc. (JSI) implemented the Supply Chains for Community Case Management (SC4CCM) project with funding from the Bill & Melinda Gates Foundation. JSI partnered with the Milken Institute School of Public Health at The George Washington University for the endline evaluation. •GWU team: Sangeeta Mookherji, Jillian Dunning, Teemar Fisseha, Anisa Saleh •SC4CCM team: Yasmin Chandani, Sarah Andersson, Alexis Heaton, Megan Noel, Barbara Felling, Savitha Subramaniam, Mildred Shieshia

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