the shift in accountability
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Community Learning Systems : Increasing Accountability for Results from Development Assistance Joy P. Mukaire Lawrence L. Jackson Annual Conference 2009 Christian Connections for International Health. The Shift in Accountability. - PowerPoint PPT PresentationTRANSCRIPT
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Community Learning Systems: Increasing Accountability for Results from Development Assistance
Joy P. MukaireLawrence L. Jackson
Annual Conference 2009Christian Connections for International Health
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The Shift in AccountabilityChange to a transitional phase should be reflected in the shift from the traditional role of NGOs in health of service provision
From little accountability to anyone other than the individual NGO and their donors
To a change demanding that NGOs implement health care on behalf of government, working alongside MoH GOSS to support national frameworks, supporting MOH in health systems strengthening at all levels.
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Struggles of M&E SystemsHarmonization of M&E approaches Having one National Health Strategic FrameworkHaving one National M&E frameworkHaving one National Coordinating body
Strengthening and expanding M&E Capacity at all levelsPromoting decentralization of M&EImproving human capacity for M&EAllocating adequate resources to M&E
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Struggles of M&E SystemsUsing national data to prescribe solutions for local level problems/needsTreating every community/district the same even when priorities differ in natureNot knowing the magnitude of the problem being addressedMismatch between national priority and local needs Promoting utilization of program dataTo decide on prioritiesMake tactical changes to improve programsTo scale up proven project models
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Management for ResultsThere is increasing pressure to manage programs with focus on achieving results that are visible.Monitoring and Evaluation has two purposes:Aid program managers to improve their programs by using dataSub-national level (Implementation Teams)National level (Policy and Sr. Management)Support a reporting function National stakeholdersInternationally [Donors, International Organizations (RBM)]
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Macro vs Local M&E Outcome Data NATIONAL LEVELProgramDistrict 1ProgramDistrict 2Local managers need M&E data that show what is happening in the areas where they work
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Efforts to Strengthen M&E
Rapid Assessment using Lot Quality Assurance Sampling Sampling method used in industry since the 1920sAdapted to public health settings in mid-1980sLocal managers at a sub-district level using small samples determine whether a performance target has been reachedYes or No Judgment
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What is LQAS?
An analysis method that can: be used locally in supervision areasto identify priority areas: those not reaching an established performance benchmark for an indicatordata for local management decision making and for sharing information across supervision areasmeasure coverage at an aggregate level (e.g., program catchment area or district or nation)be used locally in supervision areassuitable for Reporting PurposesLQAS uses small samples (less than 20)
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ABCDEFGAssume a program areathat has 7 supervision areas or municipalities
Each one is supervised byone person
Each one has between 25-35 promoters/wards/communities to supervise
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ABCDEFGGoodBelow Averageor EstablishedBenchmark
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GoodBelow Average or Established Benchmark
Identify the reasons for program problemsDevelop targeted solutionsMaintain the program at the current level Identify Supervisors and Health Workers that can help other HealthWorkers improve their performance
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Sheet1
LQAS Table: Decision Rules for Sample Sizes of 12-30 and Coverage Benchmarks or Average Coverage of 10% to 95%
Sample SizesCoverage Benchmarks or Average Coverage
10%15%20%25%30%35%40%45%50%55%60%65%70%75%80%85%90%95%
12N/AN/A112234556778891011
13N/AN/A1123345667889101111
14N/AN/A11234456788910111112
15N/AN/A122345667891010111213
16N/AN/A122345678991011121314
17N/AN/A1223456789101112131415
18N/AN/A12235678910111112131416
19N/AN/A12345678910111213141516
20N/AN/A12345678911121314151617
21N/AN/A123456891011121314161718
22N/AN/A123457891012131415161819
23N/AN/A1234678101112131416171820
24N/AN/A1234679101113141516181921
25N/A12245689101213141617182021
26N/A12345689111214151618192122
27N/A123457810111314151718202123
28N/A123457810121315161819212224
29N/A123457910121315171820212325
30N/A123457911121416171920222426
For all coverage benchmarks (except where noted) LQAS is at least 92% sensitive and specific
N/A = Not Applicable -- Indicates that LQAS should not be used since coverage is too low for LQAS to detect.
Alpha and Beta Errors are > 10%
Alpha and Beta Errors are > 15%
Sheet2
Sheet3
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These are the problem supervision areas. The Decision Rule is 12 women delivering with a Trained Provider
Nica-CARE
Delivery Attended by a Clinically Trained Provider, Benchmark = 75%, DR=12; Mean = 65%, DR=10Delivery Attended by a Clinically Trained Provider Benchmark = 75%, Decision Rule=12; Mean = 65%, Decision Rule=10
NGO =CARE* = Below Benchmark; # = Below Mean
AREA | YES NO | TotalDistrict
--------------------------------------------AreaYesNoTotal
1 | 11 8 | 19111*819
2 | 13 6 | 19213619
3 | 19 0 | 19319019
4 | 8 11 | 1948* #1119
5 | 8 11 | 1958* #1119
6 | 15 4 | 19615419
--------------------------------------------Total7440114
Total| 74 40 | 114Mean Coverage in PVO Area = 65%
Nica-All-Delivery
Delivery Attended by a Clinically Trained Provider, Mean = 70.57%, DR=12
NGO =CARENGO =HOPE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 11 8 | 191 | 11 8 | 19
2 | 13 6 | 192 | 13 6 | 19
3 | 19 0 | 193 | 4 15 | 19
4 | 8 11 | 194 | 7 12 | 19
5 | 8 11 | 19
6 | 15 4 | 19
----------------------------------------------------------------------------------------
Total| 74 40 | 114Total| 35 41 | 76
NGO =PARTNERSNGO =PCI
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 11 8 | 191 | 10 9 | 19
2 | 11 8 | 192 | 17 2 | 19
3 | 16 3 | 193 | 16 3 | 19
4 | 16 3 | 194 | 7 9 | 16
----------------------------------------------------------------------------------------
Total| 54 22 | 76Total| 50 23 | 73
NGO =PLANNGO =SAVE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 19 0 | 191 | 17 2 | 19
2 | 13 6 | 192 | 14 5 | 19
3 | 15 4 | 193 | 16 3 | 19
4 | 15 4 | 194 | 16 3 | 19
5 | 16 3 | 195 | 14 5 | 19
6 | 15 4 | 196 | 14 5 | 19
7 | 19 0 | 19
----------------------------------------------------------------------------------------
Total| 93 21 | 114Total| 110 23 | 133
Nica-All-ORT
Demonstrates Correct Preparation of ORS Solution Mean = 77.89, DR = 13
NGO =ADRANGO =CARE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 14 5 | 191 | 14 3 | 17
2 | 4 15 | 192 | 15 4 | 19
3 | 9 10 | 193 | 14 3 | 17
4 | 12 7 | 194 | 15 2 | 17
5 | 15 3 | 18
6 | 13 5 | 18
----------------------------------------------------------------------------------------
Total| 39 37 | 76Total| 86 20 | 106
NGO =CRSNGO =HOPE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 16 3 | 191 | 15 4 | 19
2 | 19 0 | 192 | 15 4 | 19
3 | 17 2 | 193 | 18 1 | 19
4 | 17 2 | 194 | 17 2 | 19
----------------------------------------------------------------------------------------
Total| 69 7 | 76Total| 65 11 | 76
NGO =PARTNERSNGO =PLAN
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 14 5 | 191 | 15 1 | 16
2 | 13 6 | 192 | 18 1 | 19
3 | 13 6 | 193 | 18 1 | 19
4 | 17 2 | 194 | 15 2 | 17
5 | 17 2 | 19
6 | 14 2 | 16
----------------------------------------------------------------------------------------
Total| 57 19 | 76Total| 97 9 | 106
NGO =SAVE
AREA | YES NO | Total
--------------------------------------------
1 | 15 4 | 19
2 | 17 2 | 19
3 | 10 9 | 19
4 | 12 7 | 19
5 | 14 4 | 18
6 | 11 7 | 18
7 | 14 5 | 19
--------------------------------------------
Total| 93 38 | 131
Vitamin A
Vitamin A Received by Mothers within Two Months of Birth
Average = 40.8% DR=6
NGO =ADRANGO =CARE
VITAMINAVITAMINA
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------66
1 | 6 13 | 191 | 5 13 | 18212
2 | 2 17 | 192 | 11 8 | 1977
3 | 7 12 | 193 | 5 14 | 1966
4 | 6 13 | 194 | 4 15 | 19512
5 | 7 12 | 191111
6 | 10 9 | 19512
-----------+-------------+-----------------+-------------+------412
Total | 21 55 | 76Total | 42 71 | 11377
1010
NGO =PARTNERS1313
VITAMINA1515
AREA | YES NO | Total1616
-----------+-------------+------1919
1 | 13 6 | 19265126158
2 | 15 4 | 190.47547169810.5962264151
3 | 16 3 | 19
4 | 19 0 | 19
-----------+-------------+------
Total | 63 13 | 76
Nica-All-ITN
NicaSalud Baseline December 1999
Household has at least 1 BEDNET (Average= 39%, DR=5)
NGO =ADRANGO =CARE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 1 18 | 191 | 9 10 | 19
2 | 4 15 | 192 | 3 16 | 19
3 | 8 11 | 19
4 | 10 9 | 19
5 | 4 15 | 19
6 | 3 16 | 19
-----------+-------------+-----------------+-------------+------
Total | 5 33 | 38Total | 37 77 | 114
NGO =CRSNGO =HOPE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 6 13 | 191 | 4 15 | 19
2 | 3 16 | 192 | 5 14 | 19
3 | 4 15 | 19
-----------+-------------+-----------------+-------------+------
Total | 9 29 | 38Total | 13 44 | 57
NGO =PARTNERSNGO =PCI
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 4 15 | 191 | 10 9 | 19
2 | 4 15 | 192 | 6 13 | 19
3 | 3 16 | 19
-----------+-------------+-----------------+-------------+------
Total | 8 30 | 38Total | 19 38 | 57
NGO =PLANNGO =SAVE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 4 15 | 191 | 7 12 | 19
2 | 17 2 | 192 | 10 8 | 18
3 | 10 9 | 193 | 10 9 | 19
4 | 16 3 | 194 | 12 7 | 19
5 | 15 4 | 19
6 | 15 4 | 19
-----------+-------------+-----------------+-------------+------
Total | 77 37 | 114Total | 39 36 | 75
Umoyo-All-HIV
Women Who Know HIV/AIDS Can
Be Transmitted During Pregnancy
Coverage Estimate=55.66%, DR=9
NGO = AHSNGO = BCC
AREA1.02.0TotalAREA1.02.0Total
181119161319
281119281119
361319351419
491019410919
571118581119
Total385694Total375895
NGO = EkwendeniNGO = MACRO
AREA1.02.0TotalAREA1.02.0Total
117219181119
216319291019
312719371219
412719411819
591019561319
613619612719
Total7935114Total5361114
NGO = Malamulo
AREA1.02.0Total
116319Coverage Estimate=55.66%
215419Decision Rule=9
314519
418119
515419
Total781795
Regular Superv
1111
0.0230.0005290.00000027980
0.9190.8445610.71328328270.5087730414
0.8350.6972250.48612270060.2363152801
0.7370.5431690.29503256260.087044213
0.6330.4006890.16055167470.0257768403
0.5280.2787840.07772051870.006040479
0.4280.1831840.03355637790.0011260305
0.3370.1135690.01289791780.0001663563
0.2560.0655360.00429496730.0000184467
0.1880.0353440.00124919830.0000015605
0.1310.0171610.00029449990.0000000867
0.0870.0075690.00005728980.0000000033
0.0540.0029160.00000850310.0000000001
0.0310.0009610.00000092350
Session 1
Session 2
Session 3
Session 4
Proportion of Time Service is Done Correctly
ERROR
Regular Supervision of a Health Workers Observing them with 6 Clients and Permitting 1 Error in Service Provision: Service Standard = 95%
Sheet6
Error
QualitySession 1Session 2Session 3Session 4
100%
95%0.0230.0005290.00000027980
90.0%0.9190.8445610.71328328270.5087730414
85.0%0.8350.6972250.48612270060.2363152801
80.0%0.7370.5431690.29503256260.087044213
75.0%0.6330.4006890.16055167470.0257768403
70.0%0.5280.2787840.07772051870.006040479
65.0%0.4280.1831840.03355637790.0011260305
60.0%0.3370.1135690.01289791780.0001663563
55.0%0.2560.0655360.00429496730.0000184467
50.0%0.1880.0353440.00124919830.0000015605
45.0%0.1310.0171610.00029449990.0000000867
40.0%0.0870.0075690.00005728980.0000000033
35.0%0.0540.0029160.00000850310.0000000001
30.0%0.0310.0009610.00000092350
25.0%
20.0%
15.0%
10.0%
MBD001E3EA3.xls
Nica-CARE
Table 1: Delivery Attended by a Clinically Trained Provider Benchmark = 75%, Decision Rule=12; Mean = 65%, Decision Rule=10
PVO 1
AREA | YES NO | Total
--------------------------------------------
1 | 11 8 | 19
2 | 13 6 | 19
3 | 19 0 | 19
4 | 8 11 | 19
5 | 8 11 | 19
6 | 15 4 | 19
--------------------------------------------
Total| 74 40 | 114
Nica-All-Delivery
Delivery Attended by a Clinically Trained Provider, Mean = 70.57%, DR=12
NGO =CARENGO =HOPE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 11 8 | 191 | 11 8 | 19
2 | 13 6 | 192 | 13 6 | 19
3 | 19 0 | 193 | 4 15 | 19
4 | 8 11 | 194 | 7 12 | 19
5 | 8 11 | 19
6 | 15 4 | 19
----------------------------------------------------------------------------------------
Total| 74 40 | 114Total| 35 41 | 76
NGO =PARTNERSNGO =PCI
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 11 8 | 191 | 10 9 | 19
2 | 11 8 | 192 | 17 2 | 19
3 | 16 3 | 193 | 16 3 | 19
4 | 16 3 | 194 | 7 9 | 16
----------------------------------------------------------------------------------------
Total| 54 22 | 76Total| 50 23 | 73
NGO =PLANNGO =SAVE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 19 0 | 191 | 17 2 | 19
2 | 13 6 | 192 | 14 5 | 19
3 | 15 4 | 193 | 16 3 | 19
4 | 15 4 | 194 | 16 3 | 19
5 | 16 3 | 195 | 14 5 | 19
6 | 15 4 | 196 | 14 5 | 19
7 | 19 0 | 19
----------------------------------------------------------------------------------------
Total| 93 21 | 114Total| 110 23 | 133
Nica-All-ORT
Demonstrates Correct Preparation of ORS Solution Mean = 77.89, DR = 13
NGO =ADRANGO =CARE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 14 5 | 191 | 14 3 | 17
2 | 4 15 | 192 | 15 4 | 19
3 | 9 10 | 193 | 14 3 | 17
4 | 12 7 | 194 | 15 2 | 17
5 | 15 3 | 18
6 | 13 5 | 18
----------------------------------------------------------------------------------------
Total| 39 37 | 76Total| 86 20 | 106
NGO =CRSNGO =HOPE
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 16 3 | 191 | 15 4 | 19
2 | 19 0 | 192 | 15 4 | 19
3 | 17 2 | 193 | 18 1 | 19
4 | 17 2 | 194 | 17 2 | 19
----------------------------------------------------------------------------------------
Total| 69 7 | 76Total| 65 11 | 76
NGO =PARTNERSNGO =PLAN
AREA | YES NO | TotalAREA | YES NO | Total
----------------------------------------------------------------------------------------
1 | 14 5 | 191 | 15 1 | 16
2 | 13 6 | 192 | 18 1 | 19
3 | 13 6 | 193 | 18 1 | 19
4 | 17 2 | 194 | 15 2 | 17
5 | 17 2 | 19
6 | 14 2 | 16
----------------------------------------------------------------------------------------
Total| 57 19 | 76Total| 97 9 | 106
NGO =SAVE
AREA | YES NO | Total
--------------------------------------------
1 | 15 4 | 19
2 | 17 2 | 19
3 | 10 9 | 19
4 | 12 7 | 19
5 | 14 4 | 18
6 | 11 7 | 18
7 | 14 5 | 19
--------------------------------------------
Total| 93 38 | 131
Vitamin A
Vitamin A Received by Mothers within Two Months of Birth
Average = 40.8% DR=6
NGO =ADRANGO =CARE
VITAMINAVITAMINA
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------66
1 | 6 13 | 191 | 5 13 | 18212
2 | 2 17 | 192 | 11 8 | 1977
3 | 7 12 | 193 | 5 14 | 1966
4 | 6 13 | 194 | 4 15 | 19512
5 | 7 12 | 191111
6 | 10 9 | 19512
-----------+-------------+-----------------+-------------+------412
Total | 21 55 | 76Total | 42 71 | 11377
1010
NGO =PARTNERS1313
VITAMINA1515
AREA | YES NO | Total1616
-----------+-------------+------1919
1 | 13 6 | 19265126158
2 | 15 4 | 190.47547169810.5962264151
3 | 16 3 | 19
4 | 19 0 | 19
-----------+-------------+------
Total | 63 13 | 76
Nica-All-ITN
NicaSalud Baseline December 1999
Household has at least 1 BEDNET (Average= 39%, DR=5)
NGO =ADRANGO =CARE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 1 18 | 191 | 9 10 | 19
2 | 4 15 | 192 | 3 16 | 19
3 | 8 11 | 19
4 | 10 9 | 19
5 | 4 15 | 19
6 | 3 16 | 19
-----------+-------------+-----------------+-------------+------
Total | 5 33 | 38Total | 37 77 | 114
NGO =CRSNGO =HOPE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 6 13 | 191 | 4 15 | 19
2 | 3 16 | 192 | 5 14 | 19
3 | 4 15 | 19
-----------+-------------+-----------------+-------------+------
Total | 9 29 | 38Total | 13 44 | 57
NGO =PARTNERSNGO =PCI
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 4 15 | 191 | 10 9 | 19
2 | 4 15 | 192 | 6 13 | 19
3 | 3 16 | 19
-----------+-------------+-----------------+-------------+------
Total | 8 30 | 38Total | 19 38 | 57
NGO =PLANNGO =SAVE
BEDNETBEDNET
AREA | YES NO | TotalAREA | YES NO | Total
-----------+-------------+-----------------+-------------+------
1 | 4 15 | 191 | 7 12 | 19
2 | 17 2 | 192 | 10 8 | 18
3 | 10 9 | 193 | 10 9 | 19
4 | 16 3 | 194 | 12 7 | 19
5 | 15 4 | 19
6 | 15 4 | 19
-----------+-------------+-----------------+-------------+------
Total | 77 37 | 114Total | 39 36 | 75
Umoyo-All-HIV
Women Who Know HIV/AIDS Can
Be Transmitted During Pregnancy
Coverage Estimate=55.66%, DR=9
NGO = AHSNGO = BCC
AREA1.02.0TotalAREA1.02.0Total
181119161319
281119281119
361319351419
491019410919
571118581119
Total385694Total375895
NGO = EkwendeniNGO = MACRO
AREA1.02.0TotalAREA1.02.0Total
117219181119
216319291019
312719371219
412719411819
591019561319
613619612719
Total7935114Total5361114
NGO = Malamulo
AREA1.02.0Total
116319Coverage Estimate=55.66%
215419Decision Rule=9
314519
418119
515419
Total781795
Regular Superv
1111
0.0230.0005290.00000027980
0.9190.8445610.71328328270.5087730414
0.8350.6972250.48612270060.2363152801
0.7370.5431690.29503256260.087044213
0.6330.4006890.16055167470.0257768403
0.5280.2787840.07772051870.006040479
0.4280.1831840.03355637790.0011260305
0.3370.1135690.01289791780.0001663563
0.2560.0655360.00429496730.0000184467
0.1880.0353440.00124919830.0000015605
0.1310.0171610.00029449990.0000000867
0.0870.0075690.00005728980.0000000033
0.0540.0029160.00000850310.0000000001
0.0310.0009610.00000092350
Session 1
Session 2
Session 3
Session 4
Proportion of Time Service is Done Correctly
ERROR
Regular Supervision of a Health Workers Observing them with 6 Clients and Permitting 1 Error in Service Provision: Service Standard = 95%
Sheet6
Error
QualitySession 1Session 2Session 3Session 4
100%
95%0.0230.0005290.00000027980
90.0%0.9190.8445610.71328328270.5087730414
85.0%0.8350.6972250.48612270060.2363152801
80.0%0.7370.5431690.29503256260.087044213
75.0%0.6330.4006890.16055167470.0257768403
70.0%0.5280.2787840.07772051870.006040479
65.0%0.4280.1831840.03355637790.0011260305
60.0%0.3370.1135690.01289791780.0001663563
55.0%0.2560.0655360.00429496730.0000184467
50.0%0.1880.0353440.00124919830.0000015605
45.0%0.1310.0171610.00029449990.0000000867
40.0%0.0870.0075690.00005728980.0000000033
35.0%0.0540.0029160.00000850310.0000000001
30.0%0.0310.0009610.00000092350
25.0%
20.0%
15.0%
10.0%
-
DistrictS.A. = 19S.A. = 19S.A. = 19S.A. = 19DistrictS.A. = 19S.A. = 19S.A. = 19S.A. = 19DistrictS.A. = 19S.A. = 19S.A. = 19S.A. = 19Nation or RegionSA= Supervision Area
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LQAS Application in CHASApplied in two counties of Leer and Koch in Unity State to establish baseline for a CHAS implemented Access to Basic Service Quick Impact Project Estimate immunization coverage among children aged 12 59 months;Assess knowledge and practice of correct feeding practices among pregnant women and children aged 0 23 months;Estimate coverage of ITNs among children under 5 and pregnant mothers;Estimate prevalence of ARI, fever, and diarrhea among children under 5;
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LQAS Application in CHASAssess knowledge and practice of mothers and caretakers of children under 5 of critical danger signs of and correct response to ARI, fever and diarrhea;Utilization of ANC, delivery and PNC services among pregnant women; and Knowledge and use of family planning methods among women in the reproductive age bracket.Use of sanitary means of excreta disposalUse of improved water source of drinking water
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LQAS Application in CHASThe sample: A total of 5 parallel samples corresponding to the 5 project target groups, namely,Heads of householdMothers of children 0 11 monthsMothers of children 12 23 monthsMothers of children 0 59 monthsWomen aged 15 49From each randomly selected village133 households in Koch x 5 interviews = 152 households in Leer x 5 interview =
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LQAS A Catalyst for Change
A team of 14 people were trained in Unity State, six at HQ and 8 at county levelMobilizes managers and their organizations to appraise their programsEmpowers them by creating a learning environmentSupports leadership at national, district and sub-district levels
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Advantages of Using LQAS
Can be used at a local level with modest amounts of supervisionProduces information that can be rapidly interpreted by local managersIdentifies where the successes and challenges are locatedPaper/pencil analyses rather than requiring computer analyses Data can be used for national reporting, andSampling theory is rigorous
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Lessons Learned
LQAS findings revealed substantial variations in estimates of countiesThe magnitude of Sanitation problem became more visible to implementers than before something the project was not even planning to address. The substantial variation imply that local managers are better placed to make tactical changes in their ProgrammeThose responsible for providing services are better placed to analyze the challenges in their areas and decide on the strategic change
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The Christian Perspective
This is one solutions to increased STEWARDSHIP of faith-based organizations
This tool is just but a means to acceptable standards of ACCOUNTABILITY where resources are limited and competing priorities are many
This tool builds a culture of result-oriented management and the culture of accountability, a contribution Christian health services can make to Strengthening Health Information Systems and Monitoring and Evaluation
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The Power of Measuring Results
If you dont measure results you cant tell success from failureIf you dont see success, you cannot reward itIf you cannot reward success, you are probably awarding failureIf you cannot recognize failure, you cannot correct itIf you cannot demonstrate results, you cannot win public supportSource: Adapted from Osborne & Gaebler 1992
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Getting Ready
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Household Interviews
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Household Interviews
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