I wanted to give an update on our program metrics in this blog post as it has been a hot issue on our team lately. I had a call with one of our biggest donors this week about this topic, David is hard at work in the field on all sorts of Program Metric-related activities, and Jamie is spending as much time as she can on the issue when she is not consumed by her work on developing Nuru’s approach to Needs Assessments. (I just go ahead and capitalize these things….they are important). Continue Reading…

Posted from Palo Alto, California, United States.

Returning from Kenya in November last year, I’m back in the US working to provide insight and strategy on Monitoring & Evaluation systems in Kenya and soon to be Ethiopia.

Living in sunny Santa Barbara, I have the luxury of being able to visit the Ellwood Monarch Butterfly Preserve which is the overwintering site of thousands of monarch butterflies.  The butterflies, up to about 50,000 this year in count, come here each winter from November until March or so.  Without their migration, the butterflies wouldn’t be able to survive.  It is through coordination, teamwork, tireless efforts and a magical innate drive that allows them to be able to survive. Continue Reading…

Posted from Santa Barbara, California, United States.

However informative training is, it always leaves me (and I think all my Nuru colleagues) feeling like we sure do have a lot of work to do.

I am down in Southern California after three days up in the Bay Area where I attended a training session organized by Lindsay Cope and attended by a group of eight Nuru people. Thomas Hong, Matt Lee, myself, Jamie Frederick, Jake, Lindsay Cope, Chelsea Barabas, and Radhika Warrier were all trained for three days by Bonnie Kittle on Qualitative Research, Barrier Analysis, Focus Group Discussions, Key Informant Interviews, and a few other topics. Those are big topics to cover in such a short time, but Bonnie rolled with it and covered them all. She has been doing development work all over the world since the early seventies, so for every scenario we discussed, Bonnie had a first-hand example or story to share with us. That part of our training was incredibly helpful. It not only helped us further understand the concepts she was presenting, but made us feel like we could actually accomplish the complex tasks we were learning about. Bonnie gave us confidence. Continue Reading…

Posted from Palo Alto, California, United States.

What a great title for a TV show. Seriously. I can’t believe that flew, but I’m so happy that it did. I like thinking of it un-ironically (yes, you “irony” sticklers, I do definitely tend to use that word incorrectly) or un-rhetorically. Like, it’s a real question: What IS happening now? That is how I mean it in the title of this blog post.

We are gearing up for a little two-week holiday shutdown. It starts next week. Honestly, it’s a nice break for us. The team members in the field have already started their breaks, and are away from the project site as of this past Monday. David and Janine are traveling around beautiful India. Others are back home in the States, and still others have remained on the continent of Africa, but are in locations different from Western Kenya.

Last week’s post by Jamie was a great explanation as to what exactly the household survey we just conducted was all about. It will be completed with all the data entered by early next week. David will be analyzing the data in early January, and we’ll all discuss it after he returns from his break around the 20^th of January.

At that time we (by “we” I mean Jamie, David, myself and perhaps a few other folks if we can get them into the conversation like program managers and Jennifer) will also discuss all the other programs and their metrics. Here is a quick update:

• Education is using the Uwezo tool to measure literacy for students. We are working on a study design for this program. We need to know when and how frequently to test literacy rates. We also need to discuss how to assess Education’s other metrics
• Agriculture has gathered a lot of data for all of the enrolled farmers in the Master Ag Doc. We will spend time in January cleaning that data and getting it analysis-ready. We will then determine what else we need to gather and how. Maybe a phone survey of Nuru members
• CED is much like Ag. A lot of good data has been gathered in their Master file. The next step is to assess that data and see what else needs to be gathered. Again, perhaps a phone survey of Nuru members
• As you know, Healthcare and WatSan data has been gathered in the HH survey. We’ll analyze it in January
• Leadership is our most in-flux program, which is not surprising as it’s the newest. Chelsea and Jamie are working together to nail down the program’s categories for its logic model. Metrics likely to come in January

So. I’m going to Kenya in January. Did I mention that? Well, I am. I’ll be there for a week in the 2^nd half of the month. I’ll work directly with David and I hope also Jennifer, and even Troy who will also be there. It will be a great week. We’ll nail down a lot of the above Program Metric issues.

Also, tomorrow the Strategic Leadership Team (SLT) is voting on the Ethiopia expansion decision. It’s a big deal! We’ll be just putting our 2-cents in as to whether it is something we think we should pursue next year. More on that, of course, to come.

Happy holidays!

Posted from Cincinnati, Ohio, United States.

The purpose of the Nuru Household (HH) survey is to collect data to evaluate the effectiveness of the interventions conducted by Nuru International’s programs. The survey primarily addresses Nuru’s Healthcare and Water & Sanitation programs. Due to the holistic nature of Nuru’s model, the survey also aims to assess a few outcomes that result from the overlap of the Agriculture, Community Economic Development (CED) and Education programs (Figure 1).

Figure 1

Nuru monitors and evaluates each program area – Agriculture, CED, Education, Healthcare, Leadership and Water & Sanitation. The monitoring system collects data about operational activities, such as the number of staff members visiting households or the number of health behaviors taught. The evaluation system collects outcome data that results from each activity. Outcomes include changes in behavior and attitude, such as the number of people reporting to have slept under bed nets or those with an improved ventilated pit latrine.  Baseline data that is collected, like in the current survey, will not yet assess change in behavior or attitude, but rather the current situation of the community before programs are implemented.

Healthcare
From 2008-2010, the Nuru Healthcare program trained Representatives who were members of Nuru farmer groups. The Representatives were the first cadre of health trainers that the program attempted to train to disseminate disease prevention information. From the Representatives and from other individuals in the community, approximately 44 Community Health Workers (CHWs) were trained and supervised by Nuru Field Officers (FOs) and Field Managers (FMs). From 2010-2011, the Nuru Healthcare program worked with CHWs, who taught key health behaviors household-to-household in the sublocations of Nyametaburo and Nyangiti in Kuria West district. Nuru assisted in organizing and conducting trainings for the CHWs – providing skills training, supervision, and performance assessment for the home visit tasks. The Healthcare team will scale to the Ihore sublocation in May 2012, and Moheto and Ngochoni sublocations all in Kuria West district in June 2012. The HH Survey is currently being performed in the new sublocations to collect baseline data before the HC program initiates interventions.

The goal of the Nuru Healthcare program is to reduce the mortality rate of children under 5 years old in a sustainable and scalable way. The Healthcare team aims to communicate clear and correct messaging about disease prevention, teaching 6 key health topics which include:

• Safe motherhood
• Diarrhea
• Immunization and Newborn Care
• Pneumonia
• Malaria
• Nutrition

The Healthcare team teaches 8 key health behaviors within the topics, including:

• Fully immunize children under 1
• Sleep under insecticide-treated mosquito nets – especially pregnant women and children under 5
• Drink clean water
• Wash hands with soap
• Breastfeed newborns immediately and exclusively for 6 months
• Provide adequate supplementary feeding and vitamin A supplements for children under five
• Attend four antenatal care visits/safe delivery
• Treat danger signs quickly

Thus, the HH survey will also help to gauge which stage of behavior change community members are in, if at all, based on Nuru’s Healthcare program intervention. The HH Survey asks questions to determine if individuals know how to prevent certain diseases, if they know what causes diseases, and if they are making the changes to prevent diseases from occurring in the first place.

Below are the outcome indicators or program metrics the HH Survey will measure for the Healthcare program:

• % of deliveries occurring in a health facility

• % of infants less than 12 months of age who were put to the breast within one hour of delivery
• % of infants under 6 months old (ages 0-5 months) who were exclusively breastfed in the last 24 hours
• % of mothers appropriately feeding their children aged 6-59 months
• % of children aged 6-59 months who received a high dose of vitamin A in the last six months

*Indicator generation based on research from existing organizations/methodology, including USAID KPC Surveys, Measure DHS USAID, MICS, MEASURE Evaluation

Water & Sanitation
The goal of the Water & Sanitation program is to reduce water-born diarrheal diseases in rural communities. This is carried out through H₂0 training, which consists of how to use clean water (purifying), hand washing, and using latrines.

Below are the outcome indicators or program metrics the HH Survey will measure for the Water & Sanitation program:

1. % of households reporting use of latrine in the past 24 hours
2. % of households practicing good* handwashing behaviors (*soap + washing at critical times)
3. % of open defecation
4. % of latrine coverage
5. % of handwashing station coverage

Overlap of Programs
Additional questions related to agriculture were added to triangulate community-wide data for yield compared to Nuru yield for maize. Through the Community Economic Development (CED program, Nuru members can possibly access loans for paying for a plough, a plough cow or school fees. The following indicators are included in the HH survey due to their ability to cross-cut programs, supporting Nuru’s holistic model. They are not yet program metrics, but will help us begin to better understand the interplay between programs.

Agriculture-related metrics

• % of land households have for agriculture (crops, grass, trees, etc.) among those surveyed
• % of land households have for maize among those surveyed
• Average number of 90 kg bags of maize harvested last long-rainy season of households surveyed

Agriculture + CED metrics

• % of households surveyed owning a plough
• % of households surveyed owning a plough cow

CED + Education metric

• % of households surveyed able to pay school fees

Education-related metric

• % of households surveyed with out-of-school children

Logistics
To implement the survey, the M&E staff trained 6 teams with 2 enumerators each (12 total enumerators) to carry out day-to-day survey operations. One M&E Field Manager (FM) supervised 2 teams each, for a total of 3 survey groups. Each survey group carried out the survey in separate villages. The survey took approximately 40-50 minutes to complete. Each team aimed to complete 5 surveys per day, or 30 per day combined. A team of 3 data entry staff was also trained to Check, Score and Code surveys similar to the MPAT.

Posted from Santa Barbara, California, United States.