Multi-Product Campaign Process Evaluation - PowerPoint Presentation

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Multi-Product Campaign Process Evaluation Burkina Faso, 2019 (Summary)

Valence Nimbona and Kathryn Malhotra

Campaign context

Nouna

Tougan

Banfora

Gaoua

Standard LLINs

PBO ITNs

G2 ITNs

Orodara

Pilot study

d

istricts

The 2019 campaign in Burkina Faso was the first to deliver IG2 nets. PBO nets and

s

tandard

nets were also distributed.

The campaign was led by the National Malaria Control Programme (NMCP) and financed by the Global Fund, the US President’s Malaria Initiative (PMI) and other partners.

Net Type

Quantity distributed

Dates distributed

Standards-

OlysetNet

9,341

,339

29 June—3 July 2019

PBO-Permanet3.0

1,299

,245

29 June—3 July 2019

Interceptor

G2 (IG2)

1,533,618

29 Oct—2 Nov 2019

TOTAL

12,174,202

Process evaluation

Deployment of three types of ITNs required special attention during planning and implementation to ensure that the right ITNs were distributed in the right areas, that all ITNs were accounted for, and that people were mobilized to collect and use their ITNs.

A process evaluation was conducted from 24 October to 9 November 2019. Tools were developed by AMP and data collection was conducted through three methods:

Document review:

validated documents, training guides, previous campaign distribution reports and meeting reports

Interviews:

campaign partners, the NMCP, regional and district health staff, supervision teams, distribution teams and households

Field visits:

observations and interviews were conducted in the Boucle du Mouhoun region

(Dédougou health district)

and the South-West region

(Gaoua health district and Diébougou health district

)

Interview with distribution team

at Tioyo Rural Health Center

Campaign best practices

Strong coordination:

The NMCP ensured that a

Comité Ministériel d’Organisation

(CMO) with technical subcommittees, including community level stakeholders, was established.

Early development of

macroplans

:

The NMCP mobilized early support of partners to develop the campaign plan of action, logistics plan, timeline and budget for the campaign.

Careful consideration of potential challenges:

A risk assessment and mitigation plan was part of the macroplanning package that was developed under the leadership of the CMO.

Early engagement of national security forces:

The NMCP, based on lessons learned from previous campaigns and anticipating an increasingly complex security situation, engaged national security forces early.

Decision-making around communicating about different ITN types

: The NMCP made the decision to communicate about the different types of nets being distributed to all levels, including households.

Development of a rumour management plan:

Strategies were developed for identifying and responding to potential rumours, mis- and disinformation associated with the different ITN types.

Early anticipation of potential supply chain challenges:

The NMCP procured each type of ITN with a different colour of bale packaging for easy differentiation during transport and storage.

BF NMCP team and manager, Mali NMCP delegation and AMP consultants

Campaign challenges

The campaign experienced several challenges largely unrelated to the multi-product nature of the campaign:

Insufficient resources for micro-planning:

Lack of resources led to insufficient planning and budget for detailed training at the national level and delayed implementation of microplanning workshops.

Late ITN arrival:

The late arrival of IG2s in Burkina Faso caused the shift from

a single, national campaign

to a national campaign in two phases to ensure that ITNs already available in the country were in households prior to the high transmission season.

Voucher control:

A stock-out of vouchers occurred before the end of the registration process, due to some weaknesses in the management of vouchers during the household registration process.

Population movement and special populations:

Many displaced households did not travel with or lost their vouchers during insecurity, making it difficult for them to obtain their ITNs during the distribution.

ITN gap:

A 2.6 million ITN gap was identified following the household registration that needed to be addressed with the ITNs available for the campaign.

SBC plan and budget:

Insufficient resources were allocated to SBC activities which resulted in a lack of materials and tools at the different levels and planned post-distribution SBC activities having to be curtailed.

Distribution data:

The strike movement of health workers did not allow distribution data to be collected during or after ITN distribution.

Payment of campaign actors:

Significant delays were incurred in payments to volunteers through mobile money services.

The inaccurate household count caused a gap of 2,641,624 ITNs. This gap posed a challenge in proper ITN allocation.

PBO Permanet 3.0 demonstration at launching day of the campaign in Bobo Dioulasso, 28 June 2019

Lessons learned and recommendations

Lesson

Recommendation

COORDINATION

Strong coordination mechanisms must be established and functional at all levels, including representation of all key stakeholders, at least nine months before distribution.

PBO-Permanet3.0

Potential delays in the timeline for implementation of activities should be considered when developing the risk assessment and mitigation plan. It is important to build contingency plans for the coordination structures at all levels.

MICROPLANNING

Microplanning should be included in the campaign plan of action, and budgeted for accordingly.

TOTAL

These critical steps should not be omitted from the microplanning process:

Development of microplanning tools

Training of facilitators at central level (recommended for five days)

Microplanning workshops (recommended for five days) at district level with participants familiar with the operational context (e.g. from the health facility or community)

Cleaning of microplans at central level

Validation of microplans with districts, provinces and regions

Lessons learned and recommendations cont.

Lesson

Recommendation

LOGISTICS

Pipeline monitoring is critical and any shifts in ITN delivery timelines must be communicated promptly to stakeholders at all levels.

The risk assessment and mitigation plan should include possible late ITN delivery and a contingency plan (and associated budget) for managing delays in campaign implementation.

Costs for waste management and reverse logistics must be included as part of the campaign budget. The process for waste management and reverse logistics should be detailed in the

macroplans

to eliminate any ambiguities when costing the activities, as well as during implementation.

Strong microplanning is needed to minimize the need for lateral ITN movement and identify and plan for ITN distribution in hard-to-reach areas and for displaced populations.

SOCIAL AND BEHAVIOUR CHANGE

Ensure that the plan and budget for SBC are developed early and consider the extra time and resources required for a multi-product campaign.

The SBC plan and budget should include:

All tools and materials required to support the communication strategy

SBC microplanning to ensure sufficient quantities of materials are available for each district

A

rumour

management plan, including a high-level costing in case of need

A robust post-distribution SBC strategy and accompanying activities

Lessons learned and recommendations cont.

Lesson

Recommendation

TRAINING

It is critical to ensure that detailed planning for training is done at the macroplanning stage and that adequate resources are allocated to the various trainings, including:

Sufficient days and time for each training session and module within the session as per the agendas developed

Sufficient resources, tools and materials for facilitators and participants to ensure practical exercises are implemented in support of high-quality implementation

Sufficient time to ensure that procedures and policies for procurement of venues, catering and requirements are followed

HOUSEHOLD REGISTRATION, ITN DISTRIBUTION, AND RETROACTIVE CAPPING

Retroactive capping, based on actual household registration figures rather than macro or micro level assumptions, ensures that the number of ITNs being distributed to households:

Is more representative of the actual ITN needs at the household level

Does not unduly penalize large households, which are numerous across Burkina Faso

Is aligned with the ITNs available to limit the number of ITNs remaining for reverse logistics at the end of the campaign

Lessons learned and recommendations cont.

Lesson

Recommendation

SUPERVISION AND MONITORING

Ensure that implementation of activities is properly supervised and monitored, allowing for early identification and resolution of challenges. It is critical to ensure that a strong supervision and monitoring structure is planned and budgeted for at the macroplanning stage to allow for effective implementation.

CAMPAIGN PAYMENTS

Mobile money systems should be tested to ensure that they are functional in advance of the major periods of payment to community-level personnel. Campaign payments should be included in the risk assessment and mitigation plan.

Interview with household representative, Karo area, Diebougou District

Conclusion

Key takeaways during the 2019 Burkina Faso ITN multi-product mass campaign are primarily related to SBC, including the need for early consensus and decision-making about when, how and to whom communication about different net types will be transmitted, as well as logistics, particularly the need for facilitating effective supply chain management through easy differentiation of bales of different ITN types.

Many of the identified strengths, challenges and lessons learned from the 2019 ITN campaign in Burkina Faso are similar to those identified during campaigns distributing a single ITN product. This indicates that improving the efficiency and effectiveness of multi-product campaigns will involve addressing systemic campaign challenges unrelated to the choice or number of ITN types.

Tioyo Health Centre, Diebougou Health District, South West Region, IG2 demonstration at a distribution point

Thank You