Ithar Hassaballa 1 Charles Sepers 1 Stephen Fawcett 1 Davison Munodawafa 2 Peter Phori 2 Ephraim Chiriseri 2 Florence DiGennaro Reed 1 and Jerry Schultz 1 1 Department ID: 814769
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Slide1
Testing a Monitoring and Evaluation System to Capture and Communicate the Ebola Response Effort in Selected Areas in Liberia
Ithar
Hassaballa
1
Charles Sepers
1
, Stephen Fawcett
1
, Davison Munodawafa
2
, Peter Phori
2
, Ephraim Chiriseri
2
, Florence
DiGennaro
Reed
1
, and Jerry Schultz
1
1. Department
of Applied Behavior Science
2. World Health Organization African Regional Office
Slide2No conflict of interest.
Presenter Disclosure
Slide3WHO Collaborating Centre at KU (KU CC)
Capturing and Communicating the
Ebola Response EffortBackground
Methods
Context & PartnersEbola Response EffortMonitoring & Evaluation ApproachResultsSensemakingDiscussionLessons LearnedRecommendations for Practice Conclusion
Presentation Map
Slide4Designated as a WHO Collaborating Centre in 2004
Provides:
Support for building capacity through the Community Tool BoxTraining & technical assistance on M&EGuidance to WHO
Regional Offices
KU Work Group for Community Health & Development
Slide5WHO Tasked with: Monitoring & Evaluating the Ebola Response Effort
KU CC
Monitoring & Evaluation Capabilities
Responding to the Needs of
WHO Regional Office for Africa
Slide6Ebola Outbreak
Longest and largest in history of disease
Enormous health, social, and economic consequencesIntense Transmission
Delayed identification of the disease
Denial, Fear, & PanicFalse rumorsLimited understanding of the diseaseLittle to no capacity for diagnosis and treatment Community Health Volunteers provided home-based care Background
–
Ebola
Outbreak in West Africa
Slide7Participating Communities
Collaborating Partners:
KU
CC
, WHO AFROIntersectoral Action to address the Ebola outbreak Local, national, regional, and international organizationsMethods– Context & Partners
Slide8Focused on Changing the Conditions:
Reduce
exposures Chlorinated water buckets for sanitation
Safe burials
Address vulnerabilities/capabilities Education about EbolaTraining on protective behaviorsCommunity engagement effortsReduce differential consequences
P
rovide access to Ebola
diagnosis and
treatment
Engage Ebola survivors
Methods– Ebola Response Effort
Slide9Situation Assessment
Community Organization & Mobilization
Preparing the Workforce– Training & Capacity BuildingHealth Information Communication Delivery of Essential Services & Supports
Environmental Changes
Policy Changes Health System & Community Transformation Methods– Ebola Response EffortIntervention Components
Slide10KU CC Designed M&E System
Liberia-based evaluation consultant
Trained using an Evaluation Codebook KU CC team member provided feedback on monthly reports (secondary observer)Accurate characterization of activities or interobserver
agreement was at 92%
WHO Analysis Computing incidence of Ebola Combining instances of confirmed, suspected, and probable casesMethods– Measurement– Capture
Slide11Methods– Monitoring & Evaluation
Approach
Dissemination Efforts
Slide12Monitoring
& Evaluation
System
Slide13Slide14Slide15Results– Communicate
Slide16Slide17D
ecline
in incidence of Ebola
R
eported zero cases continuously for a period 42 days.World Health Organization Declared Liberia Ebola Free on 09 May, 2015 Declared Liberia Ebola Free
(for
the second
time)
on 03 September, 2015
Results Continued
Slide18Community
engagement
critical in bringing about community/system changes
I
ntervention required sustained and coordinated intersectoral action WHO’s convening power
Using
an
an
M&E
system
was important in capturing key activities
Discussion–
Lessons Learned
Slide19Strengthen
the local health
system
Build
capacity and sustain leadership through training & technical support Establish an Africa-based forum—not one outside the
continent
Address
social determinants that are the root causes of outbreaks
R
educe
differential exposures (e.g., poor housing,
sanitation)
A
ddress
vulnerabilities/capabilities (e.g., through primary education for
girls)
R
educe
differential consequences (e.g., provide universal access to diagnosis and treatment
)
Discussion–
Recommendations for Practice
Slide20Current Work
Slide21“
You get what you inspect,
not what you expect.”Bill Foege
,
House on Fire: The Fight to Eradicate Smallpox (2011)
Slide22Community Health and Well Being
Slide23“If you want to go quickly, go alone.
If
you want to go far, go together.” ~African proverb
Slide24United Nations Development
Programme
. Recovering from the Ebola crisis: A summary report of the United Nations, The World Bank, European Union and African Development Bank as a contribution to the formulation of National Ebola Recovery Strategies in Guinea, Liberia and Sierra Leone, 2015. [Internet]. 2015 Mar 12. Available from: http://www.undp.org/content/dam/undp/library/crisis%20prevention/Recovering%20from%20the%20Ebola%20Crisis-Full-Report-Final_Eng-web-version.pdf
.
Mullan Z. The cost of Ebola. Lancet Glob Health [Internet]. 2015 July 9; available from http://dx.doi.org/10.1016/S2214-109X(15)00092-3.United Nations. Making a difference: The Global Ebola Response: Outlook 2015. 2015 Jan [Internet]. Available from: https://ebolaresponse.un.org/sites/default/files/ebolaoutlook.pdf. WHO. Ebola response roadmap. 2014 Aug 28 [Internet]. Available from: http://apps.who.int/iris/bitstream/10665/131596/1/EbolaResponseRoadmap.pdf?ua=1
.
Feldmann
, H., and
Geisbert
, T.W. Ebola
haemorrhagic
fever. The Lancet 377.9768 (2011): 849-862.
Fawcett S, Collie-Akers V, Schultz J, Cupertino P. Community-based participatory research within the Latino Health for All Coalition.
J
Prev
Interv
Community.
2013; 41.3:142-154.
Fawcett SB, Sepers CE, Jones J, Jones L,
McKain
W. Participatory evaluation of a community mobilization effort to enroll residents of Wyandotte County, Kansas residents through the Affordable Care Act. Am J Public Health. 2015; 105 (S3):S433-437.
Fawcett SB, Schultz J. Community-based participatory research for health: From process to outcomes.
NewYork
:
Jossey
-Bass. 2008. Appendix 1, Using the Community Tool Box's Online Documentation System to support participatory evaluation of community health initiatives; p. 419-430.
WHO. Ebola situation report. 2015 Jan 28. [Internet] Available from:
http://apps.who.int/ebola/en/ebola-situation-report/situation-reports/ebola-situation-report-28-january-2015
.
Dhillon
R, Yates R. Building back better: priorities for Ebola-affected countries. Lancet Glob Health [Internet]. 2015 July 9; Available from:
http://
dx.doi.org/10.1016/S2214-109X(15)00032-7
Liberia Map.
https
://www.google.com/search?q=lofa+and+margibi+maps&biw=1920&bih=1065&source=lnms&tbm=isch&sa=X&ved=0CAgQ_AUoA2oVChMI0oGbirf-xwIViwuSCh3K5A2D#tbm=isch&q=liberia+map+with+counties&imgrc=-
E4PuKMPTWcYnM%3A
References
Slide25Thank you!
Ithar Hassaballa
ithar
@ku.edu