Data for Action

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Data for Action

• CCFs Experience for informed of using AIMES data
  program decisions

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CCF Zambia program locations
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Christian Childrens Fund Inc.

• A non-profit International NGO working to promote
  childrens well being with a community based
  approach
• Program in 30 countries in the developing world
• Project Management by Parents Associations or
  local NGOs with strong parents participation
• Funding sources sponsorship, grants and other
  contributions

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Annual Impact Monitoring and Evaluation System
(AIMES)

• In place at more than 1000 projects in 21
  countries for the past five years
• Facilitates continuous monitoring of coverage,
  consistency and effectiveness of CCF
  interventions
• Facilitates parents and the community
  participation in this process
• Facilitates measuring impact
• Facilitates prioritization

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AIMES Concept, Evolution and Design

• AIMES is rooted in the concept of human
  development
• It was evolved in response to the need for for a
  system that can help manage effective program
  development by projects and communities at the
  grassroots
• A Working Group consisting of field practitioners
  and assisted by a consultant selected indicators
  and designed the system
• AIMES draws heavily on the 1990 Childrens World
  Summit Goals (which now form part of the
  Millenium Development Goals)
• AIMES uses the following human development
  indicators to measure childrens well being
• Infant and under-5 Mortality Rates
• Moderate to Severe Malnutrition among children
  birth to five years of age
• Percentage of literate adults (15) in a given
  community

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• AIMES monitors the following Supportive
  Indicators to ensure coverage consistency and
  effectiveness of the program
• TT2 protected live births
• Children fully immunized by one year of age
• Malnourished children becoming normal
• Families with adequate knowledge of managing
  childhood diseases
• Families with access to clean water and safe
  sanitation
• Under-5 children and caregivers with access to
  early childhood care and development programs
• Children age 5 - 15 participating in schools
• Youth (girls and boys) age 15 - 20 attaining
  level of learning and other better life options

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Zambia Major Findings of AIMES 1999 for
communities covered by CCF

• Under-5 Mortality Rate 253/1000
• Immunization coverage gt 50
• Access to clean water 69
• Access to safe sanitation 57
• Number of U5 deaths 314
• U5 deaths due to malaria 111 or 35
• Due to diarrhea 79 or 25
• Vaccine preventable 34 or 11
• Due to ARI 25 or 8
• Due to other causes 65 or 21

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Collective Response Launching of a Comprehensive
program

• In Zambia, AIMES data helped concerned
  communities, project administration and the
  country office recognize the existence of a
  serious situation
• A series of community consultations and Parents
  association meetings were held to discuss the
  problem of high U5MR and underlying causes
• The country office negotiated and obtained
  special grant to address the problem
• They planned and implemented an intensive drive
  to address the factors contributing to the high
  U5MR
• As part of this, awareness program was
  intensified with added emphasis on home
  management of diarrhea, ARI and steps to protect
  children from malaria

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Water and Sanitation

• Enhanced Community participation in managing,
  maintaining and operating water system by
  formation and training of Water and sanitation
  committees
• Education and practical guidance for improved
  practices of sanitation and hygiene at the
  household level
• Drilling of 66 bore - holes, construction of 166
  wells and repairs of 104 wells
• Construction of 360 Ventilated Improved Pit (VIP)
  latrines

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Malaria Control

• Intensive health education program in the
  communities with special emphasis on malaria
  prevention and management
• Home to home spraying of insecticides
• Popularizing the use of insecticide treated
  bed-nets
• Enhanced collaboration with government health
  centers and support in organizing refresher
  training of their health personnel
• Working with the Government to improve laboratory
  facilities for malaria investigation
• Training of Parent Family Educators, Community
  Health Workers and Social Workers
• Distribution of insecticide treated nets to needy
  families

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Immunization

• Enhanced community education on the importance of
  immunization for childrens health
• Vigorous monitoring of children 0 to 1 for
  immunization against all vaccine preventable
  diseases
• Bringing immunization facilities closer to the
  communities
• Improved prenatal and under-five consultations by
  introduction of out reach services

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Tangible Improvements AIMES 2000

• Under-5 Mortality Rate 155/1000
• Immunization coverage 71
• Access to clean water 77
• Access to safe sanitation 64
• Total under-5 deaths reduced to 160
• Under-5 deaths due to malaria 65
• Under-5 deaths due to diarrhea 41
• Vaccine preventable 8
• Due to ARI 17
• Due to other causes 29

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How does AIMES work ?

• Family as a unit of intervention
• Parent/Community volunteers variously known as
  Guide Mothers, Parent Family Educators, etc. are
  trained as home visitors and work under the
  guidance of skilled and trained staff
• They visit each family enrolled in the program at
  regular interval, pass on health messages, extend
  guidance and support and collect information and
  data. They also monitor and report vital events
  such as pregnancies, child births, deaths etc.
• They use family card (a basic tool in AIMES
  tool box) to collect baseline data and record
  progress, major events and problems as they occur
  using every contact with the family.
• Growth Monitoring sessions are organized at
  community locations at regular intervals. These
  sessions provide excellent opportunities for
  parents and caregivers, guide mothers, health
  professionals and health workers to interact with
  each others on appropriate feeding and child care
  practices.

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How does community get involved in data based
decision making ?

• Information and data are compiled into a snapshot
  called Standard Indicator Tool for Evaluation
  or SITE as often as necessary but at least once
  every year treating December 31 as the cut off
  date.
• Major findings based on the SITE are displayed
  prominently at the project office and other
  centers of activities which the enrolled families
  and members of the community frequently visit.
• These findings are used extensively during the
  parents committee meetings and during periodical
  consultations with the community.
• Red Flags or areas needing priority attention
  are identified collectively by parents, the
  community and the project administration during
  these meetings and recorded in a tool used for
  focus (TUFF) for wider consultations involving
  the CCF country office.
• Program decisions are made based on this process
  and taking into consideration other feedback from
  all stakeholders.

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Pivotal Role for Community Volunteers
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Challenges in making AIMES work

• Ensuring lively and purposeful contact with
  families and the community on a regular basis, so
  critical for
• passing on health messages and extending needed
  support to the caregivers
• Tracking and monitoring vital events
• Collecting information and data
• Identifying and training parents and other
  community volunteers who are knowledgeable about
  the community
• Ensuring quality and reliability of data. This
  presupposes continuous training and effective
  supervision by skilled staff
• Ensuring use of data for informed decision
  making. This presupposes
• Good level of conceptual clarity about AIMES
• Interpreting data to parents and the community
• Moving from priorities based on perceived donor
  expectations to priorities set in response to
  data

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Placing AIMES in CCF Global Network

• After the system was designed, a trial run was
  given by 10 Lead Projects in different program
  countries to test the workability of the system
• Tools were adjusted and refined based on this
  exercise
• A series of trainers training and cascade
  training was conducted to cover project staff and
  parents in nearly 800 projects in 20 program
  countries
• 1996 Initial implementation by 382 projects in
  16 program countries, increasing gradually to the
  current level
• 1999 a fresh Working Group with six field
  representatives debated the quality and
  usefulness of AIMES data for informed decision
  making
• Held extensive discussion with practitioners at
  the community, project and Country Program levels
  in nine countries and made useful observations
  and recommendations
• With more than five years in practice, AIMES
  continues to evolve and expand

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Additional Areas for AIMES monitoring

• Measuring Parents and Community Participation in
  program planning and management
• Organizational framework and administrative
  processes conducive to informed decision making
• Leadership and human resource development
  supportive to informed decision making

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Paradigm Shift

• With the introduction of AIMES, there has been a
  paradigm shift in CCF approach for promoting
  childrens well being
• Focus on all children, families and community and
  not just enrolled children
• Added emphasis on addressing critical needs of
  pregnant women and nursing mothers
• Emphasis on home based and center based early
  childhood care and development programs for
  children birth to school entry and their
  caregivers
• Addressing root causes rather than symptoms of
  problems and issues affecting childrens well
  being
• Increased parental and community participation
• Constructive role of parent and community
  volunteers
• Planning and program development based on data
  and feedback from all stakeholders