In my last blog for Markets for Good I wrote about the importance of data to Riders for Health and our programmes. In seven countries across Africa our technicians are managing and maintaining vehicles so health workers can reach people with reliable health care in even the most remote places. The blog had some great feedback, but one point stood out in particular. We received a comment asking for even more practical examples of what we we’re actually doing, and how it impacts our work.
As such, we have been throwing around ideas for how Riders and Markets for Good can create a series of blogs focusing on all aspects of collecting data, how we monitor and evaluate it, and what impact it has on our programmes. We thought the best way to do this would be a real data dive into one of our programmes. Today, we proudly present the introductory blog to just that – a feature on a brand new pilot programme we are launching as you read this.
The whole team at Riders is excited to share what we doing over a long period and seeing how the information we gather changes over time. But I also hope that this will become a conversation – it would be great to hear your thoughts, experiences, and the challenges that you have overcome. Of course, if there is something specific you would like us to cover or expand on, please suggest it below.
We will follow a new Riders for Health programmes to improve coverage of child immunisation in rural areas of Lesotho, in partnership with the Ministry of Health and UNICEF. Over the coming year we will follow the project from its initial stages, through its launch and into its implementation stage.
Operational data has always been at the heart of Riders for Health’s work. Our programmes are designed so that a) they are clearly costed and b) no vehicle ever breaks down. As such, we have always collected vehicle data. It is impossible to run vehicles properly if you don’t know exactly how far each vehicle has travelled, when parts need replacing and how much fuel has been used.
But increasingly we have had the opportunity to measure the impact of our programmes on health systems. The increasing demand for clear data on a programme’s impact, and a willingness to fund monitoring and evaluation means that we are able to carry out more detailed and sophisticated monitoring. Most importantly, it means that as well as funders and partners understanding the impact of projects, it means we are able to learn and adapt our programmes in response to that data.
As Riders’ experience in monitoring and evaluating projects has developed, we are increasingly able to build data collection and analysis into projects from the outset, rather than having to retro-fit it afterwards. It means we have stronger data, can make more reliable conclusions about change, and can be more confident in what we learn.
What we are measuring
We will measure how far health workers can travel, whether they can do more, how many immunizations they are giving and where they face any new problems. To do this we are designing a log sheet that health workers will fill out at the end of each day. They will give these to the technicians when they visit them to carry out the monthly service on their bike.
Each month our M&E officer in Lesotho, Charmaine, will compile the data and report back to our partners so we can track performance and make adjustments if needed. And, after six months we will do a far more in-depth study of the programme.
In this series of blogs I plan to cover the ways we are measuring whether immunization coverage is increasing, and whether health care workers are able to do more because of the motorcycles they have. But I also want to cover how the operational and impact data can work together to build up a picture of the programme, and what we can learn from that. It will also be important to look at the challenges we face collecting and analysing data and how this causes difficulties for our monitoring and evaluation.
Reducing child mortality by strengthening under-five immunisation outreaches in Lesotho
Lesotho is off track to meet its target for Millennium Development Goal 4. Childhood deaths actually rose between 2004 and 2009, from 90 per 1000 to 177 per 1000. Immunization is one of the most effective and most cost efficient ways of improving child health but the lack of working transport and challenging geography means Lesotho is struggling to achieve good immunisations coverage.
This new project is a pilot that will run for three years. Riders will mobilise 10 health workers with new motorcycles, across two of the county’s 10 districts. We will also introduce two four-wheel drive vehicles. In July, we trained health workers to ride safely and do the daily maintenance on their bikes that will keep them working smoothly. Every month our technicians will travel out and carry out a regular service on each bike.
In the first two years, the project will be funded with support from the Jersey Overseas Aid Commission. In the third year, the Ministry of Health are committed to taking on 25% of the running costs, with the eventual goal of it being fully funded by them.
Through this project, the Ministry of Health intends to revive its Expanded Immunisation Programme (EPI) by rebranding the ‘pepa ngoana’ scheme of the 1990s. ‘Pepa ngoana’ literally means carrying a child on the back. This is usually done by mothers in Lesotho when they are walking with their children, and it was the logo used for Lesotho’s immunisation programme in the 1990s – one of the best performing in Africa. The new programme will revive the ‘pepa ngoana’ logo but will now also include a man, to show that health care is the responsibility of the whole family.
After this introductory post, we will share with you how we carried out the baseline study before the programme began, what we have learnt from it and then how we have designed data collection mechanisms. As the series continues, we will also examine the data being generated from the programme, followed by the patterns and learnings from this data collection, before we finish the series with our own conclusions from the programme.
I’m really looking forward to sharing the progress with Markets for Good, and please share any suggestions you have for future articles in the comments section below.
Thank you so much Matt, and the team at Riders For Health for their enthusiasm and willingness to share both the data and their experiences of this new pilot. Stay tuned for future updates, we look forward to the next instalment from Riders.