Mission Report Chad. Name of consultant: Eliana Gutiérrez- Amo - PDF

Missin Reprt Chad Name f cnsultant: Eliana GutiérrezAm Missin dates: August 14 th t 24 th, 2012 Lcatin (s): N Djamena, Chad Date f reprt: August 24 th, 2012 Subject f reprt: Missin reprt 1. Objectives

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Missin Reprt Chad Name f cnsultant: Eliana GutiérrezAm Missin dates: August 14 th t 24 th, 2012 Lcatin (s): N Djamena, Chad Date f reprt: August 24 th, 2012 Subject f reprt: Missin reprt 1. Objectives f the missin (frm scpe f wrk) Review all relevant cmmunicatin plans and past cmmunicatin wrk prvided by Malaria N Mre (MNM) t understand current landscape f malaria cntrl cmmunicatins Review MNM s Knwledge, Attitudes and Practices (KAP) baseline survey reprt t understand malaria landscape in Chad and t use the results t help facilitate a cmmunicatins wrkshp that will lead t an updated natinal cmmunicatins plan Review and identify key issues t address in the Chad Cmmunicatins Plan fr the 2011 Mass Lng lasting insecticide treated nets (LLIN) distributin and gather lessns learned t date and recmmendatins fr a cmmunicatins plan that will prvide a radmap fr the next several years; Review any cmmunicatins cntent and creative t date and prvide feedback t the verall technical quality f the materials; Understand hw existing data as well as KAP study culd enhance/infrm the Cmmunicatins Plan elements; Crdinate and facilitate a cmmunicatins wrkshp amng key stakehlders the week f August 20 th with the gal f: Educating all partners n the imprtance f malaria cntrl cmmunicatins Walk thrugh the KAP survey t build the case fr evidence based cmmunicatin wrk Identify the mst salient messages fr malaria cntrl Identify the target ppulatin fr the messages Invlve nntraditinal crprate, media, and entertainment partners int the cmmunicatins planning prcess t ensure maximum impact and leverage new resurces Wrk t develp a priritized list f key cmmunicatin activities ver the next 12 t 24 mnths Develp a highlevel implementatin plan harmnizing the PNLP and health partner activities Refine the current cmmunicatins plans circulating amng the health partners and PNLP; incrprate the feedback and the KAP results as well as the input cllected during 1 the cmmunicatins wrkshp; ensure prcess fr harmnizing wrk acrss partners and the PNLP 1. Missin rll ut and main accmplishments I reviewed the dcuments available regarding the cuntry s cmmunicatins activities. They are dated 2010 and have nt been updated. This made it difficult t understand the current state f implementatin f the varius planned cmmunicatins activities. The Cmmunicatin Strategy culd be imprved by: Including a mre indepth status reprt n the indicatrs at the beginning f the prject Shwing the evidence supprting the decisins made. This culd include the targets chsen fr 2013 r the behaviurs that need prmting Including a clear lg frame Making sure that the Cmmunicatin indicatrs are ttally in line with the Natinal Malaria Strategy The Strategic Plan culd be imprved by: Linking the plan t cncrete evidence Clarifying rles and respnsibilities The plan prpses t fcus n t many messages and there is n explanatin n hw these messages were selected Including in the budget funds fr testing cmmunicatin materials Fllwing these dcuments, ther mre in depth plans shuld have been develped t shw exactly what was ging t be dne fr example in terms f advcacy r at cmmunity level. I wrked clsely with MNM Research Manager t analyse the KAP baseline study and present it in a way t facilitate decisin making regarding the develpment f messages and the planning f cmmunicatins activities. The utcme f this wrk was presented and used during the cmmunicatins wrkshp. Once in cuntry, I attended a 2 day wrkshp rganised by the PNLP aimed at defining the prgramme funding gaps fr cmmdities as well as fr M&E, cmmunicatins and prgramme management. This was dne using a Rll Back Malaria template. All main partners attended the wrkshp. The wrkshp ended n Wednesday 16 th hwever it did nt manage t achieve its gals due t lack f time and insufficient data t infrm decisin making. The PNLP is due t rganise a fllwup meeting. I met with UNICEF t better understand the rganisatin s rle in the malaria cmmunicatins activities. The meeting was with Dr. Mehund Fatn, Chief Health & Nutritin and Dr. Djimasde Mbairebe, Maternal, Child Health and Malaria Specialist. It then became clear that althugh the Cmmunicatin Strategy identifies UNICEF as a sub 2 recipient f the current Glbal Fund Rund 7 PALAT prject this is nt crrect. The rganizatin is nt a subrecipient and has nly received limited funds t supprt the PNLP with the develpment f the Cmmunicatins Strategy and the Implementatin Plan dcuments. UNICEF als used sme ExxnMbil Fundatin funds t supprt the gvernment during the LLIN distributin activities in On August 21 st and 22 nd the Cmmunicatin Message Strategy tk place at MNM s ffice. The gals f this wrkshp were: I. t share the recently published KAP study results II. t learn hw t use the results f this survey t make strategic decisins abut malaria messaging (i.e. wh is the key target audience, what benefits shuld the cmmunicatin fcus n...) III. t share infrmatin and help with the harmnizatin f relevant activities run by the different partners IV. t agree n next steps In ttal 9 peple attended the wrkshp including representatives f PNLP, MSF (France), JHPIEGO, HCNC and MNM. UNICEF and UNDP representatives als attended but nly fr a few hurs n ne f the tw days. During the 1 st day f the wrkshp we fcused n using the KAP baseline data t make decisins regarding wh shuld be the primary and secndary targets f ur cmmunicatins activities. These were: ACTs/RDT: 1 st Health wrker and 2 nd mthers f children under 5. LLINs: pregnant wmen and mthers f children under 5 ITP: 1 st pregnant wmen and 2 nd health wrkers Fr each target a basic archetype was develped with the infrmatin available. An analysis f the targets perceived barriers, advantages and benefits f ding the desired behaviurs was als dne. All the wrk was prepared in small grups and then presented t everyne fr feedback and input. (See annex a) During the 2 nd day, based n the wrk dne during the previus day, prpsals were made regarding the different media channels t be used fr each target taking int cnsideratin the desired behaviurs that had been defined the previus day. (See annex a) The wrkshp ended with sharing and discussing infrmatin abut the varius activities planned by the PNLP and its partners fr the rest f the year. This exercise led t the decisin t priritise the rganisatin f a fllwup wrkshp t the ne that had been rganised by the PNLP the previus week t identify financial gaps. The PNLP als agreed t start rganising a regular partners meeting every ther mnth. Sadly, due t the PNLP s lack f financial resurces and data it was nt pssible t cme up with a mre extensive list f next steps that culd be agreed upn apart frm what the partners such as MNM and JHPIEGO are already ding. All in all, the wrkshp achieved its gals in that: 3 I. attendees left with a better understanding f the results f the KAP survey II. they learned abut the varius elements that are required t develp a successful cmmunicatin campaign and hw t use the data t make these decisins III. a prductive cnversatin tk place n the next cmmunicatin activities planned by the partners as well as the financing challenges I have als reviewed the brchure the PNLP has develped. (See annex b) Here is a summary f the feedback given: It is unclear what the purpse f the brchure is It is unclear wh the target is fr the brchure. In sme instances the infrmatin is t technical whilst in thers it is nt detailed enugh (e.g. wmen are tld t start taking ITP frm the beginning t the end f pregnancy) The dcument needs its text reviewed and simplified t suit the educatin level f the target There is n mentin f ACTs r RDTs I wuld strngly suggest reviewing the dcument t take int cnsideratin the decisins made during the wrkshp regarding target definitin, benefits, etc... t make sure all infrmatin is in line with what was highlighted as a need in the KAP study. 2. Key challenges and recmmendatins PNLP capacity: The PNLP s current lack f funding due t a discntinuatin in the disbursement f funds frm the PALAT prject is a majr challenge and the reasn why cmmunicatin activities have been relatively limited until this year. Mst f the PNLP planned activities are nt taking place and it is nly thrugh the assistance f MNM (mainly with cmmunicatin activities) and JHPIEGO (with mainly capacity building activities) thrugh Exxn Mbil s funding that certain activities are currently taking place. Recmmendatin: MNM and ther AMP partners t fllwup with PNLP t make sure that the next steps that were agreed during the wrkshp take place. The health partners shuld als make sure that the materials currently being develped by the PNLP stick t the decisins made during the wrkshp. Equally MNM and the ther partners shuld help the PNLP in priritising the many activities that they have planned (e.g. are schls a pririty?). Availability f infrmatin t make infrmed decisins: Infrmatin gathering is a real challenge in Chad. Fr example the availability in cuntry f ACTs, RDT and Fansidar is nt clear. This limits the ability t prperly understand the current cmmdities gap and the implementatin f the cmmunicatin activities as it culd be cunterprductive t develp a campaign driving peple t request prducts that are nt available. Equally, market research data is limited and utdated except fr the recent KAP study published by MNM in This study was invaluable in infrming decisins taken during the wrkshp hwever further research is needed t understand: what is the current availability f cmmdities in the public and private sectr what are the health prfessinals challenges, attitudes, knwledge and practices especially when it cmes t prescribing ACTs and IPT as well as testing fr malaria 4 cnsumers perceived advantages and disadvantages f IPT, ACTs and RDTs as well as the challenges they face t get treated Recmmendatin: The understanding f the current availability at health centre level f cmmdities needs t be priritised. Sme f the qualitative data mentined abve culd be cllected thrugh simple Fcus Grups which culd help fill sme f the gaps. During the wrkshp: as much as the gal f the wrkshp was t learn hw t use the data frm the survey, we fund that peple were nt t familiar with hw t read charts. Equally challenging was the fact that althugh a reprt n the KAP results had been sent t the participants, this was really the first time many f the participants had seen the data. Anther challenge during the wrkshp was the disappinting lack f attendance f WHO and the nly spradic presence f UNICEF and UNDP. Recmmendatins: Organize a meeting with all partners t present the cntent f the KAP survey t include rganisatins that did nt cme t the wrkshp. There will be a pssibility f cmbining this with the results frm the wave 1 survey scheduled in January, Next steps / Future planning After the wrkshp: The challenge will be t make sure that the utcme f the wrkshp is used fr the develpment f new materials as well as t assess and revise the materials that are currently being develped by the PNLP and by the ther partners. Equally, infrmatin such as wh are the main targets shuld infrm the priritisatin f the activities planned fr the future. The summary f the wrkshp decisins shuld be shared with the rganisatins that attended the meeting and the KAP survey reprt shuld be shared again with partners nce mre planning: There seems t be great need t fcus n advcacy and it seems that the PNLP has limited understanding and funding t d it prperly. This is an area where AMP culd prvide technical supprt t develp an advcacy plan which is nt currently available. 4. Cnclusin The PNLP is facing a difficult financial situatin which is having a majr impact n the cmmunicatins activities. There is a need fr partners t step in and fill sme f these gaps hwever it will be imprtant t get a clear picture f the current cmmdity situatin first. With the PNLP s limited capacity it will be imprtant that its partners increase the harmnizatin f their activities by imprving the sharing f infrmatin and crdinatin. The cuntry will als need increased technical supprt t: get a clear picture f the cmmdities currently available and the existing gaps finance and implement their M&E activities (incl. imprving the PNLP s understanding f the target audience) 5 develp a detailed advcacy plan 5. List f Acrnyms ACT: KAP survey: LLINs: M&E: MNM: PALAT: PNLP: RDTs: UNICEF: UNDP: WHO: Artemisinin Cmbinatin Therapy Knwledge, attitudes and practices survey Lng lasting insecticide treated nets Mnitring and Evaluatin Malaria N Mre Prject d Appui à la Lutte Antipaludique au Tchad Prgramme Natinal de Lutte cntre le Paludisme Rapid Diagnstic Tests United Natins Children s Fund United Natins Develpment Prgram Wrld Health Organizatin 6. List f key peple met during missin / meetings attended UNICEF: Dr. Mehund Fatn, Chief Health & Nutritin and Dr. Djimasde Mbairebe, Maternal, Child Health and Malaria Specialist HCNC: Mme. Tetimian Elizabeth, Assistant PNLP: Mr. Dinira Santa, Cellule cmmunicatin MSF: Dr. Idriss Trare, Crdinateur Pharmacien JHPIEGO: Dr. Mrgah Kdj, Respnsable PALAT/UNDP: Mme. Zahra Abakar, Assistant 7. List f Annexes a. Summary f wrkshp utcmes b. PNLP brchure 6
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