Name: Process Documentation of Community Activities
Origin: BASICS
Source: BASICS
Purpose: The Process Documentation of Community Involvement had been developed to analyze how communities participate in the design and implementation of maternal and child health programs. Lessons learned are intended to improve the effectiveness of involvement by community leaders and beneficiaries in the design and implementation of maternal and child health programs at community level
Basic Description: This tool enables health care managers to undertake systematic documentation of community involvement in maternal and child health programs.
Country Applications: Nigeria, Zambia, Ethiopia and Madagascar.
Languages Available: English
Technical Scope: In depth analysis of the design, implementation and sustainability of the community component of maternal and child health programs.
Type of Methods: Qualitative: document review, interviews based on a semi-structured questionnaire and focus group discussions.
Design: Descriptive and cross-sectional. Data gathering includes interviews with project managers, community leaders and beneficiaries of maternal and child health programs. It allows sufficient flexibility for describing unique program elements and adequate standardization to enable cross-country comparison.
Key Users of Information
Managers and planners of maternal and child health programs at national and local levels who design, implement or monitor community health activities.
Objectives and Scope of the Tool
The tool assists planners in analyzing the process of designing, implementing and ensuring the sustainability of the community component of maternal and child health programs. Lessons learned from such analysis are intended to improve the effectiveness of the involvement of community leaders and beneficiaries in the design and implementation of the maternal and child health programs.
Key Monitoring Needs and Evaluation Questions Tool Seeks to Address
This tool provides an in-depth analysis of the process of designing and implementing community health interventions, particularly the role of the community. The tool is used to draw lessons to improve the effectiveness and the sustainability of such interventions. This type of process documentation focuses on three core questions:
Key Indicators
To describe and analyze a community-based MCH program, the tool/approach asks the following questions:
How was community involvement designed and organized?
How have community programs been implemented and managed?
What evidence of and prospects for sustainable community involvement and work exist?
Research Design
This tool suggests three main methods for conducting the process:
1. Document Review: Understanding the original design of the program requires reviewing relevant documents such as:
Key items to abstract from documents include:
2. Interviews with Professional Staff
The tool includes a guide to interviewing relevant professional staff at the central, district, and health facility levels. If NGOs and other agencies have been involved, they should also be interviewed.
Activity Rating: Interviewees are then asked to rate, from their point of view, the activities which have been implemented to promote community involvement. The rating classifies activities into four categories: absolutely essential; highly recommended; complementary to program goals; and not recommended for future programs.
Based on the results of the activity rating, managers and health planners can form a priority list of activities needed required for successful community involvement in future programs.
3. Interviews/Focus group discussions with community members
Individual interviews or focus group interviews could be conducted with community leaders, TBAs, CHWs and beneficiaries (mothers). The interviews should address the following questions:
Lessons from experience
The Process Documentation of Community Involvement has been utilized by the BASICS
project in four countries: Madagascar, Nigeria, Zambia & Ethiopia. The key issues and questions
addressed were:
Madagascar: Consensus building process on messages; Link between community work and mass media
Nigeria: Linkages between Community Based Organizations (CBOs) and health facilities in an urban setting; Public-private linkages or lack thereof
Zambia: NGO partnership process especially coordination with districts and the participatory proposal development approach
Ethiopia: Development and implementation of joint action plans between community and health facility staff
The greatest challenge in implementing this exercise is often allowing sufficient flexibility to describe unique program elements while ensuring sufficient standardization for making cross-country comparisons.
The questionnaire, interview guide for health professionals and guide for focus group discussions were extremely useful in structuring the analysis. However, it is recommended that they be adapted and tested for each country situation. Since this is a qualitative tool, the ability to conduct a successful interview and lead an effective focus group discussion is key to the success of data gathering and analysis. Findings should be disseminated in a way that reflects the needs and interests of different audiences from central policy makers, to local managers, health workers, community leaders and beneficiaries.
References
Clemmons L., What Communities Have to Say About Community Involvement Approaches. BASICS' IEC and Community Mobilization Strategies for Child Survival in Madagascar. 1998, BASICS
Bhattacharyya K., Process Documentation of BASICS' Community Activities, Guidelines and Methodology. 1998 BASICS.
Brieger W., Documentation Exercise: A Process Evaluation of the Community Partners for `Health. Lagos, Nigeria. 1997, BASICS.
Contact Person
Karabi Bhattacharyya
BASICS Project
1600 Wilson Blvd.
Arlington, VA 22209
703-312-6800