Transcript iawg.net

Evaluation of Handheld Solar Lights among
Internally Displaced Populations in Two
Camps in Haiti — August 2013-April 2014
Michelle Dynes, PhD, MPH, MSN, CNM, RN
EIS Officer, Emergency Response and Recovery Branch
Prepared for IAWG Meeting 2015
Jordan, February 2015
Center for Global Health
Emergency Response and Recovery Branch
LESSONS LEARNED
BACKGROUND
US National Action Plan (USNAP)

December 2011, USNAP Women, Peace and Security

Focus on Gender Based Violence (GBV) in
humanitarian settings

Collaboration between the United States government
(USG) and IRC

Build the evidence needed to validate use of
handheld solar lights
Evaluation Goal
To document the use and benefits of
handheld solar lights among females ≥14
years and older living in Toto and Sinai
Camps, Port-au-Prince, Haiti
Evaluation Objectives
Evaluation Objectives

To assess the physical environments of camps Sinai
& Toto.
Evaluation Objectives

To assess the physical environments of camps Sinai
& Toto.

To document the utility of handheld solar lights.
Evaluation Objectives

To assess the physical environments of camps Sinai
& Toto.

To document the utility of handheld solar lights.

To determine the durability and retention of the
handheld solar light.
Evaluation Objectives

To assess the physical environments of camps Sinai
& Toto.

To document the utility of handheld solar lights.

To determine the durability and retention of the
handheld solar light.

To measure sense of safety.
LESSONS LEARNED
METHODS
Evaluation Design - Methods

Direct observation to assess
environmental conditions
Evaluation Design - Methods

Direct observation to assess
environmental conditions

Focus group discussions (FGD) to
assess perceptions, attitudes, risks
Participatory
Mapping
Evaluation Design - Methods

Direct observation to assess
environmental conditions

Focus group discussions (FGD) to
assess perceptions, attitudes, risks

Monitoring surveys to assess use,
retention and durability
Participatory
Mapping
Evaluation Design - Methods

Direct observation to assess
environmental conditions

Focus group discussions (FGD) to
assess perceptions, attitudes, risks

Monitoring surveys to assess use,
retention and durability

Household surveys to assess use,
durability, activities, and safety
Participatory
Mapping
Sample Size
FGD
Household Surveys
Sample Size
FGD

Purposive sampling
of 14-19 and 25-45

Sample Sizes
 Baseline: N=8 (n=80)
 Endline: N=8 (n=82)
Household Surveys
Sample Size
FGD
Household Surveys

Purposive sampling
of 14-19 and 25-45

2013 IOM Camp Registration
Database

Sample Sizes

Sampling parameters
 Baseline: N=8 (n=80)
 Endline: N=8 (n=82)
 20% non-response rate
 95% CI and a precision of 0.05
 10% change in safety
Final Sample Sizes and Percent Completed
Attempted
Baseline
MV1
MV2
MV3
Endline
895
801
754
721
720
Final Sample
Size
754
650
579
572
634
%
Completed
84.3
81.2
76.8
79.3
88.1
Final Sample Sizes and Percent Completed
Attempted
Baseline
MV1
MV2
MV3
Endline
895
801
754
721
720
Final Sample
Size
754
650
579
572
634
%
Completed
84.3
81.2
76.8
79.3
88.1
** 29% loss to follow-up from initiation of the baseline
survey to completion of the endline survey
Analysis

Direct observations - description analysis

FGD - Content analysis and coding of themes

Household Surveys




Descriptive statistics using SAS 9.3
Chi-square/t-tests for differences between camps & age groups
GEE models to test baseline/endline differences
A Life-Table survival analysis to estimate light retention
Evaluation Timeline
May
2013
June
2013
July
2013
Aug
2013
Sept
2013
Oct
2013
Nov
2013
Dec
2013
Jan
2014
Feb
2014
Mar
2014
Evaluation Timeline
Solar Lights
Pre-test
May
2013
June
2013
July
2013
Aug
2013
Sept
2013
Oct
2013
Nov
2013
Dec
2013
Jan
2014
Feb
2014
Mar
2014
Evaluation Timeline
Direct
Observation
Baseline
Survey
Solar Lights
Pre-test
May
2013
June
2013
Baseline
FGD
July
2013
Aug
2013
Sept
2013
Oct
2013
Nov
2013
Dec
2013
Jan
2014
Feb
2014
Mar
2014
Evaluation Timeline
Direct
Observation
Baseline
Survey
Solar Lights
Pre-test
May
2013
June
2013
Solar Lights
Distribution
Baseline
FGD
July
2013
Aug
2013
Sept
2013
Oct
2013
Nov
2013
Dec
2013
Jan
2014
Feb
2014
Mar
2014
Evaluation Timeline
Direct
Observation
Baseline
Survey
Solar Lights
Pre-test
May
2013
June
2013
Solar Lights
Distribution
Baseline
FGD
July
2013
Aug
2013
Monitoring
Visit 2
Monitoring
Visit 3
Monitoring
Visit 1
Sept
2013
Oct
2013
Nov
2013
Dec
2013
Jan
2014
Feb
2014
Mar
2014
Evaluation Timeline
Direct
Observation
Baseline
Survey
Solar Lights
Pre-test
May
2013
June
2013
Solar Lights
Distribution
Baseline
FGD
July
2013
Aug
2013
Direct
Observation
Monitoring
Visit 2
Monitoring
Visit 3
Monitoring
Visit 1
Sept
2013
Oct
2013
Nov
2013
Endline
FGD
Dec
2013
Jan
2014
Feb
2014
Endline
Survey
Mar
2014
LESSONS LEARNED
FINDINGS
Demographic Characteristics – Endline Survey
Demographic Characteristics – Endline Survey
Total
N(%)
n=634
Camp
Sinai
Camp
Toto
N(%)
n=271
N(%)
n=363
P-value#
Age
14-19 years
20 years & older
0.017
84 (13.3)
53 (18.4)
40 (10.6)
550 (86.8)
235 (81.6)
336 (89.4)
<0.001†
Education
No education
59 (9.3)
35 (12.9)
24 (6.6)
Primary
193 (30.4)
102 (36.7)
91 (25.1)
High school
356 (56.2)
129 (47.6)
227 (62.5)
* Reported as % (SE); # Chi square p-value when categorical and t-test p-value when
continuous; † Fisher’s Exact tests were done.
Demographic Characteristics – Endline Survey
Total
N(%)
n=634
Camp
Sinai
Camp
Toto
N(%)
n=271
N(%)
n=363
P-value#
Age
14-19 years
20 years & older
0.017
84 (13.3)
53 (18.4)
40 (10.6)
550 (86.8)
235 (81.6)
336 (89.4)
<0.001†
Education
No education
59 (9.3)
35 (12.9)
24 (6.6)
Primary
193 (30.4)
102 (36.7)
91 (25.1)
High school
356 (56.2)
129 (47.6)
227 (62.5)
* Reported as % (SE); # Chi square p-value when categorical and t-test p-value when
continuous; † Fisher’s Exact tests were done.
Demographic Characteristics – Endline Survey
Total
N(%)
n=634
Camp
Sinai
Camp
Toto
N(%)
n=271
N(%)
n=363
P-value#
Age
14-19 years
20 years & older
0.017
84 (13.3)
53 (18.4)
40 (10.6)
550 (86.8)
235 (81.6)
336 (89.4)
<0.001†
Education
No education
59 (9.3)
35 (12.9)
24 (6.6)
Primary
193 (30.4)
102 (36.7)
91 (25.1)
High school
356 (56.2)
129 (47.6)
227 (62.5)
* Reported as % (SE); # Chi square p-value when categorical and t-test p-value when
continuous; † Fisher’s Exact tests were done.
Demographic Characteristics – Endline Survey
Total
N(%)
n=634
Camp
Sinai
Camp
Toto
N(%)
n=271
N(%)
n=363
P-value#
Age
14-19 years
20 years & older
0.017
84 (13.3)
53 (18.4)
40 (10.6)
550 (86.8)
235 (81.6)
336 (89.4)
<0.001†
Education
No education
59 (9.3)
35 (12.9)
24 (6.6)
Primary
193 (30.4)
102 (36.7)
91 (25.1)
High school
356 (56.2)
129 (47.6)
227 (62.5)
* Reported as % (SE); # Chi square p-value when categorical and t-test p-value when
continuous; † Fisher’s Exact tests were done.
Nighttime Activities among Women:
Baseline/Endline Comparison
Nighttime Activities among Women:
Baseline/Endline Comparison
Camp Sinai (N=237)
Baseline
(% yes)
Endline
(% yes)
Odd Ratio
(95% CI)
P-value
Personal
66.7
90.4
4.5 (2.1, 10.0)
<0.001
Religious
50.0
53.0
1.1 (0.6, 1.9)
0.839
Buy goods
27.9
71.1
5.3 (3.4, 8.5)
<0.001
Social
24.2
25.3
1.0 (0.5, 2.1)
0.924
Work
16.7
9.64
0.6 (0.2, 1.4)
0.203
Personal
68.2
77.4
1.6 (0.9, 2.9)
0.144
Religious
41.4
50.9
1.4 (0.8, 2.5)
0.195
Buy goods
28.5
70.8
5.5 (3.5, 8.6)
<0.001
Social
36.8
27.4
0.7 (0.4, 1.3)
0.259
Work
20.5
20.8
1.0 (0.5, 2.0)
0.991
Camp Toto (N=316)
Nighttime Activities among Women:
Baseline/Endline Comparison
Camp Sinai (N=237)
Baseline
(% yes)
Endline
(% yes)
Odd Ratio
(95% CI)
P-value
Personal
66.7
90.4
4.5 (2.1, 10.0)
<0.001
Religious
50.0
53.0
1.1 (0.6, 1.9)
0.839
Buy goods
27.9
71.1
5.3 (3.4, 8.5)
<0.001
Social
24.2
25.3
1.0 (0.5, 2.1)
0.924
Work
16.7
9.64
0.6 (0.2, 1.4)
0.203
Personal
68.2
77.4
1.6 (0.9, 2.9)
0.144
Religious
41.4
50.9
1.4 (0.8, 2.5)
0.195
Buy goods
28.5
70.8
5.5 (3.5, 8.6)
<0.001
Social
36.8
27.4
0.7 (0.4, 1.3)
0.259
Work
20.5
20.8
1.0 (0.5, 2.0)
0.991
Camp Toto (N=316)
Nighttime Activities among Women:
Baseline/Endline Comparison
Camp Sinai (N=237)
Baseline
(% yes)
Endline
(% yes)
Odd Ratio
(95% CI)
P-value
Personal
66.7
90.4
4.5 (2.1, 10.0)
<0.001
Religious
50.0
53.0
1.1 (0.6, 1.9)
0.839
Buy goods
27.9
71.1
5.3 (3.4, 8.5)
<0.001
Social
24.2
25.3
1.0 (0.5, 2.1)
0.924
Work
16.7
9.64
0.6 (0.2, 1.4)
0.203
Personal
68.2
77.4
1.6 (0.9, 2.9)
0.144
Religious
41.4
50.9
1.4 (0.8, 2.5)
0.195
Buy goods
28.5
70.8
5.5 (3.5, 8.6)
<0.001
Social
36.8
27.4
0.7 (0.4, 1.3)
0.259
Work
20.5
20.8
1.0 (0.5, 2.0)
0.991
Camp Toto (N=316)
Objective 1:
Physical Environment
Environmental Characteristics - Observation
Environmental Characteristics - Observation
Shelters
Camp Sinai
Camp Toto
Tents
Wood Shelters
Environmental Characteristics - Observation
Camp Sinai
Camp Toto
Tents
Wood Shelters
Electricity
No

Large Solar Panels
No

Lighting at public places
No

Shelters
Lighting
Environmental Characteristics - Observation
Camp Sinai
Camp Toto
Tents
Wood Shelters
Electricity
No

Large Solar Panels
No

Lighting at public places
No

MINUSTAH
No

PNH
No

Camp Committee
No

Shelters
Lighting
Presence of actors
Objective 2:
Utility of the lights
Frequency of Handheld Solar Light Use - Survey
Frequency of Handheld Solar Light Use - Survey
Total
Camp
Sinai
Camp
Toto
N (%)
N (%)
N (%)
n=634
n=271
n=363
606 (95.6)
255 (94.1)
351 (96.7)
536 (84.7)
236 (87.4)
300 (82.6)
Solar light use
At least once per day
No other working flashlights
Frequency of Handheld Solar Light Use - Survey
Total
Camp
Sinai
Camp
Toto
N (%)
N (%)
N (%)
n=634
n=271
n=363
606 (95.6)
255 (94.1)
351 (96.7)
536 (84.7)
236 (87.4)
300 (82.6)
Solar light use
At least once per day
No other working flashlights
96% of females reported at least daily use
Frequency of Handheld Solar Light Use - Survey
Total
Camp
Sinai
Camp
Toto
N (%)
N (%)
N (%)
n=634
n=271
n=363
606 (95.6)
255 (94.1)
351 (96.7)
536 (84.7)
236 (87.4)
300 (82.6)
Solar light use
At least once per day
No other working flashlights
85% of households had no other working flashlights
Use of Lighting Sources:
Baseline/Endline Comparison
Use of Lighting Sources:
Baseline/Endline Comparison
Baseline
(% yes)
Endline
(% yes)
Odd Ratio
(95% CI)
P-value
Inside Candle
88.0
31.1
0.1 (0.0, 0.1)
<0.001
Inside Gas Lamp
18.0
7.7
0.4 (0.2, 0.7)
<0.001
Outside Candle
23.9
13.6
0.5 (0.3, 0.8)
0.005
6.0
4.7
0.8 (0.3, 1.7)
0.515
Inside Candle
56.6
20.3
0.2 (0.1, 0.3)
<0.001
Inside Gas Lamp
47.9
25.0
0.4 (0.3, 0.5)
<0.001
Outside Candle
22.8
9.8
0.4 (0.2, 0.6)
<0.001
Outside Gas Lamp
19.5
7.9
0.4 (0.2, 0.6)
<0.001
Camp Sinai (N=237)
Outside Gas Lamp
Camp Toto (N=316)
Use of Lighting Sources:
Baseline/Endline Comparison
Baseline
(% yes)
Endline
(% yes)
Odd Ratio
(95% CI)
P-value
Inside Candle
88.0
31.1
0.1 (0.0, 0.1)
<0.001
Inside Gas Lamp
18.0
7.7
0.4 (0.2, 0.7)
<0.001
Outside Candle
23.9
13.6
0.5 (0.3, 0.8)
0.005
6.0
4.7
0.8 (0.3, 1.7)
0.515
Inside Candle
56.6
20.3
0.2 (0.1, 0.3)
<0.001
Inside Gas Lamp
47.9
25.0
0.4 (0.3, 0.5)
<0.001
Outside Candle
22.8
9.8
0.4 (0.2, 0.6)
<0.001
Outside Gas Lamp
19.5
7.9
0.4 (0.2, 0.6)
<0.001
Camp Sinai (N=237)
Outside Gas Lamp
Camp Toto (N=316)
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge

Used most often by women and girls
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge

Used most often by women and girls

Generally available when needed
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge

Used most often by women and girls

Generally available when needed

Sense of improved protection
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge

Used most often by women and girls

Generally available when needed

Sense of improved protection

Economic benefit
Perceptions of Handheld Solar Lights - FGD

Durable, light-weight, easy to carry and held charge

Used most often by women and girls

Generally available when needed

Sense of improved protection

Economic benefit

Some concerns
Comments about the Lights - FGD
“With no electricity, we can be cocky
[‘chèlè] as we have a lamp. It makes us
proud to feel special”
“I love my lamp. The lamp is my heart, it
stays with me when I sleep.”
Comments about the Lights - FGD
“I am scared to go to some places for fear
that people will take the lamp.”
“I sleep with one eye open and one eye
closed so that they won’t steal my solar
panel.”
Objective 3:
Light Durability &
Retention
96%
29 lost lights
28 lost to
follow-up
92%
30 lost lights
12 lost to
follow-up
88%
26 lost lights
12 lost to
follow-up
83%
36 lost lights
52 lost to
follow-up
533 lights retained
121 lights lost
Objective 4:
Measuring safety
Baseline/Endline Comparison of Perceptions
of Feeling Protected Outside the Home at Night
100
80
60
Baseline
Endline
40
20
0
Camp Sinai (N=237)
Camp Toto (N=316)
Baseline/Endline Comparison of Perceptions
of Feeling Protected Outside the Home at Night
100
80
60
OR 0.4 (0.2, 0.6)
p-value <0.001
Baseline
Endline
40
20
0
Camp Sinai (N=237)
Odds of feeling protected
DECREASED by 63%
Camp Toto (N=316)
Baseline/Endline Comparison of Perceptions
of Feeling Protected Outside the Home at Night
OR 2.2 (1.2, 4.1)
p-value 0.016
100
80
60
Baseline
Endline
40
20
0
Camp Sinai (N=237)
Camp Toto (N=316)
Odds of feeling protected
INCREASED by 118%
Reasons for Feeling Unprotected Outside the
Home at Night - Survey
Total
Camp
Sinai
Camp
Toto P-value
N (%)
N (%)
N (%)
n=97
n=76
n=21
Thugs
57 (58.8)
47 (61.8)
10 (47.6)
0.244
Loud noise/cursing
37 (38.1)
32 (42.1)
5 (23.8)
0.129
Hearing gun shots
34 (35.1)
33 (43.4)
1 (4.8)
0.001
Physical violence
28 (28.9)
27 (35.5)
1 (4.8)
0.006
Rock/bottle throwing
22 (22.7)
19 (25.0)
3 (14.3)
0.387
Sexual violence
19 (19.6)
17 (22.4)
2 (9.5)
0.231
Reasons for Feeling Unprotected Outside the
Home at Night - Survey
Total
Camp
Sinai
Camp
Toto P-value
N (%)
N (%)
N (%)
n=97
n=76
n=21
Thugs
57 (58.8)
47 (61.8)
10 (47.6)
0.244
Loud noise/cursing
37 (38.1)
32 (42.1)
5 (23.8)
0.129
Hearing gun shots
34 (35.1)
33 (43.4)
1 (4.8)
0.001
Physical violence
28 (28.9)
27 (35.5)
1 (4.8)
0.006
Rock/bottle throwing
22 (22.7)
19 (25.0)
3 (14.3)
0.387
Sexual violence
19 (19.6)
17 (22.4)
2 (9.5)
0.231
Thugs and loud noise most common reasons for feeling
unprotected; 1 in 5 feared sexual violence
Reasons for Feeling Unprotected Outside the
Home at Night - Survey
Total
Camp
Sinai
Camp
Toto P-value
N (%)
N (%)
N (%)
n=97
n=76
n=21
Thugs
57 (58.8)
47 (61.8)
10 (47.6)
0.244
Loud noise/cursing
37 (38.1)
32 (42.1)
5 (23.8)
0.129
Hearing gun shots
34 (35.1)
33 (43.4)
1 (4.8)
0.001
Physical violence
28 (28.9)
27 (35.5)
1 (4.8)
0.006
Rock/bottle throwing
22 (22.7)
19 (25.0)
3 (14.3)
0.387
Sexual violence
19 (19.6)
17 (22.4)
2 (9.5)
0.231
Women in Sinai were more likely to feel unprotected
from hearing guns shots and physical violence
LESSONS LEARNE
LIMITATIONS
Limitations

No control group, so unable to draw causal
conclusions about the impact of lights

Intervention did not take place in an acute emergency
setting, so findings may be different in other contexts

Difficult to translate and measure complex concepts
such as safety

Social desirability bias many have impacted
responses
Recommendations
Improve the physical
camp environment in
IDP camps in order to
affect the security and
safety of women and
girls.
Recommendations
Improve the physical
camp environment in
IDP camps in order to
affect the security and
safety of women and
girls.
Closer monitoring of
protection issues to
allow identification and
response to changes
over time.
Recommendations
Improve the physical
camp environment in
IDP camps in order to
affect the security and
safety of women and
girls.
Closer monitoring of
protection issues to
allow identification and
response to changes
over time.
Support distribution of
handheld solar lights
for individual use to
improve the quality of
daily life.
Recommendations
Increase of security
presence and
community patrols
inside the IDP camps
Recommendations
Increase of security
presence and
community patrols
inside the IDP camps
Handheld solar lamps
as one aspect of an
overall package
offered to women and
girls in emergencies.
Recommendations
Increase of security
presence and
community patrols
inside the IDP camps
Handheld solar lamps
as one aspect of an
overall package
offered to women and
girls in emergencies.
Future studies should
assess the utility and
durability of lights in
other settings and
across emergency
phases.
Acknowledgements
IRC staff-NYC and Haiti, IRC Contractors
Anjuli Shivshanker
Fedna Edourd
Francesca Rivelli
Jennifer Miquel
Leora Ward
Miriam Castanedo
Nicole Klaesener-Metzner
Reginald Bazile
Virginia Zuco
FGD facilitators, survey enumerators, data
entry clerks, and drivers
CDC staff-Atlanta and Haiti
Anna Gajewski
Erica Kantor
Barbara Marston
Holly Williams
Basia Tomczyk
Jennifer Whitmill
Brian Wheeler
Mariana Rosenthal
Colleen Hardy
Roodly Archer
Curtis Blanton
Samira Sami
USAID OFDA staff-DC and Haiti
Anjelica Fleischer
Carolyne Siganda
Courtney Blake
Jonathon Anderson
Women and families of Camp Toto & Sinai
For more information please contact Centers for Disease Control and
Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
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position of the Centers for Disease Control and Prevention.
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