Transcript Nigeria Malaria Impact Evaluation Claribel Abam Festus Okoh

Impact Evaluation
Launching the Malaria Impact Evaluation
Program
Nigeria Malaria Impact
Evaluation
Claribel Abam
Festus Okoh
Ramesh Govindaraj
Joe Valadez
Iris Boutros
Sebastian Martinez
Intervention
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Scale up of the coverage and use of LLITNs, ACT, IPT and
IRS in seven program states
Innovative demand and supply side approaches, with the
objective of reaching 80% use of ITNs by vulnerable group
by 2010.
The impact evaluation design was focused on two areas of
primary importance:
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Delivery of LLITNs and ACT through private sector
Ways of improving the implementation and performance of the
alternative delivery mechanisms.
Ways of improving coverage and use of LLITNs and ACT on the
demand side
Focus on
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PMV (Patent Medicine Vendors)
RMM (Role Model Mothers) /TBA (Traditional Birth Assistant)
CHW (Community Health Worker) /VHW (Village Health
Worker)
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Supply Side Policy Questions:
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National Level (7 program states):
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What is the effect of delivery of LLITNs and
ACT through the private sector (PMVs) on
coverage and usage of LLITNs and effective
anti-malarial treatment?
Pilot Schemes:
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What is the marginal effect of alternative
incentive schemes on the performance of
PMVs?
What is the marginal effect of followup/ongoing training on the performance of
PMVs?
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Demand Side Policy Questions:
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National Level (7 program states):
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What is the effect of Role Model Mothers
(RMM) on the coverage/use of LLITNs and
effective anti-malarial treatment?
Pilot Schemes:
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What is the effect of alternative incentive
schemes to RMMs, TBAs and CHWs on the
coverage and usage of LLITNs and effective
anti-malarial treatment?
What is the effect of follow-up/ongoing training
to RMMs, TBAs and CHWs on the coverage and
usage of LLITNs and effective anti-malarial
treatment?
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Indicators
coverage of LLITNs
 use of LLITNs
 use of ACTs
 fever
 other maternal and child health outcomes
 socio-economic outcomes (labor supply,
income/consumption, schooling, etc)
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Evaluation Design - National
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Incorporation of PMVs and RMM through LGA
level training activities over a 9-12 month
period.
Random roll out of training activities amongst
LGAs across 7 project states
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Exogenous variation in the presence of PMVs/RMM (6-9
month exposure)
Exogenous variation in exposure to treatment
thereafter
LGAs trained first constitute the treatment group
LGAs trained last constitute the control group.
Consider opportunities for randomizing at Ward level.
Roll out of training activities commence by June 2007.
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Evaluation Design – Pilot Studies
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Representative sample of evaluation
communities or villages:
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Random assignment of incentives to PMVs
Random assignment of training to PMVs
Random assignment of incentives to
RMMs/TBAs/CHWs
Random assignment of training to
RMMs/TBAs/CHWs
Unit of randomization likely to be the
community or village
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Sample and Data
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National
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LQAS Monitoring data
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62 LGAs in 7 states
Baseline already conducted in late 2006
Follow up in early/mid 2008
Power calculations needed to determine detectable
effect size
Pilot:
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Primary household level data on representative
sample of communities
Sample sizes to be determined
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Staffing Plan
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Impact Evaluation Team:
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Impact evaluation experts (World Bank/IFS)
Country team (National/State/LGA Malaria
Programs)
Local Academics
Data Collection (National Bureau of Statistics
NBS)
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Timeline
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Short Run Activities:
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Mid-May: technical work to randomize roll out
of LGAs (training of PMVs) followed by a
videoconference
June: Workshop in Abuja for planning of
national impact evaluation
August: Country level workshop for M&E and
IE for planning of pilot impact evaluations
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Budget
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Short run expenses:
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Mid-May expenses for videoconference
meeting (1 day, domestic travel for 15 people)
Expenses for training in June (6 days,
domestic travel for 15 people)
August workshop (5 days, domestic travel for
15 people, venue, etc)
Budget TBD, aprox $100,000 for initial
activities
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