Decision Framework for Prioritization of Anemia Action The next phase of the district workshop is the prioritization process. After completing the inputs of the DATA tool (the National Questionnaire and the District Questionnaire, you viewed the outputs reflected in two dashboards, the Overview Dashboard and the Findings Dashboard. Based on these outputs, you will now go through a prioritization process which will enable you to prioritize actions and develop an action plan for anemia-related interventions, per sector. The following presentation will review why prioritization is needed, and the process you will go through, step by step.

Why Prioritize? Resources are limited Decisions need to be made, even in the absence of data Opinions matter: perspective and expertise of district level staff *Read out loud the reasons listed for why prioritization is needed*: Resources are often limited and thus activities that will have high impact should be prioritized. Often data is not available at the district-level, however, even without data, decisions can be made to improve programs. These decisions can be made based on the expertise and perspective of district level staff, who have an understanding of the local context and are in charge of implementing programs in the communities. Slide 2

Steps in prioritization process Step 1: Review anemia situation Step 2: Review anemia programs Step 3: Review inputs to prioritization Step 4: Identify and assess barriers Step 5: Formulate plan of action *Read out loud the five steps involved in using DATA and explain to workshop participants that these will be covered in the next few slides.* Slide 3

Step 1: Review Anemia Situation From the Overview Dashboard: Prevalence Risk factors The first step is to review the anemia situation, which was done following the completion of the national and district questionnaires. The Overview Dashboard, shown here, presents the anemia prevalence and risk factor information. Slide 4

Step 2: Review Anemia Programs From the Findings Dashboard: Policy Program Exists Program Coverage The second step is to review the anemia-related programs, which was done following the completion of the national and district questionnaires. The Findings Dashboard, shown here, presents the policy, existence of program, and program coverage information. The barriers section found to the right of the policy/program section, has not yet been completed at this stage. The barriers will be assessed and completed during the prioritization process (Step 4). Slide 5

Step 3: Review inputs to prioritization Policy Commodities Funding Provider training Client demand Coverage Other factors- inputs from participants Found in Dashboard The third step of the prioritization process is to review the factors that DATA considers as key elements for program implementation and decision making, which include the following: *Read aloud the factors and their explanations*: Policy: Presence of a policy, without which the intervention is not likely to be implemented. The policy is determined at national level, with districts adhering to national policy. Commodities: covers adequate and consistent supply of the commodity is required for an intervention. The commodity factor also comprises logistics and supply chain issues. Funding: covers adequate and consistent allocation of resources to successfully implement an intervention Provider training: covers adequate training of staff including refresher training and supportive supervision to ensure high quality of services Client demand: covers the awareness of and interest in or demand for the intervention in the target population. Coverage: covers the overall percentage of the target population receiving the intervention, which depends on demand and quality of service delivery. Note that districts likely do not have population-based coverage information, but they may have reported information or facility-based coverage information that will give some indication of coverage. g. Other factors brought up by participants during the prioritization process that fall outside of the elements included in DATA, but may be critical to address. After going through the six factors included in DATA, participants will have a chance to bring up other factors in the discussions. One example is ‘compliance’ which captures the percentage of a target population practicing an intervention correctly. Although other factors are not shown in the tool itself, they will be captured by the note-taker of the workshop and also included in the plan of action if the group determines they are important considerations. Slide 6

Step 4: Identify and assess barriers to program implementation Discuss barriers for each intervention under each category: Commodities, Funding, Provider Skills/Training, and Client Demand Assess barriers according to: No barrier (0) Somewhat of a barrier (1) Very much a barrier (2) Note: There is an option of N/A for commodities in IYCF and DCC. The fourth step (once the outputs of the tool are reviewed and the inputs of the to prioritization are reviewed in Steps 1-3), is to identify the major barriers to successful program implementation, according to the elements discussed in the previous session. During this step, the facilitator of the workshop will pull up the Findings Dashboard on the projector, and for each intervention discuss the existing barriers with the participants. The note-taker of the workshop will be taking notes during these discussions to record a comprehensive perspective, and the facilitator will fill out the Barriers section of the Findings dashboard at the same time, based on consensus in the group. The barriers will be assessed using three categories- no barrier, somewhat a barrier, and very much a barrier. Note that there is an option in the tool to select N/A for the interventions of IYCF and DCC, where a commodity is not needed. Slide 7

Step 5: Formulate Plan of Action Review inputs from dashboards and participants List prioritized activities/interventions for each sector Discuss how activities are integrated into routine planning at the district level The fifth step in the process is to formulate a plan of action through prioritization of activities. Once the workshop participants have reviewed the dashboards and discussed and assessed the barriers, the facilitator will ask participants to prioritize actions for specific interventions. This is done in a group work, by sector, where participants discuss together what activities they should prioritize over the next year for the interventions specific to their sector, that will address anemia more effectively. They should ask the following questions in their group: -What can their sector do to improve the situation? -What activities and interventions should be prioritized to achieve this? -Are there similar barriers across sectors that can be addressed by sectors working together? Once ideas have been prioritized, and the plan of action has been detailed in the group work, per sector, participants come together in plenary and present their prioritized activities. They will discuss with the facilitator and as a plenary group how the activities will be integrated into routine planning at the district level. Slide 8

Thank you!