1. Knowledge Practice and Coverage (KPC) Overview October 3, 2012

2. Child Survival and Health Grants Program (CSHGP)  Grants to PVOs since 1985  Currently most 5 years, previously 3 and 4 years  Currently 37 active projects  Africa, Asia/Near East, Latin America, Europe and Eurasia  Rural and urban; Sub-national, district level  Integrated Projects with Technical areas of:  Immunization; CDD; Nutrition; Micronutrients; Breastfeeding; Birth Spacing/FP; ARI/Pneumonia; Malaria; MNC; STI; HIV/AIDS  Emphasis on program learning and operations research

3. Knowledge Practice and Coverage Survey (KPC)  Developed by JHU / CSSP 1990  Based on 30x7 cluster methodology used by EPI program  Rapid survey methodology  Household selection done in the field  Computer simulations conducted validated methodology  Used by PVOs since 1991  Collect baseline, mid-term and final  Intervals 2-3 years

4. KPC - Purpose  Grantees  Understand the health situation in project area  Measure progress toward results  Operations research  USAID (CSHGP) to measure the contribution of the portfolio of grants to improved health

5. KPC - Characteristics  Consists of:  12 modules (technical areas) Grantees select modules relevant to technical areas of project Within each module, grantees select questions and indicators relevant to interventions  In transition: To requiring Key indicators for relevant technical areas Instead of Rapid CATCH indicators for all technical areas regardless of project interventions

6. KPC - Characteristics Process of updating tool to ensure that indicators are compatible with:  DHS, MICs  Measure Evaluation  LiST Tool  Latest indicators developed by SNL and MCHIP  PMI

7. KPC - Characteristics  Rapid population based survey  Small sample size  Adapted to collect information from a variety of technical areas  Easy for PVOs to implement  Targets mothers of children 0-23 months

8. KPC - Characteristics  Two standard sampling methodologies  30x10 cluster sample of 300 (coverage for entire project area) May increase sample size for operations research  LQAS sample of 95 (coverage for entire project area) or 19/supervision area to determine areas that need additional attention Recommended for monitoring, but not for operations research

9. Resources http://www.mchipngo.net/controllers/link.cfc?method=tools_mande http://www.mchipngo.net/controllers/link.cfc?method=tools_mande  KPC modules:  Questionnaires; tabulation plans; indicator definitions; instructions; consent forms  Key indicators; Rapid CATCH indicators  KPC Trainer of survey trainers (TOAST)  The Rapid Household Survey Handbook

10. Resources  Rapid Catch requirements by cycle  How to write a survey report  Methodology and Sampling Appendix  Procedures for Anthropometric Measurement  KPC Field Guide

11. Resources  Lot Quality Assurance Sampling (LQAS)  LQAS Trainer’s Guide  Assessing Community Health Programs: Using LQAS for Baseline Surveys and Regular Monitoring Participants Module  LQAS Protocol for Parallel Sampling  LQAS Frequently asked Questions

12. KPC TOST Training 10.5 day course to train survey trainers covers:  Questionnaire design  Sampling procedures  Including sampling frame and household selection  Selecting survey team and the role of each member  Training interviewers and implementing field work  Logistics planning  Budgeting  Data analysis  Report writing  Use of information, emphasis on program decisions

13. Country Applications: Purpose [30 cluster] CountryFrequency/Purpose HKI – Niger (grant dates: 2004-2009); Diffa region Frequency: Baseline September 2005 Will be repeated: Mid-term: 2007 and Final 2009 Purpose: 1. Understand the health situation in the project area 2. Measure progress toward results (MTE, FE) 3. Required by USAID as part of measuring the contribution of the portfolio of CSHGP grants to improved health

14. Country Applications: Core indicators [30 cluster - Niger] Percentage of children 0-23 months who slept under an insecticide-treated net the previous night. Percentage of children age 0-23 months whose births were attended by skilled personnel (doctor or nurse with midwifery skills) Percentage of children age 0-5 months who were exclusively breastfed during the last 24 hours. Percentage of children 0-23 months who were born at least 24 months after the previous surviving child. Percentage sick children age 0-23 months who received increased fluids and continued feeding during an illness in the past two weeks.

15. Institutional Capacity-Building [30 cluster-Niger] Function Host Country Organization(s) Selecting sample frame and households For all areas, except data entry, HKI was trained during KPC TOST. Training interviewers & conducting fieldwork HKI trained in country team, which consisted of Ministry of Health staff and HKI staff. Data entry HKI and MOH staff implemented the survey together. Data analysis Information dissemination and use

16. Time and resources [30 cluster]  Time (start to finish) – Niger:  14 days for questionnaire design, sampling frame, cluster selection and logistics planning (during KPC TOST)  2 days training in country  5 days field work  Normal time from planning to discussion of results is 30 days of full work.  Includes field work, data entry/ analysis, report writing, developing action plan .

17. Technical Assistance [30 cluster - Niger] FunctionTA Provided and Cost Selecting sample frame and households KPC TOST Training interviewers & conducting fieldwork KPC TOST Data entry Data analysis KPC TOST Report writing KPC TOST, CSTS reviewed draft Information dissemination and use KPC TOST

18. Use of findings/reports [30 cluster- Niger]  Who used reports? (Country Missions, host country government, NGOs, other donors)  HKI, MOH – Diffa, USAID/GH  How did they use them – specific program decisions  Local decisions: Because level of malnutrition found was to be high (33.6% -2 SD) and begins after children reach 6 months, project will include Intensive Nutritional Rehabilitation Centers for severely malnourished children. Also HKI will coordinate with NGOs involved in food aid and distribution in the region.

19. Use of findings/reports [30 cluster- Niger]  How did they use them – specific program decisions  Local decisions: Because level of exclusive breastfeeding is low (5.7%) behavior change communication strategies will be developed.