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by Caitlin McQuilling
“Don’t automate a broken system”
Monitoring and evaluation is often the most difficult part of any development program. It’s often an afterthought for implementers, too busy worrying about rolling out the immediate and the tangible to worry about how they’ll evaluate their work at some later stage.
It’s important that data is not something that’s just written down in a grid each month and never seen again. The strongest programs are the ones in which ground level staff find their reporting useful in their daily work. By making data helpful to ground level staff it makes their reporting in turn more accurate.
Even though RMF put a focus on our M&E from the beginning of our program, it has continued to be one of the biggest struggles in implementing our program on the ground. As our program grows we are not only constantly assessing, analyzing and evaluating our data but also try to give the same level of analysis to the processes by which we collect data.
In this age where there seems to be a tech solution for everything, many development programs make the mistake of thinking that technology will be a “silver bullet” which will fix all of their challenges in the field. The best advice we received from one of the technology experts we were consulting with when deciding which direction we should take our program was “don’t automate a broken system,” meaning that before introducing any new technology, an organization should make sure their fundamentals are solid. As we moved forward with the planning of two innovative technology pilot programs for data collection integrating technology such as mobile phones or digital slates, we also needed to ensure that the fundamentals of our program are strong and that we understand and were honest about our strengths and weaknesses in data collection.
The month of April was RMF’s Community Mapping Month in Barwani district as part of our Community Mobilization Pilot with the Department of Women and Child Development. The team started this community mobilization activity by having a two day training on the method for Community Nutrition Educators (CNEs). This was to ensure that all CNEs used similar, participatory methods in doing the mappings.
The first day was at the office in conjunction with the weekly team meeting where mapping techniques, use of symbols, and methods to involve community stakeholders were discussed. The second day of training, Anjana split the CNEs into two groups and took them out to a village near Barwani to do a practical mapping exercise as a group. This hands-on mapping training turned out to be the most effective, with the feedback from many CNEs saying that this gave them the most clarity and confidence.
In March 2009, when I was conducting the initial field visits to develop RMF’s Malnutrition Eradication Program I visited a village called Shali Dana, in Kalwa block of Khandwa district in Madhya Pradesh. I remember being shocked and overwhelmed by the amount of children with severe acute malnutrition I saw in this village and the complete apathy and absence of government services in this village. We saw dozens of glassy eyed children with thinning hair, bulging stomachs, and protruding ribs, empty anganwadi centers, and children who had been tortured by traditional healers in the name of recovery because of the absence of government health services. Seeing this village convinced me that RMF had no choice but to do something drastic about this problem.
An angel, from JustDial.com by Caitlin Mcquilling
I’m often asked what keeps me going in the face of the hardships and emotionally taxing situations we face working on issues such as childhood malnutrition and HIV/AIDS day in and day out. My answer is simple: it’s all about finding inspiration in the most unexpected of places and circumstances.
On Tuesday while out on a village visit we came across a little girl, Gila, who was extremely sick and dangerously malnourished. She and her family had just returned from a month long stay at a private hospital in Dahod, Gujarat where Gila was properly diagnosed with tubercular meningitis, but unfortunately was not given the proper treatment. Over the month she was there the family spent their entire savings and then some only to see Gila rapidly deteriorating. After a month when the family could no longer afford “treatment” they were sent home. This is when we found the family in the village, desperate for us to help in any way we could. As soon as I saw Gila I knew she needed expert medical care not available in the state of MP. We told the family that we would have to bring the little girl to the hospital immediately and they eagerly agreed without a second thought.
Introducing a new pilot initiative within RMF’s Eradicate Malnutrition Program: Strengthening Community Management of Childhood Malnutrition through community mobilization, and nutrition and health education of mothers and pregnant women in Barwani, Madhya Pradesh
Madhya Pradesh has the highest rate of childhood malnutrition in India, with upwards of 60% of all children under 5 years old underweight. In many tribal communities in the state, this rate may be even higher, with alarmingly high rates of severe and moderate acute malnutrition. These communities often have limited access to government resources meant to prevent and treat malnutrition and have low levels of awareness about proper young child care.
Continuing with our Malnutrition Eradication Program series and fundraiser
All children who are treated at RMF’s NRC come back every 15 days for 2 months for follow-up clinics to ensure that the children are still healthy and gaining weight. They are seen by our pediatrician, given a nutritious meal, and given a transportation allowance to allow them to get to the NRC and back home. These are always our staff’s favorite days of the month when we get to see the children again who we had bonded so much with over the 2-3 weeks they were in our care.
Its all in the follow-up.
Sonu, one of our NRC’s most dramatic success stories, was back at the NRC for his second follow up looking positively chubby. All children who are treated at RMF’s NRC come back every 15 days for 2 months for follow-up clinics to ensure that the children are still healthy and gaining weight. They are seen by our pediatrician, given a nutritious meal, and given a transportation allowance to allow them to get to the NRC and back home. These are always our staff’s favorite days of the month when we get to see the children again who we had bonded so much with over the 2-3 weeks they were in our care.Continue reading
Over a year ago Ganesh Kamath was shocked to read about the staggering malnutrition rates in India. A native of Kerala who has lived in California for over 50 years, Ganesh knows India well, but was shocked to find out that almost half of all Indian children are malnourished. He started to research the problem some more and was moved by the grim tales of malnutrition coming out of the media in India. He and friends, who all felt that malnutrition should not exist in India, formed a group to look into this issue and explore ways in which they could do something. After a year of research and bouncing ideas back and forth Ganesh volunteered to go to India on behalf of the group to see firsthand what the problem was and what could be done. After contacting various NGOs working in India, they decided that Real Medicine Foundation was a good place to start and sent Ganesh out on a fact finding trip to see the reality on the ground.
Ganesh arrived in Jhabua after a grueling few days of travel but, notebook and camera in hand, was ready to start right away. Over the 5 days he was here Ganesh joined RMF India on our daily routine in the field, in the office handling 10 things at once, in the NRC, and at the Bhil Academy. Ganesh handled it all with enthusiasm, interest, and respect for the work going on. We spent three days out in the villages on spot checks to see our CNEs in the field and to check on NRC follow up cases. One day after over an hour in a jolting car ride we had to walk about 2 miles in the heat of the day to reach an anganwadi center buried in a remote village. This up and down hill walk through fields and across streams wore out me, and I’m a runner, but Ganesh was right there with us. He was able to see first -hand the scope of RMF’s work, the challenges we’re up against, and to meet the women who make this all happen. Now that’s due diligence!
Ganesh will now head back home and report to his group about what he’s seen here in India. He has many great ideas on how he can help out RMF and some of the individual children he met here. Ganesh plans on giving talks to local groups about the program and approaching his friends and neighbors about how they can contribute to ending malnutrition in India one child at a time.