At the outset of Phase II of the CMN in May 2014, the project team set the ambitious goal to support 36 CMAM programmes to establish programme-specific action plans to improve access and coverage. These action plans would be developed based on the results of coverage assessments conducted with the CMN's support.
By the end of the project, the team had succeeded in supporting the design of 45 action plans
, all of which included activities to enhance community mobilisation in the programmes. Since the completion of the project, an analysis has been conducted to assess the design and content of the action plans and the extent to which they were successfully implemented. The analysis also assessed the impact that the action plans had on the coverage of the programmes.
The review is available in full here.
The CMN was able to review 35 of the 45 action plans. In 10 programmes, it was not possible to conduct a review: in some programmes insufficient time elapsed between finalisation and analysis to enable inclusion in the analysis or staff were unresponsive or key staff left their positions soon after finalisation of the action plans.
Key results were as follows:
- The majority of the action plans included between 10 and 30 specific activities which were tailored to the programme. Each of these included measurable indicators and targets.
- 45% of the programmes had budget available or had flexibility in existing budget lines to cover the cost of activities.
- In spite of this, 60% or 21 of the programmes completed more than half of the activities in their action plans. Of these, 11 completed more than 70% of activities.
- The majority of the programmes (70%) suffered significant staff changes during the implementation period indicating that activities can continue despite the high staff turnover which is synonymous with the aid sector.
- Follow up assessments estimated changes in treatment coverage in 10 of the programmes. These were conducted at least 12 months following the initial coverage assessments.
- In two programmes, coverage increased by more than 10%.
- In five, coverage increased by less than 10%.
- In three, coverage decreased (by between 1.4% to 10.3%)
The changes in coverage as a result of implementing the action plans were lower than anticipated. Also owing to competing priorities, few programmes were able to complete follow up assessments. Therefore the analysis was unable to fully assess the impact of action plans on coverage.
However it did conclude with some important learnings:
- Activities which set out to enhance community engagement (e.g. regular engagement with community leaders and mothers of malnourished children) were generally popular with programme staff helping to reconnect them with the communities in which they were based.
- Significant increases in coverage only came about following significant changes to the CMAM model (e.g. in ACF's programme Kita in Mali where community health workers delivered SAM treatment in the community alongside other diseases).
- Changes in community behaviour and engagement with the CMAM programme take longer than 12 months to come about.