The Community Assessment carried out during Stage 1 of a SQUEAC assessment will generate much information about the weaknesses and strengths of a CMAM programme. This information is validated during Stage 2 and the likelihood survey further adds to it by providing programme practitioners with information about the main barriers to access faced by caregivers. However to improve coverage requires proactive measures and a commitment to understand and improve access.
Based on all of this information, the final (and essential) part of a SQUEAC assessment should therefore be to formulate a community mobilization effort to increase access and uptake to CMAM services in tandem with strategies to improve quality health services. This should be in the form of an action plan which should target both community mobilization strategies and the service components of the CMAM program.
The action plan is a tool used to build the capacity of host partner, local health system and community members to take action in accordance with the barriers, needs and potential of the community that are identified by the community assessment. It is a road map for implementing the community assessment’s recommendations to improve community access to and uptake of the CMAM services by clarifying what will be done, who will do it and how it will be done.
This page outlines the nine steps to take to devise the action plan:
The Tools section contains useful templates used during the action plan formulation process.
The following individuals should be the principle actors involved in preparing an action plan:
This will help to create more culturally-appropriate CMAM interventions which will maximize the positive impacts for local people and minimize the opportunity costs to them. Involving the community as early as possible in the planning stage will empower the community and increase their participation in the CMAM program, consequently increasing community ownership of the CMAM program.
The second step in the planning process is to synthesize and articulate the community and SQUEAC assessment findings in order to answer the two core questions of the planning process: Where are we? And what do we have to work with?
Answering these questions will guide the team to understand the communities, context and the status of community mobilization activities and services of the CMAM program.
Using the collective thinking about CMAM programming and information from second step, determine the third core question in the action plan development process; where do we want to be? (I.e., what the host partner and local health office with community want to achieve?) These answers to this question should be the overall goals of the action plan.
Once it is clear “where we are today” and “where we want to go," the subsequent step is to address the question; “How do we get there?" I.e., by what the means will we achieve the goal? I.e., what are the detailed interventions required to achieve the goals and specific objectives?
1) Assign community mobilization focal persons from the district to community level to coordinate the community participation and mobilization activities in the areas;
2) Link or integrate the community mobilization for CMAM with existing community mobilization mechanisms for other health and non-health programs in the area;
3) Ensure there is community participation in the planned outreach activities for the CMAM program in order to address caregivers’ barriers to access the services, and health facility’s challenges to deliver the services e.g., transport of RUTF;
4) Develop standardized sensitization messages on CMAM and produce materials;
5) Three outreach strategies: Early and active case-finding and referral of children with SAM for treatment; Follow-up home visits for problem cases; and sensitization (Health education and SBCC) about CMAM and malnutrition;
6) Technical and supportive supervision to nutrition workers and community outreach workers
7) Coordination of the community mobilization activities at all levels
For each intervention/activity, the expected change to be achieved for the target population should specified and quantified within a given time frame. This will be done by defining performance indicators for each activity and target setting.
The performance indicators and targets will help the local stakeholders to track the progress of the actions towards to the overall goals and objectives of the plan. The source of the information /indicators, and the monitoring and evaluation mechanisms should be integrated into a logical frame.
Documents containing examples of indicators and activities for action plans are available in Tools.
The sixth step in the planning process is to define the location where the activity will be implemented. Depending on the community assessment findings and resources, some of the activities may need to be focused in specific locations within the project area, and resource directed to the most needy communities.
Once it is clear what and where these should be implemented, the next step is to set the specified timeline for each activity, when it should be done and who should be responsible for carrying out the activity.
Any action plan without sufficient resources is ineffective. The required budget for each objective and intervention should be estimated and indicated by the planning team. The source of resource should also be identified. They can include internal and external sources and community contributions. The budget can be refined further by the host partner later.
At this stage, it is useful to classify the interventions into two groups: short term and long term interventions. The short term interventions are activities that can be implemented by the host partner and/or local health system using the available resources in project year. The long term interventions require additional resources, which can be generated from internal and external sources and are likely to be implemented beyond the current project /budget year.
Advocacy with donors in-country will be helpful for the host partner to raise additional resources for the implementation of the action plan. This can be done by debriefing and sharing the assessment findings and actions needed with UNICEF and donor representatives in the country.
It is very important for the host partner and local health services to follow up the implementation of the action plan. The follow up can be done with quarterly updates. The involvement of the donors would strength the follow up and the likelihood of the implementation of the action plan. A template for updates is available in Tools.