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Nigeria Malaria Impact Evaluation

Launching the Malaria Impact Evaluation Program. Nigeria Malaria Impact Evaluation. Claribel Abam Festus Okoh Ramesh Govindaraj Joe Valadez Iris Boutros Sebastian Martinez. Intervention. Scale up of the coverage and use of LLITNs, ACT, IPT and IRS in seven program states

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Nigeria Malaria Impact Evaluation

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  1. Launching the Malaria Impact Evaluation Program Nigeria Malaria Impact Evaluation Claribel Abam Festus Okoh Ramesh Govindaraj Joe Valadez Iris Boutros Sebastian Martinez

  2. Intervention • Scale up of the coverage and use of LLITNs, ACT, IPT and IRS in seven program states • Innovative demand and supply side approaches, with the objective of reaching 80% use of ITNs by vulnerable group by 2010. • The impact evaluation design was focused on two areas of primary importance: • Delivery of LLITNs and ACT through private sector • Ways of improving the implementation and performance of the alternative delivery mechanisms. • Ways of improving coverage and use of LLITNs and ACT on the demand side • Focus on • PMV (Patent Medicine Vendors) • RMM (Role Model Mothers) /TBA (Traditional Birth Assistant) • CHW (Community Health Worker) /VHW (Village Health Worker)

  3. Supply Side Policy Questions: • National Level (7 program states): • What is the effect of delivery of LLITNs and ACT through the private sector (PMVs) on coverage and usage of LLITNs and effective anti-malarial treatment? • Pilot Schemes: • What is the marginal effect of alternative incentive schemes on the performance of PMVs? • What is the marginal effect of follow-up/ongoing training on the performance of PMVs?

  4. Demand Side Policy Questions: • National Level (7 program states): • What is the effect of Role Model Mothers (RMM) on the coverage/use of LLITNs and effective anti-malarial treatment? • Pilot Schemes: • What is the effect of alternative incentive schemes to RMMs, TBAs and CHWs on the coverage and usage of LLITNs and effective anti-malarial treatment? • What is the effect of follow-up/ongoing training to RMMs, TBAs and CHWs on the coverage and usage of LLITNs and effective anti-malarial treatment?

  5. Indicators • coverage of LLITNs • use of LLITNs • use of ACTs • fever • other maternal and child health outcomes • socio-economic outcomes (labor supply, income/consumption, schooling, etc)

  6. Evaluation Design - National • Incorporation of PMVs and RMM through LGA level training activities over a 9-12 month period. • Random roll out of training activities amongst LGAs across 7 project states • Exogenous variation in the presence of PMVs/RMM (6-9 month exposure) • Exogenous variation in exposure to treatment thereafter • LGAs trained first constitute the treatment group • LGAs trained last constitute the control group. • Consider opportunities for randomizing at Ward level. • Roll out of training activities commence by June 2007.

  7. Evaluation Design – Pilot Studies • Representative sample of evaluation communities or villages: • Random assignment of incentives to PMVs • Random assignment of training to PMVs • Random assignment of incentives to RMMs/TBAs/CHWs • Random assignment of training to RMMs/TBAs/CHWs • Unit of randomization likely to be the community or village

  8. Sample and Data • National • LQAS Monitoring data • 62 LGAs in 7 states • Baseline already conducted in late 2006 • Follow up in early/mid 2008 • Power calculations needed to determine detectable effect size • Pilot: • Primary household level data on representative sample of communities • Sample sizes to be determined

  9. Staffing Plan • Impact Evaluation Team: • Impact evaluation experts (World Bank/IFS) • Country team (National/State/LGA Malaria Programs) • Local Academics • Data Collection (National Bureau of Statistics NBS)

  10. Timeline • Short Run Activities: • Mid-May: technical work to randomize roll out of LGAs (training of PMVs) followed by a videoconference • June: Workshop in Abuja for planning of national impact evaluation • August: Country level workshop for M&E and IE for planning of pilot impact evaluations

  11. Budget • Short run expenses: • Mid-May expenses for videoconference meeting (1 day, domestic travel for 15 people) • Expenses for training in June (6 days, domestic travel for 15 people) • August workshop (5 days, domestic travel for 15 people, venue, etc) • Budget TBD, aprox $100,000 for initial activities

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