We’re building a new UNICEF.org.
As we swap out old for new, pages will be in transition. Thanks for your patience – please keep coming back to see the improvements.

Evaluation database

Evaluation report

2017 Somalia: Evaluation of Social Mobilization Network (SMNet)



Author: Dr. Helen Guyatt ; Flavia Della Rosa ; Catharine Russell ; Florence Muiruri

Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 3’ of the report, and the executive feedback summary labelled as ‘Part 4’.

Background:

In 2013, scattered polio outbreaks in Somalia prompted a proactive vaccination response. As part of these activities, the Social Mobilization Network (SM Net) was established to raise awareness about polio in Somalia and specifically, prepare households for receiving vaccination teams into their homes. Commissioned by the United Nations Children’s Fund (UNICEF) office for Somalia, this report provides the findings of an evaluation of the SM Net campaign, and also addresses whether SM Net could be used for similar health issues.

Purpose/Objective:

The purpose of the SM Net evaluation was twofold: firstly, to determine the successes and failures of this approach, and secondly to explore whether the network could be used for other health campaigns. More specifically, the evaluation aimed to assess: the impact of the SM Net on community knowledge and awareness, and levels of trust and support for immunization; the strength, efficiency and effectiveness of its management and structure; the impact on coverage and refusal rates; and the feasibility of SM Net to deliver on other child survival and development interventions.

Methodology:

The evaluation employed a mixed methods approach, including qualitative and quantitative data gathered from primary and secondary sources. Primary data was collected from in-depth interviews (IDIs) and focus group discussions (FGDs) with the following groups of stakeholders: SM Net partners (Group 1), coordinators and implementing partners (Group 2), vaccinators and District Field Assistants (DFAs) (Group 3), community mobilizers (CMs) (Group 4) and community members (Group 5). These interviews were conducted this February through April 2017 in the 14 SM Net districts spread across Puntland, Somaliland, and South Central. The respondents were asked a range of issues related to the relevance, effectiveness, efficiency, impact and sustainability of the SM Net campaign. Secondary data from Independent Monitoring (IM) by the World Health Organization (WHO) provided information on changes in vaccination coverage and refusal rates from 2013 through 2016.

Findings and Conclusions:

Analysis of the IM data found that, overall, vaccination coverage had steadily increased, and the refusal rates decreased. In 2016, vaccination coverage was 96 percent in Somaliland, 97 percent in Puntland and 97 percent in South Central. This represents an increase from 2013 of 12 percent in Somaliland, 4 percent in Puntland and 6 percent in South Central. Of those children not receiving vaccination in targeted communities, between 15 (South Central) and 35 percent (Puntland) are a result of parental refusal. However, the major cause of unvaccinated children was the child not being available. Despite the progress made by SM Net, in 2016 there were seven districts in South Central where no IM data collection was undertaken due to insecurity. It is unclear what the situation is for residents there.

Recommendations:

More research is required to understand the routes that nomads take. Further research is also required to understand why certain groups of people (such as fathers and some religious groups) continue to refuse the vaccine. Most urgently, the programme must address the recent influx of unvaccinated migrants into urban areas, as they increase the risk and spread of a polio outbreak. It is critical to ensure that there are sufficient, and sufficiently trained, frontline workers to effectively engage these populations. CMs, in particular, should be recruited from within the target communities. As they are the lynchpin of the SM Net approach, it is critical that CMs receive additional resources to access remote locations and engage HtR groups. The success of SM Net is largely due to their efforts, and SM Net’s sustainability and replication for other health awareness campaigns highly depends on CMs receiving the resources they need. All stakeholders agreed that the SM Net approach should be used for other health campaigns. More research is needed to identify how this would fit into existing health care activities, and what additional resources, such as outreach services, would be required to ensure access to interventions.



Full report in PDF

PDF files require Acrobat Reader.


 

 

Report information

Year:
2017

Country:
Somalia

Region:
EASAR

Type:
Evaluation

Theme:
Health

Language:
English

Sequence:
2017/001

New enhanced search