July 24. AIM Health Mid-term Evaluation

When I heard the words qualitative data and AIM Health Mid-term Evaluation for the first time, I was puzzled. Qualitative? What data? What is AIM? Mid-term? Do I need to take some kind of mid-term exam? What I had known about AIM was AIDS Impact Model – a program that projects the consequences of the AIDS epidemic – from LiST. But I realized that AIM-Health was Access to Infant and Maternal Health, in this case. Oh, my acronym!

Spectrum Policy Modeling System is to analyze evidence-based information to estimate the impact of development programs and policies. Several project models system – Demography (DemProj), Family Planning (FamPlan), AIM, RAPID (Socioeconomic Impacts of High Fertility and Population Growth), PMTCT (Prevention of Mother-to-Child Transmission of HIV) and LiST (Lives Saved Tool) – are integrated into this Spectrum. So to speak, it is computer software to estimate the future! Especially, I am going to analyze LiST to estimate the impact of health intervention for maternal, neonatal and childhood health. By using LiST, I need to figure out how World Vision 7-11 Strategy has been and will have been implemented well during AIM-Health project period.

<7-11 Strategy> http://www.wvi.org/health/7-11-health-strategy

For qualitative data, I have been conducting in depth interviews (IDIs) for various areas of AIM-Health stakeholders. I have about 20 interviewees, and I finally begin to see daylight. I have interviewed PHU in-charge, District M&E officer, District hospital senior clinical person, point person in DHMT, development facilitators, project manager, base manager, national technical coordinator, WV M&E officer, grant finance managers. Additionally, I asked other staff who are involved in AIM-Health at some point, so I interviewed National Director and Finance Acquisition Manager. But I am not still done yet. I need to make an appointment with local council/district chairman and ADP manager. It seems a little early to give self-general critique, but I have to move on to LiST analysis from now!

The hardest thing about having an interview was that the almost all interviews kept being postponed for many reasons. People have broken or changed the appointed time, or they were busy with doing other things. Especially, Ebola outbreak suddenly restricted me to reach the rural area, so it became impossible for me to see them in-person. I am still trying to meet people through Skype, but poor Internet connection and long-distance communication keeps me from succeeding in interview. All IDIs were supposed to be done by the 2^nd week of July, but I am already late for almost 3 weeks.

The second hard thing was that I was totally ignorant of AIM-Health project. What is timed and targeted counseling (ttC)? What is positive deviance-hearth? What is community health committees (COMMs)? What is citizen voice and action (CVA)? Every time I interviewed, I was confused what I am doing: Am I actually interviewer? Or am I learning or evaluating? Am I listening to lecture from interviewees? I think the answer is all YES. But until recently, I had been wondering about my role because I am not WV staff but mere ignorant intern; I knew nothing about this project, so how do I evaluate mid-term AIM-Health project? So I asked my school colleague, Allyson in Ghana, “Why the position Intern exist? For my good? Or organization’s good?” Her answer was “Both.” This simple and clear answer explained everything. It was totally up to me how to balance my daily life to learn, work, make a good relationship with staff, explore new environment, enjoy new food, make friends, find hobbies, understand local people’s life and so on. In the same vein, I can not only learn but also work during interviews. If there is something to hear again or want to know, I have to ask that without any constraint. However, if I had knew more about the project in advance, I would not have spent time to ask the basic questions to interviewees during the given short time, and the quality of IDI would have been much better because I would have asked better questions.

The third hard thing was language. I heard my fellow colleague, Denice in Tanzania, had interviews accompanied by translator because people speak Swahili. And I saw Nicole’s picture that she was with other data collectors.

<Fellow Denice in Tanzania’s Blog> 
http://denicemarie.wordpress.com/

<World Vision Global Health Fellows Programme’s Blog> https://worldvisionghfp.wordpress.com/

Let's transcribe IDIs! 

Here in Sierra Leone, people speak English very well. I am so impressed that people in West Africa take the unified exam written in English for graduating high school, and they freely go to another country to enter university. By comparison, my English is dumb. I endure so hard with my rough English and rough writing in my blog. African’s unique pronunciation and accent was hard for me to understand for the first time. As time goes by, I have been accustoming myself to their English. My cell phone is hero; it functions as wonderful recorder. After interview, I listened to interview recordings again and again until I get perfectly what they said. Staff in the office had meetings and something to talk, so I barely heard the recording. My guesthouse in rural area was quite enough to hear recording, but I lost passion to do extra work at home in somber darkness. Actually, No light had nothing to do with transcribing because my laptop still had half-charged battery; but the shadows of night made me stop doing anything.

The fourth hard thing was respondents' order of priority toward interview. This IDI is my top priority as a fellow, so I need to get all IDIs done. On the other hand, some interviewees may consider IDI as the least concerned task; I called a respondent every day to make an appointment, but I could not meet him and instead, I sent interview questionnaire to him. I felt like I was interrupting busy staff; they have urgent emails, and somebody stepped in and do some work with a respondent even during interview.

When I drank bear with Momoh yesterday night, I asked him what makes challenging to him during the work. He said that he had a proposal to submit by noon today, so he was really busy, and continued as follows:

“Normally, we may feel unsatisfied the slow Internet connection, no electricity, no clean water. However, if I don’t finish my project on time, that means I did nothing. Those circumstances are just excuses. The most important thing is the result.”

He is right. No matter where I am, getting things done is the most important. I may have sweet excuses that might have been hindering my given roles; ‘Oh, everyone here is in chaos because of Ebola, and I can’t concentrate anything,’ ‘Oh, relocating to the new place is so stressful, so I need more time,’ ‘Oh, I have no electricity and no Internet at home, so it affects my work badly.’ I will allow no excuses. It is my responsibility to stay physically/mentally fit under those circumstances. Rather, I believe those circumstance will make me much stronger.

After those twists and turns, now I have most of transcribed qualitative data. The next step is how to analyze the data. Well… I do not know how to do it yet. There are always hindrances in every step! However, It is fine because I am also going to learn and work at the same time, just like I did for IDIs. AIM-Health mid-term evaluation is slowly going on, but it is on a cruise. Remember, Slow and steady wins the race.