PMA2020/Indonesia. Training of resident enumerators to use smartphones before they head out into the field for the first round of data collection.
Performance Monitoring and Accountability (PMA2020) is a 5-year monitoring and evaluation project created to answer the call for better data to guide family planning programs. Using innovative mobile/smartphone technology, it collects nationally representative data on health and development, including family planning and water and sanitation, across 10 countries in Africa and Asia. The project is funded by the Bill & Melinda Gates Foundation and implemented by the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. Scott Radloff, PhD, the PMA2020 project director, describes the project’s scope to GHN's Dayna Kerecman Myers for Part I of this exclusive Q&A. Please check back next week for Part II.
How do PMA2020’s principles align with the data revolution surrounding the Sustainable Development Goals (SDGs)?
The international community, as expressed through the SDGs, has asked for more frequent data, faster turnaround, and stronger country ownership around the collection of data itself.
PMA2020 delivers on all of these points. We collect data every 6 months to start with, and then we shift to annual collection. The data collection period, for each round of the survey, is completed within a 6-week period and a summary report of results is made available to policymakers and program managers shortly after.
We work through local university and research institutions, like Addis Ababa University in Ethiopia and the University of Kinshasa in the Democratic Republic of Congo. Our aim is to build the skills of these country partners to eventually take on all aspects of data collection on their own, with limited assistance from Johns Hopkins.
How do the countries translate the data into concrete action? Are there any early success stories on this front?
We’re working in countries that made commitments to the goals and principles of Family Planning 2020 (FP2020), aimed at increasing access and use of contraceptives in the poorest countries of the world. All of these countries have their own teams that track progress against their goals, and they’re using our data to help track that progress and to inform their programs.
To further build country ownership of the data, we convene key stakeholders to review the data coming out of each round; we also work in tandem with other organizations, like Advance Family Planning, working to translate the data into policy briefs and programs on the ground.
A number of countries have seen an uptick in the use of contraceptives, but use often lags in certain sub-groups, like adolescents, rural residents, and poorer women. Better data on adolescents has helped inform programs to focus attention on reaching adolescents in countries including Uganda.
What additional health/development areas, beyond the current focus areas (family planning and water/sanitation), do you think PMA2020’s mobile technology platform could be harnessed to address?
For now, the family planning and water/sanitation surveys are combined. The Johns Hopkins Water Institute here at the School led the pioneering work on using this mobile phone technology, and PMA2020 adapted their pilot tests to address family planning. But the program is designed to build a data collection platform that is adaptable to use for other health areas. Equipped with smartphones, female enumerators who are recruited from their communities can gather data efficiently and turn results around rapidly. As the enumerators have lulls between rounds of surveys, our goal is to increase the number of questionnaires over time to cover other health priority areas. We hope to add new modules in maternal and newborn health, an expanded water, sanitation and hygiene (WASH) module, nutrition, adolescent health, and primary health care, focusing on strengthening health systems more generally.
Which countries have proved the most challenging for PMA2020? Have you stumbled upon any unexpected resistance from governments in any of the countries where you work?
All of the countries we work in are committed to FP2020, so they’re all interested in improving data collection. When we introduce this project, we always start off with visits to the government and key stakeholders. They all have been very supportive of not just the content of the survey, but also the technology. All of these countries want to be on the cutting edge of new ways of collecting data more efficiently, more effectively. Gaining support from community leaders has also proved key to ensuring our surveys are well received. We do encounter challenges however, particularly in areas not well served by cell phone networks. Our rapid turnaround requires enumerators to upload data to a server soon after each interview. Most countries have fairly strong cell phone networks, but most have some more remote areas with weaker connectivity, requiring our enumerators to travel to the nearest hotspot to upload the data.
There are technical challenges, too, such as keeping the phones charged; in some cases we’ve purchased solar chargers to help. Just like cell phone connectivity, as cell phones become more broadly accessible, communities find their own ways of getting them charged. You often will see entrepreneurs cropping up to provide cell phone charging for a fee.
Have the conflicts in places like Nigeria and the Democratic Republic of Congo obstructed your efforts?
The survey spots are randomly selected, and sometimes they fall in insecure parts of the country. In those cases, we’ll often choose a new area, or we’ll drop it entirely, because the security and safety of our staff – both in country and in Baltimore – are paramount to the project.
Will you be able to expand to other countries in the near future, and which countries yet-to-be reached are your biggest priorities? Are there countries with great need that will miss out on PMA2020 because they are too unstable politically?
We’re about 2 years into the project, and we’ve launched in 9 countries to date. We’re just now completing the first round of surveys in Indonesia, our first site in Asia (and also the largest we’ve undertaken to date). Soon we’ll start data collection in India and Pakistan, and we also plan to expand our surveys in Nigeria soon.
Please check back early next week for Part II.