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Posts Tagged ‘lessons’

This is a guest post from David Schaub-Jones who works with SeeSaw, a social venture that focuses on how technology can strengthen sanitation and water providers in developing countries. Follow SeeSaw on Twitter:  @ontheseesaw.

In June, two organisations focussed on using ICT (Information and Communications Technology) in the water and sanitation sector joined forces in Cape Town. SeeSaw, a social enterprise that customises ICT to support sanitation and water providers and iComms, a University of Cape Town research unit (Information for Community Oriented Municipal Services) co-hosted a two day event to look at how ICT tools are changing the way that public services function in developing countries.

(from SeeSaw’s website.)

There are growing expectations that harnessing ICT intelligently can bring about radical improvements in the way that health, education and other sectors function, particularly in developing countries. SeeSaw and iComms wanted to look at this in more detail – and to build on the open sharing of experience to provide general principles to those planning to harness ICT for public service delivery. Their overarching goal is to help practitioners cut through much of the complexity and hype surrounding ICT usage and give them a robust set of guidelines with which to plan and negotiate partnerships and projects on the ground.

The event brought together 30+ practitioners – with water sector professionals from across Southern Africa joined by their colleagues from the health sector – a sector that has been quick to innovate, try different approaches and learn lessons. A full write-up of the event can be found here in the Water Information Network of South Africa’s October Newsletter. (See www.win-sa.org).

Key messages

1) Putting in place an effective ICT system can make a visible impact on the ground. It can pay for itself quite quickly in terms of efficiency gains and even costs saved. Yet a fair amount of thought must go into designing the system to fit the local context – just transplanting a system that has worked in one place to a new environment is generally a recipe for trouble.

2) An important spin-off result of looking at how to use ICT is that the effort taken to design a responsive system forces stakeholders to reflect more closely on the existing structures, process and current information flows. This can have significant benefits even if no system is later built.

3) A recommendation is to spend due time and effort in understanding the system, asking direct stakeholders what information they currently get, what information they need and then seeing how and whether ICT systems can be used to gather data that can generate additional, better or faster information and get it to where it is needed (in a way that suits the working patterns of those individuals).

4) For impact at any significant scale it is crucial that ICT systems, whether in healthcare or water and sanitation, integrate with existing government systems. There is a great risk of fragmentation – too many organisations piloting new ICT systems put in place technologies or processes that cannot easily be absorbed into existing government systems (or worse still, undermine these).

5) A lot of initiatives, particularly in the healthcare system, have tried to harness ICT to get people to do what is good for them. And only that. For instance, cellphones used to gather field information can be restricted so that they can only do one thing and no longer function as a phone. Airtime and data bundles used for transmitting information can be isolated to only contribute to ‘the project’. The disadvantage is that this turns the device into something used only for work, something alien and otherwise ‘not useful’. Alternatives do exist though and can be productive. If frontline workers being asked to use phones and new ICT tools are permitted – sometimes on a limited basis – to use them for their own purposes (browsing the internet, accessing facebook, receiving SMS) then they are more likely to engage with the project, look after the equipment, etc. A balance is surely needed, but a quid pro quo arrangement can be a sensible approach. This was characterised as “give them pizza with their broccoli”!

6) ICT tools can be incredibly powerful at improving the flow of data and, from there, the flow of information. But what if the flow of information is not the real problem? There are many issues that undermine healthcare or water and sanitation systems – and a lot of them have little to do with information. Cultural conflicts, different worldviews, individual rivalries, dysfunctional facilities – all of these can be the ‘sand in the gearbox’. Don’t assume that a new ICT system is going to solve all problems – after all, these are tools, not a panacea to what are typically complex and entrenched challenges.

Next Steps

SeeSaw and iComms are now exploring how to take forward research into how to improve information flows and how incentives shape the behaviour of different stakeholders within any ICT system designed for the water and sanitation sector. A similar event is also planned for East Africa in early 2013.

If you are interested in hearing more about these topics, subscribe to SeeSaw’s newsletter for more details.

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I spent the past few days at the mHealth Summit where James BonTempo and I (supported by Plan International USA and MCHIP via USAID) co-hosted the “mHealth Reality Booth,” which we hoped would bring some mHealth practitioner reality to the Summit and offer an opportunity to capture some learning from folks working on the ground and implementing mHealth programs in some of the less cushy environments.

As people came by the booth, we asked them if they’d be willing to do a short video that completed the idea:

“We thought that…. but in reality….” or “Most people think…. but in reality….”

We ended up with some great advice on mHealth design and implementation. Watch below or on YouTube! If you have an mHealth Reality you want to add in the comments or as a ‘video response’ please do!

Here’s our talk-show host intro (why does self-filming always make me look so weird?) and our list of mHealth Realities underneath. Enjoy!

1) Phones do get stolen, so you should involve health workers in determining what the consequences are when it happens.

2) When hospitals are gutted, cell towers are gone and there’s no electricity, for example during the Great Floods in Pakistan, you have to go back to the basics.

3) The technology should be the last thing to think about in the design process. You need to know the what first, and then think about the how.

4) Mobile operators are very interested in exclusivity. This is a challenge if you want your project to reach the entire population.

5) Even if your macro level research tells you that 80% of households have mobile phone access, it doesn’t mean that 80% of women have mobile phone access.

6) There’s literacy, and then there’s ‘mobile phone literacy’. Both are important.

7) If your paper form is crap, your mobile data collection form will also be crap.

8 ) You need policies on lost, damaged, stolen phones, and emergency mobile phone resuscitation training.

9) You will be beholden to traditional funding cycles regardless of how innovative you are, or how sustainable your own business plan is.

10) NGOs just want to come in and do one year pilots, pack up and leave, and come back to do another one year pilot. This is not sustainable. Governments need to be involved. (in French translation pending…)

11) You really need someone who’s available locally to provide technology support and someone who’s good at helping others use and be comfortable with tech.

12) Power is always a consideration. Having it figured out in one place doesn’t mean you have it solved for another place.

13) Things take a really long time. Much longer than you initially think.

14) You might love designing for iPhones and Androids, but if your users don’t have iPhones and Androids, well, that’s not very useful, is it?

15) There are very talented software development firms in places outside of the US and Europe.

16) Every assumption you have about an area or a population is probably wrong.

17) Every country has a different set of mHealth issues and there’s no way of anticipating until you have hands on the ground there.

18) User testing will help you understand what users really want. And NGOs need to ask themselves the hard question: why do we really want to use new technologies?

19) People in low resource settings and with no previous experience really can learn to use smart phones and like it.

Watch all 20 on YouTube.

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In early 2005, following the Tsunami, I collaborated with a cross-section of people at the organization where I work to put together a summary of lessons learned and some short guidelines for working with children and communities in emergencies.

All of us had been directly responsible for supporting and/or coordinating disaster response with communities, staff, local and national governments, international and national NGOs, children, youth, schools and teachers, or some combination of the above, in the countries where we lived and worked.  We discussed preparedness as well as relief and recovery phases. We talked about how child focused community development organizations, like the one where we worked, should look at children’s survival, development, participation and protection in a disaster situation and we created some internal guidelines.

Some of the most important things that stayed with me from the weeks we spent talking with each other, with peer organizations, and with our colleagues who were dealing with the 2004 Tsunami are related to the importance of child participation and protection during emergencies.  These recommendations can be applied now to the crisis in Haiti.

  • Don’t assume children or their families can’t do anything for themselves. Local coping mechanisms are often overlooked and underestimated by central governments or aid organizations, creating unnecessary dependency.  Participating and taking control of their situation can actually help people return to normal sooner. I clearly remember an example of an IDP camp where all the services (food, water) were at first centrally coordinated by the municipal government.  A manager from our organization was able to convince the government to engage camp ‘residents’ and organize children and youth into smaller groups who handled particular responsibilities. Suddenly the trash in the camp was picked up and time spent in the food line went from 2 hours to 20 minutes, tempers lowered and people relaxed a bit and got on with things.  The Children and Participation: Research, Monitoring and Evaluation with Children and Young People by Save the Children is a general guide that can help staff think through and orient participation of children and young people in emergencies.  Child-Oriented Participatory Risk Assessment and Planning (COPRAP): A Toolkit developed by the Center for Disaster Preparedness (CDP) in the Philippines is another excellent resource. Both were adapted and used by Plan during the conflict in Timor Leste, for example.
  • Child protection is critical during an emergency and after. During a disaster the typical social patterns and groupings that protect children may be challenged or broken. Children can be further harmed, abused and exploited by those who take advantage of the chaos.  Unaccompanied children can be preyed on if mechanisms are not established quickly.  Personal information about children is often shared or published widely in the interest of helping find parents or relatives or find missing persons, yet it can also help unscrupulous people to identify unaccompanied children and prey on them, especially now when published on the internet.  Birth registration and restoration of lost identity and other civil registration documents are critical to halt trafficking, as is close coordination among organizations, governments, communities and local agencies/staff.  Community members and the affected population can play a strong role in protecting their children, as can older children themselves.  The Interagency Guiding Principles on Unaccompanied and Separated Children, put together by the International Committee of the Red Cross, International Rescue Committee, Save the Children UK, United Nations Children’s Fund (UNICEF), United Nations High Commissioner for Refugees (UNHCR), and World Vision, gives an excellent overview of protection.  Further resources are available at Better Care Network’s website which has materials on separated children in emergencies, how to prevent separation through good relief and response efforts, registration, documentation and tracing, emergency care arrangements, verification and family reunification.
  • Unaccompanied children should not be given up for foreign adoption during the emergency phase. Experience in many past emergencies and conflicts has shown that this is just not the way to go.  In the emergency phase there is no way to ascertain which children are orphans with no other family at all, versus children who might be orphaned but have family somewhere who could take them in.  Taking children out of the country to feed them without a long-term, sustainable plan for them can end up being more complex than finding a way to feed and care for them in country.  Supporting removal of children from their own country during a time of upheaval can also engender a negative reaction among the affected population, who may come to see every external face that comes into the community or camp as someone coming to steal their children.  Interim and emergency care should be consistent with the long-term goal of family reunification.  More background on this can be found at the International Foster Care Association’s website.
  • Participation and protection go hand in hand. The greater the amount of knowledge and ownership that children, youth and their families and communities have, the safer they will be and the sooner they will recover. When the affected people have more input in the relief, recovery and reconstruction, efforts are more successful.  This means linking and coordinating with existing community organizations and structures, local government mechanisms, local non-governmental organizations.  Though it may appear that everything is wiped out in a major disaster, leaders will emerge and regroup.  Plan’s publication “After the Cameras have Gone:  Children in Disasters” offers some examples and insights on protection and participation in disaster situations.
  • Report ethically. The media will undoubtedly look for the ‘best’ story in the interest of raising the most funds possible for the emergency.  In media-speak, unfortunately, that often means the hardest hitting story, the most emotional story, and some journalists/media folks will go extremely far to get it.  However, journalists and agencies bringing journalists to affected communities should obviously not further harm children or take advantage of affected persons in their drive to get the best story.  Journalists should not ask children to relive traumatic experiences or to make them tell stories that upset them just to get a shot of a child crying.  The golden rule applies – how would you like it if that were you or your child?  Children or other community members may be too polite or unsure of whether they can say ‘no’ to a journalist, especially if that journalist is foreign or comes with an aid agency or entity that is linked with emergency aid.  Those working regularly with children and their families should ensure them that they can refuse to talk, they can halt an interview, or not have their picture taken. Local staff managing media visits should feel empowered to intervene on behalf of children in these cases. UNICEF’s “Child Rights and the Media” Guidelines for Journalists and Media Professionals, published by the International Federation of Journalists, gives a background and guide for ethical reporting on children in general.  These guidelines include things like striving for sensitivity when reporting on issues involving children and avoiding use of stereotypes and sensational presentation to promote journalistic material involving children, and they should apply in emergency situations as well.

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