Waiting for Registration .. Patiently
When this project was being officially launched one year ago under the Food for Work and Food for Assets programs, we had planned for the opening event to be held in Kenya. With less than a few weeks to go, all hell broke loose in Kenya with election violence. That reality left us scrambling to change venue at the last moment. Yesterday, I had a touch of deja vu. During the night, a small militia attempted to launch a coup here in Lesotho, if you could really call it that as the chaps didn’t appear to give it much planning (did this make the outside news?). Some military and civilian vehicles were hijacked, followed by a shoot out at the Prime Minister’s residence and then the subsequent chase to the border due to the aforementioned poor planning. All of which culminated in a firm hand quashing the attempted coup. A friend that works here in Lesotho tells me that he could have planned it better himself!
It happens that the following morning is the official review session that has been organized by the World Food Program (WFP) on the LMMS systems. Unfortunately, staff within the UN were all in a tizzy given the events during the night. While the UN folks were preoccupied with security, Lesothians were apparently making up for lost sleep, as there was a decidedly sleepy feel town … more so than usual.
Our expansion work with WFP’s follows hot on the heels of the introduced systems for the Food-for-Assets/Work (FFA) programs in Lesotho and Kenya that began last year. The UN group were introduced to the systems during the FFA rollout. They were also included in a planning session we had organized last November (2008) in South Africa on the IT systems. WFP Lesotho’s new Country Director (Mr. Bhim Udas) had suggested we engage following the FFA experience. In a meeting that we had with him a few days ago, he again reiterated the need for these solutions in the work that they are involved with. While WFP are able to track consignments from the port of origin through to the various intermediary warehouses (entry points to the country and district warehouses and then down to the final distribution centers), there is a serious challenge in tracking where the food goes after the warehouse centers – “from the FDPs [Final Distribution Points], we just don’t know what happens .. we need to understand how food is being utilized”.
This sounds quite familiar. A challenge that many NGOs, multilaterals and government bodies have is with the lack of immediate access to information to understand the efficacy of program interventions. From our food distributing perspective understanding where food is going and how it is being used is important us for us to determine appropriate strategies for intervention. It’s also important for us to ensure that rations are being used by those most in need. Of course from an organizational perspective as well, fraud does happen and we need to understand what misappropriation of assets is occurring and guard against it.
Through funding through the German government (GTZ), WFP was able to engage with the LMMS team to deliver a prototype on the application for World Vision’s use within the Targeted Feeding programs (akin to Supplementary Feeding) that WFP was funding in Lesotho.
What’s Targeted Feeding?
Targeted Feeding are programs in which individuals who are deemed at risk, are supported by supplementary rations in an effort to prevent mortality due to malnutrition. In general, children under five, pregnant and lactating mothers and the sick are people who are often identified for Targeted Feeding programs. The food that is administered under these programs is supposed to provide for the additional nutritional needs of this at-risk subpopulation (in emergency context, this is often an effort to get these people to catch up with the nutritional levels of the general population). Targeted Feeding are programs where individuals are generally classified as mild to moderately malnourished (the more chronic malnourishment warrants a Therapeutic feeding program, which is often administering cooked food to individuals).
There is a certain degree of controversy over Targeted Feeding programs in the humanitarian sector. Knowing if supplementary food aid is actually delivered to the person most in need can be problematic. In certain situations (e.g. where general rations are insufficient), the supplementary food is often shared among family members and in some cases (especially conflict contexts), supplementary rations may be diverted to members of the household who are deemed more important. Understanding where food aid goes is exactly why I am advocating for more investment in expanding the LMMS systems into post distribution monitoring. With our systems that are now capable of gathering program information right down to the beneficiary level, we have a set of tools that can integrate between asset allocation and program monitoring. I’m hoping that we can begin to build this functionality early in the next fiscal year cycle.
I’ve digressed a wee bit .. back to Targeted Feeding. Under these programs, people may be discharged (“graduated”) from the program once their at-risk vulnerability improves. In the Lesotho case, Targeted Feeding runs within the domain of the chronically ill, many with HIV complications – unfortunately most will never be graduated from the programs given the nature of their illness and the hurdle of poverty that keeps them dependent on aid. The main categories for at-risk in these programs are people affected by HIV/AIDs (as of November, 2008 almost 25% of the adult population were estimated to be HIV+ in this country) and TB.
Supplementing Diets
The Targeted Feeding programs in Lesotho are being run in conjuncture with Health Programming organized by other NGOs. Photos on this entry were actually taken at a Health Clinic in the countryside that was built by Medecins Sans Frontieres.
Health Clinic out in the Country
People attend the health clinics on a monthly basis. Those adhering to Anti-Retro Viral Treatments, TB Treatment, Maternal-Child Health programs and PMTCT (Prevention of Mother to Child Transmission) health programs are given dry food rations for themselves and their families (family ration allotment is needed given my explanation above on ensuring that affected households reserve the supplementary portion for the individuals being targeted). Ration sizes vary based on the Targeted Feeding program one is registered in. Rations also include high calorie biscuits (CSBs).
Convening back in Lesotho was at the bequest of WFP who wanted to put on a formal review of our software developed under the Targeted Feeding module. The development of these systems was put under an utterly crazy three-month target set for the team in order to meet GTZ’s fiscal funding schedule. Three months is not a lot of time, particularly given the fact that the negotiation process between WFP and WVW took us two months before we could even secure access to funds to start the process of systems development! Our team was forced to take the risk on starting work ahead of MoUs being signed. Not really ideal to say the least.
The software has been developed and we have done a fair bit of training for our colleagues and their Implementing Partners. However we will need to run through substantial testing and some modifications before completing the roll out within Lesotho for the full Targeted Feeding programs. What’s more important is that we will be releasing the improved version of LMMS in December .. so we also need to ensure that our staff and our humanitarian partners are primed for the improved version of LMMS then.
In the meetings I had with WFP country personnel in Lesotho, this was something that I expressed quite clearly. Often people assume it’s a simple procedure developing the code and rolling out. The reality is not that simple. A fast scale up is great, but only when we are confident on the systems. Failure to do so can be a real nightmare in future upgrades and patch fixes. Equally important is the fact that the organizations have to be ready: End users trained in using the tools, decisions on maintenance, security procedure established, food aid recipients educated on the what’s and why’s and so on.
The WFP review session that we have been invited to, presented background information on what has been developed and a field trip to see the systems in action. This is a period of reflection on the introduced system within WFP and to seek input from WFP’s other implementing partners (WFP does no actual field distribution and relies on partners like WV and other NGOs to get the food out to beneficiaries).
Despite a lower than expected turnout at the review session, the feedback has been positive. At the end of the day – there is a mandate to do more with the system and to get it scaled up. This is coming from WFP and other implementing partners including local NGOs, The Clinton Foundation and the Red Cross as well the European Commission who sent a representative. All of which is good endorsement of our efforts and makes me a happy camper in the sense that we are moving toward an integrated humanitarian solution.
Seeing LMMS in the Field
Card Printing in the Field
Issuing Cards
First Prints - Linking to Beneficiaries
Beyond the reflection meetings, what was particularly instructive to me over the last few days was the learning I gathered during field observations on how distributions are being conducted by other organizations. I’m familiar with the way WV does this, but viewing the other organizations methodologies was extremely useful in defining how LMMS can assist in the process of gathering pertinent information for better humanitarian programming. It was also instructive to me from the perspective of how to introduce systems development and change management within the implementing organizations.
In no particular order some of the lessons I’m taking away from this experience:
Lesson 1: Live pre-intervention observations are critically important and should be conducted as soon as possible in the software requirements gathering process. Sounds obvious I know, but WFP did not meet their obligation for us to do this on our initial request (in part due to the challenge of the three-month timeline that was actually one month of hands-on work). In truth, I don’t think they had distributions that we could observe during the one-month period). The result has been an incomplete software specification that is just going to cost us more money and more time.
Lesson 2: The value of field-observations and later field-testing with real data cannot be understated. No length of time in the requirements mapping in an office with staff will give you the reality of what is needed by the field. Today’s exercise demonstrated how checked and rechecked requirements gathered by my team made no difference in the fact that the supervisors and end-users did not present complete requirements to the team. In some cases, the assumptions that were presented were completely incorrect. Field based trials are extremely effective in understanding how the LMMS systems are to be used and how the systems handle field realities.
Lesson 3: It also has struck me to define in black and white the processes within an organization that are absolutely set in stone and those where we are afforded the luxury of re-engineering the way business is done. Everybody wants to throw in their two cents .. and I guess there is value in that. Some of these inputs simply do not reflect what an organization is capable or prepared to do. At the end of the day, it’s vital to identify those people within an organization that are capable of making the decisions on implementing change. Assuming senior management input in this regard is not a safe bet. Often times, senior management will be administrators who will defer detailed implementation to the field experts. Discovering whom these internal change champions are and getting them involved in the process of change as soon as possible is so important. But even if you do identify them, the act of accumulating information from these folks can be a real test of your interviewing and listening skills to tease out the information that you need.
Lesson 4: Organizing humanitarian distribution takes a ton of planning. What struck me during the field visit, in which I observed a registration and distribution process of a smaller NGO that partnered with WFP, was the utter chaos that can quickly ensue when planning is not given sufficient attention. To put it bluntly, the coordinators today did not do such a great job. What were the problems? It was evident that communications between the head coordinator and field monitors broke down early. Communication flowing from the two coordinators just did not filter through to the support staff (food monitors). What also struck me (again) was the sheer abundance of paper floating around and the hindrance it causes. Getting information from one end of the distribution site to another, means waiting for some one to physically walk it over. It was overwhelming and what I saw was a lot of staff shuffling around without getting the work that needed to be completed, done.
Lesson 5: Sensitizing the community to new ways of doing things should not happen the day of the change! Its clear that the implementing partners did not prepare the community for the change.
With with the Community on LMMS
I witnessed confusion among beneficiaries on what they were supposed to be doing during registration and I suspect the lack of preparedness on the part of the implementing partner caused a fair degree of stress on the beneficiaries.
Clearly, there is also a need to have members show up for registration prepared to share pertinent information … delays in the process of electronic registration were due in part to not having information at hand to answer key questions (dates of birth etc).
Lesson 6: It was also interesting to see that validation of data at registration did not happen. The monitors did not have the time or the access to resources (records or community members to corroborate information) that should have helped in ensuring that data being collected was valid. Any effort to register beneficiaries must be accompanied with checks against what data is being collected; otherwise your feeding programs will suffer from things like inflated family sizes, multiple registrations (at centers and across centers), incorrect photo linkages to data records, possible registration of ‘phantom’ families and so on.
Lesson 7: Ultimately this is data about people that we are capturing and using. This is information that should be collected in a manner that is sensitive to privacy and ownership issues. Fundamentally, only information that is needed for our objectives on better programming should be collected. The tendency in the design phase of systems such as LMMS is for people to overestimate the data they want to collect. Understanding this tendency ahead of time, should help to question the volumes of data being touted for capture and thereby alleviate some of the concerns on privacy and ownership. Recognize too that there is also a cost associated with redundant data collection (e.g. storage, maintenance, security). I’m glad to say that World Vision has already begun the process of addressing privacy rights and data ownership by working with the communities themselves.
Lesson 8: Introducing change takes time. Often an immediate assessment on the RoI is screamed for, but there has to be adequate time given to the systems being introduced before performance or RoI can be meaningfully interpreted. As an example, it was very evident today on the time it takes just to get used to handling new equipment. Early registration efforts were averaging about 20 minutes per household (an average of 5 members per household). Way too long! With a little bit more familiarity with the systems that number had whittled down to about 8 minutes per household toward the end of the day. That’s still too long. I’m confident that those numbers can come down even further, but in following up on the preceding thought.. I wonder if we can also revisit the value of all the information being captured at registration in an effort to streamline the process.
Complicating the process of using the tools was the phenomenon of overcrowding that happens ever time I see LMMS being deployed: One food member with the mobile unit, had five or six other staff peering over their shoulders and everybody was giving their two cents in the process. I witnessed one of our drivers in the ruck, giving his inputs too on which buttons to press!! Somewhere in the ensuing fray is the poor beneficiary just trying to get their card scanned so they can get their food and get out of there.
Overcrowding
This ruckus has to stop – in the future it must be a one on one with the beneficiary, with access to a support person should there be problems. What I was also acutely aware of was that ‘overcrowding’ is in part due to reluctance with certain people to handle the IT tools. This is understandable; there will also be some people who fear breaking the tools or just not performing well enough with a new system. Better training so that staffs feel comfortable with the tools prior to throwing them in at the deep end is always a better idea. Also having a mentor (non-techi) floating around for questions and answers that are in end-user language is fundamental. A seasoned (i.e. exposed to the IT tools) monitor who relates with their food monitor counterpart – does a much better job of hands on support and psychological confidence building in the field. We also need to control the degree of support that our technical team delivers. There was a tendency of the CSDT to want to step in and do the job for food monitors when problems arise. This is counterproductive in the long run.
Observation 9: One last comment on change before I leave this entry alone and go to bed, there is also a very tangible concern by many field personnel that technology threatens their jobs. Philosophically, I would hope that in the humanitarian sector we could be comfortable with the concept of working to put ourselves out of work … the reality is that this is also people’s livelihood. The threat that people feel must be acknowledged and the organizations implementing such change should be prepared to face the concerns and the resistance from staff. In introducing these new technologies, we have to do to a better job in preparing for the difficult aspects such as job losses and for the more positive elements that job changes will introduce. I’m not sure I have the answers on how best to accomplish this (suggestions?), but being fully transparent on what the implications of change will be and providing sufficient support to staff as they develop the needed skills will factor prominently. On that note, I’m leaving it there. Off to Zimbabwe tomorrow for a review of LMMS in that country – a massive undertaking given the crisis in that country … sad given that this was at one time the bread basket for Southern Africa. I was a kid last time I was in Zim, I suspect that this one will be an eye opener.
Jay Narhan Project Updates
… there’s still a lot to do and we are pressing ahead.
