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IRC's Client Voice and Choice initiative and Ground Truth Solutions pilot case study A: integrated community case management in South Sudan

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The IRC's Client Voice and Choice initiative and Ground Truth Solutions are piloting an approach to better understand and strengthen how humanitarian assistance incorporates the preferences, aspirations, and expectations of the people at the focus of aid. This document details the methodology and findings of the pilot examining South Sudan's integrated Community Case Management (iCCM) program. The iCCM program aims to reduce under-five child mortality and morbidity from malaria, diarrhoea, pneumonia, and acute malnutrition. The program works through a network of Community-Based Distributors (CBDs) from local communities who provide awareness of, and treatment for, these four conditions.

Implementing the Feedback Mechanism—What We Learned

  • Internally vs. externally collected feedback does not offer clear differences. The differences in the survey scores obtained through the data collected internally by the program team were not consistently higher or lower than those collected by the external partner. The favorability of the response when the survey was administered by IRC staff, compared to administration by the external partner, was higher for some questions (those concerning service quality, service accessibility, respect and dignity of staff) and lower on those questions concerning provision of information and voice/agency. However, the greatest differences seen never exceeded a 10 percent variance from one form of survey administration to the other. Given the particular context and relationship that the team had with the community, the significantly lower cost of internal data collection, and the ability of staff to ‘close the loop’ (report back to clients on how staff could or had responded to their feedback) immediately when administering the survey, the team’s future preference is for internal data collection.
  • Adjust survey and dialogue session frequency to the program. The survey rounds were run at two- month intervals that, at the time of designing the feedback mechanism, seemed appropriate given the more ‘developmental’ context of the iCCM programme compared to other humanitarian ‘crisis’ contexts where the IRC is operating. However, the program team reported needing more time to course correct and, as such, recommended a four-month spacing for future rounds. While sufficient time to course correct following receipt of client feedback is an appropriate reason to allow additional spacing between rounds, program leadership should note that lack of time in the program schedules for necessary follow-through (dialogue) and follow- up (closing the loop) does not become an excuse to limit client interaction. Rather, appropriate scheduling should be addressed by building this communication into future project designs, work plans, management practices, and budgets accordingly.
  • Use surveys to highlight topics for further exploration through dialogue sessions. The program team valued the combination of a survey followed by dialogue in specific communities where results were most pronounced. If new surveys are not conducted, or more interspersed in the future, program teams may wish to consider using dialogue/focus group sessions to follow-up on issues identified through other routine monitoring data.

Next Steps and Recommendations from these Pilots

The program team directly identified many of the next steps for them to take forward regarding lessons from the pilots. CVC and Ground Truth also provided other recommendations:

  1. Continue to use a variety of channels for clients to provide feedback, and engage clients in identifying preferred communication channels. The combination of regular surveys plus focus group discussions offered the program team useful information on what clients feel, why, and things to do in response.
  2. Continue to use client feedback to both triangulate monitoring data and challenge and/or verify the program team’s assumptions about what is and is not working and why.
  3. Continue to champion a culture of continuous improvement, facilitating open and honest communication and involvement of all program team members when interpreting what clients feel and think, and suggesting ways to respond.
  4. Empower the clients, the CBDs, and supervisors to talk to the program team through established channels or through routine engagement, urging them to share feedback and ideas on how to improve the iCCM program. Use this communication exchange to close the loop and report on what the team has done, can do, and why.
  5. Share the experience and lessons that the program team learned with other program teams in South Sudan, with technical advisors and, through them, those teams implementing similar programs in other countries.

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