Will the Katine baseline survey be of much use?

28 May, 2008

Information about the Katine baseline survey can be found here:

Development aid projects don’t always start with baseline surveys. More widespread use of baseline surveys would be a good thing. They can be useful for a number of reasons:

  • The results can be used to engage stakeholders in discussions, at the beginning of a project, about what needs to be changed, and how
  • The results of subsequent re-surveys can be compared to the baseline survey to see what has changed (and not). This information can be useful both during project implementation and at the end of a project: to help improve the effectiveness of a project, and to help show its overall impact to other parties e.g. policy makers or donors.

Nevertheless, I have some major concerns about the household baseline survey that was carried out in Katine in January this year. I am concerned that it may not be able to serve the second of the two purposes I have listed above. It may not be of much use.

There are two reasons why I am concerned. The first is about what is missing. The household survey randomly sampled 95 households from six parishes in Katine sub-country. AMREF will be proving assistance to all six parishes over the next few years. The sample did not include any similar parishes nearby that could be used as a comparator, otherwise known as a control group. So, even if the re-survey in 2010 does show significant improvement in people’s lives it will not be clear what this means. It could be a reflection of the fact that conditions have improved across the district, and across the country even. “A rising tide lifts all boats”

The lack of a control group is not necessarily a disaster. Often, especially in large development projects with a significant emphasis on decentralised planning, interventions will vary across locations. If this is the case then we can also expect that the desired outcomes (i.e. changes in peoples lives) to vary across locations. We could make some predictions, then test these against observations, to find out what kinds of interventions are associated with what kinds of outcomes. For example, does investing across all sectors (health, water, education), make more of a difference than investing heavily in just on sector (e.g. water). Or is it simply a matter of how much is invested, with bigger investments making more of a difference than small investments?

Will this internal comparison be possible in Katine? The random sample of households was designed to make statistically valid comparisons between the six different parishes. However, from the information I have seen so far, it is not expected that AMREF’s interventions will vary substantially between these parishes. The parish is not an important planning unit, in the way that AMREF is working in Katine. The most common unit of planning seems to be the village. There are health committees, water committees, farmers groups and credit groups at the village level, and AMREF (and its partners) will be working with all of them. In addition, there are some larger planning units: the 13 schools (and their associated School Management Committees and Parent Teachers Associations) and the three major health centres.

Fortunately, AMREF has begun to develop a database on all villages, and on the schools and health centres. In my next visit I will be asking about the kinds of data being kept in those databases, and how well it is being maintained, and used. This is where the investment in baseline data collection and regular monitoring thereafter, will be most crucial.

PS1: There may be some voices within AMREF who think this sounds too much like research, too removed from the practicalities of improving peoples lives. I would describe it as a kind of action research, that can help ensure that AMREF’s interventions are as effective as possible, and replicable by others.

PS2: This more recent posting is also relevant, because it talks about comparisons between Katine sub-county and other sub-counties in Soroti district


4 Responses to “Will the Katine baseline survey be of much use?”

  1. What were they using for birth control before you started helping, what were the # of live births, how many lived to adulthood. Are the women now being taught birth control and are the men allowing them to use it? Over population is problem with resource allocations, seems to me. stephanie

  2. rickjdavies Says:

    Hi Stephanie

    If you follow the link above (The survey results) and go to page 23 of the baseline survey report you will find this information:

    – “Knowledge of modern methods of contraception is very similar across the five areas, with most women knowing about female sterilization, oral contraceptive pills, injectables and condoms. The great majority (86%) know a place in Soroti district for obtaining contraceptives”.

    – but… “Despite the high level of knowledge of the most commonly used methods in Uganda, only five women (4%) reported currently using a modern contraceptive method: female sterilization (1), injectable (1) and condoms (3)…The contraceptive prevalence rate is lower than the national average seen in the 2006 UDHS for a rural area (15%) or the Eastern region (17%)”
    – and 79% of women and 84% of men know that using condoms reduced risk of getting HIV/AIDS

    So, your question “Are the women now being taught birth control and are the men allowing them to use it?” is an appropriate one, which I will relay to AMREF, for their response.

    I am not quite sure what you mean when you say that “Over population is problem with resource allocations”. Are you saying there are too many people for the resources available? If so, you may be interested to know that not all farming land is under cultivation, so there is no absolute shortage of arable land in Katine sub-county. While there are problems with sufficient quality health and education services the causes of these problems are not the rate of population growth.

    PS: I looked for information on numbers of live births in Katine, but could not find it in the baseline survey

  3. Ravi Ram Says:

    Hi Stephanie and Rick,

    I’ve relayed your comments/questions to the team in Uganda and am awaiting their reply. Will keep you posted on this.

    Best regards,
    (AMREF M&E Leader)

  4. rickjdavies Says:

    Hi Stephanie and all

    I have now received comments back from AMREF on the issue of family planning and on land use. They are:

    1. Re “Are the women now being taught birth control and are the men allowing them to use it?

    According to baseline results, knowledge about family planning methods among both men and women was high (90%), although use is extremely low (4%). Unfortunately attitudes of women and/or men towards family planning method was not captured in the survey report and we hope that this (together with any other information regarding the social-cultural-religious or health systems related determinants on use of contraceptives) will be captured in the second year of the project when the promotion of family planning methods starts. This information will help further inform the project plans/strategies /approaches in promoting FP in Katine during its second year.

    During the second year of the project we plan to train Village Health Teams (VHTs) on the use of family planning methods and support them to provide information on the use of family planning methods to the community. We will also support them to provide family planning supplies (including condoms) to community members as part of their wider role of providing community based health services. This will include referrals to the health facilities for more surgical methods of family planning eg tubal ligation, intrauterine coil device (IUCD), vasectomy, Norplant Implant, etc

    Gender with emphasis on male involvement is a key strategy for AMREF not only for family planning but also other health activities specifically at the community level.

    The project hopes to devise strategies for male involvement, with full participation of the community in Katine (men and women), to ensure ownership and sustainability.

    Other interventions addressing reproductive health include:

    1. Training of TBAs in recognition of danger signs, effecting early referrals, PMTCT, Immunization, and prevention of malaria in pregnancy.

    2. Training of health workers in obstetrics care

    3. Rehabilitation and equipping Atirir Health centre IV operations theatre, mostly to aid delivery and surgical operations for maternal related complications.”

    2. Re land use,

    “Land as factor in population and reproductive health doesn’t arise as land shortage is not a serious issue here. The problem is poverty as exhibited by large tracks of uncultivated land. This is due to limited technology and farm inputs to make productive use of land beyond the family’s physical labor force, however large the family may be. Even were some families produce more, there’s limited access to markets for their products, hence a disincentive to cultivate large tracks of land. So, land isn’t a factor in reproductive health here but poverty (low incomes), household food security (being able to feed the whole family with nutritious food all year round), family health (especially mothers health and children-spacing them) and education (being able to take children to school and meet their needs).”

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