Coordinating aid to Katine

9 October, 2009

Richard Kavuma has writen an interesting article about the role of insecticide treated bednets in preventing malaria, especially amongst young children in Katine (See Net gains in preventing malaria). His article notes that while bednets have reduced malaria there are other important prevention measures that are not being addressed, most notably ensuring a continually available stock of anti-malaria drugs in the local clinics.

I was very interested to read that there was another agency that was providing bednets in Katine, and in other areas of Soroti District. In fact “Since August 2007, … PSI Malaria Control, which supports governments with malaria prevention programmes, has given out 89,660 nets to households in the district’s 17 sub-counties – including Katine.” This compares to the 5,478 bednets given out by AMREF in Katine.

Amongst international aid agencies, especially bilateral (government) and multilateral (inter-govermental) there has been a strong movement over the last decade towards greater coordination and harmonisation of their aid efforts. These intentions were documented in the 2005 Parish Declaration, and have been systematically monitored since then.

Richard’s story raises questions in my kind, and perhaps others, about the reasons for AMREF being involved in bednet distribution, when there another agency present in the district doing the same thing, but on a much larger scale, and possibly with more specialist knowledge in this area. Did PSI start their distributions after those made by AMREF? Could AMREF’s resources (funding and staff) now be better directed elsewhere? Or are there good reasons for AMREF to continue providing this additional channel for bednet distribution?

The reference in Richard’s story to families buying ordinary (untreated) bednets raises a related set of issues. What has happened to the private sector suppliers of  bednets to Katine (and Soroti as a whole), since the distributions of free treated bednets by PSI Malaria Control and AMREF?  Have their sales collapsed, or have they expanded? (and does AMREF know what is happening here?)  It seems highly likely that the only way treated bednets will continue to be made available to families in Katine after the current project comes to an end will be through the private sector suppliers, if theyare still in this business. Is AMREF thinking in these terms?

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One of the often claimed advantages of providing aid through NGOs is their ability to be more innovative, especially when compared to government structures. In practice innovations by NGOs are not as common as one might expect, at least in my experience.

One of the more interesting features of the KCPP is the setting up of a “community media centre” which has four computers connected to the internet. This is in a large room in the same building as the AMREF office, which is about a hundred metres from the Katine sub-county local government offices, and just off the main road that runs north-south through the centre of the county. In the last progress report provided by AMREF, earlier this year, it was reported that

More than 100 community members have received basic training in computer skills so they can write simple stories. There is a committee who oversee the resource centre from the community. 30 people were specifically selected and trained as Trainer of Trainers. About 40 school children also received similar training from both primary and secondary schools. Over 25 community members visit the media centre daily to seek knowledge and learn. Some read and contribute to blogs on the project website. A media centre committee has been formed by the community to be part of its running

AMREF’s Mid-Term Review subsequently reported in August that:

Five centre users were interviewed together with Joseph Malinga the Community Media Facilitator.  More than 100 people have been trained in basic computer skills.  All five of the users have posted blogs on the Guardian website, they are know as ‘Katine Informer’.  All five use email, four email outside Katine and two of those email outside Uganda. The users considered that the service would be sustainable; they saw the possibility of an internet café provider from Soroti running the centre although they were fearful of the cost as twenty minutes of internet time in Soroti costs the equivalent of a meal.  Two on-line chat sessions have been held, linking school children in Uganda and the UK.  Some equity issues exist; people with poor, or no, English are disadvantaged.

What is the objective being pursued, and how will we know when it is being achieved? One seems to be to provide opportunities for Katine residents (other than AMREF staff) to participate in the discussions taking place on the Guardian website. This has happened, on a modest scale. The other may be to provide internet café facilities which are more accessible, in terms of location and cost. This is happening, though as noted above, there are big questions about sustainability that need to be addressed. In the short term it will be useful if AMREF could provide some detailed statistics on usage of the internet facility since it started, including total number of users (broken down by gender at least) and some form of frequency distribution showing numbers of visitors x number of visits by them. Are a small number of people using the facility frequently and the rest only once or twice, or is use more evenly spread?

Is this all there is? Or could more be done with this facility? AMREF reported on the media centre under the heading of “Empowering communities with information, knowledge and exchange of ideas”. If that is the wider objective, then how could it be achieved?

The Economist of 26th September has an interesting article on telecoms in emerging markets, that if read could prompt some more imaginative thinking by AMREF about the possibilites. Uganda is mentioned a number of times, as a place where there is rapidly expanding mobile phone coverage, and where there are some interesting innovations in the types of services being provided via mobile phones. Some of these are being supported by Google, the Grameen Foundation and the mobile phone networks themselves. They include provision of agricultural information via text messages, as well as the better known money transfer services.

Despite the poverty of many households in Katine, mobile phones are not a rarity. There are enough around to make it worthwhile for at least one person in Katine’s Tuesday market to earn income by charging people’s mobile phones using a truck battery (See Guardian article on this). On my first visit to Katine I was surprised to find that mobile phone reception in the sub-county is better than in the part of outer Melbourne where my mother lives. Katine’s open and flat landscape helps.

AMREF’s  baseline survey of Katine, carried out in late 2007, did not ask about mobile phone use, nor did the more recent survey contracted by CARE in early 2009. The focus of both of those surveys , like many development project baseline surveys, was on deprivation and constraint, rather than opportunities. Perhaps it is now time to investigate the opportunities people see around them, and work on how access to those opportunities could be improved. Time could be spent finding out more about the access to mobile phones (owned and borrowed) and the purposes they are used for. The new road is also likely to be seen as an opportunity by many people in Katine, and not just a risk (e.g. more vehicle accidents and more HIV cases).

The Economist article highlights a number of possibilities that could be explored in Katine. One is the role of intermediaries. In Bangladesh this first took the form of a woman (a Grameen group member) in each village selling mobile phone use (for incoming and outgoing calls)  to others in the same village on a call by call basis, while buying the phone from Grameen on an instalment basis. Would this be possible in Katine? Is it already happening on an informal basis? More recently Grameen is looking at the possible role of “information intermediaries”, who can help others get access to particular mobile phone based information services. In Katine that role could be expanded to helping others access useful information via the internet, without having to use the Community Media Centre computers themselves (remembering that a high percentage of Katine residents are not literate). These “infomediaries” might the ones would could afford to pay for internet access, and be willing to do so.

More information is needed, about the use of mobile phones and the use of the internet in Katine. With the current users of the internet in the Community Media Centre what services are they using? Email, text chat or skype for communications? Visiting social networking sites or using Google for information searches? For information about Uganda matters or about the rest of the world?  Looking forward it would then be useful to try to idnetify Uganda -specific information is available on the internet, which might be of most interest to Katine residents. Provided by the government and others.

Re the use of mobile phones I suspect there are many innovatory uses already being explored by people in Katine, but not yet widely appreciated by aid agencies and donors. For example, to what extent are government officials already using mobile phones to submit verbal reports, or at least texted data on key indicators? How often are meetings being convened through networks of phone calls? Are any farmers receiving commodity price information through their telephone contacts? Further afield is the whole area of money transfer. Are households receiving money transfers from Kampala via mobile phone, and at what cost?

According to the Economist a recent study found that “adding an extra 10 mobile phones per 100 people in a typical developing country boost growth in GDP by 0.8 percentage points” Would connecting up a local population of mobile phone users with skilled internet users lift this figure further? Or should any investments that can be made focus on exploiting the uses of the most widely used technology, i.e. mobile phones rather than the internet?