No “one size fits all”

DRC Part 1: Monitoring nutrition in South Kivu

Access issues in South Kivu WFP/Kusum Hachhethu

Access issues in South Kivu
WFP/Kusum Hachhethu

The Democratic Republic of the Congo (DRC) is a vast country, roughly the size of Western Europe. It’s therefore no surprise that implementing mVAM, even in one country, requires a lot of adaptation. When we want to introduce new tools or indicators or want to implement our existing tools in a new setting, we can’t just assume that what has worked before will work in the same way in a new context.

A few weeks ago, two mVAMers, Kusum and Jean-Baptiste, went to Kasai and South Kivu in DRC to scope out how feasible it is to use mobile monitoring in some of the most remote or conflict-ridden regions of the country and how our tools could be adapted to support WFP’s work in these areas.

In Part 1, we follow Kusum into the South Kivu region of DRC where we want to improve nutrition monitoring for women:

In South Kivu, a lack of real-time, regular data on the nutritional status of women and children makes monitoring and programming difficult. The WFP country office therefore wanted to explore alternative methods of data collection, which would allow them to receive updates more quickly, regularly and at a reduced cost. But before regular mobile data collection can take place, we have to go through a process of assessing the feasibility and validity of our methods by conducting a scoping mission followed by a mode experiment. In South Kivu, we visited two sites: Lusenda IDP camp and Bunyakiri town.

Focus group discussions with women in South Kivu WFP/Kusum Hachhethu

Focus group discussions with women in South Kivu
WFP/Kusum Hachhethu

Careful scoping is necessary to understand how feasible it is to contact women using mobile phones as low phone ownership rates among women and potential gender norms may prevent women from participating in phone surveys – an issue which we encountered in Kenya. In both settings we wanted as much information as possible to ensure that our feasibility study was sufficiently rigorous. We therefore conducted focus groups and interviews with women, men, and young people, and key informant interviews with camp managers, government partners, and field staff.

What we found was that while very few women in these locations own a personal mobile phone, most women have access to household phones. The findings from our feasibility nutrition study in Kenya were similar, so from our experiences there, we can assume that with prior notice to community leaders before phone calls and appropriate sensitisation activities with men, we would be able to reduce the barriers to reaching women.

However, apart from the factors we need to take into account specifically when trying to contact women, there are also some general challenges we need to address when using mobile methods to reach people in South Kivu. Many people in the Lusenda camp use Burundian SIM cards to stay in touch with relatives in Burundi and will be charged roaming costs when receiving or making phone calls from a call centre based in  DRC. Another challenge is that network coverage is highly variable even within these locations. For example, while it is excellent in the central market area of the camp, it is very poor in the new refugee settlement areas.

Lusenda IDP camp WFP/Kusum Hachhethu

Lusenda IDP camp
WFP/Kusum Hachhethu

In view of these challenges, maintaining an adequate response rate will require perseverance and some adjustments. For instance, it is important to contact women from camp households using our Burundi phone line rather than the DRC one. To increase the response rate, we will also need to send out reminders to community leaders about the upcoming survey and to make multiple phone call attempts at different times of the day and different times of the week.

The next step in South Kivu will be to conduct a mode experiment, which will allow us to understand if there is a potential bias when collecting nutrition data remotely using phone interviews. This mode experiment will also help us understand if there are any differences in the the socio-economic characteristics between among households with and without phones that would bias our results.

If all goes well, step two will be regular data collection of the nutrition indicator Minimum Dietary Diversity of Women (MDD-W) using live calls to conduct trends analysis and monitor the nutritional status of women. At the end of this long process, from scoping out the feasibility of using mVAM for nutrition monitoring to collecting data regularly, the information can be used to inform programmes and policies to improve the nutritional status of women and children in South Kivu.

Stay tuned for part 2 of our blog mini-series on DRC, in which we follow Jean-Baptiste into the Kasai region!

Also published on Medium.

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