mVAM for nutrition: findings from Kenya

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Photo: WFP/Kusum Hachhethu

We’ve used mVAM to collect data on a range of things that impact food security – so what about information on nutrition? Back in October, we went to Kenya to conduct a study on whether we could use remote mobile data collection to gather information on women and children’s nutrition.

The summary of our findings from the case study are now available in a new report from mVAM and our partners in the study, WFP’s Nutrition Division and the World Agroforestry Centre (ICRAF).

Read more:

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Myanmar: assessing emergency needs without access

Photo: WFP/Myanmar

Photo: WFP/Myanmar

 

Late last year, an attack by an armed group on border police posts in Myanmar led to a government security sweep in Rakhine State and recurrent clashes and violence in many villages. As a result, access to a large part of the north of the state was closed off to humanitarian organizations, leaving the already highly vulnerable inhabitants of the townships to fend for themselves.

Unable to access the area since 9 October, WFP decided to use mobile surveys to conduct remote emergency assessments. While not as thorough as face-to-face assessments, mobile surveys could still provide a good snapshot of how people were coping in the areas that were closed off. Furthermore, mobile surveys serve as a means to address a critical information gap where there is little to no information about the needs of the most vulnerable and food insecure, as we have seen in complex emergency settings elsewhere such as during the Ebola crisis and Yemen. But let’s come back to Myanmar and rewind just a few years: hearing from people in these areas would have been impossible – essentially no one had mobile phones.

Myanmar’s mobile transformation

Myanmar’s telecommunication market has come a long way. Not so long ago, Myanmar was one of the “leastconnected countries in the world” – just seven years ago, SIM cards cost up to $1,500, and few people had them. In 2013, after the government awarded contracts to two foreign mobile operators, the price of a SIM card fell to $1.50 and network coverage began to roll out across the country. Once the mobile revolution began, things moved fast. Soon, mobile penetration exceeded even that of much better-off neighboring countries, such as Thailand[1]. By 2015, 96 percent of wards and 87 percent of villages in Myanmar had a mobile signal, and nearly 60 percent of households owned a mobile phone[2].

A case for mobile surveys in Myanmar

WFPs first mobile assessment in Myanmar took place in November 2016, with 32 key informants from 12 villages in Maungdaw and Buthidaung north, complementing face-to-face interviews of 48 WFP beneficiaries at 8 food distribution points in Buthidaung south. This was at the end of the lean season (the period between harvests when households’ food stocks tend to be the lowest), and respondents told us that due to the deteriorated security situation, people faced serious difficulties in reaching markets, were not able to go to work, nor access agricultural land and fishing areas and. Resulting crop losses could result in mid to long-term impact on food security while households’ terms of trade had decreased and posed a serious concern regarding their ability to purchase sufficient food.

Though low mobile penetration in rural areas of the country posed a challenge for phone surveys, people were nonetheless eager to participate in the survey and share their stories. In order to participate, some people even arranged to borrow phones from neighbors if they did not own one themselves.

A second phone survey in December allowed for a greater sample size and therefore a better understanding of the living conditions in the surveyed areas. WFP spoke to 116 respondents in 70 villages in Maungdaw Township. By this time, the people we spoke with mentioned that there was widespread food insecurity throughout the township. The situation was particularly problematic in the north, where markets were not functioning and access to agricultural land or fishing grounds was restricted. Livelihood opportunities were scarce and the lower demand for daily labour had had an immediate impact on the most vulnerable.

Photo: WFP/Myanmar

Photo: WFP/Myanmar

What’s next?

The data collected through the phone surveys helped WFP to get some understanding of the needs in the no-access areas, and to use this information for advocacy with the Government and humanitarian stakeholders. On 9 January 2017, after three months, WFP was finally granted access to all areas where it had operations prior to 9 October, and was able to distribute food to 35,000 people in the villages of Maungdaw north. With the area open again, WFP and its partners are now preparing for thorough assessments on the ground, which will give a fuller picture of the food security situation and also allow us to validate the findings of the phone surveys.


[1]http://lirneasia.net/wp-content/uploads/2015/07/LIRNEasia_MyanmarBaselineSurvey_DescriptiveStats_V1.pdf

[2]http://www.gsma.com/mobilefordevelopment/wp-content/uploads/2016/02/Mobile-phones-internet-and-gender-in-Myanmar.pdf

Can we reach rural women via mobile phone? Kenya case study

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WFP/Kusum Hachhethu

 

A few months ago, we published a blog post on our plans to test collecting nutrition data through SMS in Malawi and through live voice calls in Kenya. We just got back from Kenya where we conducted a large-scale mode experiment with ICRAF to compare nutrition data collected face-to-face with data collected through phone calls placed by operators at a call center. But before we started our experiment, we did a qualitative formative study to understand rural women’s phone access and use.

We traveled to 16 villages in Baringo and Kitui counties in Kenya, where we conducted focus group discussions and in-depth interviews with women. We also conducted key informant interviews with mobile phone vendors, local nutritionists, and local government leaders.

So in Kenya, can rural women be reached via mobile phone?

Here are the preliminary findings from our qualitative study:

  1. Ownership: Women’s phone ownership is high in both counties. However, ownership was higher in Kitui than Baringo, which is more pastoralist. From our focus group discussions and interviews, we estimate that 80-90% of women own phones in Kitui and 60-70% own phones in Baringo.
  1. Access: The majority of women had access to phones through inter- and intra-household sharing even if they didn’t own one themselves. This suggests that even women who don’t own a phone personally have access to phones that they may be able to use to participate in phone surveys.
  1. Usage: Women mostly use phones to make and receive calls, not send SMS. This supports our hypothesis that voice calls, not SMS, would be the optimal modality to reach women through mobile surveys.
  1. Willingness: Women were enthusiastic about participating in phone surveys during our focus group discussions and in-depth interviews, implying that they are interested in phone surveys and willing to take part.
  1. Trust: Unknown numbers create trust issues, but they are not insurmountable. Women voiced concerns about receiving phone calls from unknown numbers. Despite these trust issues, we were eventually able to successfully conduct our phone surveys after sensitizing the community, using existing community and government administration structures.
  1. Network: Poor network coverage, not gender norms or access, is the biggest barrier to phone surveys in the two counties. Women identified network coverage as the biggest barrier for communication. Some parts of the counties had poor to no network coverage. However, we found that phone ownership was high even in these areas, and women would travel to find network hotspots to make or receive phone calls.

So in conclusion, yes, in Kenya it is possible to reach rural women by phone.
Our findings from Kitui and Baringo counties show that we can reach women in similar contexts with mobile methodologies to collect information on their diet as well as their child’s diet.

We are also analysing the quantitative data from our mode experiment to find out whether data on women and children’s diet collected via live phone operators gives the same results as data collected via traditional face-to-face interviews.

Going mobile in Afghanistan

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WFP food security analyst Mudasir Nazar talking to internally displaced people (IDPs) in a camp near Kabul, during an mVAM scoping mission in October 2016. (Photo: WFP/Jean-Martin Bauer)

More than three decades of war, unrest and natural disasters has left Afghanistan with poor infrastructure and millions in severe poverty and facing enormous recovery needs. This insecurity pushed many Afghans to flee to surrounding countries like Iran or further afield to western Europe. It’s estimated there are 2.5 million Afghan refugees currently living in Pakistan many of whom arrived in the country in the late ‘70s during the war with the Soviet Union. In fact, in Pakistan, most Afghan refugees are second or third generation. Because of renewed political tensions, thousands are now starting to return to Afghanistan from Pakistan and it’s expected that there will be 600,000 arrivals by the end of the year. These returnees will require temporary assistance as they reestablish their livelihoods. Along with other humanitarian agencies, WFP is ramping up its work to prepare for this influx of people.

Mobile population, mobile monitoring

For humanitarian agencies like WFP, moving around Afghanistan is often difficult due to security restrictions and remoteness. This means we often have trouble directly contacting the returnees and IDPs we are helping, and getting information on the security or market situation in areas where they are settling.

But this is changing: mobile technologies now allow us to collect information remotely, not only from beneficiaries themselves, but also from members of the community such as tribal elders or shopkeepers. We are now preparing to use mVAM to reach people throughout Afghanistan – an approach that WFP already uses in nearly 30 countries.

Mudasir Nazar is a food security and market analyst with WFP Afghanistan, and is leading the set-up of mVAM here. After completing a Master’s degree in  Humanitarian Assistance at Tufts University (US), Mudasir is now back in Afghanistan with WFP. Like many of the returnees WFP is now helping, Mudasir grew up as an Afghan refugee in Peshawar, Pakistan. He came back to Afghanistan with his family years ago, settling in Kabul, but still relates very personally to what returnee families are going through at the moment: ‘A few years ago, I was in their shoes,’ he says.

Through mVAM, we will be asking questions about market food prices and food availability in areas where people are settling; what humanitarian assistance people need and what they are already receiving; and what livelihoods and coping strategies they are using to survive in their new (often temporary) homes. This data will allow us to understand the context into which people are resettling, and help WFP and others to provide the right type of assistance, to the right people.

Using mobile monitoring makes sense: the Afghan cell phone market has grown tremendously in past years. There are an estimated 20 million cell phone subscriptions in the country, out of a total population of 30 million people.  A recent study by USAID shows that while only 25% of women are literate, 80% have access to a mobile phone – either their own or shared within their household. When we visited an IDP camp recently and asked who owned at least one mobile phone in their household, everyone raised their hands.

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Mudasir holds a power bank which is typically used to charge phones. (Photo: WFP/Jean-Martin Bauer)

We have found that most of the people we meet tend to utilize only the basic features of their phones, and rarely use SMS or other messaging services. IDPs and returnees also often have trouble keeping their phones charged, since many are living in informal settlements with no electricity. Though some own small portable ‘power banks’, many have to pay to charge their phones elsewhere. People also often don’t have any airtime balance on their phone. They typically top up once a month with a credit of 50 Afghanis (roughly US$1), which runs out quite fast.

So what does this mean for mVAM in Afghanistan?

Firstly, we will be calling people through live operators – rather than using more sophisticated tools such as SMS or robocalls, as WFP did in other countries. Secondly, we will need to provide a modest airtime credit incentive to encourage people to answer, and to help offset any battery charging costs.

We  will also make sure that our call center is staffed by all-female operators, to make sure we reach women, some of whom might otherwise be reluctant to speak to a male stranger over the phone.

 

 

Voice calls in Niger: when basic works best

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WFP/ Cecilia Signorini

As many of you know, mVAM has expanded considerably in the last few years and we are now present in 26 countries. You may be familiar with high profile places we work in like Syria, or those where we are testing out new technologies like Haiti. We therefore wanted to write an update on one country that we haven’t spoken about in a while: Niger.

What is WFP doing in Niger?

To give you a reminder of why we are working there here’s a quick rundown. Niger is a landlocked low-income country in the Sahara-Sahel belt with a population of over 16 million people. Every year the United Nations Development Programme (UNDP) does a Human Development Index based on indicators of income, health and education indicators and Niger has ranked 188 out of 188 for the last few years. WFP estimates that 2.5 million people in Niger are chronically food-insecure. Increasing regional instability has only worsened the situation. Niger is currently responding to two emergencies: the recent Malian civil war in the north and Boko Haram in the south east whose insurgency and systemic violence has forced even more people to move, destroying community assets and food reserves. The volatility of this situation means that getting accurate food security information is both incredibly important and unfortunately very difficult. To get some more information from the ground we spoke to Moustapha Touré, who works on VAM and Monitoring and Evaluation (M&E) in WFP’s Niger country office. For the full interview (in French) watch out for an upcoming episode of our VAM Talks series, our podcast about how WFP sources its food security data.

Why mVAM?

The country office in Niger was keen to add extra dimensions to their food security analysis, and with insecurity rife in and around Diffa, it made sense to try remote monitoring.  Moustapha was the VAM officer in Goma where mVAM started in 2013, and when he arrived in Niger, his ideas and experience helped him to establish mVAM in the country, which quickly flourished. In our blog last September we wrote about how the team in Niger scaled up from their pilot surveys in the refugee camps working with a Niamey-based call center, iTelCom. This call center is pretty special – they are actually based in Niger’s first and only start-up incubator. By working with them, we are also contributing to the emergence of a local start-up specializing in digital engagement in vulnerable communities.  

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WFP/VAM

The call center had begun placing calls to refugees from Mali in the camps of Abala and Mangaize in early 2015. One of the advantages of mVAM is ‘no boots on the ground’: we can conduct food security surveys without having to put anyone in the line of fire. When increasing attacks from Boko Haram meant it became urgent to get data from Diffa, the corner of Niger on the Lake Chad basin, our partner was able to ‘shift’ to this new area with relative ease, thanks to their prior experience.

mVAM and displacement

The complexity and longevity of the insecurity affecting Niger means that ‘displacement’ has many different meanings. Populations have been moving in and out of the country for so long that it’s sometimes almost impossible to define them as a ‘refugee’ a ‘returnee’ or an ‘internally displaced person’ (IDP). Many of the Malian refugees in the north are pastoralists whose livelihoods depend on moving around with their livestock so living in an enclosed refugee camp is even more of an issue. To try and solve this problem new areas have been designated as ‘Zones d’accueil des réfugiés’ (ZAR) or refugee hosting areas. Unlike a standard camp setting, they are open spaces where displaced people have room to graze animals, allowing them to continue their traditional lifestyle. In Diffa, recent Boko Haram attacks have caused a new wave of displacement in June raising the total to more than 240,00 displaced people in the region. All of this means that the questions we have in our food security surveys about a household’s displacement status is not nuanced enough to provide us with any useful answers. So we were wondering how the team in Niger is dealing with this complex landscape in terms of their implementation of mVAM.

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WFP/Cecilia Signorini

Moustapha said one way of coping with this was making sure to “conduct face-to-face surveys before mVAM” to get some prior information about the households. This information serves as a base which they can use to monitor the movements of the populations. They also change their terminology, making sure they only refer to “forced displacements” to specify that they only want to know about the movements because of a specific shock rather than seasonal movements. The reason this works in Niger is because the only mVAM modality used is our live calls so more time can be taken explaining this terminology than with SMS. Sometimes basic really works best!

In fact, this baseline information has already come into use. One area that has suffered from a recent attack is Bosso, resulting in a large amount of displaced households. As Moustapha pointed out, via mobile phones we can maintain a direct line to the affected populations, wherever they happen to be. Based on their responses, “we can see when they moved, whether they moved just once or if they are constantly moving or returned”. This might sound a bit CIA but the information is actually really useful for WFP operations. With a better understanding of affected populations we can make sure distributions are in the best places.

Challenges ahead?

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WFP/Cecilia Signorini

Whilst the system is working quite well there are always areas that can be improved. We spoke before about the challenges of mobile coverage in this largely rural context, so they are talking to the phone companies to try and get better coverage. There are also issues in terms of female responses. Less than 5 percent of women own their own
mobile
and some women don’t have the right to use a phone to receive a call without their husband’s permission, otherwise they could invite accusations of adultery or subversion of their husband’s authority. WFP’s West Africa Regional Bureau is working hard to try and solve some of these issues, exploring the possibilities of using female operators or using face-to-face recruitment.

We don’t think we will be using our fancy IVR and chatbots in Niger anytime soon, but it does look like mVAM is set to stay. As well as continuing the regular data collection in Diffa, Moustapha and the team plan to expand countrywide.

The El Niño Aftermath: Tracking Hunger in the Millions in Southern Africa

We’ve been writing a lot about how mVAM can help in conflict situations where whole areas are cut off because of violence or an epidemic (see our blogs on Yemen, Somalia, Iraq and article on Ebola). But over the past year, the world was disrupted by another type of event- a climatic one: El Niño. The El Niño weather pattern results from a warming of sea temperatures in the Pacific roughly every three to seven years. This El Niño was one of the strongest on record.  The reason why El Niño was so concerning is its global reach, it didn’t just affect the Pacific; places as far away as Guatemala, Pakistan, Indonesia and Ethiopia were all at risk of floods and/or droughts. While the El Niño itself has abated, it has left millions hungry in its wake (current estimates are that 60 million people are food insecure globally). And a La Niña year is looming.

One area that has been particularly affected is Southern Africa. Across the region, this year’s rainfall season was the driest in the last 35 years. Most farmers are facing significantly reduced and delayed harvests.

El Niño hit when Southern Africa was already vulnerable to food insecurity. The region had already experienced a poor 2014-15 harvest season, meaning that food stocks were already depleted. Now, after El Niño, roughly 41 million people are classified as food insecure. On 13 June 2016 WFP categorized the region as an L3 emergency – a situation requiring the highest level of humanitarian support. We’re therefore dramatically expanding our national food security monitoring in the region so WFP can quickly provide as much relevant food security information as possible to effectively respond to the crisis.

Predictions that this El Niño would have a big effect had already started coming in 2015 so we began setting up mobile monitoring in countries that were particularly vulnerable to El Niño. We started in Malawi which had very disruptive weather patterns looming (potentially too much rain in the north and huge rainfall deficits in the south). We lacked current household data to track the impact on food security across the country.

To get information quickly and cheaply, we started a monthly SMS survey with GeoPoll in December 2015. And Malawians sure were quick to respond! In 24 hours, we had 1,000 questionnaires completed.  When analyzing the results, we wanted to make sure people were understanding our texts. The adult literacy rate in Malawi is only 61.3% so we kept the questionnaire short and as simple as possible. We included questions for one food security indicator- the reduced coping strategy index (rCSI) which asks people about the coping strategies they are using when they don’t have enough to eat. We also checked that the data made sense, and in general, the rCSI behaved as we would suspect. It was correlated with people’s messages about their community’s food security situation and their wealth status. As with all of our surveys, we are continually improving them. In this case, we increased our sample size and district quotas to capture more people in rural areas.

Monitoring Maize Prices

IMG_0095Market prices, especially maize prices, are key to Malawians’ food security. Maize is the staple food, used to make nsima which is consumed daily. So to monitor market prices in 17 hotspot districts, we collected phone numbers from over 100 traders in 51 markets throughout Malawi. We first tried asking them prices by text message, but we didn’t receive many responses.  It seems like sending back a series of texts is a bit too much to ask of traders who volunteered out of their own good will to participate in our market survey. We therefore set up a small call center in WFP’s country office. We trained two operators, and they were quickly placing calls to traders every week. When they could just answer a quick phone call instead of having to type in answers, traders willingly reported current commodity prices.

Our latest report from June 2016 shows that maize prices are now between 50 and 100 percent higher than this time last year. This is having a big effect on Malawians. As you can see from our word cloud, alarmingly ‘not-enough’ featured prominently in our open ended question about maize.

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Nutrition Surveillance for the first time

In most countries, we have been concentrating on household level indicators like food consumption. But health centers treating malnutrition could potentially give us important indications of the nutrition situation of different parts of the country. In Malawi, WFP works with health centers to address moderate acute malnutrition (MAM) in Malawi by providing fortified blended foods. So to make the most of our call center, we decided to call these health centers every two weeks and track malnutrition admission data for children (aged 6-59 months) and for adults with HIV/AIDS or tuberculosis. In the first six weeks of monitoring, we saw a big increase in the number of moderate acute malnutrition admissions for children increased greatly where severe acute malnutrition rates did not show a clear pattern. We dug further, and the Ministry of Health had initiated mass screenings to enroll malnourished children in nutrition programmes which generally pick up moderately malnourished children. With health center admission data, it’s important to check what else is going on in the country. We’re hoping to soon pilot contacting mothers of malnourished children about their children’s progress to gain additional insight into the nutrition status of vulnerable populations in Malawi.

Now that we have Malawi firmly established, we’ve started reporting on Madagascar and our data collection is ongoing in Zambia, Lesotho and Mozambique. So watch this space for more news about how we get on in these next few months.

Our 5 hacks for mobile surveys for 2015

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An mVAM respondent in Mugunga III camp, DRC.

  1. Gender matters. Design and run your survey in a way that promotes women’s participation. With mobile surveys, it’s hard to get as many women to respond as men. Make sure you’re calling at the right time and that you provide incentives. We also recommend having women operators. For more of our thinking on gender in mobile surveys, check out our blog entry on gender issues in West Africa.
  1. Validate mobile data against face-to-face data. Your mobile survey results may differ significantly. In many contexts, cell phone penetration has not reached the most vulnerable groups. In DRC, we had to provide phones to Internally Displaced Persons (IDPs) and access to electricity- to learn more check out our video and our blog entry. But it’s not always possible to distribute phones so it’s important to check your results against other data sources. Also, people get tired of answering their phones all the time so attrition and low response rates will affect your results.
  1. Mind the mode!  Your results will differ according to whether the survey is done through SMS, IVR, or live calls by an operator. Live calls have the highest response rates, but you have to be ready to pay. For simpler data, we have found that SMS is effective and cheap. Just remember- the context matters. SMS is working well with nationwide surveys, even in countries where literacy rates are not that high- check out our recent results in Malawi. However, SMS can be a problem in communities where literacy rates are very low or familiarity with technology is low as we found in DRC IDP camps. For Interactive Voice Response (IVR) that use voice-recorded questions, the jury is still out on its usefulness as a survey tool.  IVR didn’t work as well as SMS in Liberia, Sierra Leone, and Guinea during the Ebola crisis (HPN June 2015). But IVR has potential as a communication tool to push out information to people. Check out our entry on our two-way communication system where we use IVR to send distribution and market price information to IDPs in DRC.
  1. Keep the survey user friendly and brief. Always keep your survey short and simple. Stay below 10 minutes for voice calls, or people will hang up. If you are texting people, we don’t recommend much longer than 10 questions. Go back to the drawing board if respondents have trouble with some of your questions. With mobile surveys, you don’t have the luxury of explaining everything as with in person interviews. It might take a few rounds to get it right. When we want food prices, we’ve found we need to tweak food items and units of measurement in Kenya and DRC to best capture what people buy in local markets. Again, short and sweet should be the mobile survey mantra.
  1. Upgrade your information management systems. There is nothing as frustrating as collecting a lot of great data – without being able to manage it all! Standardize, standardize, standardize! Standardize questions, answer choices, variable names, and encoding throughout questionnaires. Automate data processing wherever possible. Also, you’ll be collecting phone numbers. This is sensitive information so make sure you have the correct confidentiality measures in place. Check out our Do’s and Don’ts of Phone Number Collection and Storage and our script for anonymizing phone numbers. Finally, share your data so others can use it! We’re posting our data in an online databank.

 

 

Iraq: learning under pressure

The mVAM project has taken on a new challenge:  that of working in Iraq, where 5.2 million people are in need of urgent humanitarian assistance, and where 2.5 million have been displaced due to violent conflict. Iraq is a middle income country with high levels of literacy, and where nearly all households own a mobile phone. High insecurity has made face-to-face surveys very difficult in the country’s central governorates in recent months. It seems a good context to deploy the mVAM remote mobile data collection system, which collects urgently needed data that can be immediately analysed and reported on to inform emergency response.

Since January, we have been placing weekly calls to our partners in insecure locations in the central governorates. People are interviewed using a streamlined market questionnaire that focus on the prices of staple foods and market trends. Our first bulletins show that conflict has had a severe impact on food market prices, especially in Anbar, where the price of a basic food basket costs double that in the nearby city of Baghdad.

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Cost of a basket of food providing 2100 kcal, February 2015. Source: WFP mVAM

In March, we began placing survey calls to randomly selected respondents from a private call center. Our partner is an Iraqi mobile operator, with a large phone subscriber database. We are targeting a sample of over 1,000 phone calls covering all 18 Iraqi governorates. The questionnaire we are using includes questions on food consumption and coping strategies, and results can be disaggregated by sex and age. Operators are placing calls in Arabic, Kurdish and English.  The ongoing March survey will serve as a baseline for future phone survey rounds using the same approach. The information we produce will be used to identify the areas of Iraq that are most in need of food assistance, and how needs are changing over time. We will also be able to understand the food needs of the most vulnerable groups, including people who were displaced as a result of the conflict.

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An mVAM operator placing phone call surveys. Erbil, Iraq.

After the Ebola response in 2014, mVAM’s deployment in Iraq marks the second time the tool is used at scale in an emergency. We have already learned a lot from our experience in Iraq:

  1. In Iraq we opted for calls placed by operators instead of SMS or interactive voice response. We felt it was imperative to have operators in order to build trust in a conflict environment, especially during the first rounds of data collection.
  2. Using operators also provides the flexibility to collect more complex indicators – such as the food consumption score – that we have not been able to implement by SMS, and that require an operator’s presence to properly administer.
  3. We have had to offer larger airtime credit incentives than in other countries, because of higher income levels.

We’re sure to improve the mVAM tool thanks to the experience underway in Iraq. Please check our website for our reports on Iraq.

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mVAM call center in Erbil, Iraq.