Participatory Monitoring and Evaluation of Ebola Response Activities in Lofa County, Liberia: Some Lessons Learned

Abstract

To address the Ebola outbreak in West Africa, the World Health Organization and the United Nations Children’s Fund led a multilevel and multisectoral intervention known as the Ebola response effort. Although surveillance systems were able to detect reduction in Ebola incidence, there was little understanding of the implemented activities within affected areas. To address this gap, this empirical case study examined (a) implementation of Ebola response activities and associated bending the curve of incidence of Ebola virus disease and (b) candidate factors associated with fuller implementation of the Ebola response effort. A mix of qualitative and quantitative methods were used to address these questions. A participatory monitoring and evaluation system was used to capture, code, characterize, and communicate nearly a hundred Ebola response activities implemented in Lofa County, a highly affected area in Liberia. The Ebola response effort was enabled by community engagement and collaboration across different sectors. Results showed fuller implementation corresponded with a marked reduction in Ebola virus disease. This report concludes with a discussion of how monitoring and evaluation can strengthen implementation of activities needed to address disease outbreaks.

Participatory Monitoring and Evaluation of the COVID-19 Response in the Africa Region

“…The WHO Collaborating Centre from the University of Kansas brought expertise and capabilities for monitoring and evaluating collaborative efforts, including protocols for sensemaking or systematic reflection on the data (Fawcett & Schultz, 2008). The WHO AFRO and WHO CC at Kansas teams had previously collaborated on using these participatory research and sensemaking protocols to monitor and evaluate the Ebola response in the Africa Region (e.g., Hassaballa et al, 2019; Munodawafa et al, 2018; Sepers et al,2018).…”

“…Participatory monitoring and evaluation and sensemaking protocols hold promise for enabling partners to better understand and address a variety of health and development issues. For instance, we have seen its value in supporting efforts to (a) address communicable disease outbreaks, including Ebola and COVID-19 (e.g., Hassaballa et al, 2019; Holt et al, 2021); (b) promote care coordination for those with low-income (e.g., Hassaballa et al, 2015); (c) enhance health access and culturally competent health services (Fawcett et al, 2018); and (d) enroll underserved groups in affordable health insurance (e.g., Fawcett et al, 2015). In particular, the sensemaking protocol enables stakeholders—including those most affected and those responsible—to construct their own meaning of the data and its implications for improvement.…”

Participatory Monitoring and Evaluation of the COVID-19 Response in a Local Public Health System

“…The KU team brought experience in monitoring and evaluating the Ebola response in Liberia, in collaboration with the World Health Organization Regional Office for Africa (Hassaballa et al, 2019; Munodawafa et al, 2018; Sepers et al, 2018). The KU team also had concurrent experience partnering with the WHO Africa Regional Office designing and implementing a similar M&E system for examining the COVID-19 response in 47 countries in Africa.…”

“…and (b) "What factors or critical events were identified as enabling or impeding the COVID-19 response of the local public health system?" A participatory M&E system (Center for Community Health and Development, n.d.; Fawcett et al, 2015;Hassaballa et al, 2019) was used to capture, code, characterize, and communicate the COVID-19 response by the local public health system. The team captured COVID-19 response activities using interviews with key actors in relevant sectors (e.g., public health leadership, director of emergency preparedness, city managers, county administrators, hospital administration, federally qualified health care centers, lead businesses, schools, social services, and university staff).…”