Presented by Molly Cannon at the 2016 AEA conference.

1. Custom Country Tool
Global Application
Molly Cannon, MPH
MEASURE Evaluation
October 27 2016
American Evaluation
Association Conference

2. Presentation Key Points
 Tool development in Uganda
 Adaptations in South Sudan
and Lesotho
 Global relevance

3. Revise the Government of Uganda
Vulnerability Index based on
recommendations from Phase III
MEASURE Evaluation assessment.
USAID/Uganda Request

4. Brief History of the VI Assessment
 MGLSD Vulnerability Index (VI)
created in 2012, assessment by
MEASURE Evaluation in 2014
 Several challenges
• Purpose of the tool
was unclear
• Tool did not capture the
“most vulnerable”
• Data quality issues
• Cost/sustainability concerns
 Underlying issues
• 29 questions, all equal weight
• Cut-off points
• Manual calculation
• Lack of supporting materials

5. Tool Development Approach
 Stakeholder engagement, including
OVC TWG workshop in Uganda
• What information gap will this revised
tool fill?
• What is meant by “vulnerability” in the context
of the OVC program?
 Develop a tool “fit for purpose” to avoid a
“super tool” that can’t do it all
 Avoid collecting extraneous information—
ethical considerations

6. Designing a Tool “Fit for Purpose”
Information Needs Framework

7. Information Need
HH Identification and Prioritization

8. Challenge with Identification

9. What is Vulnerability?
 Unpacked vulnerability
 Discussed and adapted 16 indicators—presence/
absence of condition in HH (no index)
 Agreed on priority indicators for enrollment:
• “Severe” child protection issue
• HIV+ individual
• Child-headed household
• Any child who has gone a whole day/night without
eating
• Any school aged child who is not enrolled
in school
How to Prioritize?

10. HVPT Toolkit
 Toolkit Manual
• Guidance document with tool (2 pages, 20 mins)
• TOT manual
• Database user guidelines
 Excel database for CBOs to automate the
prioritization process
• Lists prioritized HHs for enrollment based on the
# CBO is able to enroll
• Allows for updates
• Lists all urgent referrals needed for district/
program staff
Note: Finalization of materials involved a pilot with four IPs and 166 HHs.

11. Adaptations
 South Sudan (4Children)
 Approved by MOH, PEPFAR IP tool
 Implementing in October
 Lesotho (ASSIST Project)
 Identification as first step in case
management model
 Multiple stakeholders

12. Going Global
 Through 4HIV305
 Developing guidelines for adapting the
identification and prioritization tool
 Learning about new identification issues
given health facility referrals
 Presenting at the American Evaluation
Association Conference

13. Questions for Consideration
What do we do after the HVPT process?
Start with case management tools/care plans.
Can we use this tool for graduation?
Not exclusively—it can be part of the process, but
needs to be aligned with case management
information.
How can we be sure to meet PEPFAR needs?
Include HIV+ as high priority indicator.

14. This presentation was produced with the support of the
United States Agency for International Development (USAID)
under the terms of MEASURE Evaluation cooperative
agreement AID-OAA-L-14-00004. MEASURE Evaluation is
implemented by the Carolina Population Center, University of
North Carolina at Chapel Hill in partnership with ICF
International; John Snow, Inc.; Management Sciences for
Health; Palladium; and Tulane University. Views expressed are
not necessarily those of USAID or the United States
government.
www.measureevaluation.org