1. Introduction to the Child Status Index
Florence Nyangara, Ph.D.
MEASURE Evaluation/Futures Group
March 17, 2009
Regional Conference
Kigali, Rwanda
2. Regional_CSI_conference_03_09 2
Background
Estimated 12 million
children are orphans in
SSA (UNICEF ’06)
Program support to 4
million orphans and other
vulnerable children
(PEPFAR report, 2008)
How has the support
benefited the 4 million
OVC? This is the Question?
New York Academy Primary School for OVC,
Nyamira District, Kenya, receive school supplies,
2007: photo by F. Nyangara
3. Regional_CSI_conference_03_09 3
OVC Program Structure……
Multidimensional – education, health, legal, PSS, etc.
Multisectoral – Ministries of health, gender, women, etc
Multilevel of interventions; Direct services to the child, indirect to
household or community
Child
Household
Community
BOTTOM-LINE: All OVC support (Direct or indirect services) are aimed at-
“IMPROVING CHILD OUTCOMES”
4. Regional_CSI_conference_03_09 4
Understanding the Situation!
In 2006, field assessment of M&E for OVC programs in several
countries revealed that;
Numbers of children/services were used to track progress
No outcome monitoring at all levels of OVC programming
Quality of services provided to children was compromised
Monitoring tools and indicators were not consistent
Community volunteers were doing most of the M&E work
Thus: USG requested MEASURE Evaluation to develop a
tool that would assist partners to monitor child well-being
5. Regional_CSI_conference_03_09 5
Rationale for Developing the CSI Tool
To address gaps on existing measures/tools of child well-being that are;
Modeled on Western Cultures/international standards - no local perspectives
One-dimensional - when in reality child well-being is multidimensional
Focused on outputs or process indicators – little on outcomes
Costly – in terms of capacity and funds to train data collectors etc.
To holistically capture the multiple benefits of OVC programs on children
To help match OVC levels of needs with available support (child-focused)
To provide a common approach to assess outcome progress across programs
To help align quality of services with child outcomes
To incorporate the perspectives of beneficiaries and service providers regarding
child well-being as defined in there local context (their community
interpretations)
6. Regional_CSI_conference_03_09 6
How CSI was Developed
MEASURE Evaluation and Duke university partnerships with NGOs,
community leaders, workers, guardians, and children in Kenya and
Tanzania (PEPFAR Funds)
Ground-up and participatory approaches used to get community buy-in,
provide their INDICATORS (end-user’s and local perspectives)
Local program staff and community members in Kenya and Tanzania
participated in concept, design, content, and field testing of the tool
Consultations with experts and use of existing OVC frameworks,
PEPFAR OVC guidance, and previous research on child development in
resource poor countries affected by HIV/AIDS guided its format
Research team set selection criteria for identified outcome domains
i.e. should be measurable and changeable by program interventions
8. Regional_CSI_conference_03_09 8
What the CSI Tool Evaluates
Twelve outcome areas included
Food and Nutrition - (Food Security; and Nutrition & Growth)
Shelter and Care - (Shelter and Care)
Protection - (Abuse & Exploitation; and Legal Protection)
Health - (Wellness; and Health Care Services)
Psychosocial - (Emotional Health; and Social Behavior), and
Education and Training - (Performance; and Education/Work)
Rating: 4= No problem; 3=A little problem; 2= Bad problem;
1=Emergency situation)
(SEE TOOL)
9. Regional_CSI_conference_03_09 9
Characteristics of the Child Status Index
Child focused
Simple, reliable & intuitive
Its domains are measurable, changeable by program interventions
Many domains to reflect overall child well-being than one-
dimensional
Captures all the key dimensions of child wellbeing
Reflect both positive and negative outcomes/benefits of children
receiving services
Constructs that can be measured or adapted across ages and
cultures
NOT - A policing tool
NOT – Promoting any type of service delivery method etc.
10. Regional_CSI_conference_03_09 10
Advantages of Child Status Index Tool
Provides a consistent way to assess how close children are to the
desired outcomes or program goals.
Puts focus on outcomes/child’s wellbeing rather than on just
number of services delivered.
Can help field staff monitor and ensure appropriate responses to
actual child needs
Program managements and improvements - evaluate the
effectiveness of services
Support advocacy
Raise awareness among frontline staff about all areas of a child
wellbeing
Accountability - demonstrate program progress
11. Regional_CSI_conference_03_09 11
Learning to use the CSI - 5 Basic Steps
The Child Status Index dimensions and Record sheet
Conduct the CSI assessment visit
Score and complete the CSI Record Form
Plan necessary follow-up to address needs
Implement follow-up plan through appropriate service
delivery
12. Regional_CSI_conference_03_09 12
Guidelines for gathering CSI Data
• Rater should be known to household (no strangers!)
• Normal greetings (i.e. respect and compassion)
• Rater inquires about the overall well-being of entire family
i.e. “How are the children?” (normal in SSA)
• Rater proceeds with a brief, informal discussion with the
caregiver and child; and other adults such as teachers (as
needed) – be spontaneous/natural – not interrogations!
• Begin the conversation with general questions about the
child and his/her life, to encourage the person to talk
• The best method of discussion is informal, using open-
ended questions
• The information could be gathered from multiple persons,
as needed especially on issues of abuse if suspected
• Information for rating the CSI could also gathered through
observations
• Make sure you know both the goal and contents of each
domain
• Make sure to cover all 12 domains to rate child
13. Regional_CSI_conference_03_09 13
How often should CSI be used..
As part of a home visit conducted by volunteers & frontline
staff (monthly in some areas, some OVC) to be used as a;
• Basis for an individual care plan for a child (service needs)
• Monitor changes in a child outcomes and needs over time
Periodically as determined by program or service providers
and purposes (e.g. 6 months, annually) to;
• Establish a baseline of relative need (Who are neediest and
for what?)
• Determine aggregate impact of services delivered
• Knowledge – based practices (e.g. determine most effective
program models in improving wellbeing of children.)
14. Regional_CSI_conference_03_09 14
Training on the Use of the CSI
Discuss with volunteers or other stakeholders – buy-in
Work with partners to determine who would complete the evaluation,
frequency, and literacy demands
Like any survey instrument ensure that volunteers understand the
importance and usefulness of collecting child outcomes
Discuss how to conduct informal interviews to gather information from
various sources about the wellbeing and rating of each child
Score the children and fill the summary form on the outcomes, services
received, important events that happened in the child’s life, etc; and
Practice with a few children (PRACTICUM). Then discuss the results to
address any issues arising.
16. Regional_CSI_conference_03_09 16
Who is implementing the CSI?
Individual child level use – several NGOs have adapted
the CSI and are using it to collect baseline data, develop
case management types of plans for child etc
Programs and National M&E systems- in progress:
Rwanda, PC3-Ethiopia, Tanzania,
Several others in planning stages
17. Regional_CSI_conference_03_09 17
Group Exercises (Training AID)
An imaginary story of Maria (give hand out and ask
the participants to rate Maria)
Jeopardy Game (innovative training AID) by Africare
19. MEASURE Evaluation is funded by the U.S. Agency for
International Development (USAID) through Cooperative
Agreement GPO-A-00-03-00003-00 and is implemented by
the Carolina Population Center at the University of North
Carolina in partnership with Constella Futures, John Snow,
Inc., ORC Macro International, and Tulane University.
Visit us online at http://www.cpc.unc.edu/measure.
Editor's Notes
To avoid using tools of international standards to track child progress in SSA which has unique problems, needs, requiring different solutions
To promote local community appropriate innovativeness to contribute to the solutions of their own problems
To set reasonable targets
To generate frequent and timely information for program management and decisions at local level
Participants (225): government, USAID/mission, partners (CRS, Pathfinder & Christian AID in KE; AFRICARE/COPE and Salvation Army in TZ), community/OVC leaders, MVC committee members, Caregivers, children (youth), religious leaders (priests), teachers (Vocational school)
Focus groups
Caregivers
Children
Youth
Community members
and key informant interviews
Using unstructured & broad questions that systematically build on each other
Find out if there are existing tools that monitor child wellbeing
Discuss with volunteers or other stakeholders –buy-in
Work with partners to determine who would complete the evaluation, frequency, and literacy demands
Like any survey instrument ensure that volunteers understand the importance and usefulness collecting child outcomes
Discuss how to conduct informal interviews to gather information from various sources about the wellbeing and rating of each child.
Score the children and fill the summary form on the outcomes, services received, important events that happened in the child’s life, etc; and
Practice with a few children (pilot-test). Then discuss the results to address any issues arising.
An imaginary story of Maria (give hand out and ask the participants to rate Maria)
Jeopardy Game is an innovative way of reinforcing the training contents for the trainees and it is fun (by Africare). I welcome Maalim Maalim to take us through and there are prices to be given to the winning team.
