Table 1 Implementation review findings on monitora performance
Performance category | Findings |
|---|---|
Retention | • Average length of service for monitoras was 2.5 years. • 25 % of the original cohort was still working after 5 years. • Monitoras moved in and out of the program, which was facilitated by the team approach. |
Motivation | • Active participation of beneficiary families was critical. • One third of monitoras noted the lack of family support. |
Training | • Each community had at least one monitora who had participated in the original training. • However, 60 % of monitoras were learning by doing. • Monitoras in MOH communities received training on AIN-C and case management, while monitoras in NGO communities received additional training modules. |
Supervision | • The content and quality of supervision varied. • Supervision was mainly focused on monthly health center meetings, but in NGO communities monitoras received additional supervision. |
Supplies | • No stock-outs of basic materials were noted. • 90 % of scales used for weighing were accurate. |
Data use | • 85 % of the child lists tracking children in the community were good. • Quality of progress bars tracking attendance and growth faltering depended on the quality of the child lists. • There was little use of bar charts by MOH for decision-making. |
Community action | • Implementation was not uniform. • Community action depended on support from outside the community, with communities receiving support from health center promoters doing better. • Determined that about 20 % of causes for growth faltering that needed attention were issues outside the family. |