Best Practice: Child-Centered Community Development
How Plan’s program approach positively affects effectiveness and sustainability.
By Ann Wang, Senior Writer/Communications Specialist, and Justin Fugle, Senior Program Manager, Plan International USA
Malaria is the primary cause of illness in Burkina Faso and kills more than 7,500 people there every year. It is more prevalent during rainy season when standing water allows mosquitoes that transmit malaria to multiply in huge numbers. These mosquitoes are most active at night and usually bite people while they are sleeping.
Providing mosquito nets to every household in the country would dramatically reduce suffering and would allow the people of Burkina Faso to spend less time being sick and more time building a brighter future for their families and communities. Addressing this lost productivity is vitally important given that Burkina Faso is one of the poorest countries in the world.
Through a program implemented by Plan International Burkina Faso with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), nearly 8 million long-lasting insecticidal nets (LLINs) were distributed to almost every family in every city and village in Burkina Faso between September 2010 and January 2011. The result was universal LLIN coverage (defined as the availability of one LLIN per two people) for the first time in the nation’s history. Through its community development approach, Plan and its partners also provided training in the proper use and maintenance of the mosquito nets to more than 98 percent of Burkinabes.
Plan’s unique approach
In 2003, Plan International adopted a child-centered community development (CCCD) approach as its international framework for program work. Plan’s shift to CCCD represents a significant transition in the organization’s approach to its program work, having evolved from a sponsorship organization providing direct handouts for children in need, to an international development organization focused on addressing the root causes of poverty. The CCCD approach is guided by the following primary principles: children at the center, human rights standards and principles, responsibility and accountability, inclusion and nondiscrimination, gender equality, and stakeholder participation.
The ability to achieve these principles is rooted in key strategies such as anchoring programs in the community, holding governments accountable, strengthening the capacity of civil society, engaging with the corporate sector, advocacy, and working in partnership for greater impact. To varying extents, these strategies are leveraged simultaneously, with the objective of working toward fulfilling the full potential of children, families and communities in Plan’s 50 program countries around the world.
Plan’s comparative advantage in pursuing CCCD lies in its ability to work not only with the communities, but also across a variety of levels to address development issues more effectively. This multilevel approach lets Plan create linkages and synergies between different actors and tie its experience from community-level engagement to policy-making at the national and international levels.
The country-wide LLIN distribution campaign in Burkina Faso required attentiveness and careful planning. Civil society was involved in all phases of the project, from the regional level through the community level. To understand the needs of each household, Plan conducted a survey and a census across the entire country. And to ensure survey participants understood the survey, each village team included several facilitators who spoke the local language. More than 9,000 volunteers were trained, mobilized and supervised, and they raised the malaria awareness of more than 13.5 million people. This level of engagement has created community ownership of the project and is expected to lead to improved success rates in LLIN usage and reduced numbers of malaria cases each year.
Findings from the Transnational NGO Initiative
Earlier this year, a study was commissioned by Plan International USA and conducted by the Transnational NGO Initiative of the Moynihan Institute of Global Affairs at Syracuse University to better understand how CCCD enhances Plan’s program effectiveness and sustainability. The study, How does CCCD Affect Program Effectiveness and Sustainability?, assessed the implementation practices of CCCD and then evaluated the effects of CCCD on program outcomes and sustainability. It identified specific, preferred targets and strategies used in CCCD programming. For example, Plan primarily engages with communities and state institutions, while more attention could also be focused on other civil society actors or linkages between local stakeholders. At the community level, strategies of capacitybuilding and participation dominate. When interacting with government institutions, Plan also emphasizes capacity-building of frontline government personnel.
Overall, the study determined that CCCD did have a positive impact on program implementation, although effects on behavior change and service access and quality have been more pronounced than those on sustainability or equity.
Plan supports a variety of processes aimed at changing the self-perception of community members, appealing to their self-interest or taking advantage of peer-pressure mechanisms. These mechanisms are more effective when community groups actively participate in program implementation. The main limitations the review identified point to gaps between awareness and practice, mostly when programs only include one-time interventions and when cultural barriers are high.
A local community member in Burkina Faso explained how behavior change efforts in Plan’s program had increased awareness and encouraged widespread use of mosquito nets. “The nets have been helpful for us. In the past, we did not sleep under nets and we contract malaria. Mosquitoes swarmed and we couldn’t sleep. But with nets, we no longer get mosquito bites and there are fewer malaria cases. Nets should be washed with neutral soap and we must lay it in the shade to dry.”
Service access and quality
Plan’s work with community-based groups was the most frequently mentioned CCCD related strategy that enhanced program effectiveness in terms of improved service access and quality. Plan has also seen some success in using community-level experiences to influence national-level policy decisions that facilitate scaling up its programming. The main challenges in using community-based approaches in enhancing services include quality issues due to a lack of resources and community-level capacity.
In Burkina Faso, Plan’s longstanding relationships at the community level positioned it well as the Global Fund’s implementing partner for a nationwide distribution campaign. Its close ties to communities and broad reach in the country ensured 98 percent of the population had access to and training on use of mosquito nets by the end of the distribution campaign. As part of the distribution and awareness campaign, over 590,000 people also received home-based malaria treatment from community health workers.
The study found that Plan does not advocate or implement a one-sizefits-all sustainability strategy across the organization globally. Instead, country programs focus on either community capacity or state capacity, depending on local context and program characteristics. However, Plan has had some success in enhancing the sustainability of its results by linking communities with state institutions, for example, by integrating community volunteers into state-run planning and implementation processes. The main challenges identified in this area are weak state capacity and political will to assume program responsibilities, the fragility of community-based groups, and a lack of formal emphasis on sustainability strategies by participating stakeholders.
In Burkina Faso, to address the risk of decreased usage of LLINs over time in and to enhance program sustainability, Plan broadcast awareness radio advertisements and implemented several neighbor-to- neighbor communications campaigns in villages throughout the country. These home visits instructed community members about proper usage of LLINs (e.g., sleep under LLINs each night). Plan’s volunteers also used the visits to collect discarded LLIN packaging and send it to central waste facilities.
The study indicates inconsistency in Plan’s approach toward equity. It also shows that equity concerns, while visible in program planning stages, frequently get lost during the implementation phase. Plan’s attention to equity is more consistent on gender issues and the rights of children more generally, while CCCD efforts are rarely directed at more distinct vulnerable groups such as children with disabilities or migrant children.
The future of CCCD
The study presents the latest evidence of the increased effectiveness of Plan’s programs as a result of the CCCD approach. Lessons learned will be used to further document and trace the effects of CCCD on Plan’s contributions to the improvement of children’s lives in program countries. As a key step in strengthening the understanding and implementation of CCCD across Plan’s programs, Plan has instituted internal audits to determine each country’s level of achievement for CCCD’s key indicators. The reports from those audits are sent directly to the appropriate governance bodies for follow-up, a sign of their importance to the organization.
In addition, Plan’s monitoring and evaluation (M&E) systems have been updated to track Plan’s ability to mobilize communities to be the central actors in their own development. The M&E systems also measure the progress that Plan and communities achieve together in improved health care, education, water and sanitation, child rights and other key areas. Plan has also launched a systematic, internal training process called the Plan Academy. Based on evidence from external, independent evaluations of Plan’s work, including this study, the Plan Academy will train Plan’s leaders, managers and practitioners in the most effective aspects of CCCD. To help ensure training is put into practice, all four of Plan’s regional offices have hired a CCCD specialist, who will accompany and monitor Plan’s country teams as they translate their training into more effective program design and implementation for communities.
This article originally appeared in InterAction's Monday Developments Newsletter, December 2011.