As our world becomes more connected and advances in technology and transportation make travel faster and cheaper, the threats to human health become one of the most important non-traditional global security issues. The global health community is recognizing a need for comprehensive approaches to addressing existing and future threats to health security based on well planned, designed and implemented strategies. Post response recovery interventions represent a very important segment in this protective system. As they are focused on stabilization after emergencies, these interventions lay critical foundations for prevention, risk mitigation and preparedness.
Given the emergent nature of programming in a post response period, program design, monitoring evaluation, research and learning (D-MERL) play a vital role in evolving program strategy and enabling collaboration, learning and adapting. In such contexts, D-MERL systems should be flexible to accommodate the program’s needs for urgent action and to allow for iterations of major D-MERL products to take place over time as conditions change. For example, after review of initial program results or once new partners join, aspects of the D-MERL system may need to change or iterate. However, D-MERL “stakes in the sand” must mark each stage, so that implementation and other D-MERL activities can proceed without delays in planned and coordinated ways, not ad hoc.
Currently, post response recovery programs lack practical guidance on how to establish balanced D-MERL systems that respond to these unique needs. The purpose of this document is to help USAID staff plan for and implement effective and efficient programs and MERL systems in a post-response recovery. The information presented here derives from experiences during a 27-month MERL technical assistance pilot following the 2014-2016 Ebola epidemic in Sierra Leone, Liberia, and Guinea (see figure below), as well as literature on D-MERL in a post-response recovery setting. It reinforces ADS 201 and preserves the institutional knowledge developed during the Ebola public health recovery and other similar efforts needed post Zika and Ebola outbreak in DRC.
The paper comprises six building blocks of strategies which will strengthen and balance D-MERL systems during such recoveries. Each block follows this structure:
- A framing question faced by staff, accompanied by a description of the issues
- A discussion of why this matters
- Success strategies for addressing the issues
- A suggested timeline for addressing the issues. Note that the timelines are illustrative and based on a hypothetical program of 2 years or more duration. For shorter programs the timeline needs to be adjusted accordingly
- The interdependencies illustrating the connections with other building blocks
- The trade-offs represent the consequences that USAID staff might anticipate if this building block is not addressed.
We also produced a Heuristic Tool to help USAID staff plan for and implement effective and efficient programs and MERL systems in a post response recovery. This heuristic tool is quick reference document developed to assist program managers and MERL practitioners navigate the process of building the balanced D-MERL system in this evolving context.
These publications were produced by the Institute for Development Impact (I4DI) and World Vision under the BalanceD-MERL Program, Cooperative Agreement Number AID-OAAA-15-00061, funded by the U.S. Agency for International Development (USAID).
The authors would like to thank the USAID Development Lab and Global Health Bureau teams for their insights and effort in providing feedback to draft versions of the document, which informed the development of this guidance. Gratitude is also extended to Rebecca Baylor from the William Davidson Institute at the University of Michigan (WDI), for her review and recommendations.
For more information and additional guidance contact us.