Videos generated from evaluation learning
The sixth MSF International Evaluation Day took place on February 4th 2016 in Amsterdam. Here you can view footage from the event, including films from the first session on Responding to Outbreaks. NB: the page is password protected so if you would like to view the films please email the evaluation group to request the password.
MSF Anthropology Reports
Conception of Kala Azar medicines: an anthropological study of patients’ perception of and experience with Kala Azar and its treatment in Bihar, India (2016) internal
This report does not explicitly look at an outbreak but focuses on perceptions of disease, a perspective that may be useful in designing an outbreak response. In early 2007, MSF began supporting existing Kala Azar diagnostic and treatment services in Hajipur Sadar District Hospital in Bihar, India. This research examined the perceptions of Kala Azar and its treatment among people who suffered from the disease. The general objective was to allow the patients’ perspectives to be considered by policy makers when deciding which treatments to upscale.
Emergency Snapshots are short summaries of the key lessons learned from a response.
Emergency snapshot: Vaccination Campaign- OCG E-Cell response in Guinea Conakry, 2012 (2012) internal
“Strengths in unity”: A real time evaluation of an MSF collaborative approach to a meningitis outbreak in Niger (2016) (2016) public
2015 saw the first large scale Meningitis C outbreak in Africa since 1979. MSF had been working intermittently in Niger since 1985 and in 2015 MSF took the leading role in the treatment of patients with suspected meningitis. The overall objective of this real-time evaluation was to evaluate the joint-MSF response in terms of its appropriateness, timeliness and effectiveness as well as the coordination amongst the four MSF operational centres and with external partners.
Four MSF sections responded to a renewed measles outbreak in DRC in 2015, including OCG in Tanganyika, the northernmost and most remote of Katanga. OCG’s Emergency Cell and Operations requested an evaluation of the comprehensive strategies used in Tanganyika, specifically their relevance, coherence, efficiency and effectiveness.
Evaluation of MSF-OCP’s response strategies during the 2015 measles epidemic in Katanga, DRC (2016) (2016) internal
Related to the same measles outbreak as the evaluation above, this evaluation was commissioned to look at the OCP response. This evaluation analysed the responsiveness, relevance, efficiency and effectiveness of the strategies implemented according to the resources available.
Challenges in Diagnosing Human African Trypanosomiasis: Evaluation of the MSF OCG project in Dingila, DRC (2015) public
Between late 2010 and the end of 2014 MSF carried out a project to combat Human African trypanosomiasis, also known as sleeping sickness, in DRC. In early 2014 staff recorded a significant decline in the number of positive cases from active screening, with a high probability that this reduction was the result of a previous systemic problem of over-diagnosis. This evaluation was commissioned with the general objective to critically examine the Dingila project with an emphasis on the medical aspects, the diagnosis and the programme that led to the over-diagnosis.
Version française: Défis en matière de diagnostic de la Trypanosomiase Humaine Africaine: Evaluation du projet THA de MSF OCG à Dingila, RDC (2015) public
NB: the full version of this report is available in French only (see below)
This evaluation was a follow-up of an evaluation carried out in 2014. This evaluation focussed on organisational aspects of the Chemical Prevention of Seasonal Malaria (CPS) programme, levels of knowledge among the population about CPS and its acceptability, and comparing the acceptability and efficiency of different modes of distribution.
Version française: Capitalisation de la mise en œuvre de la chimio-prévention du paludisme saisonnier au Niger (2015) public
EXECUTIVE SUMMARY: Capitalisation of the implementation of seasonal malaria chemoprevention in Niger (2014) public
NB: the full version of this report is available in French only (see below)
The precursor to the above report, this evaluation was initiated to assess the implementation of Chemical Prevention of Seasonal Malaria (CPS) which was first implemented in Niger in 2013. The evaluation focussed on the impact of CPS in the target area, medical practices and unwanted side effects of CPS, and compared the implementation strategies of the different MSF sections.
Version française: Capitalisation de la mise en œuvre de la chimio-prévention du paludisme saisonnier au Niger (2014) public
Evaluation of two emergency interventions: outbreak of malaria and epidemic of measles, Orientale Province, DRC, June 2012-September 2013 (2014) internal
This evaluation was carried out to assess the appropriateness and effectiveness of two OCG emergency interventions in DRC. During the malaria outbreak, MSF led a four-month emergency intervention targeting some 380 000 people. In response to the measles epidemic, MSF intervened for nine months and covered some 741 000 persons. The objective of this evaluation was to capitalise on the lessons learned so as to improve preparation and response capacity for future epidemics in similar situations.
Measles epidemic in Katanga, DRC (2010-11): Box Recommendations & Minutes/Review-Reflection day, MSF-OCP Feb 2012 (2012) internal
Written summary of the outcomes of the Reflection Day in 2012. The aim of the Reflection Day was to contemplate lessons learned from MSF’s response to the Measles epidemic in DRC, where MSF teams vaccinated 1.5 million children during a 10-month period, and treated 51,000 cases. Major questions concerned the magnitude of the intervention and the decision making process.
Version française: Epidémie de Rougeole au Katanga, DC (2010-2011), Revue-Journée de Réflexion & Minutes, MSF-OCP, Fev.2012 (2012) interne
General lessons learned, recommendations and reminders of several Cholera outbreaks interventions (2012) internal
This table summarises the key lessons learned from MSF's cholera interventions in Zambia 2004, 2006, 2008, 2010 (OCBA), Guinea Bissau 2005-2008 (OCBA), Juba 2006 (OCBA), Haiti 2010-2011 (OCBA), Angola 2006 (OCB, OCA, OCBA), Zimbabwe 2009 (OCB, OCA, OCBA)
OCG response to cholera in Haiti, October 2010 - March 2011 (2011) internal
The nearly 1.5 million people left homeless after the 2010 earthquake moved into spontaneous settlement sites throughout Port-au-Prince and other cities, where sanitation and hygiene conditions were extremely poor leaving residents particularly vulnerable to water-borne diseases. The first cases of cholera were confirmed in October 2010 and the outbreak turned into one of the most severe of the last century. MSF-OCG requested an evaluation of its response in order to analyse the overall effectiveness and appropriateness of different strategies used in this particularly challenging context.
Is humanitarian water safe to drink? (2011) public
Although not strictly an evaluation, this paper is based on evaluation learning about the provision of water in emergencies. Several outbreaks of hepatitis E, transmitted via the water supply, occurred in refugee and IDP sites in the Sahel (Sudan in 2004, and Chad in 2007) and in central Africa (Central African Republic in 2002, and Uganda in 2007). MSF was responsible for all or part of the water supply, as well as medical care. The report is split into two parts: part 1 is the written form of a symposium held in 2010, discussing humanitarian interventions where the water supply is subject to problems, water and health: the current state of scientific knowledge and available technologies, and access to water: sociological, economic and political aspects. Part 2 is an article entitled ‘Water and health in unstable situations’.
Cross-Disciplinary Review & Discussion Day Cholera Haiti, MSF-OCP (2011) internal
Write-up of the Haiti Cholera Day. The event was requested by OCP in order to draw lessons from MSF’s intervention, focussing on constructive discussion and review of three areas: epidemiology, medical and watsan, hygiene and logistics strategies.
Version française: Journée Revue-Réflexion Transversale Cholera Haïti (2011) interne
MSF-OCB had been present in Sierra Leone since 1995, and in 2011 was running two projects in Bo district, a low endemic area for Lassa Fever. In February 2011, four MSF staff members acquired Lassa Fever in the MSF-run hospital, 2 of whom died. This led OCB to propose an evaluation of the chain of events leading up to the tragedy, in order to learn lessons in terms of the relevance and effectiveness of preparation and infection control and management of the Lassa Fever cases, and possibly adjust internal procedures or processes.
In early 2010 MSF-OCB responded to an increase of malaria in northern parts of Burundi. This evaluation assessed the relevance, timeliness, appropriateness, effectiveness and efficiency of the intervention as well as the managerial set-up.
In August 2008 an outbreak of cholera occurred outside Harare, the capital of Zimbabwe. This outbreak, seen before the regular seasonal increase in cholera cases, retrospectively signalled th ebeginning of the worst cholera epidemic experienced in Zimbabwe’s history. The three sections of Médecins Sans Frontières (MSF) present in the country (OCA, OCB and OCBA) all responded to the epidemic. By the end of the epidemic, MSF had aided in the care of nearly 65 000 of the 100 000 cases presenting to health structures, in what was one of the largest cholera interventions in MSF’s history. The overall objectives of this review were: Review the overall MSF intervention, including strategies used, timeliness of the response,intersectional cooperation and communication, and collaboration with the MoH and partners; Review of preparedness and regional approaches; Follow-up of recommendations made in the evaluation of the 2006 Angola epidemic (see below).
Evaluation of Epidemic Response in MSF-CH 2006/2007 (2007) internal
MSF-CH responded to 20 epidemics between 2006 and mid 2007 including Cholera, Meningitis, Measles, Plague and Rift Valley Fever. This evaluation was carried out to investigate key indicators of timeliness, effectiveness and efficiency in MSF-CH's interventions in 2006/7, with the purpose to improve response to epidemics within OCG. The evaluation team was asked to synthesise lessons learned from different interventions, and to look at decision-making processes involved in launching epidemic response, timing of interventions, and choice of intervention strategies.
Overall response to cholera epidemics in Angola in 2006 (2007) internal
In 2006 cholera was once again detected in Luanda, Angola’s capital. The epidemic started on February 13, 2006, in one neighbourhood but spread rapidly to the other municipalities and then to the neighbouring provinces following the main transport axes. MSF intervened in Luanda and in 11 provinces across the country by opening various Cholera Treatment Centres and Cholera Treatment Units. MSF-B was the first section to intervene, with other sections joining progressively as needs were perceived. This evaluation was initiated by the operational directors of the 5 operational sections in order to assess the quality of the global MSF intervention during the 2006 choler aepidemic in Angola in terms of effectiveness and efficiency. The overall goal of the evaluation was to describe lessons learned from the MSF intervention and to produce a document for improved cross-sectional choler aemergency interventions in the future.