(P07-009-25) Lessons Learned in a Low-Resource Setting Providing Surgical Rehabilitation: A Community-Academic Partnership Promotes Health Equity for Children With Disabilities

Objectives: A surgical rehabilitation program, Kafika House, provides equitable care for children with surgically treatable disabilities in Tanzania. There is a paucity in the research regarding the implementation of monitoring and evaluation (M&E) plans in resource-limited settings. A community-academic (C-A) partnership between Kafika House (Arusha, Tanzania) and St. Catherine University (St. Paul, MN, USA) offers insights into rehabilitative program M&E. The objective of this work is to utilize the Ecological Framework to assess responsiveness, quality, and fidelity in the implementation of a M&E plan, highlighting adaptations for health equity and advancing global academic knowledge on organization challenges.

Methods: Kafika House partnered with an interdisciplinary academic team from St. Catherine University in 2020. Through an 18-month iterative process, the team created a M&E plan. To measure health outcomes, assessment tools were developed to monitor and evaluate perioperative health for children with cleft lip/palate, spina bifida, skeletal fluorosis, osteomyelitis, burn scar contractures, or clubfoot. Kafika House staff interviews measured responsiveness to M&E tools. Review of data collected from piloting the tools developed for program and impact evaluations measured data quality and fidelity.

Results: Motivation for data quality and fidelity during collection is improved through data collector buy-in, facilitated by a responsive and communicative C-A partnership. Adaptations included increased funding and training and sustainable integration and administration of M&E tools in response to resource limitations. The implementation review supported Kafika House in identifying staff members who are appropriate for evaluation.

Conclusions: By utilizing an ecological approach to measure responsiveness to a M&E plan, data quality and fidelity, and determine adaptations for sustainability, we have demonstrated utilizing a M&E plan promotes health equity in low-resource settings with appropriate support and communication within a C-A partnership. C-A partnerships are a uniquely effective avenue for culturally-relevant identification of global health challenges and implementation of M&E to increase the sustainability of the data collection.

Funding Sources: GHR Foundation