In global health and development, the best laid-out plans rarely go as planned. Take the evaluation project that I’m managing, for example. It seemed so simple to me: spend a week or so collecting hard copies of client data from almost 50 sites across Malawi, spend two weeks entering the data into an electronic database, spend a month cleaning and analyzing the data, and then write up the results in time for the Christmas holiday. In a past update, I described that the process was more complex, though hopeful that it would be completed during a two-week leave I took in November. I’d envisioned that upon my return, our team of three would have completed data entry and we would start the process of data cleaning and the “fun” stuff: analyzing the data and seeing program results. What I came back to nearly gave me a heart attack; our team had actually backtracked due to “technical difficulties.”
My initial response was disbelief, and then frustration (especially since I had to relay the lack of progress to my boss, my bosses boss, and a director at headquarters). But after two days of meetings, phone calls, and sifting through piles of data, I realized that all the frustration in the world wouldn't solve the problem; I had to develop a plan.
My initial response was disbelief, and then frustration (especially since I had to relay the lack of progress to my boss, my bosses boss, and a director at headquarters). But after two days of meetings, phone calls, and sifting through piles of data, I realized that all the frustration in the world wouldn't solve the problem; I had to develop a plan.
Lesson One: communication is key. I am more convinced than ever that in life – professional or personal – communication is a major proponent of success. In my current position, this is no different. There are so many people involved in the evaluation: community health workers, who are intimately familiar with the data they collect; in-country management staff, who oversee the community health workers and manage national-level data; headquarters staff, the “top dogs” who make international decisions that affect the entire organization (and who also set the deadlines that affect our work at the country level). There has also been a lot of fluidity: management staff who spend alternating weeks in the field, and community health workers, who are often meeting with clients; the resignation of a colleague who was co-managing this project; the brief leave of the sole data entry officer. With these circumstances, it’s no wonder that communication is crucial.
Lesson Two: development is the way forward for health. The transition from paper to computer records has been a topic of debate in the context of the developing world. The challenges against it are numerous – inconsistent power, high costs, belief in the lack of technical capacity – but the challenges that arise from not implementing such a change are numerous as well. Since the beginning of October, we launched our attempts to collect data, thinking the process would be quick: contact managers to make photocopies of logbooks with hundreds of clients’ information, and send those copies to our head office in Lilongwe. But between slow transport, illegibility of the copies, and lost data, a simple process has become challenging. I've spent hours on the phone, speaking with community health workers in my sad attempt at the local language of Chichewa. I’ve requested that sites resend data when its quality seemed compromised. I even made a six-hour trip to three sites just recently since we couldn't get in touch with them by phone, hand-copying client information to ensure data accuracy. I kept thinking that if we used computer databases and invested in training personnel here, an expensive investment but with many returns, we could have avoided several of these challenges.
The Verdict: Overall, I am proud to say that by the end of this year, we would have collected all necessary data (albeit a month behind schedule). I continue to learn a lot through this data management process. I can’t say that I see a future in this – nor would I have expected I’d end up here post-Master degree – but it is a learning experience that a classroom couldn't teach me. While I continue to learn about then non-profit world and working with colleagues from very different backgrounds, I’m also learning about myself: about the way I directly and indirectly communicate, about the way I handle stressful situations, about the role of leadership when there are still people above you. I’m learning that I am a creative problem-solver – that there is no such thing as “no” in my rulebook – but that I also need to be creative in the way I interact in places where that same mode of thought is not a norm. And perhaps most importantly, I’m learning to accept that while plans are important, flexibility and adaptability in a global setting are just as necessary. An unexpected lesson from a data management assignment, but an eye-opening one nonetheless.
A version is also posted at: http://scoutbanana.org/health-in-africa/from-the-field-managing-data-102/ and here.
