Kenya OVC-CT Programme Operational and Impact Evaluation

• Important health-determining behaviour, such as: carer and child attendance at health &nutrition education / growth monitoring sessions; carer knowledge of health issues coveredby these sessions; prevalence and impact of adult chronic illness; utilisation of VCT andART services;• Household relations around expenditure, including who makes decisions within thehousehold on how to spend the cash;• Impact on support from other households and programmes;• Economic and social costs for households included in the scheme, and any impact onsocial relations; and• Uptake of child birth registration documents and adult ID cards.The simpler of these measures will be included in the second round of the quantitative survey.More complex or subtle effects may only be investigated in the qualitative studies.FosteringThe programme has the fostering and retention of orphans in the community as a central objective.The household survey will track what happens to orphans in the sampled households over theperiod and will be able to compare programme and control households on the extent to which theyremain in the households. This will provide information on the apparent impact of the programmeon the retention of orphans in the household. However, it will provide little information on whathappens to newly orphaned children. The community questionnaires have collected information onthis and the follow-up survey will seek to assess any changes in community-level information.However it should be noted that this will be approximate, and precisely estimating the impact of theprogramme on fostering rates would require a different study design and a much larger sample.The evaluation is focussed, rather, on estimating the impact on the welfare of existing orphans.1.3 The baseline surveyOPM was initially told to mobilise a team for January 2006. This team undertook design andpiloting work, but the finalisation of the sample and implementation of the survey was constrainedto follow the development and implementation of the Programme, which took longer than had beenanticipated. The fieldwork for the baseline quantitative survey was eventually implementedbetween March and August 2007.The evaluation covers Nyanza (Kisumu, Suba, Homa Bay and Migori districts), Nairobi, Kwale andGarissa. These districts were identified by the programme. The programme operates in a numberof locations within these districts. 8 However, the evaluation is being undertaken in only fourlocations per district: two with programme intervention and two acting as controls. The evaluationlocations were selected randomly after excluding any with particularly low poverty rates,inadequate capacity to supply the relevant health and education services, or large existing OVCsupport programmes. Intervention/control status was allocated randomly to give two of each perdistrict.The choice of which districts would impose conditions was also made randomly. Conditions wereimposed in Homa Bay, Kisumu and Kwale; there were no conditions imposed in Garissa, Migoriand Suba. In Nairobi, conditions were imposed in one location (Dandora B), but not in the other(Kirigu). The intervention and control locations will remain as intervention and control locations at8 Note that locations are the unit outside Nairobi. In Nairobi, sub-locations were identified. Where thisdocument refers to locations, it should be taken to mean sub-locations in Nairobi.6