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In 2013, Somalia was affected by an outbreak of poliovirus type 1 (WPV1) with 194 cases followed by five cases in 2014. Although the last case of WPV1 in Somalia prior to this outbreak was reported six years ago, the country has experienced a continuous transmission of circulating vaccine-derived poliovirus type 2 (cVDPV2) since 2008. The last outbreak of WPV1 initiated in May 2013 and has resulted in 199 WPV1 cases in South Central zone and Puntland including the five cases in Jariban district of Mudug region in 2014 in the months of May and June.
The outbreak was attributed to a large reservoir of children unvaccinated against poliovirus. Approximately one million children had not been immunized between 2009 and 2012 due to restricted access for humanitarian actors especially in the South Central zone. In addition, the cases in 2014 were closely related to nomadic groups, whose movements often make it difficult to track and implement health practices. While access challenges in insecure areas drove the initial waves of transmission, the tail end of the outbreak was seen in populations where access is limited due to remoteness and lifestyle (nomadic/pastoral).
A number of activities were implemented in response to the outbreak. Initially these focused on establishing structures to plan, respond and monitor the implementation of efforts to stem the outbreak. The Social Mobilization Network (SM Net) was also set up with the aim of raising awareness on polio and increasing coverage of the polio vaccine in access compromised areas. Funding for the SM Net has recently declined. This has translated into a lower number of polio immunization campaigns per year: in 2015, seven campaigns were carried out and in 2016 six campaigns were carried out. Only five campaigns are planned for 2017, and two for 2018. It is anticipated that the SM Net system could be used to deliver other campaigns including other immunizations (such as measles and tetanus), handwashing practices and infant and young child feeding (IYCF).
In response to the reduction in funding for SM Net, and in order to investigate whether this system could be used to deliver other health interventions, the United Nations Children’s Fund (UNICEF) office for Somalia has commissioned an evaluation of the SM Net programme. This inception report presents the work undertaken during the inception phase of the SM Net evaluation. This primarily focused on developing a comprehensive understanding of the programme through the review of reports and secondary data, and the evaluation of similar programmes through an extensive literature review. Together these were used to define the Theory of Change (ToC), research questions, indicators and data collection tools to be employed in evaluating the programme. The report also explains the timeline and action plan for delivery of research outputs.
The report is organized as follows: Section 2. Background to SM Net and Polio in Somalia; Section 3. Literature Review; Section 4. Theory of Change; Section 5. Research Questions; Section 6. Proposed Methodology; Section 7. Key Themes and Data Analysis Plan; Section 8. Data Collection Tools; Section 9. Workplan and Timelines; Section 10. Risks and Assumptions; Section 11. Support and Advisory group and Section 12. Bibliography.