1. How DTM (Site Assessment) can be useful for
Health Clusters in the field

2. DTM OPERATIONS OVERVIEW
Since its inception in Iraq in 2004, DTM has expanded its coverage to reach 65 countries. Past and present implementation contexts include conflicts, natural disasters and complex emergency settings, from small and short-term cases to large-scale, regional and protracted displacement trends and migration crises.

3. DTM Components Tracks movement of flows at specific points
MOBILITY TRACKING
FLOW MONITORING
Tracks movement of flows at specific points
Tracks mobility and cross-sectoral needs in locations of interest (systematically)
Groups
and
Location
Sub-components:
Baseline Area/Location
Site/community Assessment (Stock population)
Emergency Event Tracking (Sudden large movement of population)
Sub-components:
Baseline Assessment
Flow Monitoring Registry
REGISTRATION
SURVEYs
Gather specific information using sample from population of interest
Registers individuals or households for beneficiary selection, vulnerability targeting and programming
Explain only that DTM is made by various components, methodologies and tools, but we will focus only on Site Assessment here. Flow monitoring (mixed migration flows) may also be interesting for this sector, but we do not have the time to discuss it here, feel free to approach me after the end of the session, if you are interested in knowing more.
Households
and
Individuals
Sub-components:
Rapid Emergency Registrations
Verification for Registration
Biometric Registration
Not all DTM components are always rolled out in every country: DTM is implemented according to need, so different components may be rolled out in different countries.
Examples:
Return Intention
Community Perception
Displacement Solutions
Flow Monitoring Surveys

4. DTM aims at providing data and information that is useful and used for response: e.g., information that help your Clusters in their response

5. What DTM Site Assessment cannot do for the Cluster
DTM Site Assessments cannot replace a Health assessments or programme monitoring
DTM Site Assessments is done through Key Informants and Observation (not individual surveys)
DTM Site Assessments does not interview Health specialists
DTM Site Assessments enumerators are not Health specialists
DTM Site Assessment cannot ask questions on diseases and cause for morbidity and mortality, and cannot provide epidemiologically-valid statistics

6. So, why is DTM Site Assessment useful for the Cluster?
DTM Site Assessments are regularly implemented (in rounds) and can monitor changes over time
DTM Site Assessments collect inter-sectoral data (e.g., locations and numbers), in addition to some sectors-specific data
DTM Site Assessments have a very large territorial reach within the country
DTM Site Assessments are implemented in a large number of crisis (very likely you will find a DTM exercise in your country of operation)
Data are shared quickly after cleaning. Modalities of data sharing are flexible, including data for urgent action.
DTM is one of various data sources for the Cluster
DTM is flexible, and can be adjusted: it is focused on providing useful data for response
Global Cluster and DTM have agreed on a list of recommended questions for Site Assessments

7. What DTM Site Assessment CAN do for the Cluster
Provide estimates of population and groups at location level
Monitor change over time in many locations
Inform on access to services in many locations on an ongoing basis
Raise red flags/alerts
Provide information to help cluster prioritize their in-depth assessments …

8. How can Cluster and DTM can work on the field to obtain useful information for response

9. Approach: Profiles needed for Evidence- Based Decision-Making
IM Expert:
Data and analysis
Subject Matter Expert:
Interpretation: Making sense of analysis
Context /Cultural Expert
Translation: What does it mean in this context?
Decision-Maker (at Strategic, Programmatic and Operational level):
Take action
Evidence-based decisions and response
Lack of evidence
Lack of cultural understanding
Lack of sectoral understanding
Lack of action
Evidence – based decision making and response is generated by the interaction of four main skillsets. Excluding even only one of them undermines the veracity and usefulness of results.
The modalities and process of their interaction must be rigorous and predictable, for results to be useful and usable
Discounting Information Management (IM) skillset results in lack of evidence.
Discounting the subject matter or the cultural expertise prevents make sense of information (for a specific sector and in a specific culture/context).
Excluding decision-makers results in lack of appropriate action.
Only mention that we have been jointly working within the Grand Bargain on how data can be used more and we identified that it is about linking amongst decision makers, sectoral, IM and context experts
Modified by EDAUUR - Grand Bargain Work Stream for Needs Assessment

10. When is crucial that DTM and clusters engage?
Design: Identification of what information your Cluster needs and can obtain from DTM
Analysis- identify how and who:
- does the descriptive analysis (charts, tables and maps)
- makes sense of the data in that specific context (interprets)
- provides recommendations for action
There are various moments in which DTM and Clusters should engage, but the crucial ones are: Identifying information needs, and analysing.
It is also important to agree on how DTM will share data (e.g., specific sensitive datasets) with cluster and how often, and how to provide feedback to change questions over time.
We have an example of Sensitive data sets in the data dictionary among Health questions (sudden increase in deaths): we do not want to report that on a public DTM report, we want to share that info and the comments with Health Cluster, that will use them to identify possible red flags/places where health experts should go and assess further. Sharing publicly such information is equal to misinforming and can even be problematic.

11. Do not start from the question: start from the decision
Design: how to engage?
Identify the decisions to be made
Cluster Coordinator (& members)
Available Info & Missing Info
Cluster IMO (ask members)
What is the best tool?
Cluster IMO
Best question & answer options
DTM and Cluster IMO
Time-Saving Practice: show cluster coordinator & members a mock-up of the final charts & maps before finalizing the questions
Do not just include questions: start form the decisions to be made( Identify the decisions the cluster has to make in order to respond), then look at information (Identify what information you have and what information is missing to make such decisions), then Identify the best available tool to capture the missing information (e.g., is it DTM? Or another system?) and only at that point, work with DTM/IMO to jointly identify the most appropriate question and options to capture the needed information.
Ask DTM/IMO to show you a mock up of how the final charts, tables and maps will look like, with fake data: it is like building a house.. Don’t you want to see the plan of how it will look like before you pay for the works?
Do not start from the question: start from the decision

12. Analysis: Agreeing on Options for Analysis DTM and Clusters
Early on, it is important to agree (between DTM and Clusters in the field) on who does what and the flow of the analysis process.
Levels of Analysis
There are various levels of analysis:
Usually DTM would do the first analysis (explore data, clean data), the Cluster IMO and DTM could agree on who makes initial charts and maps (description)
The higher levels of analysis (explaining, interpreting and deciding on actions for response will usually be made by Cluster Coordinators and Cluster members. DTM and Cluster IMO have a role in supporting interpretation by clarifying what the data say and guiding on reliability and accuracy of data, in light of the methodology. This would usually happen in a cluster meeting or in an ad-hoc meeting. It is key to agree on how this process will look like from the beginning, to avoid that cluster coordinators/members cannot use the data.

13. Balancing pressure for timely results and engagement with data users: Broadening Engagement – a phased approach
Time and human resources for engaging with all data users are often limited. Productive consultation is time consuming. Clusters, WGs, programmes and other potential users are numerous and data are needed ASAP. However, collecting useful data without engaging with data users greatly limits data and analysis use.
A phased approach, broadening engagement, is a practical suggestion to manage such competing priorities.
Start by using questions, answers and analysis suggested in the data dictionary and standard analysis & dissemination plan, that were developed together by DTM , Global Clusters, AoRs and Sectoral Experts
Prioritize responders based on a) largest impact; 2) evolving information needs
Plan to reach all relevant stakeholders: Communicate the plan and articulate reasons for prioritization
As all the process takes time, you will see that engagement can only happen as a phased approach. This means it may take time for DTM to get in touch with your cluster… however, if you see added value, you can get in touch with DTM early on, and be amongst the first clusters to engage.
To ensure DTM provides data the cluster can use, even at the start of an emergency, we (DTM Global Support Team and Global Health Cluster) have worked jointly to identify a limited number of questions we suggest DTM starts collecting, as they should be useful to the cluster everywhere.

14. Global Cluster and DTM Site Assessment questions
DTM and Global Cluster worked to identify basic number of useful information DTM can provide to the clusters in the field, that can be collected through DTM site assessment methodology.
Ask Health Cluster Epidemiologist (Boris) to explain how the questions were selected and why questions like “Do children have access to vaccines?” or “how many cases of cholera there were in the last month?” were not included.
Choose 5 questions from the data dictionary and ask participants to give examples of how they would use each one of them.

15. Where can you find DTM reports and data?
DTM public data and reports are online and available at: and (through a search by Country).
For questions and support, contact the DTM coordinator in your country (ask for his/her contact details).

16. Thank you!
Questions?