BRAC: Decline in Performance Amidst Transitions

After transitioning to a new stage of partnership with BRAC earlier this year, we are now only reporting on 2,500 CHWs who have full DESC support due to BRAC’s change in strategy and funding availability.

BRAC is transitioning the remaining 1,500 of their CHWs (who do not have DESC support) to government as eCHIS rolls out. Unfortunately, CHW performance continued to decline in Q2 with low reporting rates.

The main challenges include stockouts of commodities, which affects services like sick child treatments; tech glitches that affected antenatal care tasks; and ineffective supervision, with a large supervisor to CHW ratio of 1:150 that prevents regular touch points.

This is despite recoveries in some DESC components, such as phone replacements and a return to in-person supervision in Q2 which we hoped would improve performance. BRAC implements a supervision model where well-performing CHWs — called super CHWs — are paired with poor-performing CHWs for support.

Plans are underway to ensure all CHWs are physically supervised at least once a month. Additionally, tracking coordinates and GPS will be utilized as a verification tool for in-person supervision.

Meanwhile, digital reporting for family planning has started; this data was previously collected manually but family planning workflows have been incorporated into the CHW app as of the end of May; by June 76% of CHWs were digitally reporting.

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