SCENARIO 2
| A. Table 1: Project Description | |||||||||
| Inputs | Process/ Activities | Outputs | Outcomes | Impact/ Goal | |||||
| What goes into the program?
| What does the program do? | What happens as a result of the program? | What are the short/ medium term benefits for participants? | What are the long term or broader benefits of the program? | |||||
| Certain resources are needed to operate the program. | If the program has access to inputs, then they can be used to accomplish planned activities.
| If planned activities are accomplished, then the program will hopefully deliver the amount/ type of product and/ or service intended. | If planned activities are accomplished to the extent intended, then participants will benefit in certain ways.
| If these benefits to participants are achieved, then certain changes in organizations, communities, or systems might be expected to occur. | |||||
| Þ The SPRINT Initiative has funded 50,000 USD Þ The Family Planning Organization of the Philippines’ staff has been funded by SPRINT Þ Community groups (in particularly 30 youth volunteers) were recruited and trained to assist need of displaced persons Þ Reproductive health kits including clean delivery, dignity and hygiene Þ Family Planning Organisation of the Philippines distributing supplies such as condoms Þ Clinical facilities
| Þ Minimum Initial Service Package Delivery Agency Identification among the displaced population in Zamboanga City is for a duration of 3 months. It is used by Family Planning Organisation of the Philippines for Reproductive Health so that they may apply aspects of the Minimum Initial Service Package. The 5 objectives of this program are to identify organisation, stop and manage the outcomes of sexual violence, reduce HIV, prevent death and illness and plan for sexual and reproductive healthcare. Þ Minimum Initial Service Package training (Family Planning Organization of the Philippines staff and youth volunteers): Zamboanga City youths assisted with project activities and used the Minimum Initial Service Package and project implementation; they are involved in project implementation Þ Identification of delivery sites to implement aspects of the Minimum Initial Service Package (on-ground assessment) Þ Data gathering including baseline, PH data, baseline and displaced people, as well as, documentation (service delivery) to attain 5 objectives of Minimum Initial Service Package Þ Coordination of delivery and local services Þ Materials including dignity, clean delivery, condoms and hygiene kits have been distributed to attain the five objectives of the Minimum Initial Service Package funded by Family Planning Organisation of the Philippines Þ Community information sessions on reproductive health Þ Reproductive Health Working Group initialised with UN Population Fund (Department of Social Welfare and Development, Department of Health, and the Mindanao Emergency response Network): coordinating the Sexual and Reproductive Health response to the crisis of Zamboanga City | Þ Appointment of appropriate agency for Minimum Initial Service Package delivery Þ Adequate and quality training provided of 30 volunteers and staff Þ A number/quality of delivery sites of services identified Þ Availability of data for baseline for a number of displaced people Þ A number/quality of sexual and reproductive health services delivered to displaced people Þ Preparation of family planning assistance for the displaced population Þ A quantity of condoms handed out to target the population in geographic locations Þ Kits including hygiene kits, dignity and clean delivery have been distributed to targeted groups. This being women in reproductive age and pregnant women Þ Numerous health education sessions on community health information delivered for a significant amount of attendees Þ Formation and initiation of Reproductive Health Working Group
| Þ Institutional capacity to increase as well as to respond to the disaster with the Minimum Initial Service Package and to apply their five objectives including to put a stop to sexual violence and its consequences and to reduce HIV and other STIs Þ Increase in awareness and knowledge of available sexual and reproductive health services amongst the displaced population. Thus, decreases issues and consequences associate with sexual and reproductive health Þ Amongst the displaced people, a positive increase in sexual and reproductive health behaviours. Utilisation of materials including clean delivery condoms and hygiene kits distributed Þ Improved and better access to sexual and reproductive health facilities for the targeted people for HIV care and treatment. Growth in identification of numerous delivery sites Þ Improved and better access for sexual violence support facilities. The ensure coordination of delivery and local services. Þ A decreased rate of those incidences of HIV and other STIs Þ Decreased rate of unplanned or unwanted pregnancies Þ Decrease in neonatal, maternal, and infant morbidity and mortality Þ Long-term availability and support of appropriate and accessible sexual and reproductive health facilities | Þ To a great extent, ensuring sexual and reproductive health and rights of all displaced people especially women and children. Enhancement and education of the people of concern Þ Decreased rate of harassment and sexual violence. Prevention and quality response to associated sexual violence issues Þ Sexual and reproductive health awareness and rights integrated into area and national recovery as well as development programmes. Strengthening partnerships and cooperation with all associated stakeholders Þ Decreased prevalence of HIV and other STIs of displaced persons, an in turn a decrease in associated negative symptoms Þ Access to HIV treatment and services for displaced population living with AIDS or HIV. Raising overall visibility, branding and image of services Þ Decrease of burden of disease in relation to sexual and reproductive health including neonatal, maternal and infant health as well as associated negative symptoms Þ Stable and reasonable population and family sizes; low amount of unplanned and unwanted pregnancies Þ During disasters, minimising social instability and the improvement of educational programs and welfare processes | |||||
| B. Table 2: Evaluation questions (based on the project description in Table 1) | |||||||||
| Inputs (taken from table 1): | Evaluation question(s): | ||||||||
| The SPRINT Initiative has funded 50,000 USD | At each operational site, what were the expenses of directing medical assignments at every operational spot? Is 50000 USD from Sprint enough to cover the supply needed over the intended time period of the course? | ||||||||
| The Family Planning Organization of the Philippines’ staff has been funded by SPRINT | How did the staff prioritise time for particular operational activities? Was their enough staff to ensure quality program processes and activities? | ||||||||
| Community groups (in particularly 30 youth volunteers) were recruited and trained to assist need of displaced persons
| Were 30 youth volunteers enough for the necessity of the program? | ||||||||
| Reproductive health kits including clean delivery, dignity and hygiene | Were reproductive health kits easily accessible when the displaced population needed them? | ||||||||
| Family Planning Organisation of the Philippines distributing supplies such as condoms
| Were condoms easily accessible when the displaced population needed them? | ||||||||
| Clinical facilities
| Were sufficient amounts of clinical facilities consistently easily accessible when the displaced population needed them for the program’s activities? Were clinical services easily accessible from every delivery site? | ||||||||
| Processes/Activities (taken from table 1): | Evaluation question(s): | ||||||||
| Minimum Initial Service Package Delivery Agency Identification among the displaced population in Zamboanga City is for a duration of 3 months. It is used by Family Planning Organisation of the Philippines for Reproductive Health so that they may apply aspects of the Minimum Initial Service Package. The 5 objectives of this program are to identify organisation, stop and manage the outcomes of sexual violence, reduce HIV, prevent death and illness and plan for sexual and reproductive healthcare. | Was a particular agency accountable for the organisation of the program delivery? | ||||||||
| Minimum Initial Service Package training (Family Planning Organization of the Philippines staff and youth volunteers): Zamboanga City youths assisted with project activities and used the Minimum Initial Service Package and project implementation; they are involved in project implementation. | Prior to the initiation of the program delivery, were all the training for the volunteers and staff adequately provided and completed? | ||||||||
| Identification of delivery sites to implement aspects of the Minimum Initial Service Package (on-ground assessment) | How many delivery sites of the Minimum Initial Service Package were measured and considered suitable for delivery of services? | ||||||||
| Data gathering including baseline, PH data, baseline and displaced people, as well as, documentation (service delivery) to attain 5 objectives of Minimum Initial Service Package | Were there satisfactorily enough data resources offered? | ||||||||
| Coordination of delivery and local services | Was the processes and programs activities provided in a reliable and fitting coordination? | ||||||||
| Materials including dignity, clean delivery, condoms and hygiene kits have been distributed to attain the five objectives of the Minimum Initial Service Package funded by Family Planning Organisation of the Philippines | At each operational site, were there satisfactorily enough materials accessible for medical missions? | ||||||||
| Community information sessions on reproductive health | Did trained staff and volunteer members conduct information sessions appropriately? | ||||||||
| Reproductive Health Working Group initialised with UN Population Fund (Department of Social Welfare and Development, Department of Health, and the Mindanao Emergency response Network): coordinating the Sexual and Reproductive Health response to the crisis of Zamboanga City | To begin the working group, were fitting partners acknowledged and contacted? | ||||||||
| Outputs (taken from table 1): | Evaluation question(s): | ||||||||
| Adequate training provided of 30 volunteers and staff | How many volunteers and staff had quality and complete training which was suitable for all the program activities? | ||||||||
| A number/quality of delivery sites of services identified | Were a number of delivery sites chosen appropriately in respect to the geographic location of the displaced persons? | ||||||||
| Availability of data for baseline for a number of displaced people | Was a survey conducted to inform needs to delivery teams?
| ||||||||
| A number/quality of sexual and reproductive health services delivered to displaced people | Were sexual and reproductive health services easily accessible to displaced persons including pregnant women when needed? | ||||||||
| Preparation of family planning assistance for the displaced population | Was there support and counselling for family planning when needed? | ||||||||
| A quantity of condoms handed out to target the population in geographic locations | Were free condoms consistently distributed to all participants and at the different sites? | ||||||||
| Kits including hygiene kits, dignity and clean delivery have been distributed to targeted groups. This being women in reproductive age and pregnant women | Were free kits consistently distributed to all participants and at the different sites? | ||||||||
| Numerous health education sessions on community health information delivered for a significant amount of attendees | Were displaced persons highly educated on health? How many participants were during this education session? | ||||||||
| Formation and initiation of Reproductive Health Working Group | Was the information shared agreed to in regarding work allocation and distribution? | ||||||||
| Outcomes (taken from table 1): | Evaluation question(s): | ||||||||
| Institutional capacity to increase as well as to respond to the disaster with the Minimum Initial Service Package and to apply their five objectives including to put a stop to sexual violence and its consequences and to reduce HIV and other STIs | Were all fully trained volunteers and staff able to confidently provide components of the Minimum Initial Service Package program? | ||||||||
| Increase in awareness and knowledge of available sexual and reproductive health services amongst the displaced population. Thus, decreases issues and consequences associate with sexual and reproductive health | Did targeted groups utilise the provided services? Do the participants or patients know about the sexual and reproductive health issues that may arise? | ||||||||
| Amongst the displaced people, a positive increase in sexual and reproductive health behaviours. Utilisation of materials including clean delivery condoms and hygiene kits distributed | Have greater incidences of safer sex practices been obtained by the population? | ||||||||
| Improved and better access to sexual and reproductive health facilities for the targeted people for HIV care and treatment. Growth in identification of numerous delivery sites | Has there been improvement in the accessibility of sexual and reproductive health facilities for those who need HIV care and treatment? | ||||||||
| Improved and better access for sexual violence support facilities. The ensure coordination of delivery and local services. | Was there an improvement in the accessibility of sexual violence support facilities? | ||||||||
| A decreased rate of those incidences of HIV and other STIs | Was there a prevention of new incidences of those with HIV and other STIs? | ||||||||
| Decreased rate of unplanned or unwanted pregnancies | Was there a prevention of unplanned or unwanted pregnancies? | ||||||||
| Decrease in neonatal, maternal, and infant morbidity and mortality | Has there been a decline in neonatal, maternal, and infant morbidity and mortality complications? | ||||||||
| Long-term availability and support of appropriate and accessible sexual and reproductive health facilities | Was there a great amount of greater accessibility of sexual and reproductive health services towards the completion of the project? | ||||||||
| Impact/ Goal (taken from table 1): | Evaluation question(s): | ||||||||
| Decreased rate of harassment and sexual violence. Prevention and quality response to associated sexual violence issues | How did the prevalence and incidence of harassment and sexual violence revolve throughout and after the incident in comparison to baseline? | ||||||||
| Sexual and reproductive health awareness and rights integrated into area and national recovery as well as development programmes. Strengthening partnerships and cooperation with all associated stakeholders | What were the displaced people’s responses of the sexual and reproductive health? How did it revolve throughout and after the incident in comparison to baseline?
| ||||||||
| Decreased prevalence of HIV and other STIs of displaced persons, an in turn a decrease in associated negative symptoms | How did the incidence of HIV and prevalence other STIs revolve throughout and after the incident in comparison to baseline? | ||||||||
| Access to HIV treatment and services for displaced population living with AIDS or HIV. Raising overall visibility, branding and image of services | What was the amount of the displaced population who lived with either AIDS or HIV had easy accessibility to fitting treatment at the completion of the process in comparison to baseline? | ||||||||
| Decrease of burden of disease in relation to sexual and reproductive health including neonatal, maternal and infant health as well as associated negative symptoms | What changes were seen in the burden of disease in relation to sexual and reproductive health comprising neonatal, maternal and infant health were detected throughout and after the incident in comparison to baseline? | ||||||||
| Stable and reasonable population and family sizes; low amount of unplanned and unwanted pregnancies | In what way did the amount of unplanned or unwanted pregnancies change throughout and after the crisis in comparison to baseline? | ||||||||
| C. Table 3: Performance indicators, means of verification, assumptions and challenges: | |||||||||
| Evaluation question | Performance Indicators | Verification | Assumptions/ Challenges | ||||||
| At each operational site, what were the expenses of directing medical assignments at every operational spot? Is 50000 USD from Sprint enough to cover the supply needed over the intended time period of the course? | Cost ($) – per operational site per medical mission and per patient | § Number of patients which can be obtained from clinical records. Costs per purchase; staff hours and orders. | Clinical records are utilised to accurately and efficiently manage patient numbers regarding operational site and medical mission. For each of these, the resource allocations are also noted. | ||||||
| How did the staff prioritise time for particular operational activities? Was their enough staff to ensure quality program processes and activities?
| % of time allocated for the following: Logistics, administrative tasks, training and professional development, interagency collaboration, conducting medical sessions and conducting information session | § Internal staff activity records | To avoid recall bias, hours divided by tasks are accurately recorded in a suitable time frame. | ||||||
| Were 30 youth volunteers enough for the necessity of the program? | # of volunteers and % of their hours per week available for the program | § Internal staff activity records | The hours staff members work voluntarily will be recorded accurately to avoid recall bias. The available hours staff can work as volunteers will also be noted. | ||||||
| Were reproductive health kits easily accessible when the displaced population needed them? | % of medical missions with adequate # of kits in relation to these missions | § Medical mission records § Inventory records | Inventory records, accurate records and medical mission reports will be detailed and precise. | ||||||
| Were condoms easily accessible when the displaced population needed them? | # of sites who experienced condom shortages for more than one whole day | § Inventory records | Daily inventory records will be kept and recorded accurately. It is vital to keep track of all inventory in order to notice whether there will be shortages of stock. | ||||||
| Were sufficient amounts of clinical facilities consistently easily accessible when the displaced population needed them for the program’s activities? Were clinical services easily accessible from every delivery site? | # of clinical facilities and its associated geographical location of clinical services % of delivery sites within an appropriate proximity of each clinical service | § Assessments of initial site § Data obtained from clinical staff and volunteers operational records | The initial assessment of sites will be recorded and pertain adequate and accurate information describing the facility. The clinical data is kept up to date and recorded accurately and precisely. The service proximity present is a barrier to reach service access, where safety concerns may also undermine access. | ||||||
| Was a particular agency accountable for the organisation of the program delivery? | Was a particular agency accountable for the organisation of the program delivery? yes or no | § Data from obtained from records and meeting minutes as well as observation | All records and meeting minutes are accurately noted and stored safely. | ||||||
| Prior to the initiation of the program delivery, were all the training for the volunteers and staff adequately provided and completed? | % of volunteers and staff completing training prior to the initiation of the program delivery Measurement of quality of training provided | § Observation of training § Attendance records § Training and staff records
| All training provided to staff is appropriate and relates to the program. Staff and volunteers also have a thorough understanding of the importance of training and the safety reasons behind it. The attendance of staff to all training sessions are recorded and is vital as this results in knowledge transfer. | ||||||
| How many delivery sites of the Minimum Initial Service Package were measured and considered suitable for delivery of services? | # of sites measure and assessed and therefore the % of sites deemed suitable for delivery of services | § Assessments of initial site | The initial site will be examined and reported on with an abundance of information. A checklist will be compared with the initial assessment to ensure that all points of the criteria are met to ensure all sites are appropriate. | ||||||
| Were there satisfactorily enough data resources offered? | # of available data sources and the measurement of the coverage quality | § Data from clinical records such as ministerial records and population-based surveys | The accuracy, reliability and the overall validity of the data captured. Assumes data is cleaned and correct. Other governmental departments and non-government organisations may not deliver the data needed. | ||||||
| Was the processes and programs activities provided in a reliable and fitting coordination? | # and coordination of information provision and meetings and the feedback measurement by the trained staff and volunteers | § Management records of meeting minutes § Questions asked by staff | Meeting minutes and records are accurate and valid and collected regularly. Assumes the importance of consistent coordination. Assumes staff and volunteer participation in interviews ensuring representative, truthful and reliable answers. | ||||||
| At each operational site, were there satisfactorily enough materials accessible for medical missions? | % of medical missions directed with accessible and appropriate material % of operational sites with accessible and appropriate material | § Inventory records § Medical mission records § Operational site records | Assumes consistence in defining the term ‘sufficient’. Accurate inventory records. Accurate reports on operational sites and medical missions. | ||||||
| Did trained staff and volunteer members conduct information sessions appropriately? | % of information sessions which were directed by trained staff | § Medical mission records § Operational site records § Staff training records | Accurate records and reports on operational sites, medical missions and records of staff training. Assumes that information conferences are better when directed by trained volunteers or staff and that trainings offered are essential for delivering information. | ||||||
| To begin the working group, were fitting partners acknowledged and contacted? | # of partnerships identified and thus the % of them being contacted | § Records of project management | Assumes the accuracy and validity of project management records in a systematic way to classify fitting contacts and partners. | ||||||
| How many volunteers and staff had quality and complete training which was suitable for all the program activities? | The first part of the question has already been addressed above. This will focus on the training provided and its quality | § Checklist § Training observation | Assumes the appropriateness and objectiveness of the checklist. Assumes experienced observers and their availability. | ||||||
| Were a number of delivery sites chosen appropriately in respect to the geographic location of the displaced persons? | Sites of geographic location for displaced people and the % proximity of delivery sites with evacuation sites | § Project management records: data obtained from non-government organisations and government organisations in regard to distribution of the displaced population | Management records accuracy. Assumes data accuracy taken by partners and other associates. Other governmental departments and non-government organisations may not deliver the data needed. Delivery sites accessibility may correspond to violence and other issues during incidences. | ||||||
| Was a survey conducted to inform needs to delivery teams?
| Prior to commencement, % of medical missions with availability of demographic information | § Records of medical mission | Assumes that records deliver adequate data based on the convenience of demographic material. Assumes all significant records for medical missions. | ||||||
| Were sexual and reproductive health services easily accessible to displaced persons including pregnant women when needed? | % of labours which were attended by an obstetrician birth attendant Average wait time (in days) for an appointment | § Medical records such as medical mission surveys and health care clinic records | Ensures all processes are recorded accurately including their waiting times. The accuracy, reliability and the overall validity of the survey. | ||||||
| Was there support and counselling for family planning when needed? | Average wait time (in days) for an appointment # of support and counselling for family planning provided when needed | § Medical mission surveys § Records of Health care clinic | Assumes that every session is entered correctly into the system including waiting times for an appointment. The accuracy, reliability and the overall validity of the survey. | ||||||
| Were free condoms consistently distributed to all participants and at the different sites? | This question has already been addressed | § N/A | N/A | ||||||
| Were free kits consistently distributed to all participants and at the different sites? | This question has already been addressed | § N/A | N/A | ||||||
| Were displaced persons highly educated on health? How many participants were during this education session? | # of participants involved # of health education sessions which was delivered at every site Measurement of the quality of the information sessions | § Data records obtained from staff activity § Observations such as checklists | To avoid recall bias, hours divided by tasks are accurately recorded in a suitable time frame. Assumes the appropriateness and objectiveness of the checklist. Assumes experienced observers and their availability. | ||||||
| Was the information shared agreed to in regarding work allocation and distribution? | Was an agreement regarding sharing work or information distribution agreed to? Yes or no | § Records of project management | Assumes that the agreements are meeting objectives and are appropriate. Project management records accuracy. | ||||||
| Were all fully trained volunteers and staff able to confidently provide components of the Minimum Initial Service Package program? | The questions regarding training has already been addressed. This will concentrate on the volunteers and staff’s perception % of volunteers and staff able to confidently deliver their services and programs | § Questionnaire | Survey’s reliability and validity. Survey participation. | ||||||
| Did targeted groups utilise the provided services? Do the participants or patients know about the sexual and reproductive health issues that may arise? | # of different patients. Initiation of health services contacted per 1000 people Knowledge of sexual and reproductive health level | § Clinical records § Survey including contact and knowledge | Assumes that every appointment is entered correctly into the system Survey’s reliability and validity. Survey participation. | ||||||
| Have greater incidences of safer sex practices been obtained by the population? | % of safes sex practices | § Survey | Survey can avoid repetition as well as survey fatigue. The accuracy, reliability and the overall validity of the survey; taken into account participation. | ||||||
| Has there been improvement in the accessibility of sexual and reproductive health facilities for those who need HIV care and treatment? | This question has already been addressed | § N/A | N/A | ||||||
| Was there an improvement in the accessibility of sexual violence support facilities? | # of facilities provided for sexual violence support Average wait time (in days) for an appointment | § Records of healthcare clinic record § Surveys of medical mission | Assumes that every session is entered correctly into the system including waiting times for an appointment. The accuracy, reliability and the overall validity of the survey. | ||||||
| Was there a prevention of new incidences of those with HIV and other STIs? | During crisis time, # of incidences of new HIV and AIDS cases | § Public health data § Records of clinical healthcare | Assumes sufficiency of testing is taken into consideration during the crisis period. Social stigma linked with AIDS and HIV may impact testing numbers in particularly populations who are at high risk. Assumes that new cases were spread during the crisis period. | ||||||
| Was there a prevention of unplanned or unwanted pregnancies? | % of new pregnancies categorised as unplanned or unwanted | § Antenatal surveys managed throughout maternal care services | Assumes appropriate and quality assessment of women in easily accessible and safe facilities. Data noted is accurate. Barriers including communication, interpersonal and cultural may invalidated the results or data and may have attributed to biasness. | ||||||
| Has there been a decline in neonatal, maternal, and infant morbidity and mortality complications? | The % of dying women because of problems during childbirth per 5000 deliveries Mortality of children under the age of one per 50000 live births | § Data obtained from clinical health services § Surveys of medical mission § Data from public health | Accurate and valid records of mortality with appropriate case classifications are kept and updated on a regular basis. Assumption that all cases have been reported to the correct management authorities. | ||||||
| Was there a great amount of greater accessibility of sexual and reproductive health services towards the completion of the project? | # of facilities and services toward the termination of the project % of operational capacity in comparison to the intervention period | § Records § Observation | Assumes appropriateness of the observations. Assumes that all opening hours, services and procedures are accurately recorded. | ||||||
| How did the prevalence and incidence of harassment and sexual violence revolve throughout and after the incident in comparison to baseline? | # of sexual violence acts which were reported monthly during the crisis measured per 1000 populace | § Records of law enforcement | Minority people are frequently underrepresented in reporting sexual violence. Victims may not report to law authorities during the incidence period. Assumes the accuracy of the reports and that they are shared and up to date. Assumptions that the reporting is alike to prior times and are demonstrative of true cases. | ||||||
| What were the displaced people’s responses of the sexual and reproductive health? How did it revolve throughout and after the incident in comparison to baseline? | This question could have already been addressed by comparing baseline data or adding extra questions concerning people’s awareness prior | N/A | N/A | ||||||
| How did the incidence of HIV and prevalence other STIs revolve throughout and after the incident in comparison to baseline? | Prevalence of other STIS and the incidences of HIV throughout and after the incident | § Data of public health | Assumption that all cases have been reported to the correct management authorities. Assumes the data availability. Other challenges regarding testing are mentioned above. | ||||||
| What was the amount of the displaced population who lived with either AIDS or HIV had easy accessibility to fitting treatment at the completion of the process in comparison to baseline? | % of people living with HIV and with access to appropriate facilities and services as well as antiretroviral treatment | § Data of public health data § Surveys § Clinical records | Accuracy of management records and data. Assumption that all cases have been reported to the correct management authorities. Assumes the data availability. The accuracy, reliability and the overall validity of the survey; taken into account participation. | ||||||
| What changes were seen in the burden of disease in relation to sexual and reproductive health comprising neonatal, maternal and infant health were detected throughout and after the incident in comparison to baseline? | Data of burden of disease | § Data of public health | Accuracy of management records and data. Assumption that all cases have been reported to the correct management authorities. The accuracy, reliability and the overall validity of the survey; taken into account participation. | ||||||
| In what way did the amount of unplanned or unwanted pregnancies change throughout and after the crisis in comparison to baseline? | Incidence of unplanned or unwanted pregnancies throughout and after the crisis | § Antenatal surveys managed throughout maternal care services as well as after the crisis | Barriers including communication, interpersonal and cultural may invalidated the results or data and may have attributed to biasness. Women have undertaken fitting assessments accurately in safely reachable facilities. Validity of capturing data. Supposes quality comparable data denoted after the crisis. | ||||||