"programme_id","programme_title","programme_language","programme_type","other_program","iso3code","country_name","program_location","area","status","start_date","end_date","brief_description","references","related_policy","new_policy","partner_gov","partner_government_details","partner_un","partner_un_details","partner_ngo","partner_ngo_details","partner_donors","partner_donors_details","partner_intergov","partner_intgov_details","partner_national_ngo","partner_nat_ngo_details","partner_research","partner_research_details","partner_private","partner_private_details","partner_other","partner_other_details","cost","fsector_0","fpartner_0","fdetails_0","fsector_1","fpartner_1","fdetails_1","fsector_2","fpartner_2","fdetails_2","fsector_3","fpartner_3","fdetails_3","fsector_4","fpartner_4","fdetails_4","fsector_5","fpartner_5","fdetails_5","fsector_6","fpartner_6","fdetails_6","fsector_7","fpartner_7","fdetails_7","fsector_8","fpartner_8","fdetails_8","fsector_9","fpartner_9","fdetails_9","fsector_10","fpartner_10","fdetails_10","fsector_11","fpartner_11","fdetails_11","fsector_12","fpartner_12","fdetails_12","fsector_13","fpartner_13","fdetails_13","fsector_14","fpartner_14","fdetails_14","fsector_15","fpartner_15","fdetails_15","fsector_16","fpartner_16","fdetails_16","fsector_17","fpartner_17","fdetails_17","fsector_18","fpartner_18","fdetails_18","fsector_19","fpartner_19","fdetails_19","fsector_20","fpartner_20","fdetails_20","fsector_21","fpartner_21","fdetails_21","fsector_22","fpartner_22","fdetails_22","fsector_23","fpartner_23","fdetails_23","fsector_24","fpartner_24","fdetails_24","fsector_25","fpartner_25","fdetails_25","fsector_26","fpartner_26","fdetails_26","fsector_27","fpartner_27","fdetails_27","fsector_28","fpartner_28","fdetails_28","fsector_29","fpartner_29","fdetails_29","fsector_30","fpartner_30","fdetails_30","fsector_31","fpartner_31","fdetails_31","fsector_32","fpartner_32","fdetails_32","fsector_33","fpartner_33","fdetails_33","fsector_34","fpartner_34","fdetails_34","fsector_35","fpartner_35","fdetails_35","fsector_36","fpartner_36","fdetails_36","fsector_37","fpartner_37","fdetails_37","fsector_38","fpartner_38","fdetails_38","fsector_39","fpartner_39","fdetails_39","fsector_40","fpartner_40","fdetails_40","fsector_41","fpartner_41","fdetails_41","fsector_42","fpartner_42","fdetails_42","fsector_43","fpartner_43","fdetails_43","fsector_44","fpartner_44","fdetails_44","fsector_45","fpartner_45","fdetails_45","fsector_46","fpartner_46","fdetails_46","fsector_47","fpartner_47","fdetails_47","fsector_48","fpartner_48","fdetails_48","fsector_49","fpartner_49","fdetails_49","action_id","theme","topic","new_topic","micronutrient","micronutrient_compound","target_group","age_group","place","delivery","other_delivery","dose_frequency","impact_indicators","me_system","target_pop","coverage_percent","coverage_type","baseline","post_intervention","social_det","social_other","elena_link","problem_0","solution_0","problem_1","solution_1","problem_2","solution_2","problem_3","solution_3","problem_4","solution_4","problem_5","solution_5","problem_6","solution_6","problem_7","solution_7","problem_8","solution_8","problem_9","solution_9","other_problems","other_lessons","personal_story","language" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","
A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","While Tanzania has achieved high vitamin A supplementation coverage over the past few years, there is concern that this achievement is fragile because of decentralization. A2Z is supporting national, zonal, regional, and district health teams to institutionalize twice-yearly distributions through ongoing advocacy and routine planning and budgeting. This activity is conducted in collaboration with the National Program for Extension of Tools and Strategies, the Tanzania Essential Health Interventions Project, Ifakara Health Research and Development Centre, the Tanzania Food and Nutrition Center (TFNC), and UNICEF. To foster sustainable vitamin A supplementation, the A2Z project is supporting behavior change communication through community workers and a popular radio serial. Based on information gathered on sustainability indicators by TFNC with support of A2Z and HKI, those districts that have not yet integrated funding for vitamin A supplementation in their plans are receiving additional technical support. Several resources developed in Tanzania are available to ensure program sustainability.
","Given the twice-yearly nature of the VAS program as well as its historic evolution from immunization campaigns, it is easy for district staff to see the program as separate from their regular day-to-day work. Considering the program to be part of the routine work for the district is critical for sustainability, and is reflected in both attitudes and the support provided to the program. Ninety-one (76%) of the 119 districts regarded implementation of the twice-yearly VAS and deworming program to be a routine activity. About 84% considered VAS and deworming a very important service, and 99% thought the service should continue. Although the majority of the districts viewed VAS/deworming as a routine activity, more than half (55%) had not yet included VAS/deworming services in their routine supervision checklist. Moreover, payment of allowances to staff for VAS/deworming while at their normal duty stations implies that these services were viewed as special rather than routine. The allowance scheme in particular, with an excessive number of supervisors at some distribution sites and inadequate supervision at other sites, may increase a district’s vulnerability to a decline in coverage. Overall, 11 districts (9%) were judged vulnerable with low sustainability related to supervision and monitoring
","Those districts that have not yet integrated funding for vitamin A supplementation ","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Others, please specify below","For an activity to be sustained, it must be considered part of the district’s regular activities, and thus must be included in the annual planning process.","Management","The VAS program requires clear management for effective and efficient implementation, and thoughtful management also reflects the value placed on the program. Poor management may make the program vulnerable, and less likely to be sustained in an effective fashion.","Supplies","The VAS program depends on effective logistics, and capsule and promotional materials must reach distribution sites on time and in adequate quantities for the program to be effective. Poor logistics supply management makes the program vulnerable. Adequate communication between programs and departments within district councils facilitated effective use of available resources in 117 (98%) of the districts assessed.","Financial resources","Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.","Insufficient staff","Twice yearly VAS distribution involves extended outreach to communities, and thus requires significant mobilization of both health staff and community volunteers. Failure to plan for adequate human resources is likely to place districts at risk of not sustaining their coverage achievements.","","","","","","","","","","","","Planning
Districts should be encouraged to budget for the program in their own CCHP budget including the basket fund which is considered the most reliable source of funds. Once basket funds are planned, they cannot be reallocated
Advocacy and community ownership
The program is more likely to continue effectively if it is understood and valued by community members who are involved with planning and implementation.
Management and Leadership
Efforts should be made to protect the current best practices in management and leadership reported in most of the districts.
Logistics Supply
Key actors at the national level need to ensure timely procurement and delivery of supplies to the districts
Supervision and Monitoring
Districts should determine the appropriate number of site supervisors to contain costs and include VAS/deworming in the routine supervision checklist to ensure that children missed during the twice-yearly events are reached through “mop up” actions.
Advocasy and Community Ownership
The successful efforts to date should continue to build community ownership of the program through well-designed, regular sensitization meetings and advocacy to engage the community, mobilize participation, and raise the profile of VAS/deworming events.
Availability of Financial Resources
Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.
Availability of Human Resources
Local councils and the central government need to fill staff positions and find secure mechanisms to ensure mobilization of adequate human resources to sustain service delivery.
Programme Effectiveness
Efforts should be made to maintain the high performance of the majority of districts and help the few low performing districts improve their coverage.
","","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","With advocacy from A2Z/HKI and other donors, the Government of Tanzania in December 2006 adopted a policy for the use of zinc for the treatment of diarrhea. A2Z/HKI provided technical support to the National IMCI coordinator to incorporate zinc therapy as part of diarrhea management and developed modified IMCI guidelines. Zinc treatment and low osmolarity solution oral rehydration salts (ORS) have been incorporated into the National Standard Therapeutic Guidelines. The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University. The formative research also tested the acceptability of zinc treatment for diarrhea among mothers and caretakers. The findings of the study are expected to be used to assist in the development of health worker training modules and behavior change communication materials for use by the Ministry of Health and Social Welfare and the community.
","Under-five mortality rate
","","","","","","","Vulnerable groups","","Zinc supplementation in the management of diarrhoea>>>Zinc supplementation in the management of diarrhoea>>http://www.who.int/elena/titles/zinc_diarrhoea","","","","","","","","","","","","","","","","","","","","","","The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University.
","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Twice a year, at designated times, the three programs distribute capsules to children aged six months to five years. Each program follows a campaign model based upon intensified social mobilization and service delivery over two to seven days. The twice-yearly events have created a cadre of field-tested personnel in the three countries, who are skilled at working with the local communities and at promoting their support and active participation. All three programs have been associated with National Immunization Days (NIDs), a WHO global program to eradicate polio. Since NIDs were held annually, however, they provided an opportunity for only one dose of vitamin A each year. Because children with vitamin A deficiency should receive a supplement at least twice a year (every four to six months), another mechanism was needed for the second dose. Relying exclusively upon facility-based distribution to deliver the second dose was not a viable option for several reasons, but in particular because healthfacility attendance for older children was not high enough to ensure adequate coverage in the one-to-five-year age group.
In Zambia, the first non-NIDs vitamin A supplementation program was launched in August 1999, and later renamed Child Health Week (CHW) to make the focus on the child more explicit. It was also felt that, instead of limiting activities to a vertical vitamin A supplementation program, the opportunity should be seized to deliver an integrated service that included not only vitamin A capsules but also other health services such as de-worming, health education, immunization, family planning, prenatal care, and growth monitoring. Districts were encouraged to provide an integrated package of services commensurate with their local capacity and need — as long as vitamin A supplementation remained the core activity during that week. In Zambia, the first NIDs campaign took place in 1997, and was a nationwide undertaking. The program was scaled down to about half the districts in recent years. Since 1999, the focus has shifted to priority districts, where communities have been at a constant risk of cross-border polio infections due to civil-war-related migrations from neighboring countries. This narrower focus is referred to in Zambia as sub-NIDS.
The first round of vitamin A supplementation in Ghana was integrated into NIDs in 1996. By 1999, a detailed plan was developed to implement a nationwide stand-alone supplementation program for the second round. In 2000, the Ministry of Health (MOH) carried out the first vitamin A standalone capsule distribution in the country’s ten regions. Since that date, the program has become a two- to three-day stand-alone event used to deliver a second dose of vitamin A to all children 6 to 59 months of age. Volunteers from the Ghana Education Service, along with personnel from other decentralized departments, assist with the supervision and capsule-distribution effort. Community-based volunteers are in direct contact with caregivers and children and also work very closely with health workers, assemblymen, chiefs, opinion leaders, gong-gong beaters, and other community leaders to mobilize beneficiaries, administer vitamin A, and maintain distribution records.
In contrast to Zambia and Ghana, Nepal followed a phased approach to program implementation. Integration of vitamin A into NIDs in Nepal was initiated in 1997,
four years after a supplementation program was established in 8 of the country’s 75 districts. The second distribution campaign has since been phased in at a rate of eight to ten districts per year. By 2001, the program covered all but three politically unstable districts. Under the program, high-dose vitamin A capsules are distributed to all children aged 6 to 59 months during a twoday event.
","
Ghana
A monitoring team consisting of national, regional, and district supervisors carries out organized and random spot checks. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. Capsule-distribution teams use all means of transportation available within the region and district, whether these be 4x4 vehicles, 2x4 pickups, motorcycles, or bicycles. MOH, district assemblies, decentralized departments, and local and international NGOs provide fuel and contribute to vehicle maintenance. At the end of each day, tally sheets are counted and summary sheets completed. Data are compiled by sub-district and district health management teams. After all figures are checked for accuracy, district coverage is calculated. District coverage data are sent to the regional nutrition officers and senior medical officers of public health, who compile regional coverage figures before sending them to the Nutrition Unit in Accra. Using regional figures, the Nutrition Unit estimates national coverage.
Zambia
Monitoring teams consisting of national, provincial, and district staff carry out systematic or random observations, depending on what they are monitoring. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. At the end of each day, tally sheets are counted, summary sheets completed, and data compiled. District figures are then checked for accuracy, after which district coverage is calculated and the results forwarded to NFNC.
","Ghana: 3.5 million children ","Ghana: Exceeded target in May 2001; Zambia: 28 percent in 1999, 88 in Febraury 2002","","serum retinol levels of &lt;20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","serum retinol levels of <20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Insufficient staff","In Zambia and Ghana, it has been somewhat more difficult to generate a consistent cadre of volunteers for the vitamin A distribution. In each country, districts mobilize health post and sub-health post staff, identify extended outreach sites (including clinics, schools, and community centers),and then recruit community members to assist them with their activities. In Ghana, this has been relatively successful since there have been adequate clinic staff and a manageable number of outreach sites. In spite of this, many districts have continued to do some house-to-house visits to ensure high coverage. In Zambia, it has been more difficult to recruit community volunteers, and the clinic staff have been stretched to cover outreach sites.","","","","","","","","","","","","","","","","","","","","","Robin Houston (2003). Why They Work: An analysis of three successful public health interventions - Vitamin A supplementation programs in Ghana, Nepal, and Zambia
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Five data collection methods were used:
During the fieldwork, the enumerators worked in pairs. The enumerators were not allowed to use the instruments in the facilities where they worked. Each pair spent a full day at a health facility. Field supervisors supported the enumerators during the data collection and checked the questionnaires for consistency and completeness. This was to ensure that the data collected was accurate as possible.
","""""Many pregnant mothers do not come to ANC because they had several normal pregnancies and think all will continue to go on well always.”
- Health worker, Apac
“ The health worker at the health centre is very rude, she has no time for us; so we fear even asking questions or discussing any issue about our health. So I go all the way to Naguru health clinic and only here if I have no money for transport.”
- A pregnant woman, Kojja, Mukono
“ I think these tablets for blood should be given only to pregnant women who have no blood. It may cause a high blood level and lead to high blood pressure.”
- TBAs, Kyampisi
“ Women with increased blood should not take these tablets (iron and folic acids) because their heartbeats will increase and they will sweat very much.”
- TBAs, Seeta Nazigo
“ Some mothers say it smells and they throw away the tablets soon after the clinic.”
- Pregnant mothers, Kojja
“ Some mothers do not like taking tablets when they are pregnant.”
- Pregnant mothers, Seeta Nazigo
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Ethiopia
MOST is providing technical and implementation support to the Ministry of Health in the development of a national micronutrient program. The program is a cooperative effort between the MOH, USAID/Ethiopia, MOST, and UNICEF. Program components include strengthening of the newly formed nutrition division at the MOH and the micronutrient committee; development of a locally designed vitamin A supplementation strategy and its pilot test; support for initial trials of vitamin A sugar fortification in one of the country's four sugar factories; and support for information, education, and communication activities.
South Africa
MOST is working with counterparts at the University of the Western Cape (UWC) to support and strengthen a new vitamin A supplementation program being started by the Department of Health in Eastern Cape province. MOST is also supporting a pilot initiative by UWC that aims to incorporate micronutrient interventions into the Eastern Cape Integrated Nutrition Program.
.
","","","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Government agencies encouraged the initial development of fortification: NFNC promoted initial research, sponsored meetings, and coordinated activities related to fortification; MOH researched the legal framework; the National Institute for Scientific and Industrial Research (NISIR) provided technical guidance; the Food and Drug Control Laboratory (FDCL) conducted monitoring and evaluation; and the Zambian Revenue Authority (ZRA) examined the tax structure. Industry acceptance allowed planning to begin, but donor support was critical to the development of the program: the U.S. Agency for International Development (USAID) was the lead financer of the project and provided technical assistance, UNICEF provided spare parts, and the Japanese International Cooperation Agency (JICA) provided spectrophotometers for Zambia Sugar and the FDCL.
While legislation was still being developed, Zambia Sugar went ahead with the launch of fortified Whitespoon Sugar on May 15, 1998. Zambia Sugar began its fortification program at 15 mg/kg, but cost considerations led the company to reduce the level to 10 mg/kg within three months. In May 1997, one year before fortification began, a consultant estimated the cost of fortifying 100,000 metric tons of sugar at 16 mg/kg to be around $1 million U.S., while fortifying at 20 mg/kg would cost almost $1.25 million.24 Reducing the level from 16 to 10 mg/kg could thus have reduced costs by approximately $375,000 a year.
","Modified Relative Dose Response Test (MRDR) in children
","The first outside tests of fortificant levels in sugar were controversial. Four months after the launch of fortified sugar, a team consisting of representatives from the MOH, the NFNC, and NISIR visited the Zambia Sugar mill. The team tested samples from the mill at the FDCL; these tests showed far lower levels of vitamin A than those shown in tests by Zambia Sugar. The government’s tests indicated a range of 0–13.6 mg/kg, while Zambia Sugar’s tests indicated a range of 9–21 mg/kg for the same samples. Zambia Sugar believes that the samples suffered sedimentation in the transport to the government laboratory and that this explains the different results.
MOST, the USAID micronutrient program, sponsored the creation of training manuals for health inspectors and Food and Drug enforcement officers, as well as a national training workshop from September 24 to October 7, 2000. The workshop focused on inspection procedures and methods, provided laboratory training where appropriate, and included a trip to the Zambia Sugar plant. Since the implementation of that program, Zambia Sugar has expressed satisfaction with law enforcement efforts. UNICEF subsequently funded workshops at the district level, using reproductions of the training manuals that had been produced with MOST funding.
","nationwide","..","","","","Vulnerable groups","","","Financial resources","","Communication","","Financial resources","","Adherence","","","","","","","","","","","","","","","","","English" "11493","Strengthening Agricultural Technologies among People Living with HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda","English","Multi-national","","KEN|UGA","Kenya|Uganda","Busia, Kenya|Busia, Uganda","Rural|Peri-urban","completed","01-2007","01-2008","The Food and Nutrition Technical Assistance Project (FANTA) of the Academy for Educational Development (AED) and the Ministry of Health (MOH) AIDS Control Programs (ACPs) in Kenya and Uganda worked together between 2007 and 2008 to integrate nutrition into the activities of HIV support groups in the border towns of Busia Uganda and Busia Kenya, funded by USAID/East Africa. The aim was to build skills in nutrition and disseminate national materials on nutrition and HIV developed by the national ACPs. However, PLHIV in the border towns increasingly reported lack of access to adequate food, in terms of quantity and variety, as the main reason they could not apply the dietary practices recommended during counseling sessions. In response, between September 2007 and September 2008 FANTA and the ROADS Project collaborated to facilitate the diffusion and use of appropriate technologies to improve the productivity of PLHIV agricultural activities developed under the ROADS Project in the two border towns.
","http://www.fantaproject.org/downloads/pdfs/FANTA_Busia2008.pdf
","8762|8576|8430|8302|8241|8671|8237","","Food and agriculture","Ministry of Agriculture, Department of Culture and Social Services, Kenya│Ministry of Animal Industry and Fisheries (MAAIF), Uganda│National Agricultural Advisory Services (NAADS), Uganda","","","Family Health International (incl.AED)","","","","","","National NGOs","AIDS Support Organisation; National Agricultural Research Organization (NARO), Uganda","Research/academia","Busia Agricultural Training Centre (BATC) in Kenya, Kenya Agricultural Research Institute (KARI)","","","Other","Africa 2000 Network","","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","East Africa","Other","","Busia Parish Catholic Church, Kenya","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11492","","Promotion of food security and agriculture","","","","Pregnant/lactating women with HIV/AIDS","","Busia , Kenya and Busia Uganda","Community-based","","The process involved identifying simple technologies to increase farm and garden outputs and linking clusters of people living with HIV (PLHIV) with local agricultural institutions including the Ministry of Agriculture (MOA), Department of Culture and Social Services, Kenya Agricultural Research Institute (KARI), and Busia Agricultural Training Centre (BATC) in Kenya and the MOA, Ministry of Animal Industry and Fisheries (MAAIF), National Agricultural Research Organization (NARO), and National Agricultural Advisory Services (NAADS) in Uganda, as well as community development officers, community-based organizations (CBOs), and nongovernmental organizations (NGOs) in the districts. FANTA facilitated the development of a participatory learning process to motivate groups of PLHIV to learn the new technologies to increase farm and garden output.
In phase one of the participatory learning process, FANTA and ROADS helped members of the clusters and agricultural institutions understand the agricultural technologies used in Busia, Kenya and Busia, Uganda to improve productivity. Phase two facilitated a process of linking cluster with agricultural institutions to help cluster members implement existing technologies that they had not widely used and to assess the impact of the process on the adaptation of the technologies. Neither FANTA nor ROADS invested substantial funds in the process, but provide technical assistance and connected the clusters to locally available technical assistance and support.
Three sensitization meetings were held, one joint meeting between cluster representatives, the FHI Cluster Coordinators, and FANTA staff and two meetings with groups on either side of the border. The meetings laid the foundation for agreement on the purpose of the activity and sharing of expectations. Over a period of two weeks, the group representatives identified viable and interesting agricultural technologies used in their localities and discussed how easily they could be implemented by PLHIV living in the towns (urban setting) and how they could improve their food diversity. In meetings with the agricultural institutions (mainly from Kenya), examples of agricultural technologies and activities were identified and discussed. Ministry of Agriculture and BATC extension personnel were available in the meetings to explain the different technologies.
The cross-border learning process was initiated by 14 representatives of the Ugandan clusters, who visited their peers on the Kenyan side of the border in November 2007. For two days they visited homes and training centers to see different agricultural technologies and livelihood activities implemented in Kenya and discussed the
feasibility of their adoption in their own context. At BATC the Ugandan visitors toured all the Group identification of learning content and methodology Preliminary sensitization meetings with cluster groups Group consultative meetings Meetings of Cluster representatives with departments of agriculture, NGOs, research institutions, and farmer training Cross‐border learning and home visits Arrange meetings among ROADS representatives, cluster representatives from Kenya and Uganda, and FANTA. Explain the different technologies that could be used in the locale and by PLHIV. Agree on how groups would implement the technologies and priorities. Group consensus meetings See different technologies in the communities and discuss.
Visits were also made to school gardens, community land (e.g., belonging to clusters of orphans and vulnerable children [OVC] in Kenya), seed multiplication sites, and farmer training centers. The cluster members discussed opportunities for and challenges of implementing similar activities in the urban Uganda context. Group consensus meetings were held to prioritize what the clusters wanted to learn about and the optimal methods of learning.
","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF interventions will encourage employment of women extension agents in the public sector and ensure that they are well represented in extension-related training activities in the public and private sectors. Women typically have more limited access to seeds, tools, credit, and marketing information than men. Liberia FTF MYS activities will give explicit attention to issues of equity in access in order to increase women‘s access and FTF will also provide support for women to participate in producer/marketing groups and associations.
Through private and public sector extension, USAID will provide lead farmers and producer organizations identified as change agents with specialized skills. Change agents will also receive support to acquire planting material and inputs through public and private sector channels. Availability of improved planting materials is facilitated through investments in CARI, private sector players, and CORAF. USAID will promote suppliers of seeds, fertilizers, insecticides, herbicides, tools, and livestock by developing their technical knowledge and skills and through support for increased agricultural credit. These entrepreneurs will provide services to others in their respective value chains. Over the five years of the FTF program, both the public and private provision of extension services will reinforce and expand the skill sets of change agents to increase productivity and coordinate with county and local health service providers to extend the reach of nutrition-related behavior change in order both to raise incomes and to improve health outcomes.
Small-scale rice and cassava processors will be a central focus of FTF interventions. Those interventions will help processors to build a supplier base, acquire equipment, access finance, and implement appropriate business practices. It is expected that they will then provide farmers with technical assistance to assure themselves of sufficient supplies of quality commodities to process. The program will work with and support both processors and traders to invest in processing equipment, storage facilities, and transport. It will work with farmers on improving post-harvest handling practices and on producing a consistent and predictable flow of goods. Over the five years, USAID direct beneficiaries will develop the skills, knowledge, and attitudes - plus have the capital, equipment, clients, and market linkages - to continue to expand their production, processing, and/or marketing businesses.
Given the paucity of reliable data, a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to a series of baseline surveys to collect production, labor, and market information and to facilitate MOA data collection and analysis, especially related to the focus counties. Based on the prioritized constraints that are identified, targeted and sequenced support will be directed to specific steps on the value chain, including to:
Nutritional benefits will accrue from both increased availability of and access to Liberia‘s primary food staples (rice and cassava). Increased commercialization will provide smallholders the increased incomes needed to obtain more and better food and improved processing will promote fortification to enhance the nutritional value of cassava and to improve the quality of rice. Public and private extension change agents will be trained to engage farmers, communities and farmer organizations across the range of behavioral change needed to promote essential nutrition actions.
","The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
There are an additional six indicators which require baselines to measure project-level activity. In collaboration with the MOA, USAID/Liberia IPs will lead baseline data collection on crop and animal production improvements (indicators 9 and 10 in the results framework), on the value of incremental sales (indicator 16 in the results framework), and on the application of improved technologies and practices by individuals and organizations receiving USG assistance (indicators 13 and 15 in the results framework).
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
","Planned interventions targeted at the key value chain constraints and implemented via the actions of private and public change agents will reach over 92,000 rice and cassava farmers in the six target counties","Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa ","","Gross margin per unit of land or animal of selected product (crop/animal varies by county);Percent increases in crop yields; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; &amp; CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Value of agricultural and rural loans; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Gross margin per unit of land or animal of selected product (crop/animal varies by country);Percent increases in crop yields; Number of individuals who have received USG supported short-term ag sector productivity or food security training;Number of new additional ha under improved technologies or management practices as a result of USG assistance; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs receiving USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Kilometers of roads improved or constructed; Value of agricultural and rural loans; Value of new private sector investment in the ag sector or food chain leveraged by FTF implementation; Number new laws and policies implemented to support private enterprise growth; Number of jobs attributed to FTF implementation; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","Promote high-yield seed and related inputs, including demonstration plots to test the use of improved seeds, fertilizer, and pesticides, and to introduce better land and water practices and farming methods;","Staff skills/training","Build capacity in both public (county-level) and private sector extension, including farmer organizations, traders or other private sector actors to invest in small sized processing mills and storage facilities","Financial resources","Provide access to finance and credit guarantees, directed at lead farmers and small processors","Stakeholder","Implement training to capacitate processors to become key change agents in market and credit transactions","Communication","Improve the transparency of market price information to farmers and strengthen business service providers, as an alternative means to make extension type services","","","","","","","","","","","","","","English" "11523","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","LBR","Liberia","Bong County, Liberia|Lofa County, Liberia| Nimba County, Liberia|Grand Bassa County, Liberia|Montserrado County, Liberia|Margibi, Liberia","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF Core Program 2 will undertake investments in horticulture pilots to encourage smallholders in relevant areas of all focus counties over time, but will initially focus on peri-urban locations near Monrovia which are close to the largest and most lucrative market and minimize constraints related to storage and transport. These activities will build on a change agent model similar to that for the rice and cassava value chains by supporting lead traders and lead farmers to acquire equipment for transport and storage and to acquire business and marketing knowledge. Key FTF horticulture interventions will include formation and strengthening of farmer associations, post-harvest management and logistics support, promoting public-private partnerships, and providing information and training for behavior changes to promote improved family nutrition.
FTF investments to develop the goat value chain will implement pilot activities that are closely coordinated with the substantial USDA Food for Progress goat value chain enhancement program that will be working to re-establish breed stock and infrastructure for processing. The change agent focus of investment will be on community animal health workers and Core Program 2 activities will train and lend support to them so that they can directly assist improved breeding through the provision of services and infrastructure, making commercialization profitable. USAID/Liberia will determine the scope and scale of change agent engagement in pilot sites based on local conditions and in close coordination with the USDA program.
The US Government in Liberia will make an estimated 30 percent of FTF MYS investments in Core Program 2, with roughly 60 percent of these directed to interventions to address vegetable value chain pilot activities and the remaining 40 percent for implementation of goat pilots. Reflecting the phased approach to Liberia FTF value chain interventions, only 10 percent of first-year investment will be in the diet diversification value chains, while 63 percent of MYS vegetable and goat value chain investments will be carried out in years four and five. As with Core Program Area 1, given the lack of reliable data a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to ensure relevant baseline surveys to collect production, employment, and market information and to facilitate data collection and analysis, especially related to the focus counties. These investments will be phased to take advantage of opportunities that already exist in peri-urban areas for vegetables and related to the USDA program for goats. Within the proposed total program level, anticipated investment levels in these value chains will be lower in the first two years of strategy implementation and will ramp.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities:
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF investments in Core Program 3 will address selected aspects of the LASIP program for institutional development to support the value chains that are the focus of Core Program Areas 1 and 2. FTF investments in agriculture policy, advocacy support, and research will fund key institutions to carry out actionable research leading to improved land, soil, and water resource management and use and agronomic practices and more productive animal husbandry. FTF Program Area 3 activities will be integrated in the value chain support in order to expand the capacity of civil society groups to analyze and advocate for policy reforms (e.g., in regard to rice pricing and sanitary and food safety standards for food and meat processing) and to help create a more market-friendly policies and an improved trading environment for Liberian smallholders.
The Liberia FTF MYS will assist the MOA to define and implement its decentralized, demand-driven, participatory, pluralistic (i.e., engaging public, private, civil society actors), and accountable agricultural extension system. The critical role of women extension agents will be emphasized and opportunities for them to develop professionally, both in terms of education and field practice, will be supported. Program Area 3 investments will target partnerships with the public and private sectors and other development partners to: accelerate adoption of modern agronomic technologies and practices at the farm level; create effective knowledge distribution mechanisms; and build capacity of the MOA to provide specialized extension services. Revised agricultural extension curricula will provide more effective training in areas such as land use and techniques to reduce soil fertility losses, water resources management, low-cost and organic fertilizers, post-harvest loss reduction, pest management measures, participatory extension methodologies, women‘s participation in extension activities, farmer organization development, participatory rural appraisal, farmer field school methodology, and farmer-to-farmer extension. These investments will support widespread provision of high quality extension to Liberian smallholders. Core Program 3 interventions on market structure development will create opportunities to establish market information systems to support private and public decision making and invest in alternative profit sharing/contract models between change agents and farmers to ensure equitable market exchanges, based on transparent information and rational decision making behavior. These activities will provide the foundation for fair and transparent markets accessible to all Liberian smallholders.
All FTF MYS investments in Core Program 3 will be integrated to support value chain activities in transforming rice and cassava staples value chains and piloting the income and diet diversification vegetable and goat value chains. Thus, these activities to advance the enabling environment and build capacity will contribute to ensure benefits of the value chain investments reach all 142,375 households the program will work with, including the 91,120 poor households.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities:
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","MAIZE AND DROUGHT-TOLERANT STAPLE CROP VALUE CHAIN
Kenya’s maize sub sector is approaching a critical time when input supply characteristics, land reform, availability of supporting factors of production, and market price dynamics will define the competitiveness of the industry in the mid- to long term. This environment presents an opportune moment for the USG’s current and future investments. At the same time, there has been a dearth of investment in alternative staple crops and, as a result, there is a lack of data. In collaboration with the private sector, FTF will support value chain assessments that deepen and fill gaps in existing knowledge – especially related to these crops in SA2 – to inform the FTFS’ further implementation and private sector investments.
As noted, yields of staple crops in Kenya are low relative to regional averages. Addressing productivity issues in maize and drought-tolerant staples will be a key focus. Promoting improved transfer of technologies will require investment in agricultural research to develop improved technologies. This will be especially important for the neglected drought-tolerant crops. Equally important is the dissemination of knowledge of these technologies, accompanying management practices, the extension services to transfer knowledge on how best to use technologies, and the commercialization and dissemination of technologies to farmers who need them. Consequently interventions will leverage private sector partners in concert with public sector extension services (although limited in certain counties of the two focus areas) to disseminate and commercialize improved technologies through ―smart‖ extension methods, e.g., ICT.
Achieving productivity growth also will require program investments to promote improved access to high-quality inputs that are affordable and provide the knowledge (extension services) on how to use them optimally, including improving input use efficiency through proper soil and water management techniques. Seed and fertilizer companies and agro-dealers will play key roles in setting up demonstration plots and holding ―farmer field days‖ so that farmers can learn about different varieties and practices. Efforts will be made by the Mission to incorporate gender awareness and nutrition- and food preparation-related messaging during those ―field days.‖ The seed and fertilizer companies have also begun to package inputs into smaller quantities, thereby more affordable to poor farmers. The current KMDP is working through its sub-grantees, like Farm Input Promotions (FIPS) – which uses samples of inputs (i.e., seeds, fertilizers, etc.) donated by private companies – for demonstration on farmers’ fields, provides extension information, and sells inputs in small affordable packages, an approach that has been effective in increasing access to inputs and extension services to women.
Market access will be essential to increasing smallholder incomes. The Mission will facilitate a more structured market for staple food crops by: 1) increasing smallholder farmers’ understanding of end-market requirements; 2) facilitating access to training to meet end-market requirements; and 3) improving farmers’ market intelligence and capacity to make informed decisions. Public and private sector investments in storage and centralized market infrastructure will improve the benefits smallholders gain from market engagement and lead to increases in rural household incomes.
Regarding sorghum, market outlets seek varieties with high milling and brewing qualities, and subsistence farmers require high-yielding varieties with specific taste, color and cooking characteristics. The segmentation of these varieties and products to meet the specific market demands has not been done and, as a result, farmers’ marketing strategies are ―hit or miss.‖ Hence, the program will segment the market niches and match the niches to sorghum varieties and products. This approach will highlight the opportunities for farmer organizations to deliver to the segmented market outlets through the segmented sorghum varieties and products.
Fostering investments by the private sector as well as access to rural finance will be essential to the sustainability and scalability of productivity improvements. Kenya has a vibrant private sector hungry for profitable opportunities. To both meet the development challenges and make a profit, USAID/K will use its new Innovation Engine (see below) to buy down the risks for private sector investments in innovative areas. To improve access to rural finance, the Mission’s program, along with USAID/EA's FTFS program-related activities, will:
By tapping into the networks of EAGC, the activities will help build regional linkages for traders. In addition, access to rural finance will be further improved through USAID's recently commenced Financial Inclusion for Rural Microenterprises (FIRM) project which – in collaboration with the U.K. Department for International Development (DFID) – will improve productivity and growth of agricultural value chains through expanded financial services to underserved groups, geographic locations and new product areas. FIRM will facilitate opportunities for agribusiness development and overall market efficiencies through a package of financial services to vulnerable groups, including young and female smallholder farmers in rural and agricultural sectors.
Value chain development in HR1 and SA2 will require the aggregation of farmers in order to facilitate access to markets, services, financing and technology transfer. Previously, the KMDP contributed to the development of farmer associations, including women associations, in the Western Province and Rift Valley and will continue to do so in the targeted FTFS counties of those provinces. Consequently, the FTFS program will strengthen farmer groups, associations and cooperatives where they can effectively benefit their members.
A key outcome of KMDP from 2002-2010 was to foster a more responsive policy environment for the maize sub-sector. Despite KMDP's involvement in a relatively successful decade of reform, the maize sector and, to a large extent, other staple crops are still characterized by highly guarded value chain positions and often distorted policy. Consequently, the FTFS program will be a strong advocate of a market-driven approach at the national level, providing a key voice to discussions regarding GOK agricultural policies and simultaneously strengthening value chain players to advocate for better policies. The planned continuation of USAID support to the Tegemeo Institute, for example, will play a key role in advocacy based upon empirical evidence to further bolster the GOK policy dialogue.
Finally, promoting NRM and adaptation to climate change will be needed to support the sustainability of impacts under FTF. This will involve the inclusion of sustainable intensification practices (―climate smart‖ practices) in staple crop production including: 1) soil management techniques, such as conservation agriculture and integrated soil fertility management; 2) the inclusion of fertilizer and fodder trees into annual crop production systems (―evergreen agriculture‖); 3) water efficiency measures, such as rainwater capture and storage; and 4) integrated pest management. The ―climate smart‖ practices will be used in combination with drought-tolerant varieties of seeds and inputs to increase productivity, fertilizer use efficiency and climate resilience. While access to and sustainable management of natural resources will be a central theme regardless of income group or geographic area, it is particularly key to addressing the vulnerability of the poorest and most food insecure.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Financial resources","Business service provider interventions▪Grow market linkages (domestic and regional)▪Facilitate market development including structured trade and transparent transactions▪Link to input suppliers to expand services▪Provide value chain financing","Supplies","Input supplier interventions▪Expand inventory, crop and dairy services, & reach▪Link to business service providers▪Pilot aggregation (e.g., for WFP P4P program)▪Capacity building for business and financial mgmt.▪New business models","Infrastructure","Processor/buyer interventionsProposed Future USG Engagement▪Capacity building in business and finance▪Development of innovative business models▪Development of premium product schemes▪Link to input suppliers, business service providers, and producer organizations","Stakeholder","Producer organization interventions▪Continue capacity building in business, finance, contracts, grades/standards, productivity▪Link to input suppliers, business service providers, processors","","","","","","","","","","","","","","To capture lesons learnt
Combined Evaluation
Impact study
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
"," DAIRY VALUE CHAIN
The FTFS will build on the Kenya Dairy Sector Competitiveness Program (KDSCP), currently running through April 2013, which aims to improve Kenya’s dairy industry competitiveness, and increase the economic benefits to stakeholders in the entire dairy value chain. However, the KDSCP is only operating in the Central, Rift Valley and a small section of Western Provinces due to high density of dairy cattle and favorable agro-ecological conditions necessary for dairy production.
To improve productivity, KDSCP works with male and female dairy farmers to facilitate their transition from loosely organized groups into sustainable business associations able to either access or provide expanded and diversified services to their members. The KDSCP’s BDS approach facilitates service provision to all actors along the value chain, using a wide range of change agents to train farmers on productivity-enhancing technologies to increase production per cow and reduce costs of production. Fodder preservation is the key to smoothing milk flows over the entire year, and new fodder varieties developed by Kenya Agricultural Research Institute (KARI) can improve nutrition and decrease feed costs while increasing milk production. An emerging technology developed by International Center for Insect Physiology and Ecology (ICIPE) to control crops pests has spillover benefits for dairy. Planting of desmodium and napier grass at specific locations in crop fields controls cereal pests; these crops are also excellent fodder for dairy. Interestingly, it appears that women are more likely than men and youth to adopt many of these feed technologies.
Renewed efforts will be required to bring down the cost of high quality semen, so that smallholders can afford to use AI and improve the genetic potential of their animals. Efficiency of AI can be increased by improving farmers’ ability to recognize correct breeding times and improved skills of inseminators.
Milk cooling centers – a key change agent – provide an excellent platform for producers to access goods and services. The centers enable producers to bulk and chill milk as well as consolidate their needs for services and goods, thereby making it more efficient for the private sector to engage with smallholders. Processors are also key change agents whereby, through a ―check off system,‖ farmers are supplied with feed and AI and vet services, and pay for those services by having the processor deduct costs from each producer’s milk sales. Many banks that lend to dairy farmers require that they have contracts with these processors in order to guarantee their loans.
KDSCP currently focuses much of its activities on dairy quality standards, and assisting farmers, traders and processors to adopt practices that will improve the quality of milk. It works through private and public sector service providers to train smallholder dairy farmers on milk testing techniques, disease prevention and testing with modern technologies. Business Development Service (BDS) providers also facilitate farmer associations to negotiate long-term supply contracts with processors, and to receive premiums for chilled milk. More work is required, however, towards establishing premiums for other important attributes, such as butterfat content. Market information is now more widely accessible to producers through working groups that act to better coordinate the local dairy sector.
It will be important to increase the capacity of cooling centers to implement quality control frameworks, such as Hazard Analysis and Critical Control Points (HACCP), and provide assistance to acquire International Standards Organization (ISO) or equivalent quality certification. Achieving these levels of quality will be essential for Kenyan milk to enter COMESA and other international markets. Support to the Kenya Dairy Board (KDB) and the East and Southern African Dairy Association – important partners in moving Kenya towards meeting regional standards for dairy products – will also help expand Kenya’s reach into COMESA markets.
With increased organization of producers into business associations, producers will be able to increase their investments in herds through upgrading breed quality and investing in feed and animal health technologies. Service providers will have expanded demand for their goods and services (e.g., silage making equipment and forage choppers) and some, such as processors, will have an incentive to invest in expanded facilities. Some examples of investment include Nestlé’s investment in upgrading a milk powder plant at the Kenya Creameries Cooperative (KCC), while the Brookside Dairy has set up a new powder plant. Farmer-owned chilling plants have invested in trucks to transport milk to processors, and two Kenyan insurance agencies are offering insurance products to farmers.
As banks become more knowledgeable about the risks and opportunities in the dairy sector, they are increasingly lending to the sector. Several banks have come forward to finance dairy investments by using guarantee mechanisms to decrease their risk. Access to rural finance will be further improved through USAID’s FIRM Project which, in collaboration with DFID, has established a Value Chain Finance Center to promote financial access through the rural areas for firms all along the value chain.
The FIRM Project (currently running through CY 2013) has conducted a dairy value chain finance analysis that identified profitability at key parts of the value chain. Banks will increase lending in those areas of the value chain that have the most banking potential, thereby increasing investment in the sector. It will be important to identify the less bankable parts of the value chain, such as the dairy feed sector, and concentrate support to improve bankability in those parts to further develop the dairy industry.
The dairy sector also has great potential to contribute to improved NRM practices, so current and future implementers will incorporate best management practices for improved grazing, pasture management, and ―cut and carry‖ techniques to enhance productivity and ecosystem function. This will include encouraging farmers to grow fodder varieties that are complementary to annual crop production, e.g., varieties that are nitrogen fixing or important for biological control of crop pests. Such practices can have co-benefits to staple crop production since inter-cropping certain fodder varieties with annual crops (―evergreen agriculture‖) can increase crop productivity. Manure and run-off from dairy can become environmental and health hazards, but properly managed manure can contribute greatly to improved soil fertility and soil quality, including the retention of water and important soil nutrients. Use of manure is a critical component of integrated soil fertility management and thus, for dairy farmers who also cultivate crops, this is another important co-benefit. Additionally, the generation of biogas will become increasingly important as a source of energy for households as electricity and kerosene become more expensive. Consequently, the nexus between dairy farming and agriculture and ―clean energy‖ will be another area of opportunity to be addressed during the course of the Strategy’s implementation.
These interventions will be particularly important as one aspect of adapting to climate change, and producers will need training in these technologies and practices.
More dairy products available at lower costs encourage increased consumption of this nutrition rich product among lower-income groups. KDSCP works in the informal milk chain where women, the youth and very-poor dominate. Gender sensitive programming and improving quality standards naturally fits with increasing nutritional opportunities in the informal milk chain because mothers often are responsible for child rearing. Not only availing more dairy products and improving milk quality, but increasing messaging about the nutritional benefits of dairy products will encourage consumption of this nutritionally packed food product. Also, improving the informal milk chain will enhance economic benefits for women who dominate informal milk trade and rural youth engaged in off-farm milk transport services.
New support to and capacity building of various GOK and stakeholder organizations will be important to identify issues constraining Kenya’s dairy sector competitiveness. The ongoing KDSCP, however, is building capacity of the Dairy Task Force, with a focus on policy advocacy. The rejuvenated Task Force is currently leading the implementation of policy changes and action plans that are critical to the dairy sector. Assessments of key issues have provided the necessary analyses to inform stakeholders and GOK decision makers. The Task Force is increasing the interaction among value chain actors, the GOK and development partners, and has seen increased efficiencies in the sector, both for donor projects as well as private sector investments. The Dairy Master Plan – which was initially shelved due to inadequate collaboration – is now back on track.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Socio-economic status","","","Supplies","","Financial resources","","Infrastructure","","Stakeholder","","","","","","","","","","","","","","","To capture lessons learned
Combined Evaluation
Impact study
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","HORTICULTURE VALUE CHAIN
Horticulture has a distinct link to decreasing under-nutrition. Promoting production and marketing of high-nutrition horticultural crops and increasing messaging about the nutritional benefits associated with highly nutritious horticultural products will encourage increased consumption of these foods. For example, kitchen and community gardens provide excellent sources of nutrition for those who have limited access to land and/or resources. These gardens are also often managed by women. Decision-making over products from ―kitchen gardens‖ is often relegated to women for household consumption. Also, women earn direct income from marketing of surpluses from kitchen gardens.
KHCP is currently working in seven zones, including the HR1 and SA2 regions. Consequently, during the course of the FTFS implementation but in a deliberate timed fashion, the KHCP will evolve its program of activities to focus on the HR1 and SA2 regions.
Currently, KHCP expects to have the following impacts by February 2015, but these will be revised in accordance with the smooth transition to the new focus areas:
The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. ",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Sex","","","Supplies","","Financial resources","","Stakeholder","","Infrastructure","","","","","","","","","","","","","","","To capture lessons learnt
Combined Evaluation
Impact study
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","Women will form a core target group in the s FTFS because of their critical role in food production and nutrition in Kenya. It is estimated that nearly half or 44 percent of Kenya’s smallholder households are managed by women. This is largely attributed to rapid rural to urban migration by men in search of employment. Women are active at every point in the food chain and are often responsible for protecting the safety and wholesomeness of food in their households. Their contribution to food commodities such as pulses, potatoes, legumes, sorghum, fruits and vegetables is quite significant. Grown mainly in home gardens, they provide essential nutrients and are often the only food available during the lean seasons or when the main harvest fails.
In the dairy sector, women and the ultra-poor predominate in the informal milk chain. A gender value chain assessment completed by USAID in High Rainfall Zone 1 found that while the ―morning‖ milk is sold to processors, the ―evening‖ milk is often left for family consumption under the control of women in the majority of male-headed households. Most surpluses after consumption are sold in the informal chain, generating income directly for women in these households.
By FY10, female-headed households comprised 49 percent of households that benefited from USAID/K assistance. Strategies that contributed to increased women’s participation included decentralized extension approaches that are tailored to suit women’s time schedules, promotion of ―gender-balanced‖ crops and leadership training for women, and use of embedded business development service (BDS). The horticulture program recorded the highest number of women beneficiaries by supporting nutritious crops – including leafy vegetables, sweet potatoes, beans and butternut squash – where women predominate in production and marketing, and where they have greater control over revenues. Horticulture marketing contracts between women’s groups and buyers were established, allowing women to receive their payments directly.
The Kenyan FTFS will support activities that economically empower women and improve the nutritional status of women and children. Building on USAID/K’s past successes in gender and value chains, the FTFS will: Increase women’s gains by expanding support to nutritious horticultural and staple food crops; Promote private sector response by which small improvements to the informal milk chain, where women and the poor and ultra-poor predominate, could lead to healthier and more affordable options; Through the FTF Innovation Engine, seek innovations that promote local-level processing of fortified foods, such as through ―posho mills,‖ that are easily accessible and affordable to rural women; Catalyze social innovation approaches that reduce gender inequalities in agricultural production and benefits from production – such as innovations in agricultural labor saving technologies and practices to reduce women’s labor burden, linking women to extension and markets and promoting farming as a family business; Undertake gender-value chain assessments for each of the targeted sub-sectors in FTF geographical areas to guide implementation; and Scale-up training on integration of gender in value chains to all FTFS partners.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Sex","","","","","","","","","","","","","","","","","","","","","","","","To capture lessons learnt
Combined Evaluation
Impact study
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will make investments in nutrition across three critical sectors; agriculture, health, and social protection, with nutrition as the lynchpin between these sectors. As such, the USG will implement a comprehensive approach that maximizes all three sectors and strengthens and links the nutrition components of each. These investments will be underpinned by a core set of nutrition indicators that are common across all programs, and will be supported by policy investments that mirror the comprehensive nature of nutrition programming by working with the Office of the President’s Cabinet (OPC) and the Ministries of Agriculture and Food Security, Health, and Gender.
Building on lessons and experiences from current programs implementing preventive nutrition activities (e.g., the WALA and BASICS projects), USG resources will scale up prevention of undernutrition and resiliency of communities, while maintaining critical investments in treatment and nutrition service delivery. The rationale for this shift is due to the overall high prevalence of chronic undernutrition (47 percent) and the low prevalence of acute undernutrition (4 percent), the latter of which has been achieved by sustained commitment to scaling up CMAM. As a result, the USG will aim to drive a decrease in stunting as the highest level objective in FTF. The USG plans to focus on cost-effective preventive nutrition interventions targeting the 1,000 days window of development (pregnancy through two years), including maternal nutrition; early and exclusive breastfeeding through six months; use of appropriate, diverse foods beginning at six months of age; targeted micronutrient supplementation; and improved hygiene and sanitation. Activities will be integrated into health, HIV, and agriculture platforms, taking full advantage of the resources that these programs have. These investments leverage funding from health (Global Health and Child Survival), agriculture (Development Assistance), and Title II to advance nutrition objectives. The Care Group model encompasses a combined FTF and GHI approach to reduce poverty, hunger, and undernutrition by joining two complementary lines of investment at an operational level:
The objectives of the Care Groups complement value chain development activities by building capacity of:
Community-Level Organizations and Integration with Government of Malawi Systems for Health and Agricultural Extension
The Care Group in the context of this model is notable in that it supports a sustainable and simultaneous approach to agriculture, nutrition, and microfinance. Cross-fertilization of nutrition and agricultural messaging and skill building, as well as the opportunity to create cross-sector targets and results frameworks allows for a uniquely comprehensive approach.
Volunteers are trained and facilitated to conduct community outreach and follow-up in both agricultural- and health-focused nutrition interventions, thus supporting an operational link between nutrition and agriculture programming. Each volunteer takes on responsibility for conducting outreach and follow-up to some 10-12 nearby households. Care Group volunteers also have access to agricultural inputs to start and maintain community gardens, as well as engage in income-diversification through activities such as establishing voluntary savings and loan activities. Access to these inputs provides motivation and support for implementing targeted nutrition-focused interventions focused on behavior change, including:
Linking the agriculture and value chain components of the project with health and nutrition promotion at the community level is especially advantageous in that it provides opportunities to address two key crosscutting areas:
Prevention Linked with Health Service Delivery
The USG’s approach to service delivery covers community level action, improvement of quality at all levels of facilities, and strengthening the central and district level systems of management. This provides a common platform for multi-thematic messages and programs, ensuring that there are ―no missed opportunities‖. It also ensures a focused yet comprehensive basic package accessible to the Malawian population that stretches across the continuum of care from community to facility and from facility to community. At the community level, the Health Surveillance Assistants (HSAs) and health volunteers will continue to focus on interpersonal counseling, limited preventive and curative care through village clinics and drug boxes, and to create demand for services at the health facilities across family planning, maternal and neonatal health, child health, nutrition, malaria and HIV areas. At the facility level, the USG will support improved quality of care for existing interventions that target integrated and comprehensive primary health care provision and performance based incentives. At the national, zonal and district levels, USG programs will continue to strengthen the financial, management and leadership capabilities of the Ministry of Health staff. Also, programs will work closely with the technical staff to provide technical assistance and work toward meaningful policy changes. At all levels, USG resources will focus on integration of social and behavior change communication efforts through community and facility level entry points.
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","Although the main focus will be on preventing childhood undernutrition, USAID/Malawi will continue to support CMAM, building on past investments. Since 2005, USAID has supported the integration of CMAM in existing health care services. Partners are working at both the policy and community levels to ensure this integration. As of December 2009, 24 out of 28 districts are implementing CMAM in over 240 health facilities. The USG will support one additional year of the MoH’s CMAM Advisory Service to finalize the transition of complete CMAM scale-up to the GoM. An evaluation in 2012 will help inform the USG on the areas needing further investment.
Through two GDAs with Project Peanut Butter, a local producer of ready-to use therapeutic food (RUTF), USAID/Malawi’s support has resulted in an annual production capacity of over 1,200 MT of RUTF, which, when combined with production from a second local producer of RUTF, more than meets the total requirements of RUTF for Malawi, with capacity to export to neighboring countries. The USG will take advantage of this existing capacity to explore the development and promotion of ready to use supplementary and complementary foods.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will support GoM's efforts towards fortification of prioritized centrally processed foods, namely: sugar, oil, wheat and maize flour, and complementary baby foods. Data from the National Micronutrient Survey shows that the consumption of these foods has increased over the last ten years. USAID health funding will continue to support the universal salt iodization program in order to sustain the gains made with previous investments. Although not sufficient to forestall stunting in children under five, one necessary input is a high quality, low-cost complementary food. The legume and dairy value chains present a unique opportunity for the development of such a product. Malawi will take advantage and work with existing food processors (e.g., Rab processors, Project Peanut Butter and Valid Nutrition) to develop a suitable product.
Prevention and control of micronutrient malnutrition will require a concerted effort by all USAID/Malawi’s health programs, namely, malaria, family planning, maternal, neonatal and child health, HIV/AIDS and nutrition. Possible USG support to SUN for specific activities with deliverables in FY11 include the following:
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","USG investments in legume and dairy value chains are designed to boost competitiveness and promote diversification into higher-return value chains that will also spawn non-farm employment opportunities. While these investments in economic growth will be necessary to reduce poverty and hunger, they will be insufficient by themselves. Beyond growth, poverty reduction will require targeted interventions that address the needs of smallholder farmers (the rural poor) as well as more vulnerable populations. A significant smallholder need is to produce more from a very limited resource base. Conservation farming practices offer promise in this regard, by increasing yields, soil fertility and soil moisture content per unit area. Importantly CF offers a window of opportunity to increase yield from a fixed unit area, freeing up land for diversification of both other cereals and legumes. Improving market and input access and the affordability of business development and financial services tailored to the needs of smallholders is critical in order to ―pull‖ rural households into income-raising activities.
Integrating Nutrition with Value Chains (INVC)
INVC is designed to combine the livelihood benefits of an agricultural value chain approach with the nutrition benefits of increased dietary diversification. This centerpiece of Malawi’s FTF strategy will invest in the competitiveness of food staple value chains in which large numbers of smallholders, over 56 percent of whom are below the poverty line, participate, and link increased household production of nutritious crops to household consumption and improved nutritional status. INVC will link value chain development and increased household income to improved nutrition through diet diversification, and improvements in food storage, preparation, and consumption practices at the household level.
INVC’s value chain approach will focus on legumes (groundnuts and soy) and dairy, and is designed to facilitate change in both the individual value chains and the broader market and household-farming systems, looking for synergies across value chains such as common constraints and/or actors. A strong emphasis will be placed on improving the demand side of the value chain, by working to improve market linkages between input and output dealers through improved and more reliable services, including financial, business development, agronomic and livestock-related services. While most of INVC’s efforts will further develop and strengthen Malawi’s existing input and output markets serving the legumes and dairy value chains, the program will also include strengthening the capacity of processors and agribusinesses to meet export market demands, as well as building the capacity of smallholder suppliers to meet buyer demands. At the same time, INVC will work to mitigate the risks for rural households to diversify their income and food sources beyond maize through an option of conducting a vulnerability assessment for its target population and to access nutritional education that will help them translate a more diverse basket of food into improved nutrition. INVC will place a particular emphasis on women’s economic empowerment across all of its activities, including additional support and guidance to women owned businesses and women producers.
INVC will spur investment and innovation in the legume and dairy value chains through an Innovation and Investment Facility meant to provide INVC a tool to identify and support specific opportunities that can further strengthen the selected value chains and market systems within which they operate. An important use of the facility will be to buy down risk for a firm, farmer, or other value chain actor in order to encourage early adoption of new technologies, such as CF by smallholders, and spur sector-wide innovation. Facility partners may include private firms, GoM agencies, research institutes, NGOs or other local organizations, as well as other donors best placed to identify new solutions to key value chain and systemic43 constraints. This Innovation and Investment Facility will be a key instrument for developing the capacity of the private sector and will also have targets and incentives for the participation of women-owned enterprises or individuals.
A core principle of INVC will also be to build the capacity of the key value chain actors to address the competitiveness of their value chain through their own projects and interventions. As such, INVC will place a strong emphasis on building local capacity to contribute to and invest in agricultural transformation. While Malawi has numerous small businesses, local NGOs and private sector and civil society organizations, few, if any, have both the technical and administrative capacity to implement USAID projects without support. As such, INVC’s approach to capacity building will be to invest resources in local partners while leveraging their local knowledge and capacity to generate results. The project will have a target for graduating local partners to independent status that would allow them to receive USAID funds directly. As partners reach this independent status, they would take on current functions of INVC.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","A significant constraint to the development of competitive groundnut and soybean value chains is the inadequate production of breeder seed. Ten years ago, USAID/Malawi established a $250,000 revolving fund to support ICRISAT in contracting out groundnut breeder seed production, but the FISP addition of legume seed packs the significant gross margins of legumes has driven demand far beyond local seed production capacity. Given the importance of reliable input supplies to Malawi’s FTF strategy, USAID and Irish Aid will partner to expand local capacity for production of quality, certified legume seed. USAID will invest in expanding the existing revolving fund and link in the International Institute of Tropical Agriculture to enable the expansion of their efforts in soy breeder seed production. Irish AID will expand its assistance to small and medium sized enterprises to develop their capacity of to multiply groundnut seed – currently only one company (Seed Co.) is involved in soybean seed production using privately developed germplasm.","Infrastructure","Malawi also lacks an International Organization for Standardization (ISO) certified laboratory for testing and certifying groundnuts and soybeans, which limits access by exporters to broader export markets. Currently, companies that export groundnuts send samples to South Africa for testing, which is costly and limits export capacity. With Irish Aid support, ICRISAT and NASFAM are developing a low cost, rapid testing technology; however, achieving ISO certification will be costly. The EU and UNDP will also begin work next year on a project designed to support the processing and exports side of legume value chains, a major component of which will focus on bringing the Malawi Bureau of Standards up to ISO certification. USG resources will support GoM efforts to establish a national sanitary/phyto-sanitary (SPS) strategy and achieve COMESA SPS compliance, as well as to build the capacity of Bunda College and the MoAFS research stations to conduction aflatoxin mitigation research.","Financial resources","Access to finance remains a major constraint to smallholders investing in productivity enhancing technologies due to weak financial sector infrastructure, inadequate financial services options, and GoM regulatory capacity. USAID will jointly develop a Financial Sector Technical Assistance Project with the World Bank and DfID.","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","In view of the capacity challenges that exist, USAID will strengthen the capacity of the GoM to plan, implement, monitor and evaluate nutrition programs. With substantial funding increases anticipated through the FTF, USAID/Malawi will ensure that GoM institutions have adequate capacity to implement the various programs that will be designed under the initiative. This activity is in line with Strategic Objective Three of the NNPSP, which clearly outlines the capacity gaps and needs for the nutrition sector in Malawi. The USG will strengthen capacity of its partners, both government and non- governmental, as well as the private sector. USG support will be at three levels: community, institutional and tertiary. Irish Aid, the World Bank, CIDA, and the EU are all key donors in capacity building.
Strategic Analysis and Knowledge Support System (SAKSS)
Since 2008, USAID/Malawi has supported a SAKSS unit implemented through the International Food Policy Research Institute (IFPRI) at the MoAFS. The objectives of this activity are threefold: 1) generate demand-driven diagnostic and strategic research to fill key knowledge gaps, 2) establish an information and knowledge support system, in cooperation with the Southern Africa Regional Strategic Analysis and Knowledge Support System that has been set up to help promote peer and progress review of the CAADP, and 3) strengthen the capacity of national institutions, such as the MoAFS, in policy and strategy research. The Malawi Mission plans to extend the work of the SAKSS unit as part of capacity building support under FTF.
Malawi Agriculture Policy Strengthening (MAPS)
Strong civil society and private sector networks are critical to implementing the ASWAp in a way that responds to the evolving needs of its stakeholders. In recent decades, weak capacity and declining GoM interest in inclusive policy making is leading Malawi’s CAADP process towards a Government-owned rather than Country-owned process. Grounded in the CAADP principles of increasing stakeholder participation in the policy making process,44 the Malawi Agriculture Policy Strengthening (MAPS) program is designed to increase the participation of private sector and civil society stakeholders in agriculture policy dialogue.
MAPS will increase the profile, capacity and engagement of civil society and private sector stakeholders in agriculture policy development and implementation through a combination of capacity building interventions and establishing linkages between producers and consumers, including state and non-state actors, of high quality policy research. Though not exclusively, MAPS will focus on key stakeholders along the proposed FTF value chains.
MAPS capacity building activities will focus on improving organizational ability to meet its goals and objectives by strengthening administrative and financial management, organizational structure and strategic planning. The second focus of the project will strengthen policy analysis and advocacy capacity through building linkages between Malawian farmers and private sector associations and regional networks and research institutions, such as local and regional universities among civil society groups. MAPS will similarly link GoM counterparts to those research institutions to improve their ability to become informed consumers of stakeholder policy advocacy. These two components will account for the varying levels of development and readiness of organizations and associations in Malawi to take on advocacy activities. MAPS will also focus on elevating the voices of women in policy dialogue by targeting women-led civil-society/public service organizations for organizational capacity building and providing additional women-focused leadership training and gender equity sensitization to facilitate women taking on leadership roles within larger organizations.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17803","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child","6-59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
OTP Outcome
Cured % (#)
> 75%
Died % (#)
< 10%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (June-Dec)
74.5 (1540)
0.7 (14)
6.9 (143)
17.9 (371)
Niamey (Aug-Dec)
83.3 (445)
0.4 (2)
3.6 (19)
12.7 (68)
Tahoua (Aug-Dec)
86.6 (453)
1.0 (5)
10.3 (54)
2.1 (11)
Tillaberi (Jan-Dec)
86.4 (912)
1.5 (16)
11.0 (116)
1.1 (12)
Zinder (Jan-Dec)
83.6 (799)
4.3 (41)
10.0 (96)
2.1 (20)
Reporting Period: Jan - Dec, 2011
Maradi
93.5 (4510)
0.3 (16)
4.9 (235)
1.3 (62)
Niamey
NA
NA
NA
NA
Tahoua
84.2 (1054)
0.8 (10)
5.8 (72)
9.3 (116)
Tillaberi
85.5 (1484)
1.6 (27)
10.8 (187)
2.1 (37)
Zinder
94.8 (1803)
0.5 (9)
3.2 (61)
1.5 (29)
Reporting Period: Jan - Dec, 2012
Maradi
97.7 (2651)
0.1 (3)
1.5 (41)
0.7 (18)
Niamey
86.9 (839)
0.3 (3)
5.4 (52)
7.5 (72)
Tahoua
84.7 (762)
1.6 (14)
10.4 (94)
3.3 (30)
Tillaberi
89.1 (886)
1.7 (17)
8.4 (83)
0.8 (8)
Zinder
98.8 (4200)
0.3 (12)
0.1 (6)
0.8 (32)
Reporting Period: 2013
Maradi (Jan-Apr)
94.6 (546)
0.5 (3)
3.3 (19)
1.6 (9)
Niamey (Jan-May)
70.1 (129)
0.0 (0)
18.5 (34)
11.4 (21)
Tahoua (Jan-May)
92.7 (281)
0.0 (0)
4.6 (14)
2.6 (8)
Tillaberi (Jan-Mar)
95.8 (46)
0.0 (0)
4.2 (2)
0.0 (0)
Zinder (Jan-May)
99.6 (1254)
0.2 (3)
0.1 (1)
0.1 (1)
","
Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805 ","Zinder: April-May 2007, point coverage = 21.4% and period coverage = 36.1%. ","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% MAY, 2013:TILLABERRI GAM 13.3%, SAM 3.1%ZINDER GAM 11.7%, SAM 2.3%MARADI GAM 16.3%, SAM 3.0%TAHOUA GAM 13.1%, SAM 2.3%NIAMEY GAM 11.0%, 1.6%","See above","Vulnerable groups","","Treatment of dehydration in children with severe acute malnutrition>>>Treatment of dehydration in children with severe acute malnutrition>>http://www.who.int/elena/titles/dehydration_sam","Supplies","Problem: There had been some difficulties in ensuring a consistent supply of RUTF. The nutritional commodities for the treatment of SAM are supplied via UNICEF through the MOH supply structure. But there were some challenges due to logistical and organisational issues, including the local/global availability of RUTF. Solution: WV established a buffer stock to resolve the issue. ","Supplies","Problem: A lack of consistent supply of medicines to the CSIs risks the increase in morbidity and mortality from illnesses such as pneumonia and malaria which are major causes of mortality in malnourished children. The care of children under the age of five are free in Niger. However, there are frequent shortage in medicinal supply. Because of the exemption of the fee and the system of cost recovery are in place, in principle UNICEF does not provide for the medicines for activities related to CMAM program although some spot supplies are available they are often inadequate. Solution: WVN is, already involved in the provision of medicines through the activities of ADP and, in case of need, the support will be intensified during this period of crisis. In addition to the routine medicines used for the treatment of the children admitted in the OTP, it would be important that WVN also considers to provide, in the event of rupture, the medicines needed to treat the pathologies associated with malnutrition.","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program.Solution: WV developed an Instituational Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities.Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff"," Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","","","","Zeinaba Abdoulahi lost her second child five years ago at the age of 4; his death is still a source of grief for this young Nigerien mother. Earlier this year, her fourth child, Tinoumoune, was close to death. The eight-month old girl was dehydrated and losing weight. After treating her with traditional herbal remedies, Tinoumoune continued to become physically weaker and weaker and had a fever for eight days. Zeinaba says “My child was between life and death. She was fading away. I had not a droplet of hope.” Zeinaba bundled her daughter on her back and left early in the morning to walk the seven kilometres from her village to the closest health centre, which runs a community-based management of acute malnutrition (CMAM) programme supported by World Vision. Tinoumoune was diagnosed with severe acute malnutrition and admitted to the nutrition programme, where she was treated with ready-to-use therapeutic food. “In two weeks, she regained weight and became stronger and healthier. I’m very happy.” explains Zeinaba. The family has been spared the grief of a second lost child.
©2010 Ann Birch/World Vision ©2010 Gebregziabher Hadera/World
Mma Halima is a CMAM community volunteer in Niger. She started in this role after caring for her own malnourished son until he graduated from World Vision's CMAM programme. Mma Halima screens and refers malnourished children in her nomadic community and provides health and nutrition education. She describes the ripple effect of her son's rehabilitation through CMAM: ""Now in my community all the mothers are using mosquito nets and our children are not getting sick as before. Now I have only two malnourished children in my community. It is impressive.""
","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17821","","Management of moderate malnutrition","","","","MAM child|Preschool-age children (Pre-SAC)","6 - 59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","SFP Outcome
Cured % (#)
> 75%
Died % (#)
< 3%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (Sept-Dec)
88.5 (491)
0.4 (2)
8.6 (48)
2.5 (14)
Niamey (Jan-Dec)
88.6 (194)
0.0 (0)
1.4 (3)
10.0 (22)
Tahoua (Aug-Dec)
86.4 (248)
0.0 (0)
13.6 (39)
0.0 (0)
Tillaberi (June-Dec)
88.4 (501)
0.7 (4)
10.2 (58)
0.7 (4)
Zinder (Jan-Dec)
90.8 (640)
2.6 (18)
5.4 (38)
1.3 (9)
Reporting Period: Jan - Dec, 2011
Maradi
97.0 (7069)
0.0 (3)
2.2 (162)
0.7 (51)
Niamey
85.8 (1949)
0.2 (5)
7.7 (175)
6.3 (143)
Tahoua
92.1 (1413)
0.0 (0)
6.3 (96)
1.6 (25)
Tillaberi
93.7 (4413)
0.2 (9)
5.1 (242)
0.9 (44)
Zinder
95.6 (4825)
0.4 (18)
2.4 (119)
1.7 (84)
Reporting Period: Jan - Dec, 2012
Maradi
99.0 (9559)
0.0 (0)
0.4 (38)
0.6 (54)
Niamey
81.3 (1886)
0.0 (0)
10.0 (233)
8.7 (201)
Tahoua
90.1 (984)
0.2 (2)
7.7 (84)
2.0 (22)
Tillaberi
88.7 (2065)
0.2 (4)
9.7 (226)
1.4 (33)
Zinder
94.9 (5508)
0.1 (3)
2.6 (148)
2.5 (143)
Reporting Period: 2013
Maradi (Jan-Apr)
97.1 (1501)
0.1 (1)
2.7 (42)
0.1 (2)
Niamey (Jan-Apr)
73.9 (241)
0.0 (0)
18.7 (61)
7.4 (24)
Tahoua (Jan-May)
88.7 (344)
0.0 (0)
9.0 (35)
2.3 (9)
Tillaberi
NA
NA
NA
NA
Zinder (Jan-May)
99.7 (2910)
0.0 (0)
0.2 (6)
0.1 (2)
","Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805","Zinder: April-May 2007, point coverage = 28.5% and period coverage = 49.0%.","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","See above","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","Supplies","Problem: The lack of a consistent supply of nutritional commodities for SFP has put children suffering from MAM at an increased risk for relapse, non-response, deterioration in status (into SAM) and defaulting. This lack of consistency has also negatively affected the credibility of the SFP program within the community. In turn, this has reduced the overall number of caregivers accessing the SFP services and thus has become a barrier to access.Solution: Contingency planning by the Food Commodity Department and logistics within WV to avoid stock shortage. For example add an extra percentage onto projected estimations each month in order to always have stock in place. ","Communication","Problem: The lack of clarity over the use of RUSF (Ready-to-Use Supplementary Food) and the target group has introduced increased risks for MAM cases in more vulnerable age groups. These cases were not being treated properly, thereby reducing effectiveness of the SFP program. Solution: Clarification with written protocols on the use of RUSF and other nutritional commodities for MAM and the target groups should be made available in the CSIs. It is also essential that there is community sensitization/awareness in the CSI catchment communities on the MAM aspect of CMAM.","External factors","Problem - Conflicting admission criteria: Community Volunteers (Femmes Relais) screen children for MAM in the communities using MUAC. However, upon arrival to the CSI/CS, the same children are admitted into the program on the basis of W/H criteria (outlined in National Protocol). Due to the discrepancies between W/H and MUAC screening, children are rejected from the program. This can reduce the effectiveness of community mobilization because of the problem of rejection.Solution: In order to increase coverage of the program a mass screening was carried out in the 5 regions covered by WV. Over 40,000 children were screened which resulted in a subsequent increase in the SFP admission. ","External factors","Problem: Distance as a barrier to access. Some of the CSI are located very far from the communities that they are serving. Solution: Expand MAM treatment (i.e. SFP) to Health Posts (CS) in order to reduce distance travelled for beneficiaries thus helping to improve the program accessibility as well as reducing the work load in CSIs (however the program capacity must be assured before decentralising these services to health posts).","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program. Solution: WV developed an Institutional Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities. Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff","Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","01-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17823","","Food distribution/supplementation for prevention of acute malnutrition","","","","Lactating women (LW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS","","Zinder, Maradi, Niamey, Tahoua","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17824","","Nutrition education and counselling","","","","Adolescents|Adult men and women|Elderly|Family ( living in same household)|Females|Lactating women (LW)|Males|Non-pregnant women (NPW)|Non-pregnant, non-lactating women (NPNLW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS|Women of reproductive age (WRA)","","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","Once the main components of the CMAM programme (e.g. OTP and SFP) have been well implemented in the existing MOH and community structures, a focus was given to address the negative behavioural and adaptive issues around IYCF in order to prevent further malnutrition. Depending on the priorities and funding availability, some ADPs were able to integrate IYCF activities in the CMAM. These included carrying out weekly health and nutrition session on CMAM days at the CSIs (Health Centers) and reactivating PD Hearth approach to develop menus using new types of locally available foods for complementary feeding promotion. Additional objectives of IYCF included strengthening existing nutrition systems and capacity building through training of health workers and community volunteers on IYCF and carrying out a baseline survey on IYCF and quarterly monitoring of changes in behaviour (e.g. EBF rates, diversity of food groups in complementary feeding). However, apart from the weekly nutrition education sessions at the CSIs, some of the activities did not translate into action at the community level. For example, the training of national WV staff on IYCF did not cascade down to the community level with community volunteers and also did not translated into activities or development of monitoring tools at community level. Additionally, no baseline IYCF information was available and quarterly monitoring data had not been collected or was unavailable at community level.
NB: This program was funded for a year therefore continuation of the activities beyond the funding period is likely be sporadic as it will depend on various factors including staff and volunteer capacity and motivation.
","For Tillaberi and Niamey regions in July 2010-July 2011:
Nutrition education (incl. IYCF): Target 24,700; Achieved (by the 3rd quarter) 14,234
Number and percentage of infants 0-6 mos who are exclusively breastfed: Target 310 (10%); Achieved N/A
Number and percentage of children aged 6-24 mos who receive foods daily from 4 or more food groups: Target 3045 (40%); Achieved N/A
","Due to a lack of monitoring and reporting it was not possible to report on Infant and Young Child Feeding activities apart from nutrition education sessions at the health centers even if these activities had been occurring in an informal manner in the communities. But it appears that these activities had been strengthened and expanded towards the end of the programme cycle.
","See outcome indicator section","NA","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","Same as above","Vulnerable groups","","","Management","","","","","","","","","","","","","","","","","","","","","WV Niger’s implementation of IYCF activities into the ongoing CMAM program started late in the program period. Due to the high resource (human & financial) intensity of implementing a CMAM program, it was not feasible to introduce IYCF activities until the latter program stages. At the beginning of the program, the MOH staff were trained in providing nutrition education sessions at CSIs on OTP/SFP days which included IYCF messages. Later on, national WV staff were trained on IYCF with the aim that they would cascade this training to the ADP level and then to the community level. However, the training did not continue to the community level (with community volunteers) until near end of the program period.
To strengthen IYCF component of CMAM including monitoring activities, the following activities are recommended:
1. Recruit community mobilisers at ADP level who will work with district Community Focal Points, WV ADP and National Community Mobiliser. The lack of WV community mobilisers at ADP level to work alongside the Nutrition Coordinators has risked a delay in training community volunteers and may have also prevented the implementation of community mobilization activities including IYCF activities and monitoring of these activities.
2. Ensure women are represented in nutrition programs. During the IYCF investigation the 50/50 presence of women as interviewers for the IYCF investigation ensured better access to women and thus the provision of more rigorous information regarding IYCF practices.
3. Develop monitoring tools for IYCF. E.g. How many IYCF sessions held and how many participated?
4. Carry out a representative and statistically significant baseline and final IYCF survey – for EBF rates and diversity of food groups.
","","English"