"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" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","
From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010The FMOH has developed a four-pronged national strategy for PMTCT: primary prevention of HIV infection; prevention of unintended pregnancies among HIV-positive women; prevention of HIV transmission from infected women to their infants; and treatment, care, and support of HIVpositive women and their infants and families. All health centers have a system of identifying infants born to HIV-positive mothers as part of their PMTCT program. 11The following is a brief description of the flow of PMTCT services, commencing from a woman’s first visit for ANC:All women coming for ANC are routinely informed—individually or in a group—about the benefits of HIV testing for mothers and babies. During this process—known as providerinitiated HIV counseling and testing—mothers reserve the right to say “NO.” Those who say “YES” will be tested.Women with positive results are referred to MSG mentors, and ANC follow-up continues. Their partners will also be tested.MSG mentors counsel an HIV-positive woman and transfer her to the ART nurse for antiretroviral drugs.The ART nurse takes a CD4 count. If not eligible for treatment based on her count, the woman will commence treatment and ANC follow-up continues. If she is eligible for treatment based on her count, she will be put on complete antiretroviral prophylaxis that starts at 27 weeks of gestation.Follow-up continues and the mother is advised to deliver at a health facility.At delivery, the infant will be started on prophylaxis as an HIV-exposed infant.A dried blood sample will be taken from the infant for polymerase chain reaction (PCR) testing after 45 days.Follow-up continues until cessation of breastfeeding, with re-screening done six weeks later.
","CD4 countsPCR test for HIV status of iinfant
","","x","Highly HIV prevalent regions","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","","Aberash, a 33-year-old woman, was in the 36th week of her pregnancy at the time of this assessment. She was not married and had tested HIV positive. Since the time she had learned her HIV status, Aberash had been visiting the health center in Shashemene at least once every week—and sometimes more often. Her primary concern was transmitting HIV to her unborn baby. Sr Terunesh*, the nurse responsible for ANC services at the health center, had been counseling Aberash on a number of issues related to her well-being and that of the baby. These discussions usually included nutrition-related issues, specifically breastfeeding and its potential hazards. In addition to these counseling sessions, Sr Terunesh had connected Aberash with the MSG for continued support, counseling, and encouragement, both from the mentors and from other mothers in the group.* Not her real name.
","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Trials for Improved Practices (TIPs) is a relatively new and innovative methodology for Ethiopia, especially its use in shaping critical strategies to improve IYCF behaviors. The standard approach to TIPs implementation involves three household visits. The purpose of the first visit is to learn about current household feeding practices. The second visit is a ―counseling visit,‖ which includes the negotiating of a new practice with the mother or caregiver for her to try. The third visit is a follow-up visit to check on the mother’s experience in implementing the recommended/negotiated new practice. This ―negotiation TIPs‖ is mainly used in maternal and infant feeding, and identifies the best choices among a number of different actions that could yield IYCF nutrition benefits.
","Urban garden household participationFoods most frequently consumedHouseholds consuming at least four different food groups on a daily basis
","","x","Two similar, poor, urban populations from two districts (Adama and Debra Zeit)","","","","Socio-economic status","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","The results point to some specific areas that appear to be the most promising for improving complementary child feeding practices across the different age groups from 6 to 24 months:Improving the porridge/special food given to the child by adding different foods to enhance the quality and increase the energy density;Adding different mixtures to the porridge or giving different food combinations such as egg and potato;Adding fruits to the child’s diet, bearing in mind economic constraints that limit availability of fruit on a daily basis;Trying to introduce vegetables earlier, starting after six months and continuing (when mothers tried adding vegetables they found that their fears of ―doing harm‖ to the child were not justified); Increasing the amount of food provided in part by adding additional foods (fruits and vegetables); andUsing a separate bowl/plate for the child to facilitate monitoring the amount of food the child consumes.
","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promotion of handwashing or hygiene interventions was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Promoting and implementation of delayed cord clamping was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>>Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing>>http://www.who.int/elena/titles/cord_clamping","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","Urban|Rural","completed","01-2010","01-2011","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Emergency Nutrition Intervention Guideline, August 2004
","","","","National coverage","","","","","","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" "9119","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ETH","Ethiopia","Ethiopia","","","","","From January 2010 to December 2011, the Infant and Young Child Nutrition (IYCN) Project supported the Federal Ministry of Health (FMOH) and US President’s Emergency Plan for AIDS Relief (PEPFAR) partners in Ethiopia to improve maternal and child nutrition practices and increase HIV-free survival of children. Although Ethiopia has successfully integrated services for prevention of mother-to-child transmission (PMTCT) of HIV with antenatal care (ANC) services, many facility-based providers lack nutrition counseling skills and access to tools and materials to help them offer adequate support to mothers and children. The project worked with the Ethiopian government and partners to improve the quality of nutrition assessment, counseling, and support services in several communities in Addis, Oromia, and Amhara regions where the HIV prevalence rate is disproportionately high. This included developing behavior change communication tools and materials for health workers, health extension workers, and mothers’ support groups; updating the skills of agricultural extension workers to integrate nutrition education; and training health workers to better counsel mothers, particularly those who are HIV-positive, about optimal maternal, infant, and young child nutrition practices.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: Protocol for The Management of Severe Acute Malnutrition, FMOH, March 2009
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010Study preparation and data collectionDue to the post-election violence that occurred in Kenya in January and February 2008, initiation of this study was postponed from its original start date of January 2008 to May 2008 to ensure the safety of the field team. The study team for Western Province included one field supervisor and four research assistants who were fluent in the local Luhya and Swahili languages. The study team for Eastern Province included one field supervisor and four research assistants who were fluent in Kamba, Swahili, and Kikuyu. A data analyst was also hired to enter and clean data in real time, as well as to assist with data analysis. Study procedural training was held with the entire study team, led by Dr. Kiersten Israel-Ballard and Ms. Margaret Waithaka, May 19–23, 2008. This included pretesting the data collection tools, revising all translations as needed, and piloting them in multiple languages at a local clinic. The study launch was on May 26 for Eastern Province, with field support from Dr. Israel-Ballard, and June 2 for Western Province, with field support from Ms. Waithaka. The data collection tools utilized in this study are available upon request.Study populations and proceduresThis cross-sectional study was designed to collect formative research data in a descriptive manner. This study took place at APHIA II (AIDS, Population and Health Integrated Assistance [USAID-funded program]) affiliated sites in the Kakamega, Vihiga, Hamisi, and Bungoma Districts of Western Province and in the Kitui, Makueni, Kibwezi, Machakos, Mwala, Yatta, Mwingi, and Mbooni Districts of Eastern Province. These regions were selected to include food-secure areas of Western Province and food-insecure areas of Eastern Province. Data collection occurred between May and September 2008. According to the 2007 Kenya AIDS Indicator Survey, Eastern Province had an HIV prevalence of 4.7 and Western Province of 5.1.This study was composed of a convenience sample of quantitative in-depth interviews, brief post-counseling exit interviews, and counseling session observations. A total of 386 women older than 18 years of age were recruited. In-depth interviews were conducted with 285 women (137 in Eastern Province, 148 in Western Province). Women known to be HIV positive were recruited from PMTCT clinics, comprehensive care centers, and postnatal wards at local clinics and referral hospitals, as well as from support groups affiliated with the health centers. Inclusion criteria included being HIV infected, having an infant <18 months of age, and having stopped breastfeeding between 1 week to 6 months prior to participation. Survey questions focused on the period over which breastfeeding cessation took place, including the age of the infant, liquids and foods fed during this period and their associated costs and availability, infant illness, breast health, general challenges, as well as a 24-hour dietary recall to capture current infant feeding practices and challenges. Infant weight and mid-upper arm circumference (MUAC) were measured to capture current nutritional status.Post-counseling exit interviews were conducted with 80 women (50 in Eastern Province, 30 in Western Province) who had not participated in the cross-sectional survey. The difference in sample size between provinces was due to clinic staffing shortages, resulting in the lack Kenya Infant Feeding Assessment 5 of individual postnatal counseling in Western Province; group PMTCT counseling was more commonly practised Women known to be HIV positive were recruited upon leaving an antenatal or postnatal PMTCT counseling session at a health facility. Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. Counseling session observations occurred 22 times with different women and in various clinics (9 in Eastern Province, 13 in Western Province). Inclusion criteria included being HIV positive, being pregnant, or having an infant <12 months of age. In Eastern Province, four of these observations were antenatal and five were postnatal; in Western Province nine were antenatal and four were postnatal. Antenatal mothers were recruited in the antenatal care (ANC) clinic in the PMTCT section. Postnatal mothers were recruited in the comprehensive care center or in the maternal and child health (MCH) ward. Three observations were of ANC group counseling sessions rather than individual sessions; two in Western, one in Eastern. The observer used a check list to indicate whether a specified topic had been covered during the session. Although recruitment criteria were inclusive of both antenatal and postnatal mothers with infants under 12 months of age, most (n = 8) of the mothers interviewed postnatally had infants of only 1 month of age, while one mother had a 3-month-old and another had a 9-month-old infant, thus limiting the infant age ranges. All clients who met the recruitment criteria and consented to join the study during the recruitment period were recruited. To ensure eligibility and guardianship of the infant we required identification documents prior to enrollment. Additionally, 11 local stakeholders, including district and provincial nutritionists and nursing officers from Nairobi and Eastern and Western Provinces, were informally interviewed to gather their perceptions and attitudes toward infant feeding in the context of HIV in their communities.
","Weightfor-age (WFA) z-score,Upper-arm-circumference-for-age z-scoreMUACcount of the number of morbidities (0 to 5) the infant experienced during or subsequent to weaning, chosen from a list of five morbidities (respiratory symptoms, diarrhea, dehydration symptoms, fever, and refusal to eat)
","To monitor the progress of infant feeding and HIV activities, IYCN provided reporting tools which included a form to help APHIA II Western-supported PMTCT counselors accurately report on their facility-based activities in a standardized way, and to provide an opportunity to share successes and challenges; an observation checklist to provide structured feedback to facility-based counselors to improve their counseling and facilitation skills; and a reporting form for community-based workers to report on infant feeding activities. Subsequently, several PMTCT and HIV partners adopted the tools for use in their programs.
","*","Western and Eastern Province","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Confirming our post-counseling exit interview findings, we observed that few counselors discussed safe water as part of their AFASS assessment. Yet, this is a crucial factor for decision-making in this study population given that the most common water sources cited among mothers interviewed were rivers, dams, or open ponds. We also noted that the costs of replacement feeding were rarely mentioned. Interestingly, we observed more emphasis placed on risks from replacement feeding than on those from breastfeeding during ANC, but the opposite emphasis during postnatal visits, perhaps due to the perceived fear of infecting an otherwise healthy-looking infant. Regardless of when the counseling takes place, an accurate representation of risks and benefits associated with all infant feeding options needs to be conveyed to mothers. It was reassuring to note that most counseling sessions included discussion around how to stop breastfeeding, including mentioning that cessation should not occur until 6 months and that AFASS criteria should be in place, and providing an explanation of how a mother should physically stop breastfeeding (i.e., reduce number of breastfeeds per day) and how long the transition should take. However, as with the exit interviews, few mentioned manual expression to prevent breast pathologies. Although complementary foods were often discussed, mothers needed more detailed information on Kenya Infant Feeding Assessment 28 timing, frequency, quantity, diversity, and appropriate local foods to be able to optimally feed their infants. Although infants were often weighed, their growth progress was rarely discussed with the mother. Effective growth monitoring should also include growth promotion, which includes dialogue with the mother in order to identify and address problem areas before they lead to growth faltering or malnutrition.
","“I feel that those who fully understand/grasp the counseling are most likely to exclusively breastfeed.” - District Nursing Officer Western Province“If you take a mother through one-on-one counseling, most will then exclusively breastfeed successfully.” - District Nursing OfficerWestern Province
","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","Urban|Rural","completed","01-2006","01-2011","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: IMAM
","","","","National coverage","","","","","","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" "9241","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","KEN","Kenya","Kenya","","","","","The US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project built support within communities and households for improving the way mothers in Kenya feed their infants, young children, and themselves. The IYCN Project collaborated with the government of Kenya and USAID-funded partners to conduct an assessment of infant feeding practices in Kenya’s Western and Eastern Provinces, which informed several national strategies and programs. The project also completed a literature review and a formative assessment on engaging fathers and grandmothers in infant and young child nutrition. Findings informed the design of an evaluation to test the effectiveness of interventions that engage fathers and grandmothers to improve and support mothers’ dietary and infant and young child feeding practices. To complement these efforts, IYCN partnered with the USAID-supported AIDS, Population and Health Integrated Assistance (APHIA) II and APHIAplus Projects to increase support for optimal infant feeding practices at the facility level and in the community
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: intergrated management of acute Malnutrition
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","STUDY DESIGNThe study consisted of an assessment using qualitative methodology. Within the focal area of FCT, four Area Councils were selected. First, the Area Councils were divided into urban/rural groups. Within each group, the “lucky dip” technique was used to pick two Area Councils. Within each selected Area Council, two urban and two rural communities were selected. Data collection was done at the health facility level. Health workers at the health facilities served as contact persons and mobilizers for respondents. In-depth interviews (IDIs) were conducted with key individuals in each of the communities, including traditional leaders, opinion leaders, community health workers, and community health volunteers. Focus group discussions (FGDs) were held amongst primary caregivers (mothers) of children under six months of age, primary caregivers of children between 6 and 24 months, grandmothers of under-24-month-olds, and fathers with children under 24 months of age.DATA COLLECTIONData collection instruments were developed for the target groups of the study. The instruments were pre-tested, on the basis of which some moderations were made. A methodology workshop was held to train the field officers and assistants a day before field work began. The training took place in the IYCN office in Asokoro, Abuja. During the training sessions, field assistants were taken through each instrument, and possible interpretations debated and agreed upon. Role-play sessions were also conducted. The workshop was facilitated by Dr Afolabi in conjunction with the principal investigator, Dr R. A. Okunola. Data were later collected at the different sites in FCT, coordinated by the principal consultant. Health officials of Area Councils to be visited were informed some days before the arrival of the study team, and necessary mobilizations were done. On arrival, courtesy calls were made to the traditional head and permission formally obtained for entrance into the community. Afterwards, the team proceeded to the health facility, where the various interviews and discussion sessions took place. Each FGD session was facilitated by a moderator and a note-taker while the sessions were tape-recorded. The collected data were transcribed and translated into English for the purpose of analysis.
","*
","","*","2 communities in 4 area councils of the Federal Capital Territory, Abuja","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Working closely with the government is necessary to achieve sustainability beyond the life of the project. We have involved stakeholders from the government at all stages of planning and implementation of project activities. This has enabled government ownership of our activities, materials, and products, thereby ensuring their continued implementation after project closeout.Effective collaboration with key stakeholders is integral to success. We involved nutrition, PMTCT, and OVC partners from the beginning, ensuring they wereincluded in all stakeholder meetings and collaborating with them on program implementation.Integrating materials for health facilities and communities ensures consistent messages for caregivers. We found that developing the facility and community-based materials concurrently resulted in consistency of key messages for caregivers and helped establish a two-way referral system between facility-based health workers and community workers and volunteers.A cascade training approach can help programs with limited resources reach more health providers. We found that training master trainers at the national and state levels and engaging with a wide variety of partners to leverage resources helps to reach a wider group of health providers.
","“IYCN is the organization we recognize for nutrition in this country. Anything concerning nutrition we assign it to IYCN and listen to what they tell us and bring it back to stakeholders, review it and adopt it. Most of the time it involves a lot of technical discussion [with IYCN].”—Oby Okwuonu, Assistant Director, Orphans and Vulnerable Children Unit, Federal Ministry of Women’s Affairs and Social Development“This program is different because the focus is on the community. Health workers are trained to involve community counselors. This allows them tobe closer to the community.”—Aishatu Amiwe Zango, State Nutrition Officer and Trainer, Jigawa“Despite having a limited budget, IYCN has been able to reach a broad audience by integrating important infant feeding messages into government-owned documents that will reach many levels through cascade training.”—Dr. Bamidele Omotola, UNICEF
","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","STUDY DESIGNThe study consisted of an assessment using qualitative methodology. Within the focal area of FCT, four Area Councils were selected. First, the Area Councils were divided into urban/rural groups. Within each group, the “lucky dip” technique was used to pick two Area Councils. Within each selected Area Council, two urban and two rural communities were selected. Data collection was done at the health facility level. Health workers at the health facilities served as contact persons and mobilizers for respondents. In-depth interviews (IDIs) were conducted with key individuals in each of the communities, including traditional leaders, opinion leaders, community health workers, and community health volunteers. Focus group discussions (FGDs) were held amongst primary caregivers (mothers) of children under six months of age, primary caregivers of children between 6 and 24 months, grandmothers of under-24-month-olds, and fathers with children under 24 months of age.DATA COLLECTIONData collection instruments were developed for the target groups of the study. The instruments were pre-tested, on the basis of which some moderations were made. A methodology workshop was held to train the field officers and assistants a day before field work began. The training took place in the IYCN office in Asokoro, Abuja. During the training sessions, field assistants were taken through each instrument, and possible interpretations debated and agreed upon. Role-play sessions were also conducted. The workshop was facilitated by Dr Afolabi in conjunction with the principal investigator, Dr R. A. Okunola. Data were later collected at the different sites in FCT, coordinated by the principal consultant. Health officials of Area Councils to be visited were informed some days before the arrival of the study team, and necessary mobilizations were done. On arrival, courtesy calls were made to the traditional head and permission formally obtained for entrance into the community. Afterwards, the team proceeded to the health facility, where the various interviews and discussion sessions took place. Each FGD session was facilitated by a moderator and a note-taker while the sessions were tape-recorded. The collected data were transcribed and translated into English for the purpose of analysis.
","*
","","*","2 communities in 4 area councils of the Federal Capital Territory, Abuja","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Working closely with the government is necessary to achieve sustainability beyond the life of the project. We have involved stakeholders from the government at all stages of planning and implementation of project activities. This has enabled government ownership of our activities, materials, and products, thereby ensuring their continued implementation after project closeout.Effective collaboration with key stakeholders is integral to success. We involved nutrition, PMTCT, and OVC partners from the beginning, ensuring they wereincluded in all stakeholder meetings and collaborating with them on program implementation.Integrating materials for health facilities and communities ensures consistent messages for caregivers. We found that developing the facility and community-based materials concurrently resulted in consistency of key messages for caregivers and helped establish a two-way referral system between facility-based health workers and community workers and volunteers.A cascade training approach can help programs with limited resources reach more health providers. We found that training master trainers at the national and state levels and engaging with a wide variety of partners to leverage resources helps to reach a wider group of health providers.
","“IYCN is the organization we recognize for nutrition in this country. Anything concerning nutrition we assign it to IYCN and listen to what they tell us and bring it back to stakeholders, review it and adopt it. Most of the time it involves a lot of technical discussion [with IYCN].”—Oby Okwuonu, Assistant Director, Orphans and Vulnerable Children Unit, Federal Ministry of Women’s Affairs and Social Development“This program is different because the focus is on the community. Health workers are trained to involve community counselors. This allows them tobe closer to the community.”—Aishatu Amiwe Zango, State Nutrition Officer and Trainer, Jigawa“Despite having a limited budget, IYCN has been able to reach a broad audience by integrating important infant feeding messages into government-owned documents that will reach many levels through cascade training.”—Dr. Bamidele Omotola, UNICEF
","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural|Peri-urban","completed","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Behaviour change communication and/or counselling for improved complementary feeding was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","*
","","*","National coverage","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","Urban|Rural","completed","01-2009","01-2011","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9451","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","NGA","Nigeria","Nigeria","","","","","IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010. Protocol used: For now we dont have national protocol but we conduct trainings on the management of SAM using WHO Guidelines.
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010In Eastern Cape Province, IYCN supported PATH’s efforts to improve the quality, availability, and uptake of PMTCT services by strengthening under-resourced PMTCT sites and mobilizing communities to increase the uptake of those services. To prevent malnutrition and ensure HIVfree survival of children, IYCN contributed to integrating infant and young child feeding activities into PMTCT interventions. Specifically, the project helped develop atraining package for lay counselors and community health workers and supported the training of 100 community health workers on infant and young child feeding. In addition, the project assisted the provincial health department to develop tools for surveying facility-based nutritionservices.By adapting a regional, community-based planning tool for use locally, IYCN worked with private-sector partner, J & J Trust, South Africa’s Ekurhuleni Municipality, and Ward 86 within the municipality’s Nigel District to conduct a pilot program that integrated nutrition interventions into economic and community development planning. This model approach can be scaled up throughout the district and beyond to enhance awareness of the nutritional status of young children and dietary and feeding practices that can improve their health. Through this approach, IYCN trained community volunteers to engage the community in nutrition activities. The community response was overwhelming, and community leaders included nutrition activities in development plans. These new activities included establishing a support group for pregnant and lactating mothers and their parents and initiating an awareness campaign on available structures to support lactation.
","x
","","x","x","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","The use of existing structures and processes made planning community nutrition activities and allocating resources feasible. The community in Ward 86 continues to implement nutrition activities based on their community development plans. Although the project did not fund the implementation of these activities, community leaders were able to leverage existing structures and resources.Engagement with communities revealed that people are aware of nutrition and related issues, but that technical support is needed to develop creative behavior change interventions. It is possible to build better linkages between the community and health services by engaging the municipal planning system.
","“I have seen the level of interest in nutrition in the community increase, and now ward members are empowered to influence the development plans of the municipality and the district to prioritize support for nutrition.”— Benny Sikhakhane, IYCN Project consultant
","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","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" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","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" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010IYCN took a comprehensive approach to addressing nutrition assessment, counseling, and support in Zambia by working with stakeholders at the national, district, provincial, and community levels to assess needs, enhance national policies, build the capacity of health providers, implement behavior change communication strategies, strengthen monitoring and evaluation systems, and identify and share good practices. Here is a snapshot of the project’s key activities and accomplishments.
","x
","","x","National coverage","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Taking a comprehensive approach to addressing nutrition assessment, counseling, and support will help ensure a continuum of care and prevent nutritionally vulnerable mothers and children from falling through the cracks.Building the capacity of provincial teams as trainers is an efficient and cost-effective way to increase the number of trained infant feeding counselors.Community health volunteers can fill a key role in counseling and supporting mothers at health facilities, where health workers are often overwhelmed. When trained, volunteers can provide high-quality infantand young child feeding counseling for mothers.Building upon existing resources available in health facilities and communities can ensure government support and sustainability.
","“With IYCN’s support, we have been able to meet our objective of conducting high-quality training workshops for more health workers in our own province.” —Sydney Kambobe, Eastern Province Nutrition Specialist“Now I conduct cooking demonstrations to teach mothers to mix some of the nutritious local foods to give to the child. We pound meat and add it to the porridge.” —Lucy, Community health volunteer“I didn’t know that I could use the foods from my garden to make more nutritious meals for my child.” —Mother in Kabwe
","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","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" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "11456","Infant and Young Child Nutrition Project","English","Multi-national","","LSO","Lesotho","Lesotho","Rural","completed","01-2007","01-2010","From 2007 to 2010, the US Agency for International Development’s Infant & Young Child Nutrition (IYCN) Project supported Lesotho’s Ministry of Health and Social Welfare (MOHSW) to improve the nutrition of mothers and their children younger than two years of age, with a focus on those affected by HIV. The project strengthened national nutrition and prevention of mother-to-child transmission of HIV (PMTCT) policies and programs and conducted supportive activities at health facilities and within communities. As a result of the project, there is now a strengthened referral system, which allows community health workers to refer mothers and children to providers at facilities and providers to refer their patients back to community health workers for followup. Building the capacity of a wide range of community workers resulted in supportive networks for improved feeding practices in many communities, including among village chiefs, traditional healers, and men’s groups.
","Enhanced national nutrition guidelines
IYCN helped to set a countrywide standard for improved feeding practices by supporting the revision of Lesotho’s National Infant and Young Child Feeding Policy and incorporating the World Health Organization’s guidelines on HIV and infant feeding into national PMTCT guidelines. In February 2010, IYCN assisted the MOHSW with presenting the infant and young child feeding guidelines to the Minister of Health.
Facilitated multisectoral collaboration
To effectively reach communities with information about optimal feeding practices, the project fostered collaboration among three government ministries to develop joint training and supervision activities. A cascade-style approach to training community workers enabled IYCN to reach more caregivers with nutrition support. For example, IYCN supported the MOHSW to train 29 trainers at the Ministry of Agriculture, who then conducted “step-down trainings” with 496 home economists and other workers. IYCN also trained trainers at the Ministry of Education, who then trained early childhood care and development teachers. Both sets of trainees gave health talks at local clinics. The home economists showed mothers how to prepare food for their children and the teachers led discussions about good nutrition. Additionally, IYCN collaborated with each ministry to train 246 traditional healers in villages and 30 mentor mothers from mothers2mothers about how to counsel HIV-positive mothers on infant feeding.
Increased community support
Over the life of the project, IYCN supported the training of nearly 750 community health workers to counsel mothers on infant and young child feeding. Trained community health workers increased community support for optimal infant feeding practices and improved social norms, individual attitudes, and infant feeding behaviors. Through household visits, community health workers reached pregnant women and breastfeeding mothers two to four times each month. Community health workers also helped health workers create breastfeeding Masoabicommittees in some villages, which included traditional healers, grandmothers, and priests. By sensitizing village chiefs, traditional healers, community councils, grandmothers, and men’s groups, community health workers broadened support for infant and young child nutrition, which led to more public discussions about the issue. The project informally integrated traditional healers into the referral system, through which they referred mothers to community health workers.
By performing supervisory visits with 270 health providers trained by the project, IYCN monitored the two-way referral system between facilities and community health workers. Project staff also monitored community activities initiated through the project, such as growth monitoring and promotion, health talks, the creation of keyhole gardens, and cooking demonstrations. Health workers reported significant improvement in community-based growth monitoring and promotion sessions and said they were better able to detect and refer children who were growth-faltering, while keyhole gardens became a user-friendly, inexpensive, local source of vegetables.
","Growth
","","","","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Mamorena’s story: helping babies grow up healthy and strong
It wasn’t until Mamorena volunteered to be a community health worker in rural Lesotho that she learned why her first child was frequently ill as an infant. After she gave birth to her son, she only gave him water for the first seven days, delaying breastfeeding until his umbilical cord fell off—a common cultural practice in Lesotho. She eventually added breastmilk and soft porridge to his diet.
While in an IYCN training to be a community health worker, she learned that the addition of foods and liquids—even water—during the first six months of life puts infants at risk of illness, infection, stunted growth, and death.
After the training, when Momorena gave birth to her second son, she began breastfeeding immediately and exclusively. As a community health worker, she continues to share what she learned with people in her village.
Lesotho: Connecting communities with health care facilities to prevent malnutrition
At the Litsoeneng Health Centre, a small clinic in a remote area of Lesotho, Adelina, 40, a nurse, and Mabeata, 62, a community health worker in the nearby village of Khopolo, proudly tell the story of Tsepo. He’s a healthy 17-month-old boy who is learning how to walk and loves playing with other children. Mabeata and Adelina meet monthly to monitor his growth and make sure he stays healthy.
But this wasn’t always the case for Tsepo. When he was 8 months old, Mabeata visited his home to monitor his growth and discovered that he wasn’t gaining weight at a normal rate. Immediately, she encouraged his mother, Malehloa, only 16 years old, to take him to the clinic to correct the problem. After participating in a training workshop conducted by the Infant & Young Child Nutrition (IYCN) Project, the community health worker knew that it was critical to send babies with growth problems to the clinic as soon as possible. She even walked with Malehloa and Tsepo from Khopolo to visit the clinic.
“I was very concerned about Tsepo. I wanted to be there to help Malehloa understand the problem and coordinate with the nurses to follow up after the visit,” Mabeata explained.
At the clinic, Adelina—one of a small staff that includes three nurses and two counselors—asked the young mother questions about how she was feeding Tsepo. Malehloa, who stopped going to school once she was pregnant, had practiced exclusive breastfeeding since Tsepo was born. As a result, he had hardly been sick during his first six months and he was growing normally.
The problem with his growth probably started after that. Malehloa didn’t know that Tsepo needed complementary foods (other foods and fluids) in addition to breast milk to keep him well nourished now that he was older than 6 months.
To improve Tsepo’s nutrition, Adelina and Mabeata helped Malehloa identify foods she already had at home—like enriched porridge and fruits—that would be good for Tsepo. They encouraged her to continue to breastfeed in addition to feeding Tsepo enough nutritious complementary foods at the right frequency. To help him catch up on his growth as quickly as possible, Adelina gave Tsepo a nutritional supplement.
“I learned that breastfeeding alone does not satisfy the baby after six months, so I have to add other foods that are good for Tsepo,” said Malehloa.
Now, Mabeata makes frequent home visits to check Tsepo’s growth and ensure that Malehloa feeds him enriched porridge and other good foods several times a day. She smiles when she talks about how happy and healthy Tsepo is now. She has seen steady improvements in his growth.
“I am very proud. It gives me strength to see how Tsepo is growing,” she said.
Mabeata’s quick actions and persistent follow-up probably prevented Tsepo from becoming severely malnourished. In Lesotho, many babies, even those who have grown well for the first six months of life, do not receive adequate complementary foods—putting them at risk of malnutrition and making them more susceptible to severe childhood illnesses, stunted growth, developmental delays, and death. Volunteers like Mabeata are the critical link between communities and the life-saving prevention and treatment available at health facilities.
To prevent malnutrition, the IYCN Project is working to improve the links between health facilities and communities like Khopolo. IYCN provides infant and young child feeding training workshops for community health workers, emphasizing increased collaboration with health facilities. Since IYCN conducted a training workshop at the Litsoeneng Health Centre for Mabeata and 30 other community health workers—one for each village in the area—the clinic staff have seen an increase in referrals for growth-faltering from community health workers.
Adelina believes that community health workers are vital to improving the health of mothers and children served by the clinic. She says it’s not always easy to get families to the facility. They often prefer to go to traditional healers in their villages or they do not have time to walk—sometimes more than six miles to the clinic
“We cannot afford to go house to house. If we need to get information to the villages, the community health workers are there on our behalf,” Adelina said.
Mabeata has all of the qualities necessary to go door to door to teach mothers about good feeding practices. She is well respected, empathetic, and a responsible mother—that’s why everyone at a village council meeting pointed to her when the clinic needed a volunteer to promote good health in the village 19 years ago. Her advice goes a long way toward making sure children have a chance for a healthy life.
“Now I tell other moms about Tsepo’s story and how we helped him. I think it motivates them to improve feeding practices for their babies,” Mabeata said.
","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 Tanzania, Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 430,000 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.
Feed the Future Tanzania also aims to:
To help meet its objectives Feed the Future Tanzania is making core investments in four key areas:
CORE INVESTMENT AREA 1A: SYSTEMS TRANSFORMATION THROUGH AGRICULTURAL PRODUCTION AND PROCESSING
The first set of core investments contribute to IRs 1-3, 5, 6, 7, and 8. These core investments play a role in systems transformation, with a primary focus on rice and targeted interventions in maize and horticulture as secondary value chains. The main objective is inclusive agriculture sector growth, which will be accomplished through increased agricultural productivity, expanded markets and trade, increased private sector investment in agriculture- and nutrition-related activities, and increased agricultural value chain on- and off-farm jobs. Investment in these value chains will improve availability and access to staple foods and improve nutrition. USG investments will facilitate the competitiveness of smallholders in rice, maize and horticulture.
NAFAKA – Staples Value Chain Development (Rice and Maize)
Description: This program will facilitate the competitiveness of the smallholder-based rice value chain, and balance these impacts on growth with broader efforts to reduce poverty through investments aimed at improving the competitiveness and productivity of the maize value chain. This includes support to the Morogoro and Arusha-based Agricultural Research Station and National Seed Laboratory. Specific activities will:
Market-Based Solutions to Reduce Poverty and Improve Nutrition
The purpose of this project is to strengthen the capabilities of the agro-processors operating in the FTF targeted geographic areas for the staple grains of rice and maize and a range of horticultural products to build sustainable enterprises and expand and diversify the production and marketing of nutritious processed foods. This will include an array of support to processors of different scales of operations, farmers, public sector institutions involved in food technology and safety, agribusinesses, and traders.
Sustainable Horticulture for Income and Food Security in Tanzania (SHIFT)
This sustainable agriculture program aims to increase demand by expanding market opportunities for smallholder horticultural producers and processors in domestic, regional and international markets, and will work with farmers to build supply by introducing sustainable agricultural practices, increasing productivity, and reducing postharvest losses. Activities will include farmer association capacity building, nutrition education, and developing market hubs. The geographic focus is in the southern regions, and falls within the SAGCOT.
Tanzania Agriculture Productivity Program (TAPP)
This program aims to increase smallholder farmer incomes through enhanced productivity and improved domestic and export marketing of agricultural products. This program provides business services to farmers and associations in six target zones in the northern regions (Arusha, Moshi/Hai, Lushoto, Morogoro, Coast and Zanzibar). The activities include management training, marketing tools, business lobbying skills, and technical assistance for developing and marketing policy reforms. In implementing these activities, the program focuses on strengthening producer associations and preparing them to graduate from TAPP support and sustain their activities. The program strengthens market linkages by expanding domestic and export market outgrower schemes.
NAFAKA – Staples Value Chain Development (Rice and Maize)
Market-Based Solutions to Reduce Poverty and Improve Nutrition
Sustainable Horticulture for Income and Food Security in Tanzania (SHIFT)
Tanzania Agriculture Productivity Program (TAPP)
Overview
A participatory approach, which calls for active participation of all stakeholders, will be used to monitor and evaluate (M&E) FTF Tanzania. The design of the M&E system will be based on the usefulness of the data and information which is collected and processed at the different levels and intervals of program implementation and operationalization. M&E for FTF will involve on-going monitoring of program activities in the participating districts, annual evaluations, annual review workshops, beneficiary assessments, mid-term review and terminal evaluation.
Evaluations will be carried out using an independent entity to assess annual program performance. In addition, FTF Tanzania will organize annual review workshops for the duration of the program to enable implementing partners to share information on program implementation performance. FTF will also draw lessons and experiences from these workshops that can be taken into account when planning activities for subsequent years of implementation.
A matrix for the selected FTF indicators is attached as Annex A. FTF Tanzania has received assistance from USAID‘s Bureau for Food Security to provide M&E technical assistance. A preliminary M&E plan has been developed for FTF Tanzania which will be completed in September 2011 once the FTF M&E implementing partner, The Mitchell Group (TMG), has arrived in Tanzania and is fully operational.
Performance Evaluations
Performance evaluations will be carried out for selected FTF Tanzania projects to ascertain the trends in achieving project results of the FTF interventions, to document the overall progress toward objectives, and to assess what is working and what is not and why. One evaluation will be done in project year one (PY 1), another in PY 3 and the last one in PY 5. A mid-term review is planned for the end of PY 2 to assess overall progress and impact of FTF implementation, to provide for corrective actions to enhance performance of FTF, and to provide recommendations for future program designs. These recommendations will be confirmed in the terminal evaluation to be carried out in PY 5.
Qualitative and participatory methods will be utilized for the performance evaluations. Evaluators will utilize methods such as observation, focus groups, key informant interviews, stakeholder interviews and rapid survey techniques to assess progress. These techniques often provide critical insights into beneficiaries‘ perspectives on the value of programs to them, the processes that may have affected outcomes, and a deeper interpretation of results observed. Specific targets for the indicators at the outcome and output levels will be developed once FTF Tanzania has carried out the baseline survey in the FTF target areas along with the preparation of Performance Monitoring Plans.
Impact Evaluation
In addition to performance evaluations, FTF Tanzania will design an impact evaluation to test a selected development hypothesis for FTF. Ideally the impact evaluation will utilize Experimental Methodology to design and conduct the impact evaluation. This methodology will incorporate a rigorously defined counterfactual and will utilize experimental design to test the development hypothesis. At a minimum, quasi-experimental methods will be utilized to test the selected hypothesis and to determine the attribution of FTF project impacts. The Impact Evaluation will be carried out under the guidance of TMG.
Program Monitoring
All programs receiving resources under FTF Tanzania will be expected to use rigorous M&E systems that will feed into the broader FTF and GOT M&E frameworks. To the extent possible, examples of participatory methodologies built into program implementation to engage program beneficiaries in knowledge sharing, learning, and potential behavior change opportunities will be encouraged. In addition to the standard reporting requirements, the M&E program will develop and undertake baseline and other survey/assessment work (e.g. household, facility, market) to contribute to the larger M&E framework under FTF. Selected programs will designate a full-time M&E Specialist to appropriately monitor progress and engage in reporting systems for FTF as they are developed. These M&E Specialists will work to ensure that program results are jointly monitored with the ASDP and contribute to their reporting systems. The M&E Specialists will participate in annual meetings that include all implementing partners for FTF Tanzania, the FTF working group, and GOT representatives from relevant ministries.
Baselines
Baseline surveys will be required for several of the indicators listed in the annex. During 2011, a comprehensive baseline survey will be carried out by the Tanzania National Bureau of Statistics under the guidance of TMG. This baseline data will assist FTF Tanzania to set targets, monitor progress toward those targets and to initiate mid-course corrections for its programs and activities. The baseline will inform FTF Tanzania with data to determine whether or not selected activities are likely to achieve their targets.
Links to Government Monitoring Systems
The GOT will conduct rigorous M&E of their CAADP plan and supporting strategies such as the ASDP. To the extent possible, the FTF M&E framework is intended to utilize information that GOT already collects, especially at the national level. The M&E program will provide direct support to the GOT‘s National Bureau of Statistics. FTF investments in M&E will also be linked with the GOT monitoring mechanisms to build host country capacity and ability to analyze and report on results. A monitoring conceptual framework will set the stage for ensuring progress against targets, provide opportunities for learning, and employ participatory methods. Monitoring activities will support GOT analytical capacity building.
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 Tanzania, Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 430,000 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.
Feed the Future Tanzania also aims to:
To help meet its objectives Feed the Future Tanzania is making core investments in four key areas:
CORE INVESTMENT AREA 2: IMPROVING NUTRITION
Contributes to IR 4: Increased resilience of vulnerable communities and households, IR 5: Improved access to diverse and quality foods, IR 6: Improved nutrition-related behaviors and IR 7: Improved utilization of maternal and child health and nutrition services.
The second set of core investments will focus on scaling up the delivery of a comprehensive package of nutrition interventions in regions of the country with the highest rates of chronic undernutrition among children under five (also referred to as stunting) and maternal anemia. It will also focus on raising the problem of undernutrition as a key development challenge and policy issue for Tanzania to address in order to meet the objectives set forth in the CAADP and the MKUKUTA II/ MKUZA II.
Another key priority area for nutrition under FTF Tanzania will be to maximize opportunities for ―smart integration‖ with other USG investments under the Global Health Initiative. This will mean strengthening and building nutrition components into new and existing safety net, maternal and child health, HIV/AIDS, malaria and water/sanitation/hygiene programs in order to maximize synergies and leverages additional nutrition results in programs that may or may not have nutrition of children or pregnant women as a main focus of their work.
Flagship Nutrition Program
The USG has developed a new program under FTF and the Global Health Initiative designed to reduce rates of chronic undernutrition (stunting) among children under-five and maternal anemia among women of reproductive age. The program will cover the following:
Overview
A participatory approach, which calls for active participation of all stakeholders, will be used to monitor and evaluate (M&E) FTF Tanzania. The design of the M&E system will be based on the usefulness of the data and information which is collected and processed at the different levels and intervals of program implementation and operationalization. M&E for FTF will involve on-going monitoring of program activities in the participating districts, annual evaluations, annual review workshops, beneficiary assessments, mid-term review and terminal evaluation.
Evaluations will be carried out using an independent entity to assess annual program performance. In addition, FTF Tanzania will organize annual review workshops for the duration of the program to enable implementing partners to share information on program implementation performance. FTF will also draw lessons and experiences from these workshops that can be taken into account when planning activities for subsequent years of implementation.
A matrix for the selected FTF indicators is attached as Annex A. FTF Tanzania has received assistance from USAID‘s Bureau for Food Security to provide M&E technical assistance. A preliminary M&E plan has been developed for FTF Tanzania which will be completed in September 2011 once the FTF M&E implementing partner, The Mitchell Group (TMG), has arrived in Tanzania and is fully operational.
Performance Evaluations
Performance evaluations will be carried out for selected FTF Tanzania projects to ascertain the trends in achieving project results of the FTF interventions, to document the overall progress toward objectives, and to assess what is working and what is not and why. One evaluation will be done in project year one (PY 1), another in PY 3 and the last one in PY 5. A mid-term review is planned for the end of PY 2 to assess overall progress and impact of FTF implementation, to provide for corrective actions to enhance performance of FTF, and to provide recommendations for future program designs. These recommendations will be confirmed in the terminal evaluation to be carried out in PY 5.
Qualitative and participatory methods will be utilized for the performance evaluations. Evaluators will utilize methods such as observation, focus groups, key informant interviews, stakeholder interviews and rapid survey techniques to assess progress. These techniques often provide critical insights into beneficiaries‘ perspectives on the value of programs to them, the processes that may have affected outcomes, and a deeper interpretation of results observed. Specific targets for the indicators at the outcome and output levels will be developed once FTF Tanzania has carried out the baseline survey in the FTF target areas along with the preparation of Performance Monitoring Plans.
Impact Evaluation
In addition to performance evaluations, FTF Tanzania will design an impact evaluation to test a selected development hypothesis for FTF. Ideally the impact evaluation will utilize Experimental Methodology to design and conduct the impact evaluation. This methodology will incorporate a rigorously defined counterfactual and will utilize experimental design to test the development hypothesis. At a minimum, quasi-experimental methods will be utilized to test the selected hypothesis and to determine the attribution of FTF project impacts. The Impact Evaluation will be carried out under the guidance of TMG.
Program Monitoring
All programs receiving resources under FTF Tanzania will be expected to use rigorous M&E systems that will feed into the broader FTF and GOT M&E frameworks. To the extent possible, examples of participatory methodologies built into program implementation to engage program beneficiaries in knowledge sharing, learning, and potential behavior change opportunities will be encouraged. In addition to the standard reporting requirements, the M&E program will develop and undertake baseline and other survey/assessment work (e.g. household, facility, market) to contribute to the larger M&E framework under FTF. Selected programs will designate a full-time M&E Specialist to appropriately monitor progress and engage in reporting systems for FTF as they are developed. These M&E Specialists will work to ensure that program results are jointly monitored with the ASDP and contribute to their reporting systems. The M&E Specialists will participate in annual meetings that include all implementing partners for FTF Tanzania, the FTF working group, and GOT representatives from relevant ministries.
Baselines
Baseline surveys will be required for several of the indicators listed in the annex. During 2011, a comprehensive baseline survey will be carried out by the Tanzania National Bureau of Statistics under the guidance of TMG. This baseline data will assist FTF Tanzania to set targets, monitor progress toward those targets and to initiate mid-course corrections for its programs and activities. The baseline will inform FTF Tanzania with data to determine whether or not selected activities are likely to achieve their targets.
Links to Government Monitoring Systems
The GOT will conduct rigorous M&E of their CAADP plan and supporting strategies such as the ASDP. To the extent possible, the FTF M&E framework is intended to utilize information that GOT already collects, especially at the national level. The M&E program will provide direct support to the GOT‘s National Bureau of Statistics. FTF investments in M&E will also be linked with the GOT monitoring mechanisms to build host country capacity and ability to analyze and report on results. A monitoring conceptual framework will set the stage for ensuring progress against targets, provide opportunities for learning, and employ participatory methods. Monitoring activities will support GOT analytical capacity building.
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 Tanzania, Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 430,000 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.
Feed the Future Tanzania also aims to:
To help meet its objectives Feed the Future Tanzania is making core investments in four key areas:
Overview
A participatory approach, which calls for active participation of all stakeholders, will be used to monitor and evaluate (M&E) FTF Tanzania. The design of the M&E system will be based on the usefulness of the data and information which is collected and processed at the different levels and intervals of program implementation and operationalization. M&E for FTF will involve on-going monitoring of program activities in the participating districts, annual evaluations, annual review workshops, beneficiary assessments, mid-term review and terminal evaluation.
Evaluations will be carried out using an independent entity to assess annual program performance. In addition, FTF Tanzania will organize annual review workshops for the duration of the program to enable implementing partners to share information on program implementation performance. FTF will also draw lessons and experiences from these workshops that can be taken into account when planning activities for subsequent years of implementation.
A matrix for the selected FTF indicators is attached as Annex A. FTF Tanzania has received assistance from USAID‘s Bureau for Food Security to provide M&E technical assistance. A preliminary M&E plan has been developed for FTF Tanzania which will be completed in September 2011 once the FTF M&E implementing partner, The Mitchell Group (TMG), has arrived in Tanzania and is fully operational.
Performance Evaluations
Performance evaluations will be carried out for selected FTF Tanzania projects to ascertain the trends in achieving project results of the FTF interventions, to document the overall progress toward objectives, and to assess what is working and what is not and why. One evaluation will be done in project year one (PY 1), another in PY 3 and the last one in PY 5. A mid-term review is planned for the end of PY 2 to assess overall progress and impact of FTF implementation, to provide for corrective actions to enhance performance of FTF, and to provide recommendations for future program designs. These recommendations will be confirmed in the terminal evaluation to be carried out in PY 5.
Qualitative and participatory methods will be utilized for the performance evaluations. Evaluators will utilize methods such as observation, focus groups, key informant interviews, stakeholder interviews and rapid survey techniques to assess progress. These techniques often provide critical insights into beneficiaries‘ perspectives on the value of programs to them, the processes that may have affected outcomes, and a deeper interpretation of results observed. Specific targets for the indicators at the outcome and output levels will be developed once FTF Tanzania has carried out the baseline survey in the FTF target areas along with the preparation of Performance Monitoring Plans.
Impact Evaluation
In addition to performance evaluations, FTF Tanzania will design an impact evaluation to test a selected development hypothesis for FTF. Ideally the impact evaluation will utilize Experimental Methodology to design and conduct the impact evaluation. This methodology will incorporate a rigorously defined counterfactual and will utilize experimental design to test the development hypothesis. At a minimum, quasi-experimental methods will be utilized to test the selected hypothesis and to determine the attribution of FTF project impacts. The Impact Evaluation will be carried out under the guidance of TMG.
Program Monitoring
All programs receiving resources under FTF Tanzania will be expected to use rigorous M&E systems that will feed into the broader FTF and GOT M&E frameworks. To the extent possible, examples of participatory methodologies built into program implementation to engage program beneficiaries in knowledge sharing, learning, and potential behavior change opportunities will be encouraged. In addition to the standard reporting requirements, the M&E program will develop and undertake baseline and other survey/assessment work (e.g. household, facility, market) to contribute to the larger M&E framework under FTF. Selected programs will designate a full-time M&E Specialist to appropriately monitor progress and engage in reporting systems for FTF as they are developed. These M&E Specialists will work to ensure that program results are jointly monitored with the ASDP and contribute to their reporting systems. The M&E Specialists will participate in annual meetings that include all implementing partners for FTF Tanzania, the FTF working group, and GOT representatives from relevant ministries.
Baselines
Baseline surveys will be required for several of the indicators listed in the annex. During 2011, a comprehensive baseline survey will be carried out by the Tanzania National Bureau of Statistics under the guidance of TMG. This baseline data will assist FTF Tanzania to set targets, monitor progress toward those targets and to initiate mid-course corrections for its programs and activities. The baseline will inform FTF Tanzania with data to determine whether or not selected activities are likely to achieve their targets.
Links to Government Monitoring Systems
The GOT will conduct rigorous M&E of their CAADP plan and supporting strategies such as the ASDP. To the extent possible, the FTF M&E framework is intended to utilize information that GOT already collects, especially at the national level. The M&E program will provide direct support to the GOT‘s National Bureau of Statistics. FTF investments in M&E will also be linked with the GOT monitoring mechanisms to build host country capacity and ability to analyze and report on results. A monitoring conceptual framework will set the stage for ensuring progress against targets, provide opportunities for learning, and employ participatory methods. Monitoring activities will support GOT analytical capacity building.
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 Tanzania, Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 430,000 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.
Feed the Future Tanzania also aims to:
To help meet its objectives Feed the Future Tanzania is making core investments in four key areas:
CORE INVESTMENT AREA 3: CAPACITY BUILDING AND SUPPORT SERVICES
Contributes to IR 1: Improved agricultural productivity, IR 2: Expanding markets and trade, IR 3: Increased private investment in agriculture- and nutrition-related activities, IR 4: Increased resilience of vulnerable communities and households, IR 5: Improved access to diverse and quality foods, IR 6: Improved nutrition-related behaviors, IR 7: Improved utilization of maternal and child health and nutrition services, and IR 8: Improved enabling policy environment for both agriculture and nutrition.
Tanzania‘s food security and overall agricultural performance into the medium-term will be predicated upon the CAADP process and the accompanying Country Investment Plan (CIP). FTF investments will help support the drafting of the CAADP investment plan and also assist with its successful implementation in collaboration with all partners. FTF Tanzania will invest in building government capacity for policy-making, analysis, and interpretation and delivering on Tanzania‘s CAADP investment plan.
The investments will support host-country leadership and strategy planning to develop sustainability through a new generation of leadership. The USG will provide short- and long-term high-level policymaking support to GOT to develop and deliver on a robust, comprehensive CAADP investment plan and to build a formal mechanism for public-private sector dialogue. Investments will increase the capacity of Tanzanians to act as change agents for transforming the sector.
In addition, FTF will invest in research and development to build Tanzania‘s capacity to respond to challenges through innovations. FTF supports collaborative research to enhance Tanzania‘s ability to improve productivity, especially in light of climate change impacts and other constraints, both agronomic and economic.
Finally, one of the important parts of strengthening the capacity of Tanzanian agriculture is through supporting market-based financial services, including through a variety of loan programs. FTF Tanzania is utilizing innovative methods to increasing rural financing opportunities, especially through microfinance.
FTF staff and partners involved in this component will ensure that gender equitable policies are included in the TAFSIP and in its implementation, that women participate in leadership and training programs, and that women are involved in program activities with Sokoine University of Agriculture and the National Agricultural Research System.
Sokoine University of Agriculture Capacity Building
This program will expand and improve the quality of training in agricultural fields and research in support of FTF Tanzania. By supporting Sokoine University of Agriculture through a direct mechanism, FTF Tanzania will build the capacity of this Tanzanian institution to respond to agricultural issues.
This program will strengthen the training and research capacities of Sokoine University of Agriculture and the Tanzanian National Agricultural Research System. The program will support collaborative research, foster leadership in training and research through long-term training in agriculture, strengthen the capacity of Sokoine University of Agriculture, and promote tripartite Sokoine University if Agriculture - U.S. University - South-South University Cooperation.
","Overview
A participatory approach, which calls for active participation of all stakeholders, will be used to monitor and evaluate (M&E) FTF Tanzania. The design of the M&E system will be based on the usefulness of the data and information which is collected and processed at the different levels and intervals of program implementation and operationalization. M&E for FTF will involve on-going monitoring of program activities in the participating districts, annual evaluations, annual review workshops, beneficiary assessments, mid-term review and terminal evaluation.
Evaluations will be carried out using an independent entity to assess annual program performance. In addition, FTF Tanzania will organize annual review workshops for the duration of the program to enable implementing partners to share information on program implementation performance. FTF will also draw lessons and experiences from these workshops that can be taken into account when planning activities for subsequent years of implementation.
A matrix for the selected FTF indicators is attached as Annex A. FTF Tanzania has received assistance from USAID‘s Bureau for Food Security to provide M&E technical assistance. A preliminary M&E plan has been developed for FTF Tanzania which will be completed in September 2011 once the FTF M&E implementing partner, The Mitchell Group (TMG), has arrived in Tanzania and is fully operational.
Performance Evaluations
Performance evaluations will be carried out for selected FTF Tanzania projects to ascertain the trends in achieving project results of the FTF interventions, to document the overall progress toward objectives, and to assess what is working and what is not and why. One evaluation will be done in project year one (PY 1), another in PY 3 and the last one in PY 5. A mid-term review is planned for the end of PY 2 to assess overall progress and impact of FTF implementation, to provide for corrective actions to enhance performance of FTF, and to provide recommendations for future program designs. These recommendations will be confirmed in the terminal evaluation to be carried out in PY 5.
Qualitative and participatory methods will be utilized for the performance evaluations. Evaluators will utilize methods such as observation, focus groups, key informant interviews, stakeholder interviews and rapid survey techniques to assess progress. These techniques often provide critical insights into beneficiaries‘ perspectives on the value of programs to them, the processes that may have affected outcomes, and a deeper interpretation of results observed. Specific targets for the indicators at the outcome and output levels will be developed once FTF Tanzania has carried out the baseline survey in the FTF target areas along with the preparation of Performance Monitoring Plans.
Impact Evaluation
In addition to performance evaluations, FTF Tanzania will design an impact evaluation to test a selected development hypothesis for FTF. Ideally the impact evaluation will utilize Experimental Methodology to design and conduct the impact evaluation. This methodology will incorporate a rigorously defined counterfactual and will utilize experimental design to test the development hypothesis. At a minimum, quasi-experimental methods will be utilized to test the selected hypothesis and to determine the attribution of FTF project impacts. The Impact Evaluation will be carried out under the guidance of TMG.
Program Monitoring
All programs receiving resources under FTF Tanzania will be expected to use rigorous M&E systems that will feed into the broader FTF and GOT M&E frameworks. To the extent possible, examples of participatory methodologies built into program implementation to engage program beneficiaries in knowledge sharing, learning, and potential behavior change opportunities will be encouraged. In addition to the standard reporting requirements, the M&E program will develop and undertake baseline and other survey/assessment work (e.g. household, facility, market) to contribute to the larger M&E framework under FTF. Selected programs will designate a full-time M&E Specialist to appropriately monitor progress and engage in reporting systems for FTF as they are developed. These M&E Specialists will work to ensure that program results are jointly monitored with the ASDP and contribute to their reporting systems. The M&E Specialists will participate in annual meetings that include all implementing partners for FTF Tanzania, the FTF working group, and GOT representatives from relevant ministries.
Baselines
Baseline surveys will be required for several of the indicators listed in the annex. During 2011, a comprehensive baseline survey will be carried out by the Tanzania National Bureau of Statistics under the guidance of TMG. This baseline data will assist FTF Tanzania to set targets, monitor progress toward those targets and to initiate mid-course corrections for its programs and activities. The baseline will inform FTF Tanzania with data to determine whether or not selected activities are likely to achieve their targets.
Links to Government Monitoring Systems
The GOT will conduct rigorous M&E of their CAADP plan and supporting strategies such as the ASDP. To the extent possible, the FTF M&E framework is intended to utilize information that GOT already collects, especially at the national level. The M&E program will provide direct support to the GOT‘s National Bureau of Statistics. FTF investments in M&E will also be linked with the GOT monitoring mechanisms to build host country capacity and ability to analyze and report on results. A monitoring conceptual framework will set the stage for ensuring progress against targets, provide opportunities for learning, and employ participatory methods. Monitoring activities will support GOT analytical capacity building.
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 Tanzania, Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 430,000 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.
Feed the Future Tanzania also aims to:
To help meet its objectives Feed the Future Tanzania is making core investments in four key areas:
CORE INVESTMENT AREA 4: ENABLING POLICY ENVIRONMENT
Contributes to IR 8: Improved enabling policy environment and good governance for both agriculture and nutrition
FTF Tanzania will support policy reform and address major agricultural policy and governance issues by building the capacity of the government and private sector to conduct analyses and take action to identify and address the binding constraints to agricultural development. The USG will promote policies that provide an enabling environment for private sector investment in agriculture, create more certain and consistent trade policies, develop and assist in the implementation of more gender equitable policies and focus on policies that enable the implementation of key nutritional interventions. These will include policies and legal issues related to agricultural inputs, credit, markets, and land and trade policy. In order for any of the investments in food security to have the intended impact, a supportive policy environment is foundational.
Tanzania has overarching policy challenges that can seriously impact its performance with food security and its possible role as a regional provider into the future. The recent AgCLIR assessment for Tanzania identified several key policy issues that currently inhibit transformational agricultural growth, including: policy instability, multiplicity of local taxes, and a weak legal framework to protect property rights.
FTF will actively work to develop the GOT‘s capacity to analyze and implement policy instruments that address both short and long-term food security needs. Possible interventions include:
To ensure that policies that cause market distortion are avoided, FTF will create a robust monitoring system for policy reforms and will promote mutual accountability based on a consultative process rather than imposing conditionality.
One of the main challenges to promoting good governance in Tanzania is access to information by the public and by pressure groups, which is necessary for holding the government accountable in use of resources for provision of public services such as rural roads or extension. FTF will establish a communications strategy that will enhance access to information on food security and agriculture so as to foster public awareness on the program, and on state and private sector performance in the sector. The program will build upon the existing processes for ―Agricultural Sector Review‖ and ―Public Expenditure Review‖ which are held annually.
The participation of civil society, media and NGOs in shaping an agricultural development program is essential to ensuring that a program articulates the needs of the majority, including vulnerable segments of the population such as women and children. Civil society and NGOs can also assist in holding the government accountable for its performance. FTF Tanzania will support some local NGOs and civil society organizations to champion policy reforms. USG has started, and will continue, to engage civil society in the shaping of FTF, and encourage them to participate in the implementation process. The U.S. Government advocated for more engagement of civil society in the CAADP process, resulting in the engagement of the Agriculture Non-State Actors Forum (ANSAF) in the CAADP Task Force and the Drafting Team for TAFSIP. As the U.S. Government assumes the leadership of the donors‘ group for agriculture in July 2011, it will engage more NGOs and civil society organizations in the Agricultural Sector and Public Expenditure Reviews.
FTF Tanzania will advocate for policies that will address gender disparities in access to resources. For instance, the ―Secured Transactions Reforms‖ would create a legal framework to support the use of movable assets as collateral for accessing credit by small and medium enterprises. Such a system would enhance equitable access to credit, as the current system relies on the use of fixed assets such as land, and thereby often excludes women, who under traditional cultural practices have limited opportunity to land titling.
Enabling Policy Environment for Agricultural Sector Growth
The project‘s primary goal is to advance policy reform efforts in key areas identified as the critical barriers to transformation of the agriculture sector. The purpose of this project is to develop a policy partnership between government, private sector organizations, and research institutions to achieve key policy reforms in the agriculture sector and related business environment that will ensure successful implementation of the GOT‘s agriculture investment plan and FTF. The project will: strengthen the capacities of GOT institutions, the private sector, and other stakeholders for policy research and implementation of policy change that informs the CAADP process and FTF on constraints to growth; promotes dialogue among all stakeholders and partners; identifies and develops consensus on specific policies that need to be analyzed and changed; and monitors the implementation and impact of reforms intended to enable increased private investments in agriculture and trade.
Overview
A participatory approach, which calls for active participation of all stakeholders, will be used to monitor and evaluate (M&E) FTF Tanzania. The design of the M&E system will be based on the usefulness of the data and information which is collected and processed at the different levels and intervals of program implementation and operationalization. M&E for FTF will involve on-going monitoring of program activities in the participating districts, annual evaluations, annual review workshops, beneficiary assessments, mid-term review and terminal evaluation.
Evaluations will be carried out using an independent entity to assess annual program performance. In addition, FTF Tanzania will organize annual review workshops for the duration of the program to enable implementing partners to share information on program implementation performance. FTF will also draw lessons and experiences from these workshops that can be taken into account when planning activities for subsequent years of implementation.
A matrix for the selected FTF indicators is attached as Annex A. FTF Tanzania has received assistance from USAID‘s Bureau for Food Security to provide M&E technical assistance. A preliminary M&E plan has been developed for FTF Tanzania which will be completed in September 2011 once the FTF M&E implementing partner, The Mitchell Group (TMG), has arrived in Tanzania and is fully operational.
Performance Evaluations
Performance evaluations will be carried out for selected FTF Tanzania projects to ascertain the trends in achieving project results of the FTF interventions, to document the overall progress toward objectives, and to assess what is working and what is not and why. One evaluation will be done in project year one (PY 1), another in PY 3 and the last one in PY 5. A mid-term review is planned for the end of PY 2 to assess overall progress and impact of FTF implementation, to provide for corrective actions to enhance performance of FTF, and to provide recommendations for future program designs. These recommendations will be confirmed in the terminal evaluation to be carried out in PY 5.
Qualitative and participatory methods will be utilized for the performance evaluations. Evaluators will utilize methods such as observation, focus groups, key informant interviews, stakeholder interviews and rapid survey techniques to assess progress. These techniques often provide critical insights into beneficiaries‘ perspectives on the value of programs to them, the processes that may have affected outcomes, and a deeper interpretation of results observed. Specific targets for the indicators at the outcome and output levels will be developed once FTF Tanzania has carried out the baseline survey in the FTF target areas along with the preparation of Performance Monitoring Plans.
Impact Evaluation
In addition to performance evaluations, FTF Tanzania will design an impact evaluation to test a selected development hypothesis for FTF. Ideally the impact evaluation will utilize Experimental Methodology to design and conduct the impact evaluation. This methodology will incorporate a rigorously defined counterfactual and will utilize experimental design to test the development hypothesis. At a minimum, quasi-experimental methods will be utilized to test the selected hypothesis and to determine the attribution of FTF project impacts. The Impact Evaluation will be carried out under the guidance of TMG.
Program Monitoring
All programs receiving resources under FTF Tanzania will be expected to use rigorous M&E systems that will feed into the broader FTF and GOT M&E frameworks. To the extent possible, examples of participatory methodologies built into program implementation to engage program beneficiaries in knowledge sharing, learning, and potential behavior change opportunities will be encouraged. In addition to the standard reporting requirements, the M&E program will develop and undertake baseline and other survey/assessment work (e.g. household, facility, market) to contribute to the larger M&E framework under FTF. Selected programs will designate a full-time M&E Specialist to appropriately monitor progress and engage in reporting systems for FTF as they are developed. These M&E Specialists will work to ensure that program results are jointly monitored with the ASDP and contribute to their reporting systems. The M&E Specialists will participate in annual meetings that include all implementing partners for FTF Tanzania, the FTF working group, and GOT representatives from relevant ministries.
Baselines
Baseline surveys will be required for several of the indicators listed in the annex. During 2011, a comprehensive baseline survey will be carried out by the Tanzania National Bureau of Statistics under the guidance of TMG. This baseline data will assist FTF Tanzania to set targets, monitor progress toward those targets and to initiate mid-course corrections for its programs and activities. The baseline will inform FTF Tanzania with data to determine whether or not selected activities are likely to achieve their targets.
Links to Government Monitoring Systems
The GOT will conduct rigorous M&E of their CAADP plan and supporting strategies such as the ASDP. To the extent possible, the FTF M&E framework is intended to utilize information that GOT already collects, especially at the national level. The M&E program will provide direct support to the GOT‘s National Bureau of Statistics. FTF investments in M&E will also be linked with the GOT monitoring mechanisms to build host country capacity and ability to analyze and report on results. A monitoring conceptual framework will set the stage for ensuring progress against targets, provide opportunities for learning, and employ participatory methods. Monitoring activities will support GOT analytical capacity building.
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.
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