"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" "11464","Improving Maternal, Newborn and Child Nutrition in Northern Nigeria","English","Community/sub-national","","NGA","Nigeria","Kebbi, Nigeria|Katsina State, Nigeria|Jigawa State, Nigeria|Zamfara, Nigeria|Yobe, Nigeria","Rural|Peri-urban","on-going","01-2011","01-2017","
One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11461","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child|Stunted child","Children under 5 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. ","Primary health care center","","
","
One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11462","","Breastfeeding promotion and/or counselling","Infant and Young Child Feeding","","","Infants and young children|Lactating women (LW)","Infants and young children below 2 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe.","Community-based|Primary health care center","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "11464","Improving Maternal, Newborn and Child Nutrition in Northern Nigeria","English","Community/sub-national","","NGA","Nigeria","Kebbi, Nigeria|Katsina State, Nigeria|Jigawa State, Nigeria|Zamfara, Nigeria|Yobe, Nigeria","Rural|Peri-urban","on-going","01-2011","01-2017","One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11463","","Deworming","Micronutrients and Deworming","","","Preschool-age children (Pre-SAC)","Children under 5 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe.","Hospital/clinic|Primary health care center","","","
.
","
Impact, outcome and output indicators will be monitored throughout the lifetime of the programme. Data will be obtained through programme monitoring tools and through routine surveillance instruments such as the Demographic Health Survey. An independent impact evaluation will be embedded within delivery. This will assess the overall effectiveness, cost efficiency and equity of the programme.
","6.2 million children under five in northern Nigeria","6.2 million children under five in 5 states of northern Nigeria","","","","Vulnerable groups","","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" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","
A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","While Tanzania has achieved high vitamin A supplementation coverage over the past few years, there is concern that this achievement is fragile because of decentralization. A2Z is supporting national, zonal, regional, and district health teams to institutionalize twice-yearly distributions through ongoing advocacy and routine planning and budgeting. This activity is conducted in collaboration with the National Program for Extension of Tools and Strategies, the Tanzania Essential Health Interventions Project, Ifakara Health Research and Development Centre, the Tanzania Food and Nutrition Center (TFNC), and UNICEF. To foster sustainable vitamin A supplementation, the A2Z project is supporting behavior change communication through community workers and a popular radio serial. Based on information gathered on sustainability indicators by TFNC with support of A2Z and HKI, those districts that have not yet integrated funding for vitamin A supplementation in their plans are receiving additional technical support. Several resources developed in Tanzania are available to ensure program sustainability.
","Given the twice-yearly nature of the VAS program as well as its historic evolution from immunization campaigns, it is easy for district staff to see the program as separate from their regular day-to-day work. Considering the program to be part of the routine work for the district is critical for sustainability, and is reflected in both attitudes and the support provided to the program. Ninety-one (76%) of the 119 districts regarded implementation of the twice-yearly VAS and deworming program to be a routine activity. About 84% considered VAS and deworming a very important service, and 99% thought the service should continue. Although the majority of the districts viewed VAS/deworming as a routine activity, more than half (55%) had not yet included VAS/deworming services in their routine supervision checklist. Moreover, payment of allowances to staff for VAS/deworming while at their normal duty stations implies that these services were viewed as special rather than routine. The allowance scheme in particular, with an excessive number of supervisors at some distribution sites and inadequate supervision at other sites, may increase a district’s vulnerability to a decline in coverage. Overall, 11 districts (9%) were judged vulnerable with low sustainability related to supervision and monitoring
","Those districts that have not yet integrated funding for vitamin A supplementation ","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Others, please specify below","For an activity to be sustained, it must be considered part of the district’s regular activities, and thus must be included in the annual planning process.","Management","The VAS program requires clear management for effective and efficient implementation, and thoughtful management also reflects the value placed on the program. Poor management may make the program vulnerable, and less likely to be sustained in an effective fashion.","Supplies","The VAS program depends on effective logistics, and capsule and promotional materials must reach distribution sites on time and in adequate quantities for the program to be effective. Poor logistics supply management makes the program vulnerable. Adequate communication between programs and departments within district councils facilitated effective use of available resources in 117 (98%) of the districts assessed.","Financial resources","Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.","Insufficient staff","Twice yearly VAS distribution involves extended outreach to communities, and thus requires significant mobilization of both health staff and community volunteers. Failure to plan for adequate human resources is likely to place districts at risk of not sustaining their coverage achievements.","","","","","","","","","","","","Planning
Districts should be encouraged to budget for the program in their own CCHP budget including the basket fund which is considered the most reliable source of funds. Once basket funds are planned, they cannot be reallocated
Advocacy and community ownership
The program is more likely to continue effectively if it is understood and valued by community members who are involved with planning and implementation.
Management and Leadership
Efforts should be made to protect the current best practices in management and leadership reported in most of the districts.
Logistics Supply
Key actors at the national level need to ensure timely procurement and delivery of supplies to the districts
Supervision and Monitoring
Districts should determine the appropriate number of site supervisors to contain costs and include VAS/deworming in the routine supervision checklist to ensure that children missed during the twice-yearly events are reached through “mop up” actions.
Advocasy and Community Ownership
The successful efforts to date should continue to build community ownership of the program through well-designed, regular sensitization meetings and advocacy to engage the community, mobilize participation, and raise the profile of VAS/deworming events.
Availability of Financial Resources
Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.
Availability of Human Resources
Local councils and the central government need to fill staff positions and find secure mechanisms to ensure mobilization of adequate human resources to sustain service delivery.
Programme Effectiveness
Efforts should be made to maintain the high performance of the majority of districts and help the few low performing districts improve their coverage.
","","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","With advocacy from A2Z/HKI and other donors, the Government of Tanzania in December 2006 adopted a policy for the use of zinc for the treatment of diarrhea. A2Z/HKI provided technical support to the National IMCI coordinator to incorporate zinc therapy as part of diarrhea management and developed modified IMCI guidelines. Zinc treatment and low osmolarity solution oral rehydration salts (ORS) have been incorporated into the National Standard Therapeutic Guidelines. The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University. The formative research also tested the acceptability of zinc treatment for diarrhea among mothers and caretakers. The findings of the study are expected to be used to assist in the development of health worker training modules and behavior change communication materials for use by the Ministry of Health and Social Welfare and the community.
","Under-five mortality rate
","","","","","","","Vulnerable groups","","Zinc supplementation in the management of diarrhoea>>>Zinc supplementation in the management of diarrhoea>>http://www.who.int/elena/titles/zinc_diarrhoea","","","","","","","","","","","","","","","","","","","","","","The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University.
","","English"