"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" "6067","Integrated Nutrition Package","English","Community/sub-national","","LKA","Sri Lanka","Sri Lanka","Urban| Rural| Peri-urban","on-going","01-2009","01-2013","
a) Prevalence of low birth weight reduced by 4 percentage point from 2006 level; b) Prevalence of underweight among children under 3 years of age reduced by 30%; c) Mean weight gain during pregnancy increased by 30 per cent from basline data to be established in 2009; d) Nutritional anaemia among children 6 to 24 months reduced by 30 per cent; e) Nutritional anaemia among adolescent reduced by 30 per cent;
","www.mri.gov.lk/nutrition
","","","","","","","","","","","","","National NGOs","Sarvodaya","","","","","","","Mainly by the UNICEF and shared with the Government, Ministry of Health","UN","United Nations Children's Fund (UNICEF)","Every other week for 4 months - 1 sachet per time
","Percentage of children 6 to 24 months with nutritional anaemia
","Quarterly and bi-annual review meetings at the district, provincial and national levels; External reviews at the mid-point of the project implementation; Final evaluation: During this phase, data will be collected and compared with baseline information. The same data collection techniques and instruments will be followed as in the baseline. The same group of interviewers will be re-trained before data collection and their work will be supervised at community level.
","","30.00%","","25%","not completed
","Sex","","","Adherence","","Supplies","","Communication","","","","","","","","","","","","","","","","","Very good coverage of the programme with poor adherence continously. Mid term review did not show much improvement
","Sri Lanka is having mild anaemia with very less moderate and hardly any severe anaemia. MMN was tested globally in moderate to severe set up. This may be the reason we did not see much improvement compared to other countries.
","English" "6085","Weekly iron and folic acid supplementation (WIFS)/de-worming program","English","Community/sub-national","","VNM","Viet Nam","Yen Bai, Vietnam","Rural","on-going","01-2006","","Periodical deworming and weekly supplementation of iron was offered free of charge to more than 52 000 women in the province. The acceptance of the intervention and the nutritional outcomes were followed up. In March 2008 the programme was expanded to cover 250 000 and the management handed over to provincial authorities.
","Pasricha SR, et al. Baseline Iron Indices as Predictors of Hemoglobin Improvement in Anemic Vietnamese Women Receiving Weekly Iron-Folic Acid Supplementation and Deworming (2009). American Journal of Tropical Medicine and Hygiene 81;1114-9.
Phuc TQ, et al. Lessons learned from implementation of a demonstration program to reduce the burden of anemia and hookworm in women in Yen Bai Province, Viet Nam. (2009). BMC Public Health.; 9: 266.
Casey GJ, et al. Long-term weekly iron-folic acid and de-worming is associated with stabilised haemoglobin and increasing iron stores in non-pregnant women in Vietnam. (2010) PLoS ONE 5, e15691.
Casey GJ., et al. Weekly iron-folic acid supplementation with regular deworming is cost-effective in preventing anaemia in women of reproductive age in Vietnam PLoS ONE [in print]
","","","Health","Provincial Health Department","World Health Organization (WHO)","","","","","","","","","","Research/academia","University of Melbourne","","","","","80 000 USD/ year initially provided by the University of Melbourne, as a starting up (including training activities and development of education material) after the first years the Provincial Health Department covered the running cost. WHO donated the deworming drugs.","Research/academia","","University of Melbourne","Government","","Provincial Health Department","UN","World Health Organization (WHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6084","Acute malnutrition","Iron and folic acid supplementation","","Folic acid|Iron","","Women of reproductive age (WRA)","15-45 years","Yen Bai province","Primary health care center","","Weekly iron-folic acid tablets; 200mg ferrous sulphaet/0.4 mg folic acid
Deworming every 4 months with one albendazole tablet (400 mg) in the first year and 6-monthly thereafter
","Anemia prevalence
","Periodical prevalence surveys and compliance monitoring by the research and training centre for community development.
","52000 (In March 2008 the programme was expanded to cover 250 000 and the management handed over to provincial authorities.)","missing","","STH infection 75%","(after 30 months) STH infection 22%","Vulnerable groups","","Intermittent iron and folic acid supplementation for menstruating women>>>Intermittent iron and folic acid supplementation for menstruating women>>http://www.who.int/elena/titles/iron_women","Adherence","Independent monitoring started early to be able to modify training and packaging","Financial resources","No solution","","","","","","","","","","","","","","","","","","","In March 2008 the programme was expanded to cover 250 000 and the management handed over to provincial authorities.
","English" "6085","Weekly iron and folic acid supplementation (WIFS)/de-worming program","English","Community/sub-national","","VNM","Viet Nam","Yen Bai, Vietnam","Rural","on-going","01-2006","","Periodical deworming and weekly supplementation of iron was offered free of charge to more than 52 000 women in the province. The acceptance of the intervention and the nutritional outcomes were followed up. In March 2008 the programme was expanded to cover 250 000 and the management handed over to provincial authorities.
","Pasricha SR, et al. Baseline Iron Indices as Predictors of Hemoglobin Improvement in Anemic Vietnamese Women Receiving Weekly Iron-Folic Acid Supplementation and Deworming (2009). American Journal of Tropical Medicine and Hygiene 81;1114-9.
Phuc TQ, et al. Lessons learned from implementation of a demonstration program to reduce the burden of anemia and hookworm in women in Yen Bai Province, Viet Nam. (2009). BMC Public Health.; 9: 266.
Casey GJ, et al. Long-term weekly iron-folic acid and de-worming is associated with stabilised haemoglobin and increasing iron stores in non-pregnant women in Vietnam. (2010) PLoS ONE 5, e15691.
Casey GJ., et al. Weekly iron-folic acid supplementation with regular deworming is cost-effective in preventing anaemia in women of reproductive age in Vietnam PLoS ONE [in print]
","","","Health","Provincial Health Department","World Health Organization (WHO)","","","","","","","","","","Research/academia","University of Melbourne","","","","","80 000 USD/ year initially provided by the University of Melbourne, as a starting up (including training activities and development of education material) after the first years the Provincial Health Department covered the running cost. WHO donated the deworming drugs.","Research/academia","","University of Melbourne","Government","","Provincial Health Department","UN","World Health Organization (WHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8875","","Deworming","","","","Women of reproductive age (WRA)","15-45","Yen Bai ","Community-based","","","Hookworm prevalence
","","250000","missing","","","","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" "8900","Suplementaion de Micronutrientes Espolvoreados","English","National","","GTM","Guatemala","Guatemala","Urban|Rural|Peri-urban","planned","01-2012","","Programa de suplementacion con micronutrientes espolvoreados a los niños y niñas de 6 meses a menores de cinco años, con entrega semestral de 60 sobres de 1 gramo de micronutriente espolvoreado para agregar a la comida principal del niño o niña, consumo de un sobre al dia.
","","","Plan Hambre Cero 2012-2016","Health","Ministerio de Salud Publica y Asistencia Social/PROSAN y Direcciones de Areas de Salud","","","","","","","","","","","","","","","","","El costo por sobre de micronutriente es de Q0.29, lo que hace de Insumo al año por niño suplementado un costo de Q34.80. El programa incluye el costo por arrendamiento de Bodegas y logística o entrega del Insumo al puesto de atención, estos ultimos no se han estimado por ser el primer año de implementación a Nivel Nacional. El costo del Recurso Humano no se estima porque son los mismos proveedores de los servicios de salud del MSPAS.El programa se estimó una cobertura del 60% de la poblacion menor de cinco años.","Government","Finance","Ministerio de Finanzas Publicas","UN","United Nations Children's Fund (UNICEF)","UNICEF Guatemala","UN","United Nations Relief and Works Agency (UNRWA)","PMA Guatemala","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8899","","Multiple micronutrients supplementation","","Folic acid|Vitamin A|Iron|Zinc|Vitamin C","Sobre de un gramo con •Vitamina A como acetato -USP-FCC de 300 microgramos RE (Equivalente de Retinol).•Hierro 12.5 mg como Fumarato Ferroso encapsulado (Descote TH, Fumarato Ferroso 60% Ultra código de producto 94842, de Particle Dynamics USA), o como 12.5mg de Hierro Glicinoquelado.•Zinc como Gluconato de Zinc -USP-FCC de 10.0mg.•Vitamina C como Acido Ascórbico USP-FCC- 30mg.•Acido Fólico - USP-FCC 160microgramos. ","Infants and young children","Niños y niñas de 6 a 59 meses","Pais Guatemala","Primary health care center","","Entrega de 60 sobres cada seis meses por niño
","Total de niños niños/as menores de cinco años con segunda entrega de micronutrientes espolvoreados/ total de niños menores de cinco años
","Reporte Sistema de Informacion Gerencial en Salud -SIGSA- Formato VME
","1,265,023 niños y niñas","60%","Period","80% de cobertura de niños suplementados","Reduccion de Prevalencia de anemia
","Vulnerable groups","","","Others, please specify below","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Twice a year, at designated times, the three programs distribute capsules to children aged six months to five years. Each program follows a campaign model based upon intensified social mobilization and service delivery over two to seven days. The twice-yearly events have created a cadre of field-tested personnel in the three countries, who are skilled at working with the local communities and at promoting their support and active participation. All three programs have been associated with National Immunization Days (NIDs), a WHO global program to eradicate polio. Since NIDs were held annually, however, they provided an opportunity for only one dose of vitamin A each year. Because children with vitamin A deficiency should receive a supplement at least twice a year (every four to six months), another mechanism was needed for the second dose. Relying exclusively upon facility-based distribution to deliver the second dose was not a viable option for several reasons, but in particular because healthfacility attendance for older children was not high enough to ensure adequate coverage in the one-to-five-year age group.
In Zambia, the first non-NIDs vitamin A supplementation program was launched in August 1999, and later renamed Child Health Week (CHW) to make the focus on the child more explicit. It was also felt that, instead of limiting activities to a vertical vitamin A supplementation program, the opportunity should be seized to deliver an integrated service that included not only vitamin A capsules but also other health services such as de-worming, health education, immunization, family planning, prenatal care, and growth monitoring. Districts were encouraged to provide an integrated package of services commensurate with their local capacity and need — as long as vitamin A supplementation remained the core activity during that week. In Zambia, the first NIDs campaign took place in 1997, and was a nationwide undertaking. The program was scaled down to about half the districts in recent years. Since 1999, the focus has shifted to priority districts, where communities have been at a constant risk of cross-border polio infections due to civil-war-related migrations from neighboring countries. This narrower focus is referred to in Zambia as sub-NIDS.
The first round of vitamin A supplementation in Ghana was integrated into NIDs in 1996. By 1999, a detailed plan was developed to implement a nationwide stand-alone supplementation program for the second round. In 2000, the Ministry of Health (MOH) carried out the first vitamin A standalone capsule distribution in the country’s ten regions. Since that date, the program has become a two- to three-day stand-alone event used to deliver a second dose of vitamin A to all children 6 to 59 months of age. Volunteers from the Ghana Education Service, along with personnel from other decentralized departments, assist with the supervision and capsule-distribution effort. Community-based volunteers are in direct contact with caregivers and children and also work very closely with health workers, assemblymen, chiefs, opinion leaders, gong-gong beaters, and other community leaders to mobilize beneficiaries, administer vitamin A, and maintain distribution records.
In contrast to Zambia and Ghana, Nepal followed a phased approach to program implementation. Integration of vitamin A into NIDs in Nepal was initiated in 1997,
four years after a supplementation program was established in 8 of the country’s 75 districts. The second distribution campaign has since been phased in at a rate of eight to ten districts per year. By 2001, the program covered all but three politically unstable districts. Under the program, high-dose vitamin A capsules are distributed to all children aged 6 to 59 months during a twoday event.
","
Ghana
A monitoring team consisting of national, regional, and district supervisors carries out organized and random spot checks. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. Capsule-distribution teams use all means of transportation available within the region and district, whether these be 4x4 vehicles, 2x4 pickups, motorcycles, or bicycles. MOH, district assemblies, decentralized departments, and local and international NGOs provide fuel and contribute to vehicle maintenance. At the end of each day, tally sheets are counted and summary sheets completed. Data are compiled by sub-district and district health management teams. After all figures are checked for accuracy, district coverage is calculated. District coverage data are sent to the regional nutrition officers and senior medical officers of public health, who compile regional coverage figures before sending them to the Nutrition Unit in Accra. Using regional figures, the Nutrition Unit estimates national coverage.
Zambia
Monitoring teams consisting of national, provincial, and district staff carry out systematic or random observations, depending on what they are monitoring. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. At the end of each day, tally sheets are counted, summary sheets completed, and data compiled. District figures are then checked for accuracy, after which district coverage is calculated and the results forwarded to NFNC.
","Ghana: 3.5 million children ","Ghana: Exceeded target in May 2001; Zambia: 28 percent in 1999, 88 in Febraury 2002","","serum retinol levels of &lt;20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","serum retinol levels of <20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Insufficient staff","In Zambia and Ghana, it has been somewhat more difficult to generate a consistent cadre of volunteers for the vitamin A distribution. In each country, districts mobilize health post and sub-health post staff, identify extended outreach sites (including clinics, schools, and community centers),and then recruit community members to assist them with their activities. In Ghana, this has been relatively successful since there have been adequate clinic staff and a manageable number of outreach sites. In spite of this, many districts have continued to do some house-to-house visits to ensure high coverage. In Zambia, it has been more difficult to recruit community volunteers, and the clinic staff have been stretched to cover outreach sites.","","","","","","","","","","","","","","","","","","","","","Robin Houston (2003). Why They Work: An analysis of three successful public health interventions - Vitamin A supplementation programs in Ghana, Nepal, and Zambia
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Five data collection methods were used:
During the fieldwork, the enumerators worked in pairs. The enumerators were not allowed to use the instruments in the facilities where they worked. Each pair spent a full day at a health facility. Field supervisors supported the enumerators during the data collection and checked the questionnaires for consistency and completeness. This was to ensure that the data collected was accurate as possible.
","""""Many pregnant mothers do not come to ANC because they had several normal pregnancies and think all will continue to go on well always.”
- Health worker, Apac
“ The health worker at the health centre is very rude, she has no time for us; so we fear even asking questions or discussing any issue about our health. So I go all the way to Naguru health clinic and only here if I have no money for transport.”
- A pregnant woman, Kojja, Mukono
“ I think these tablets for blood should be given only to pregnant women who have no blood. It may cause a high blood level and lead to high blood pressure.”
- TBAs, Kyampisi
“ Women with increased blood should not take these tablets (iron and folic acids) because their heartbeats will increase and they will sweat very much.”
- TBAs, Seeta Nazigo
“ Some mothers say it smells and they throw away the tablets soon after the clinic.”
- Pregnant mothers, Kojja
“ Some mothers do not like taking tablets when they are pregnant.”
- Pregnant mothers, Seeta Nazigo
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Ethiopia
MOST is providing technical and implementation support to the Ministry of Health in the development of a national micronutrient program. The program is a cooperative effort between the MOH, USAID/Ethiopia, MOST, and UNICEF. Program components include strengthening of the newly formed nutrition division at the MOH and the micronutrient committee; development of a locally designed vitamin A supplementation strategy and its pilot test; support for initial trials of vitamin A sugar fortification in one of the country's four sugar factories; and support for information, education, and communication activities.
South Africa
MOST is working with counterparts at the University of the Western Cape (UWC) to support and strengthen a new vitamin A supplementation program being started by the Department of Health in Eastern Cape province. MOST is also supporting a pilot initiative by UWC that aims to incorporate micronutrient interventions into the Eastern Cape Integrated Nutrition Program.
.
","","","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Government agencies encouraged the initial development of fortification: NFNC promoted initial research, sponsored meetings, and coordinated activities related to fortification; MOH researched the legal framework; the National Institute for Scientific and Industrial Research (NISIR) provided technical guidance; the Food and Drug Control Laboratory (FDCL) conducted monitoring and evaluation; and the Zambian Revenue Authority (ZRA) examined the tax structure. Industry acceptance allowed planning to begin, but donor support was critical to the development of the program: the U.S. Agency for International Development (USAID) was the lead financer of the project and provided technical assistance, UNICEF provided spare parts, and the Japanese International Cooperation Agency (JICA) provided spectrophotometers for Zambia Sugar and the FDCL.
While legislation was still being developed, Zambia Sugar went ahead with the launch of fortified Whitespoon Sugar on May 15, 1998. Zambia Sugar began its fortification program at 15 mg/kg, but cost considerations led the company to reduce the level to 10 mg/kg within three months. In May 1997, one year before fortification began, a consultant estimated the cost of fortifying 100,000 metric tons of sugar at 16 mg/kg to be around $1 million U.S., while fortifying at 20 mg/kg would cost almost $1.25 million.24 Reducing the level from 16 to 10 mg/kg could thus have reduced costs by approximately $375,000 a year.
","Modified Relative Dose Response Test (MRDR) in children
","The first outside tests of fortificant levels in sugar were controversial. Four months after the launch of fortified sugar, a team consisting of representatives from the MOH, the NFNC, and NISIR visited the Zambia Sugar mill. The team tested samples from the mill at the FDCL; these tests showed far lower levels of vitamin A than those shown in tests by Zambia Sugar. The government’s tests indicated a range of 0–13.6 mg/kg, while Zambia Sugar’s tests indicated a range of 9–21 mg/kg for the same samples. Zambia Sugar believes that the samples suffered sedimentation in the transport to the government laboratory and that this explains the different results.
MOST, the USAID micronutrient program, sponsored the creation of training manuals for health inspectors and Food and Drug enforcement officers, as well as a national training workshop from September 24 to October 7, 2000. The workshop focused on inspection procedures and methods, provided laboratory training where appropriate, and included a trip to the Zambia Sugar plant. Since the implementation of that program, Zambia Sugar has expressed satisfaction with law enforcement efforts. UNICEF subsequently funded workshops at the district level, using reproductions of the training manuals that had been produced with MOST funding.
","nationwide","..","","","","Vulnerable groups","","","Financial resources","","Communication","","Financial resources","","Adherence","","","","","","","","","","","","","","","","","English" "11536","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","TZA","United Republic of Tanzania"," Tanzania |Morogoro, Tanzania|Zanzibar, Tanzania|Dodoma, Tanzania|Manyara, Tanzania|Arusha, Tanzania|Kilimanjaro, Tanzania|Tanga, Tanzania|Coast, Tanzania|Dodoma, Tanzani|Iringa, Tanzania|Mbeya, Tanzani","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in 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.
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 Zambia, Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Zambia is making core investments in four key areas:
1. Oilseeds, legumes, maize and horticulture value chains
2. Enabling Environment
3. Economic Resilience
4. Nutrition
Target Regions
Feed the Future is focusing its efforts in two areas: the Eastern Province, with a value chain focus on oilseeds, legumes and maize; and selected peri-urban districts near Lusaka, connecting to Eastern Province, with a particular focus on horticulture.
Highlights
Comprehensive Africa Agriculture Development Programme (CAADP) process. Zambia’s CAADP Compact was signed in January 2011, and development of the Zambia CAADP Country Investment Plan has begun. Through this Compact the Government of the Republic of Zambia is committed to the following:
Diversification of staple crop production. Diversification of selected staple value chains will:
Gender. The Zambia strategy strives to maximize the positive impact on female farmers and ensure equitable benefits for men and women by:
CORE INVESTMENT AREA 1: DIVERSIFICATION OF PRODUCTION AND INCOME – UPGRADE VALUE CHAINS
The first set of core investments in the Zambia FTF strategy contributes to systems transformation, with a primary focus on oilseeds and legumes and targeted interventions in the maize value chain, and a secondary focus on horticulture.
Feed the Future Value Chain Investments
USAID/Zambia will have several programs that contribute significantly to upgrading the oilseeds, legumes and maize value chains. This will be accomplished through several planned mechanisms, including: 1) the Production, Finance and Improved Technology Plus program, which is designed to increase food security and decrease hunger through agriculture-led growth and inclusive market access by smallholder farmers; and 2) public-private partnerships including Global Development Alliances (GDAs) to leverage private sector activity and promote market sustainability through private sector models. These efforts will stimulate agricultural growth and significantly contribute to the Millennium Development Goal 1 of halving the proportion of people living in extreme poverty and suffering from hunger by 2015. The programs will build on previous USAID-funded activities by closely linking efforts to enhance input supply with output markets, promoting value-added rural enterprises linked to selected value chains, and ensuring that women fully benefit from value chain development. One of the challenges of the previous program, given its focus on private sector sustainability, was to ensure female participation. Lessons learned from the successful Production, Finance and Improved Technologies (PROFIT) program, which closes in 2011, will be incorporated into new programs.
Programs will focus specifically on maize and oilseed/legume (particularly, groundnut, soya and sunflower) value chains in Eastern province and horticulture value chains in peri-urban Lusaka. Through this geographic focus, USAID-funded FTF activities will reach up to 25 percent of Zambian men and women smallholder farmers. Maize value chain work will focus on increasing productivity in order to meet food security. Smallholders will be benefit from an integrated approach that provides for maize food security and enables smallholders to diversify into commercial crops.
Illustrative Examples of Value Chain Activities
In-depth analysis of selected value chains. The program will conduct in-depth economic value chain analysis including market (both domestic and export) assessments, competition/profitability analyses, gender analyses, and strategies for Zambian value chains to improve competitiveness in light of market opportunities and constraints.
Value chain finance. Both the demand and supply side of value chain finance will be addressed to increase the competitiveness of selected value chains. Options to increase access to production and processing credit may include insurance, operating leases and expansion of e-banking. Activities to expand access to credit and financial services to both men and women will be assessed and implemented through a variety of mechanisms, partners and tools, including intermediary businesses, credit guarantees, microfinance and commercial banking products oriented to benefit smallholder farmers.
Provide local trade information and services. Local provider(s) of trade information and services will be supported to aid producers’ entry into local, regional and international markets, including sanitary and phytosanitary protocols, import requirements, customs and borders procedures, and contact points. The program will take extra effort to ensure equal access to information for women. The Zambia Agricultural Commodity Exchange (ZAMACE) will require support that will be gradually phased out, with the goal of achieving sustainability through self-sufficient funding of operations within three years.
Target regional export markets. The program will develop a strategy for targeting profitable export markets for Zambian products initially in the maize, legume and horticulture sectors. USAID/Zambia’s experience thus far has shown that in many cases regional markets provide more opportunities for exporters (particularly smallholders) than more distant international markets. Efforts will be made to ensure both men and women producers can access export markets.
Promote rural enterprise and cooperative development, particularly in value-added processing of selected value chains. Activities will also address marketing constraints faced by smallholder farmers, in particular women. The project will identify key agents that can create rural employment and opportunities for value addition, including cooperatives, traders, processors and agribusinesses that warehouse commodities. Governance, operations and capacity of Zambian organizations and firms that link farmers to value-added markets, including animal feed, high protein products, cooking oil and canned vegetables, will be strengthened. In particular, women-based producer and marketing associations will be organized around selected value chains.
",".
","USAID/Zambia will monitor and evaluate programs and activities throughout the strategy period to ensure that those investments are achieving objectives and maximizing returns to investments. Though many of the investments will be managed and monitored primarily by USAID, some investments will originate from other USG agencies and by government, donors, or the private sector. The Zambia CAADP Country Investment Plan will provide a framework for the development of a more comprehensive national effort in agriculture and poverty reduction that will be supported through the USG FTF effort. CAADP monitoring is addressed below. The M&E framework for the USG FTF strategy outlined in this section will be inclusive and involve all government agencies investing in FTF areas, particularly in the FTF priority geographic area, Eastern province.
The geographic focus, co-location of investments, and the timing of the initiation of new investments provide the opportunity to establish a solid impact assessment framework as well. USAID/Zambia’s approach to monitoring and evaluation will be comprised of three components: 1) project-level reporting; 2) performance management/monitoring and evaluation; and, 3) external impact assessment to capture the aggregate impact of all investments and the relative contribution of different interventions to the extent feasible.
The FTF strategy will be implemented primarily through two of the USAID/Zambia CDCS Development Objectives (DO) and will meet the requirements of CDCS Development Objectives: (1) engage in """"rigorous"""" impact evaluations; and (2) build local capacity for monitoring and evaluation. The USAID/Zambia Mission has committed to implementing the operational research, managing for results, evaluation and local capacity-building model in its CDCS, and this will apply as well to FTF.
PERFORMANCE MANAGEMENT
The FTF Performance Monitoring Plan will include indicators measuring progress towards achieving results at all levels. For each indicator, the data source and methodology, baseline, targets, and a calendar of performance management tasks, including a schedule for data collection, will be included. The selection of indicators to include in the PMP will be driven by ongoing and planned activities, the availability of baseline, and provisions made to ensure availability of data for the reference reporting period.
To monitor performance, the Mission will establish baselines and collect data for standard and customized indicators to track whether desired results are occurring and whether performance is on target. All programs receiving FTF resources will be expected to develop monitoring and evaluation strategies that are consistent with the USG Zambia’s FTF framework.
Initial stakeholder workshops will be held for the purposes of
Given that FTF has the intention to work with a broader range of partners, including local organizations, it is expected that some partners will have more limited reporting capacity. These organizations will need greater assistance, and it may be necessary to delegate the responsibility for some monitoring and reporting to external entities.
For higher level objectives, tracking performance will be beyond the manageable interest of individual projects. In particular, changes in incomes, nutritional status, and some community-level variables among others will be more appropriately measured across the program areas. The FTF Team is developing a consortium of stakeholders to assess existing data sources, and intends to identify an external entity to coordinate baseline and periodic data collection for specific indicators.
An FTF M&E plan will be finalized by the end of Fiscal Year 2011, outlining all indicators and the reporting responsibilities by all USAID/Zambia’s partners. Key FTF required indicators to be tracked and reported are listed in Annex B. Additional project-specific and other relevant indicators not included in the FTF required indicators will be added. It is important to note that all appropriate indicators will be sex-disaggregated.
EVALUATION
In line with the new evaluation policy, the FTF program intends to conduct a number of performance evaluations and impact evaluations. Evaluations of two programs closing in 2011, PROFIT and C-FAARM, will be useful for the FTF learning agenda. The USG FTF has a unique opportunity with a defined geographic focus and the initiation of new activities to establish an impact assessment framework to assess high level impact, as well as to identify the relative contribution of different intervention, such as value chain upgrading versus household level management skills. USAID/Zambia will work with partners and other agencies to develop an impact assessment methodology that is consistent with and contributes to the project performance monitoring framework, but will also test several development hypotheses.
An initial baseline survey will be conducted in Eastern province to establish current levels of key variables including incomes, nutritional status, household production and asset patterns, and agriculture technology levels. This baseline will draw from the latest survey methodologies, particularly recent work on gender and asset control24. An appropriate sampling framework will be established to assess impact, most likely on a biannual basis. A randomized approach will be considered for a sub-sample to maintain the integrity of the impact assessment; however, flexibility will be needed to consider mid-term correction in order to ensure the greatest impact over the period of the strategy.
In the context of the development challenges and opportunities identified in Zambia and outlined in Section 1.1, several development hypotheses are of interest for the impact assessment. In particular, the relative contribution will be assessed of community-level versus household-level interventions to reducing poverty and undernutrition, as well as the additional value of the co-location of interventions. Another hypothesis of interest to be tested is: By increasing productivity, improving household food security and linking smallholders to markets for agriculture commodities, FTF interventions will reduce the incentives for exploiting the natural resource base.
Performance Evaluation
The FTF program will schedule performance evaluations to focus on descriptive and normative questions including: project or program achievements (either at an intermediate point in execution or at the conclusion of an implementation period); program implementation; program perception and value; and other questions pertinent to program design, management and operational decision-making. These performance evaluations will incorporate before-after comparisons whenever feasible.
Impact Evaluation
The FTF program will conduct impact evaluations to measure the change in development outcomes attributable to FTF interventions. Impact evaluations will be based on cause-effect models and will require a credible and rigorously-defined counterfactual control. Impact evaluations with treatment and control groups help provide the strongest evidence of a relationship between interventions and measured outcomes. One hypothesis to be explored includes identifying increased benefits from combined interventions, particularly income-augmenting and nutrition-related activities. In the nutrition portfolio, the differential effect of geographically co-locating health programs active in nutrition with agriculture programs working on the productivity and diversity side of the nutrition equation can be tested.
LINK TO GOVERNMENT MONITORING SYSTEMS
USAID/Zambia has provided extensive support to the Government of Zambia in monitoring the agricultural sector, and in analyzing government data through the Food Security Research Project (FSRP). This support will continue and can be drawn upon to monitor agricultural trends. In addition, FSRP has expertise in analyzing surveys such as the biannual Living Conditions Monitoring Survey (LCMS) which tracks poverty levels, and the Supplemental Surveys, which provide quality agricultural data. This expertise can be leveraged for improved performance monitoring by the GRZ, as well as for FTF performance.
The CAADP framework focuses largely on performance in the agricultural sector. For national performance toward other MDGs, particularly those related to nutrition and gender impacts, the FTF team will work with additional partners to identify appropriate data sources and performance monitoring modalities. For example, the Nutrition Cooperating Partners sub-group may be instrumental in the creation of a data monitoring platform according to the SUN Movement principles. However, the Zambia FTF framework will focus its efforts largely on performance for the targeted FTF areas and the contribution of these changes to national levels.
","Overall, an estimated 263,000 vulnerable Zambian women, children, and family members—mostly smallholder farmers—will receive targeted assistance to escape hunger and poverty","","","Increased productivity and income from selected value chains (gross margin per unit of land or animal of selected product); Number of farmers, processors, and others who have applied new technologies or management practices as a result of USG assistance (disaggregated by sex); Value of incremental sales (collected at farm/firm level) attributed to FTF implementation (disaggregated by targeted commodity) (disaggregated by sex of household head); Value of new private sector investment in the agriculture sector or food chain leveraged by FTF implementation (Change in value – investments local and international); Increase in employment in value-added processing enterprises linked to selected commodities.","Increased productivity and income from selected value chains (gross margin per unit of land or animal of selected product); Number of farmers, processors, and others who have applied new technologies or management practices as a result of USG assistance (disaggregated by sex); Value of incremental sales (collected at farm/firm level) attributed to FTF implementation (disaggregated by targeted commodity) (disaggregated by sex of household head); Value of new private sector investment in the agriculture sector or food chain leveraged by FTF implementation (Change in value – investments local and international); Increase in employment in value-added processing enterprises linked to selected commodities.","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","","English" "11545","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","ZMB","Zambia"," Eastern Province, Zambia|Lusaka-Eastern Province, Zambia|Lusaka-Central Province, Zambia","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Zambia, Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Zambia is making core investments in four key areas:
1. Oilseeds, legumes, maize and horticulture value chains
2. Enabling Environment
3. Economic Resilience
4. Nutrition
Target Regions
Feed the Future is focusing its efforts in two areas: the Eastern Province, with a value chain focus on oilseeds, legumes and maize; and selected peri-urban districts near Lusaka, connecting to Eastern Province, with a particular focus on horticulture.
Highlights
Comprehensive Africa Agriculture Development Programme (CAADP) process. Zambia’s CAADP Compact was signed in January 2011, and development of the Zambia CAADP Country Investment Plan has begun. Through this Compact the Government of the Republic of Zambia is committed to the following:
Diversification of staple crop production. Diversification of selected staple value chains will:
Gender. The Zambia strategy strives to maximize the positive impact on female farmers and ensure equitable benefits for men and women by:
Feed the Future Value Chain Research & Development Program
Research features prominently in the Feed the Future Initiative. The FTF research strategy has three objectives: advancing the productivity frontier, transforming production systems and enhancing dietary quality and food safety. The sustainable use of natural resources and adaptation to global climate changes are additional objectives. R&D investments will include several sub-components, through collaboration between international agriculture research centers, GRZ research institutes and public universities, private sector and other partners. The project will also incorporate a competitive grants program to promote public-private research and technology adoption. A key objective of the program is to enable these entities to directly implement activities within the life of the program. All programs will outline the steps, process and timeline to enable Zambian Government, NGO and other entities to be able to directly implement selected project activities within two years after the project has begun field implementation. Finally, to be effective, the programs must also actively involve both men and women in research design and trials to ensure appropriateness to their relative needs.
Some of the key issues that the agricultural research program in Zambia will address are outlined below.
The approach should include preliminary analysis to identify high pay-off interventions with the greatest potential to increase incomes and improve nutrition for a large number of smallholder maize-based farm households, with particular attention to gender-based constraints. These interventions may include varieties, management, alternative farm resource allocation and post-harvest approaches.
Possible components of a program include:
Low Productivity and Limited Production of Groundnuts--Limiting Their Contribution to Household Nutrition, Incomes and Women’s Empowerment
Illustrative activities include:
Widespread Aflatoxin Contamination--Reducing Food Quality and Limiting Exports
Responses to the aflatoxin problem in Zambia may include:
Role of Zambian Women in Science
The FTF strategy will also invest in the development of Zambian women scientists. The African Women in Research and Development (AWARD) program has successfully supported the career of up to nine Zambian women scientists in private and public research organizations as well as civil society organizations. The AWARD Fellows are paired with a leading scientist mentor in their field who supports the development of professional skills. Training in leadership and other professional skills such as writing and communication is provided. A current AWARD Fellow recently conducted a workshop on gender in the aquaculture sector, highlighting the importance of considering gender constraints in this sector. The AWARD Fellows also become mentors to younger women, thus extending the benefits of the program. The FTF strategy will continue this investment throughout the program and work with these scientists in order to strengthen the participation of women in agricultural research.
","
.
","
USAID/Zambia will monitor and evaluate programs and activities throughout the strategy period to ensure that those investments are achieving objectives and maximizing returns to investments. Though many of the investments will be managed and monitored primarily by USAID, some investments will originate from other USG agencies and by government, donors, or the private sector. The Zambia CAADP Country Investment Plan will provide a framework for the development of a more comprehensive national effort in agriculture and poverty reduction that will be supported through the USG FTF effort. CAADP monitoring is addressed below. The M&E framework for the USG FTF strategy outlined in this section will be inclusive and involve all government agencies investing in FTF areas, particularly in the FTF priority geographic area, Eastern province.
The geographic focus, co-location of investments, and the timing of the initiation of new investments provide the opportunity to establish a solid impact assessment framework as well. USAID/Zambia’s approach to monitoring and evaluation will be comprised of three components:
The FTF strategy will be implemented primarily through two of the USAID/Zambia CDCS Development Objectives (DO) and will meet the requirements of CDCS Development Objectives:
The USAID/Zambia Mission has committed to implementing the operational research, managing for results, evaluation and local capacity-building model in its CDCS, and this will apply as well to FTF.
PERFORMANCE MANAGEMENT
The FTF Performance Monitoring Plan will include indicators measuring progress towards achieving results at all levels. For each indicator, the data source and methodology, baseline, targets, and a calendar of performance management tasks, including a schedule for data collection, will be included. The selection of indicators to include in the PMP will be driven by ongoing and planned activities, the availability of baseline, and provisions made to ensure availability of data for the reference reporting period.
To monitor performance, the Mission will establish baselines and collect data for standard and customized indicators to track whether desired results are occurring and whether performance is on target. All programs receiving FTF resources will be expected to develop monitoring and evaluation strategies that are consistent with the USG Zambia’s FTF framework.
Initial stakeholder workshops will be held for the purposes of
Data quality assessments will be conducted regularly to ensure consistency and completeness. Data collected through monitoring will be used for periodic reports to stakeholders. Given that FTF has the intention to work with a broader range of partners, including local organizations, it is expected that some partners will have more limited reporting capacity. These organizations will need greater assistance, and it may be necessary to delegate the responsibility for some monitoring and reporting to external entities.
For higher level objectives, tracking performance will be beyond the manageable interest of individual projects. In particular, changes in incomes, nutritional status, and some community-level variables among others will be more appropriately measured across the program areas. The FTF Team is developing a consortium of stakeholders to assess existing data sources, and intends to identify an external entity to coordinate baseline and periodic data collection for specific indicators.
An FTF M&E plan will be finalized by the end of Fiscal Year 2011, outlining all indicators and the reporting responsibilities by all USAID/Zambia’s partners. Key FTF required indicators to be tracked and reported are listed in Annex B. Additional project-specific and other relevant indicators not included in the FTF required indicators will be added. It is important to note that all appropriate indicators will be sex-disaggregated.
EVALUATION
In line with the new evaluation policy, the FTF program intends to conduct a number of performance evaluations and impact evaluations. Evaluations of two programs closing in 2011, PROFIT and C-FAARM, will be useful for the FTF learning agenda. The USG FTF has a unique opportunity with a defined geographic focus and the initiation of new activities to establish an impact assessment framework to assess high level impact, as well as to identify the relative contribution of different intervention, such as value chain upgrading versus household level management skills. USAID/Zambia will work with partners and other agencies to develop an impact assessment methodology that is consistent with and contributes to the project performance monitoring framework, but will also test several development hypotheses.
An initial baseline survey will be conducted in Eastern province to establish current levels of key variables including incomes, nutritional status, household production and asset patterns, and agriculture technology levels. This baseline will draw from the latest survey methodologies, particularly recent work on gender and asset control24. An appropriate sampling framework will be established to assess impact, most likely on a biannual basis. A randomized approach will be considered for a sub-sample to maintain the integrity of the impact assessment; however, flexibility will be needed to consider mid-term correction in order to ensure the greatest impact over the period of the strategy.
In the context of the development challenges and opportunities identified in Zambia and outlined in Section 1.1, several development hypotheses are of interest for the impact assessment. In particular, the relative contribution will be assessed of community-level versus household-level interventions to reducing poverty and undernutrition, as well as the additional value of the co-location of interventions. Another hypothesis of interest to be tested is: By increasing productivity, improving household food security and linking smallholders to markets for agriculture commodities, FTF interventions will reduce the incentives for exploiting the natural resource base.
Performance Evaluation
The FTF program will schedule performance evaluations to focus on descriptive and normative questions including: project or program achievements (either at an intermediate point in execution or at the conclusion of an implementation period); program implementation; program perception and value; and other questions pertinent to program design, management and operational decision-making. These performance evaluations will incorporate before-after comparisons whenever feasible.
Impact Evaluation
The FTF program will conduct impact evaluations to measure the change in development outcomes attributable to FTF interventions. Impact evaluations will be based on cause-effect models and will require a credible and rigorously-defined counterfactual control. Impact evaluations with treatment and control groups help provide the strongest evidence of a relationship between interventions and measured outcomes. One hypothesis to be explored includes identifying increased benefits from combined interventions, particularly income-augmenting and nutrition-related activities. In the nutrition portfolio, the differential effect of geographically co-locating health programs active in nutrition with agriculture programs working on the productivity and diversity side of the nutrition equation can be tested.
LINK TO GOVERNMENT MONITORING SYSTEMS
USAID/Zambia has provided extensive support to the Government of Zambia in monitoring the agricultural sector, and in analyzing government data through the Food Security Research Project (FSRP). This support will continue and can be drawn upon to monitor agricultural trends. In addition, FSRP has expertise in analyzing surveys such as the biannual Living Conditions Monitoring Survey (LCMS) which tracks poverty levels, and the Supplemental Surveys, which provide quality agricultural data. This expertise can be leveraged for improved performance monitoring by the GRZ, as well as for FTF performance.
The CAADP framework focuses largely on performance in the agricultural sector. For national performance toward other MDGs, particularly those related to nutrition and gender impacts, the FTF team will work with additional partners to identify appropriate data sources and performance monitoring modalities. For example, the Nutrition Cooperating Partners sub-group may be instrumental in the creation of a data monitoring platform according to the SUN Movement principles. However, the Zambia FTF framework will focus its efforts largely on performance for the targeted FTF areas and the contribution of these changes to national levels.
","Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty","","","","","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","","English" "11545","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","ZMB","Zambia"," Eastern Province, Zambia|Lusaka-Eastern Province, Zambia|Lusaka-Central Province, Zambia","Rural|Peri-urban","on-going","01-2011","01-2015","
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Zambia, Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Zambia is making core investments in four key areas:
1. Oilseeds, legumes, maize and horticulture value chains
2. Enabling Environment
3. Economic Resilience
4. Nutrition
Target Regions
Feed the Future is focusing its efforts in two areas: the Eastern Province, with a value chain focus on oilseeds, legumes and maize; and selected peri-urban districts near Lusaka, connecting to Eastern Province, with a particular focus on horticulture.
Highlights
Comprehensive Africa Agriculture Development Programme (CAADP) process. Zambia’s CAADP Compact was signed in January 2011, and development of the Zambia CAADP Country Investment Plan has begun. Through this Compact the Government of the Republic of Zambia is committed to the following:
Diversification of staple crop production. Diversification of selected staple value chains will:
Gender. The Zambia strategy strives to maximize the positive impact on female farmers and ensure equitable benefits for men and women by:
CORE INVESTMENT AREA 2: ENABLING ENVIRONMENT AND POLICY DEVELOPMENT
As an additional key strategy component, FTF Zambia will support the development of favorable agriculture policy through policy research and advocacy for reform. For example, continued policy reform is needed for maize to be competitive in regional markets, including a consistent and open border policy; small government strategic reserve; price-band management; and, use of the e-voucher system in input provision. Another critical investment is support to the GRZ to advance and complete the CAADP process, i.e., by helping the government develop a realistic but ambitious Country Investment Plan.
Several important policy objectives will be supported by the USG toward creating an enabling environment to achieve FTF objectives. These include:
USAID/Zambia has awarded a five-year project (2010-2015) that will assist stakeholders through a program of research, policy analysis, outreach, and training. Assistance provided will also support key agricultural policy stakeholders throughout the development and implementation of the Comprehensive African Agriculture Development Program (CAADP). The project, the Food Security Research Project (FSRP), will work closely with the Agricultural Consultative Forum (ACF), a Zambian NGO that provides a forum for policy dialogue, Ministry of Agriculture and Cooperatives (MACO), the Ministry of Livestock and Fisheries Development (MLFD), the Central Statistical Office (CSO), and other selected Zambian organizations.
The FSRP and ACF will take center stage in carrying out independent research to form the basis for developing and promoting supportive agricultural policy in Zambia. The ACF will also remain flexible to build capacity of other Zambian institutions that support the goal of improving fact-based agricultural and economic policy formulation in Zambia to nurture local capacity and local dissemination of knowledge to the public through commissioning and mentoring of local groups to undertake policy analysis. ACF and FSRP efforts in the past have addressed sound market-based principles through institutional capacity building and empirically-based policy research. Those efforts will be intensified to better support the GRZ’s implementation of its CAADP Investment Plan, which is a critical component of the FTF.
New USG funding in the project will be directed to three general activities – capacity building, more active outreach within and beyond the agricultural sector, and improvements in the quality of basic agricultural data emerging from CSO and MACO. This work will be undertaken in collaboration with other efforts to improvements overall data collection management of the CSO, particularly that being spearheaded by the U.K. Department for International Development (DFID). FTF will also fund training to support public and civil society leaders engaged in the CAADP process, as well as training of women scientists.
Key Enabling Environment Program Areas
Analytical Capacity for Improved Agricultural Policy in Zambia. Weak human and institutional capacity to analyze agricultural policy contributes to the politicization of agriculture in Zambia and a weak business climate for agricultural investment. FTF assistance will improve the analytical capacity of Zambian stakeholders. Stronger ―home-grown‖ analytical capacity and greater public outreach will lead to a greater understanding of key issues affecting agriculture by both the public at large and policy makers within the government. Informed technocrats within the government, backed by a supportive public opinion, should be able to convince political leaders to make sound decisions in agricultural policy.
New Project Directions. Emphasis will be on ―Zambianizing‖ the research capacity, which previously was not deep enough, due to limited finances and limited scope of local institutions. Increased high-level USG attention to food security issues demands a more thorough understanding of GRZ priorities and donor commitments in the sector. FSRP and ACF activities will provide the analytical basis for future US and other donor investments in the agricultural sector to combat hunger and poverty, which are aligned with the GRZ’s CAADP Compact.
Thematic And Operational Support of the CAADP Agenda. FSRP has supported the CAADP Compact process, ensuring that critical agricultural policy issues are, and will be, reflected in future policy planning and programming. FSRP support has ensured Zambian ownership of the CAADP framework, including its policies, programs, and targets. FSRP will work with policy makers and stakeholders as before, but with the added mandate of contributing to the peer review process that is part of the CAADP framework, focusing specifically on public resource allocation, investments and the implementation of policies that are the backbone of the CAADP process. FSRP will advocate that the CAADP process include a wide range of stakeholders with broad food security objectives across all four CAADP Pillars, and not result in a concentrated focus on agricultural productivity.
Political Will and Technical Capacity Building. For civil society, the press, government technocrats, and other groups to effectively influence policy, they need fact-based positions and up-to-date information from credible entities. It is therefore important, and an explicit objective of FSRP, to put fact-based information in front of the body politic. Political will shifts when confronted by an aware and informed electorate.
On-going Research Areas
New Potential Research Areas
","
.
","
USAID/Zambia will monitor and evaluate programs and activities throughout the strategy period to ensure that those investments are achieving objectives and maximizing returns to investments. Though many of the investments will be managed and monitored primarily by USAID, some investments will originate from other USG agencies and by government, donors, or the private sector. The Zambia CAADP Country Investment Plan will provide a framework for the development of a more comprehensive national effort in agriculture and poverty reduction that will be supported through the USG FTF effort. CAADP monitoring is addressed below. The M&E framework for the USG FTF strategy outlined in this section will be inclusive and involve all government agencies investing in FTF areas, particularly in the FTF priority geographic area, Eastern province.
The geographic focus, co-location of investments, and the timing of the initiation of new investments provide the opportunity to establish a solid impact assessment framework as well. USAID/Zambia’s approach to monitoring and evaluation will be comprised of three components:
The FTF strategy will be implemented primarily through two of the USAID/Zambia CDCS Development Objectives (DO) and will meet the requirements of CDCS Development Objectives:
The USAID/Zambia Mission has committed to implementing the operational research, managing for results, evaluation and local capacity-building model in its CDCS, and this will apply as well to FTF.
PERFORMANCE MANAGEMENT
The FTF Performance Monitoring Plan will include indicators measuring progress towards achieving results at all levels. For each indicator, the data source and methodology, baseline, targets, and a calendar of performance management tasks, including a schedule for data collection, will be included. The selection of indicators to include in the PMP will be driven by ongoing and planned activities, the availability of baseline, and provisions made to ensure availability of data for the reference reporting period.
To monitor performance, the Mission will establish baselines and collect data for standard and customized indicators to track whether desired results are occurring and whether performance is on target. All programs receiving FTF resources will be expected to develop monitoring and evaluation strategies that are consistent with the USG Zambia’s FTF framework.
Initial stakeholder workshops will be held for the purposes of
Given that FTF has the intention to work with a broader range of partners, including local organizations, it is expected that some partners will have more limited reporting capacity. These organizations will need greater assistance, and it may be necessary to delegate the responsibility for some monitoring and reporting to external entities.
For higher level objectives, tracking performance will be beyond the manageable interest of individual projects. In particular, changes in incomes, nutritional status, and some community-level variables among others will be more appropriately measured across the program areas. The FTF Team is developing a consortium of stakeholders to assess existing data sources, and intends to identify an external entity to coordinate baseline and periodic data collection for specific indicators.
An FTF M&E plan will be finalized by the end of Fiscal Year 2011, outlining all indicators and the reporting responsibilities by all USAID/Zambia’s partners. Key FTF required indicators to be tracked and reported are listed in Annex B. Additional project-specific and other relevant indicators not included in the FTF required indicators will be added. It is important to note that all appropriate indicators will be sex-disaggregated.
EVALUATION
In line with the new evaluation policy, the FTF program intends to conduct a number of performance evaluations and impact evaluations. Evaluations of two programs closing in 2011, PROFIT and C-FAARM, will be useful for the FTF learning agenda. The USG FTF has a unique opportunity with a defined geographic focus and the initiation of new activities to establish an impact assessment framework to assess high level impact, as well as to identify the relative contribution of different intervention, such as value chain upgrading versus household level management skills. USAID/Zambia will work with partners and other agencies to develop an impact assessment methodology that is consistent with and contributes to the project performance monitoring framework, but will also test several development hypotheses.
An initial baseline survey will be conducted in Eastern province to establish current levels of key variables including incomes, nutritional status, household production and asset patterns, and agriculture technology levels. This baseline will draw from the latest survey methodologies, particularly recent work on gender and asset control24. An appropriate sampling framework will be established to assess impact, most likely on a biannual basis. A randomized approach will be considered for a sub-sample to maintain the integrity of the impact assessment; however, flexibility will be needed to consider mid-term correction in order to ensure the greatest impact over the period of the strategy.
In the context of the development challenges and opportunities identified in Zambia and outlined in Section 1.1, several development hypotheses are of interest for the impact assessment. In particular, the relative contribution will be assessed of community-level versus household-level interventions to reducing poverty and undernutrition, as well as the additional value of the co-location of interventions. Another hypothesis of interest to be tested is: By increasing productivity, improving household food security and linking smallholders to markets for agriculture commodities, FTF interventions will reduce the incentives for exploiting the natural resource base.
Performance Evaluation
The FTF program will schedule performance evaluations to focus on descriptive and normative questions including: project or program achievements (either at an intermediate point in execution or at the conclusion of an implementation period); program implementation; program perception and value; and other questions pertinent to program design, management and operational decision-making. These performance evaluations will incorporate before-after comparisons whenever feasible.
Impact Evaluation
The FTF program will conduct impact evaluations to measure the change in development outcomes attributable to FTF interventions. Impact evaluations will be based on cause-effect models and will require a credible and rigorously-defined counterfactual control. Impact evaluations with treatment and control groups help provide the strongest evidence of a relationship between interventions and measured outcomes. One hypothesis to be explored includes identifying increased benefits from combined interventions, particularly income-augmenting and nutrition-related activities. In the nutrition portfolio, the differential effect of geographically co-locating health programs active in nutrition with agriculture programs working on the productivity and diversity side of the nutrition equation can be tested.
LINK TO GOVERNMENT MONITORING SYSTEMS
USAID/Zambia has provided extensive support to the Government of Zambia in monitoring the agricultural sector, and in analyzing government data through the Food Security Research Project (FSRP). This support will continue and can be drawn upon to monitor agricultural trends. In addition, FSRP has expertise in analyzing surveys such as the biannual Living Conditions Monitoring Survey (LCMS) which tracks poverty levels, and the Supplemental Surveys, which provide quality agricultural data. This expertise can be leveraged for improved performance monitoring by the GRZ, as well as for FTF performance.
The CAADP framework focuses largely on performance in the agricultural sector. For national performance toward other MDGs, particularly those related to nutrition and gender impacts, the FTF team will work with additional partners to identify appropriate data sources and performance monitoring modalities. For example, the Nutrition Cooperating Partners sub-group may be instrumental in the creation of a data monitoring platform according to the SUN Movement principles. However, the Zambia FTF framework will focus its efforts largely on performance for the targeted FTF areas and the contribution of these changes to national levels.
","","","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11545","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","ZMB","Zambia"," Eastern Province, Zambia|Lusaka-Eastern Province, Zambia|Lusaka-Central Province, Zambia","Rural|Peri-urban","on-going","01-2011","01-2015","
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Zambia, Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Zambia is making core investments in four key areas:
1. Oilseeds, legumes, maize and horticulture value chains
2. Enabling Environment
3. Economic Resilience
4. Nutrition
Target Regions
Feed the Future is focusing its efforts in two areas: the Eastern Province, with a value chain focus on oilseeds, legumes and maize; and selected peri-urban districts near Lusaka, connecting to Eastern Province, with a particular focus on horticulture.
Highlights
Comprehensive Africa Agriculture Development Programme (CAADP) process. Zambia’s CAADP Compact was signed in January 2011, and development of the Zambia CAADP Country Investment Plan has begun. Through this Compact the Government of the Republic of Zambia is committed to the following:
Diversification of staple crop production. Diversification of selected staple value chains will:
Gender. The Zambia strategy strives to maximize the positive impact on female farmers and ensure equitable benefits for men and women by:
CORE INVESTMENT AREA 3: ECONOMIC RESILIENCE
FTF investments in agricultural value chains will increase agricultural productivity and incomes. FTF investments in health and nutrition infrastructure will improve access to health and nutrition services and information at the district and community level. However, not all households will be able to benefit in the medium term from these investments. In addition, intra-household resource management, even in better-off agricultural households, can be a barrier to the translation of systemic investments in the agricultural and health infrastructure into improvements in benefits for women and children. The Zambia FTF strategy proposes a set of investments to address these two challenges. The investments will target households that are more vulnerable to food insecurity due to composition, illness, or other factors.
Economic Resilience Programming
FTF investments will focus on an integrated approach to building assets and risk reduction, and call for innovative models to link vulnerable households to value chain interventions and investments in community, district and provincial health systems. These programs will engage new partners and will be structured to ensure both small businesses and local partners have the capacity to participate. The program will enhance coping skills, build assets and increase rural incomes for vulnerable households in targeted areas, thereby significantly contributing to Millennium Development Goal 1 of halving the proportion of Zambians living in extreme poverty and suffering from hunger by 2015.
The vulnerable and very poor have some minimum set of assets but have been unable to move towards longer-term economic well-being and health. Frequently donor and government assistance to these households has been in the form of humanitarian relief, economic transfers or subsidies (e.g., of staple foods). USAID/Zambia seeks to support innovative ideas, concepts and programs to increase the economic resilience of the very vulnerable Zambian rural population in targeted areas.
Investments under this core investment area aim to increase the food security of vulnerable and very poor rural households in targeted areas through interventions that reduce the number of hunger months, improve nutrition and health practices, and increase the value of household assets and the ability of households to productively use those assets. These achievements are expected to contribute significantly to reducing stunting and underweight levels in the targeted households over a five-year period.
Activities will target vulnerable groups in rural areas with a minimum set of assets (land and/or labor) and fall below the poverty line of $1.25/day. These attributes characterize a majority of smallholder agricultural producers in Eastern province. To identify more vulnerable households it will be necessary to include households according to additional characteristics such as: female-headed - widowed or divorced; household with person living with AIDS (PLWA) or other chronic and debilitating diseases; household caring for or headed by orphan or vulnerable child (OVC); or disabled household head or member.
Potential Activities
Investments will build upon USAID-funded activities that work in agricultural growth, nutrition and economic resilience efforts, such as the Title II program, the Consortium for Food Security, Agriculture and Nutrition, AIDS, Resiliency and Markets (C-FAARM), closing out in 2011. The programs will implement innovative strategies and approaches to enable vulnerable rural households, including those affected by HIV/AIDS and other diseases, orphan and vulnerable child-headed households, and female-headed households, by improving food security through strengthened economic resilience. Special attention will be given to enabling very poor women to participate in expanding opportunities as producers, service providers and entrepreneurs.
Programs will take an integrated approach to improved food security – addressing availability, access and utilization components, as well as linkages to nutrition and health, and gender relations. Programs as diverse as micro-savings and lending, conditional cash transfers, ―farming as a family business‖ have all shown some potential to reduce vulnerability of poor households under specific conditions. Proposals will be expected to demonstrate scalability.
Recent evidence of preventive approaches to undernutrition in other countries provides direction for successful components of nutrition interventions. The promotion of Essential Nutrition Actions will be a fundamental component of all interventions. Other approaches will be considered. For example, a positive deviance model demonstrated that three-quarters of children under age five treated for undernutrition made significant weight gains when their diets included legumes and other high protein supplements, combined with improved health and sanitary practices, and access to clean water.18 Some microfinance schemes follow a positive deviance model in which seed capital is not injected into communities, but revolving loan funds are created based on the capital available within communities, and members increase their ability to borrow based on the amount of shares they are able (and willing) to invest in the loan fund. Savings-led financial services have been demonstrated to serve an important role in consumption smoothing. Small livestock may actually serve as savings accounts, easily converted into cash when needed. Approaches that target all farm household members, both men and women, have been shown to be effective in improving the use of resources and changing household food security. A recent gender assessment of the SIDA-funded agricultural support program reported that better internal management of household resources was a significant factor contributing to greater household food security for project participants, as measured by months of household food security19. Given strong evidence of the significance of women’s income to child nutrition, approaches that build better household management of resources and strengthen women’s effective control may have a high payoff.
Lessons learned from GCC/SL pilots on community and household use of forest resources will be incorporated into the FTF economic resilience activities. Many vulnerable households are dependent on communal resources for sources of wild foods and medicinal crops that supplement nutritional and income needs. Household use of agriculture and non-agricultural land, such as forests, for additional income will be examined to determine strategies that build resilience and improve land use, without increasing the pressure on non-agricultural lands.
","
It is envisaged that these activities will result in tangible benefits to households such as increased food availability, better management, and improved intra-household food allocation, with improved child food intake and greater diet diversity for vulnerable members. Some expected achievements leading to household level benefits include increased access of poor and very poor farming households to commercial sources of inputs and non-financial supporting services, including extension and agronomic services; increased productivity by poor and very poor farming households; application by very poor farming households of improved crop production and post-harvest practices; and increased access of poor and very poor farming households to financial services.
","
USAID/Zambia will monitor and evaluate programs and activities throughout the strategy period to ensure that those investments are achieving objectives and maximizing returns to investments. Though many of the investments will be managed and monitored primarily by USAID, some investments will originate from other USG agencies and by government, donors, or the private sector. The Zambia CAADP Country Investment Plan will provide a framework for the development of a more comprehensive national effort in agriculture and poverty reduction that will be supported through the USG FTF effort. CAADP monitoring is addressed below. The M&E framework for the USG FTF strategy outlined in this section will be inclusive and involve all government agencies investing in FTF areas, particularly in the FTF priority geographic area, Eastern province.
The geographic focus, co-location of investments, and the timing of the initiation of new investments provide the opportunity to establish a solid impact assessment framework as well. USAID/Zambia’s approach to monitoring and evaluation will be comprised of three components:
The FTF strategy will be implemented primarily through two of the USAID/Zambia CDCS Development Objectives (DO) and will meet the requirements of CDCS Development Objectives:
PERFORMANCE MANAGEMENT
The FTF Performance Monitoring Plan will include indicators measuring progress towards achieving results at all levels. For each indicator, the data source and methodology, baseline, targets, and a calendar of performance management tasks, including a schedule for data collection, will be included. The selection of indicators to include in the PMP will be driven by ongoing and planned activities, the availability of baseline, and provisions made to ensure availability of data for the reference reporting period.
To monitor performance, the Mission will establish baselines and collect data for standard and customized indicators to track whether desired results are occurring and whether performance is on target. All programs receiving FTF resources will be expected to develop monitoring and evaluation strategies that are consistent with the USG Zambia’s FTF framework.
Initial stakeholder workshops will be held for the purposes of:
Data collected through monitoring will be used for periodic reports to stakeholders.
Given that FTF has the intention to work with a broader range of partners, including local organizations, it is expected that some partners will have more limited reporting capacity. These organizations will need greater assistance, and it may be necessary to delegate the responsibility for some monitoring and reporting to external entities.
For higher level objectives, tracking performance will be beyond the manageable interest of individual projects. In particular, changes in incomes, nutritional status, and some community-level variables among others will be more appropriately measured across the program areas. The FTF Team is developing a consortium of stakeholders to assess existing data sources, and intends to identify an external entity to coordinate baseline and periodic data collection for specific indicators.
An FTF M&E plan will be finalized by the end of Fiscal Year 2011, outlining all indicators and the reporting responsibilities by all USAID/Zambia’s partners. Key FTF required indicators to be tracked and reported are listed in Annex B. Additional project-specific and other relevant indicators not included in the FTF required indicators will be added. It is important to note that all appropriate indicators will be sex-disaggregated.
EVALUATION
In line with the new evaluation policy, the FTF program intends to conduct a number of performance evaluations and impact evaluations. Evaluations of two programs closing in 2011, PROFIT and C-FAARM, will be useful for the FTF learning agenda. The USG FTF has a unique opportunity with a defined geographic focus and the initiation of new activities to establish an impact assessment framework to assess high level impact, as well as to identify the relative contribution of different intervention, such as value chain upgrading versus household level management skills. USAID/Zambia will work with partners and other agencies to develop an impact assessment methodology that is consistent with and contributes to the project performance monitoring framework, but will also test several development hypotheses.
An initial baseline survey will be conducted in Eastern province to establish current levels of key variables including incomes, nutritional status, household production and asset patterns, and agriculture technology levels. This baseline will draw from the latest survey methodologies, particularly recent work on gender and asset control24. An appropriate sampling framework will be established to assess impact, most likely on a biannual basis. A randomized approach will be considered for a sub-sample to maintain the integrity of the impact assessment; however, flexibility will be needed to consider mid-term correction in order to ensure the greatest impact over the period of the strategy.
In the context of the development challenges and opportunities identified in Zambia and outlined in Section 1.1, several development hypotheses are of interest for the impact assessment. In particular, the relative contribution will be assessed of community-level versus household-level interventions to reducing poverty and undernutrition, as well as the additional value of the co-location of interventions. Another hypothesis of interest to be tested is: By increasing productivity, improving household food security and linking smallholders to markets for agriculture commodities, FTF interventions will reduce the incentives for exploiting the natural resource base.
Performance Evaluation
The FTF program will schedule performance evaluations to focus on descriptive and normative questions including: project or program achievements (either at an intermediate point in execution or at the conclusion of an implementation period); program implementation; program perception and value; and other questions pertinent to program design, management and operational decision-making. These performance evaluations will incorporate before-after comparisons whenever feasible.
Impact Evaluation
The FTF program will conduct impact evaluations to measure the change in development outcomes attributable to FTF interventions. Impact evaluations will be based on cause-effect models and will require a credible and rigorously-defined counterfactual control. Impact evaluations with treatment and control groups help provide the strongest evidence of a relationship between interventions and measured outcomes. One hypothesis to be explored includes identifying increased benefits from combined interventions, particularly income-augmenting and nutrition-related activities. In the nutrition portfolio, the differential effect of geographically co-locating health programs active in nutrition with agriculture programs working on the productivity and diversity side of the nutrition equation can be tested.
LINK TO GOVERNMENT MONITORING SYSTEMS
USAID/Zambia has provided extensive support to the Government of Zambia in monitoring the agricultural sector, and in analyzing government data through the Food Security Research Project (FSRP). This support will continue and can be drawn upon to monitor agricultural trends. In addition, FSRP has expertise in analyzing surveys such as the biannual Living Conditions Monitoring Survey (LCMS) which tracks poverty levels, and the Supplemental Surveys, which provide quality agricultural data. This expertise can be leveraged for improved performance monitoring by the GRZ, as well as for FTF performance.
The CAADP framework focuses largely on performance in the agricultural sector. For national performance toward other MDGs, particularly those related to nutrition and gender impacts, the FTF team will work with additional partners to identify appropriate data sources and performance monitoring modalities. For example, the Nutrition Cooperating Partners sub-group may be instrumental in the creation of a data monitoring platform according to the SUN Movement principles. However, the Zambia FTF framework will focus its efforts largely on performance for the targeted FTF areas and the contribution of these changes to national levels.
","Feed the Future aims to help an estimated 834,000 vulnerable Tanzanian women, children and family members—mostly smallholder farmers—escape hunger and poverty","","","Increased productivity and income from selected value chains (gross margin per unit of land or animal of selected product) (disaggregated by sex); Increased expenditures (proxy for income) of rural households, including female-headed households; Prevalence of households with moderate or severe hunger (disaggregated by sex of household head); Per cent of children 6-23 months that receive a Minimum Acceptable Diet (disaggregated by sex); Number of vulnerable households benefiting from program activities through increased economic resilience (disaggregated by sex of household head); Women’s Dietary Diversity: Mean number of food groups consumed by women of reproductive age; Prevalence of exclusive breastfeeding of children under 6 months; Number of people with a savings account or insurance policy as a result of USG assistance (disaggregated by sex).","Increased productivity and income from selected value chains (gross margin per unit of land or animal of selected product) (disaggregated by sex); Increased expenditures (proxy for income) of rural households, including female-headed households; Prevalence of households with moderate or severe hunger (disaggregated by sex of household head); Per cent of children 6-23 months that receive a Minimum Acceptable Diet (disaggregated by sex); Number of vulnerable households benefiting from program activities through increased economic resilience (disaggregated by sex of household head); Women’s Dietary Diversity: Mean number of food groups consumed by women of reproductive age; Prevalence of exclusive breastfeeding of children under 6 months; Number of people with a savings account or insurance policy as a result of USG assistance (disaggregated by sex).","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11545","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","ZMB","Zambia"," Eastern Province, Zambia|Lusaka-Eastern Province, Zambia|Lusaka-Central Province, Zambia","Rural|Peri-urban","on-going","01-2011","01-2015","
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Zambia, Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Zambia is making core investments in four key areas:
1. Oilseeds, legumes, maize and horticulture value chains
2. Enabling Environment
3. Economic Resilience
4. Nutrition
Target Regions
Feed the Future is focusing its efforts in two areas: the Eastern Province, with a value chain focus on oilseeds, legumes and maize; and selected peri-urban districts near Lusaka, connecting to Eastern Province, with a particular focus on horticulture.
Highlights
Comprehensive Africa Agriculture Development Programme (CAADP) process. Zambia’s CAADP Compact was signed in January 2011, and development of the Zambia CAADP Country Investment Plan has begun. Through this Compact the Government of the Republic of Zambia is committed to the following:
Diversification of staple crop production. Diversification of selected staple value chains will:
Gender. The Zambia strategy strives to maximize the positive impact on female farmers and ensure equitable benefits for men and women by:
FTF Zambia is investing in capacity-building and training of health workers to improve nutrition services and nutrition education. The nutrition program will include a national mass media campaign around the Essential Nutrition Actions that will be linked to community-level behavioral and social change communications. Additionally, the program will build strong linkages to rural health services and nutrition interventions. The nutrition program is largely managed by USAID/Zambia’s Health and HIV Offices, but activities by the USAID Economic Growth Team and Centers for Disease Control will also contribute.
The Government of Zambia has recently refocused on the poor national nutrition levels by developing a National Nutrition Strategy and holding a National Nutrition Consultative Forum to discuss the strategy. Zambia has also been selected as an Early Riser under the Scaling Up Nutrition (SUN) Initiative promoted by the U.S. and a wide range of other donors. The USG participates in a recently formed Nutrition Donor Convener Group, chaired by DFID and UNICEF, under the Health Sector Working Group. The USG can play an important role in raising concern over nutrition levels within the country, coordinating USG and other donor investments, and supporting government efforts to intensify efforts to address undernutrition.
Nutrition Programming
FTF Agriculture and Food-based Nutrition Programming. FTF agriculture investments will contribute to improved nutritional outcomes through several approaches. Improved incomes for poor households as a result of improved agricultural practices and better market access can translate into improved household food availability, although this is usually not sufficient for changes in child nutritional status. FTF agricultural investments will also improve the quantity and quality of staple foods in Eastern province, resulting in reduced prices for poor households, most of which purchase food for several months of the year. In addition, FTF food-based strategies will result in more nutritious foods through strategies such as bio-fortification and breeding, particularly through increasing dissemination and production of beta-carotene-rich ―orange‖ maize and orange-fleshed sweet potatoes. Household-based approaches through the Economic Resilience programs, described in greater detail in Section 4.3 above, will focus on more equitable food distribution/income control and on communicating behavioral change messages on essential nutrition actions at the household level. These programs will also ensure that all nutrition-related activities are consistent with and support other nutrition programming, for example in nutrition training of agricultural workers and extension staff, or capacity-building of community workers other than community-based health workers. Other potential food based strategies include school feeding linkages with organizations such as the World Food Program, with the introduction of nutritious products such as soy-based products or orange-fleshed sweet potatoes.
FTF Nutrition-related Programming through the Health Sector. USG investments in the health sector are extensive and broad and make a major contribution to the status of Zambians’ health. Many of these programs have components that directly address nutrition through improving health outcomes, reducing incidence of diseases such as malaria, vaccine preventable diseases, intestinal worm infestation, etc., providing food to PLWA, and supporting orphans and vulnerable children, among others.
The USAID Health Office invests in four programs supporting systemic change in health services. These programs include support for:
The logistics program focuses on improvements in commodities and supply chains for a wide array of critical inputs such as antiretroviral drugs, family planning inputs, and bed nets. Social marketing is conducted for all important areas, including family planning, HIV prevention and inputs, and malaria. Broad spectrum media campaigns are conducted under the integrated behavior change communication investments. These campaigns are conducted at national, provincial and community levels to elicit change in a wide range of health-related behaviors.
The following national-level interventions will be considered:
Recommendations for rural areas include the following:
In addition to interventions that strengthen the health system and refocus efforts on nutrition behavior change, the FTF strategy proposes to link health, nutrition, economic resilience, and economic growth activities at the household-level, to the extent this is feasible and cost-effective. Two approaches will be adopted:
FTF Nutrition-related Investments through HIV/AIDS Programming. Another significant contributor to child malnutrition is the high rate of pediatric HIV/AIDS. Based on a 2010 technical update on WHO guidelines, for infants and young children known to be HIV-infected, mothers are strongly encouraged to breastfeed exclusively for the first 6 months and to continue breastfeeding, with adequate supplementary feeding, up to 2 years and beyond. Therefore all infants 6 months of age and older need additional, developmentally and nutritionally appropriate food sources, as breast milk is no longer sufficient. Hence, nutrition-related HIV/AIDS interventions are also under development by the USG in Zambia, and these investments will have an impact on the reduction of undernutrition in children below age 2.
High prevalence of Vitamin A deficiency in rural Zambia. Vitamin A deficiency is a long-standing public health problem in Zambia due to inadequate dietary intake. The Ministry of Health distributes vitamin A supplements during the twice-yearly child health weeks and sugar is fortified with Vitamin A. Nonetheless, according to the 2007 Zambia Demographic and Health Survey vitamin A deficiency (VAD) continues to affect 54 percent of Zambian children under 5 and women of reproductive age. These high levels of VAD may be attributed to the high prevalence of asymptomatic infections in the Zambian population. Increasing the intake of Vitamin A through a wider range of sources, combined with health interventions, including those to prevent and treat infectious disease, will decrease defiency in many vulnerable groups. Biofortified crops have a high potential to increase Vitamin A content in diets, particularly of rural households that produce their own food and have limited consumption of fortified products.
Potential agriculture activities include:
","
.
","
USAID/Zambia will monitor and evaluate programs and activities throughout the strategy period to ensure that those investments are achieving objectives and maximizing returns to investments. Though many of the investments will be managed and monitored primarily by USAID, some investments will originate from other USG agencies and by government, donors, or the private sector. The Zambia CAADP Country Investment Plan will provide a framework for the development of a more comprehensive national effort in agriculture and poverty reduction that will be supported through the USG FTF effort. CAADP monitoring is addressed below. The M&E framework for the USG FTF strategy outlined in this section will be inclusive and involve all government agencies investing in FTF areas, particularly in the FTF priority geographic area, Eastern province.
The geographic focus, co-location of investments, and the timing of the initiation of new investments provide the opportunity to establish a solid impact assessment framework as well. USAID/Zambia’s approach to monitoring and evaluation will be comprised of three components: 1) project-level reporting; 2) performance management/monitoring and evaluation; and, 3) external impact assessment to capture the aggregate impact of all investments and the relative contribution of different interventions to the extent feasible.
The FTF strategy will be implemented primarily through two of the USAID/Zambia CDCS Development Objectives (DO) and will meet the requirements of CDCS Development Objectives:
PERFORMANCE MANAGEMENT
The FTF Performance Monitoring Plan will include indicators measuring progress towards achieving results at all levels. For each indicator, the data source and methodology, baseline, targets, and a calendar of performance management tasks, including a schedule for data collection, will be included. The selection of indicators to include in the PMP will be driven by ongoing and planned activities, the availability of baseline, and provisions made to ensure availability of data for the reference reporting period.
To monitor performance, the Mission will establish baselines and collect data for standard and customized indicators to track whether desired results are occurring and whether performance is on target. All programs receiving FTF resources will be expected to develop monitoring and evaluation strategies that are consistent with the USG Zambia’s FTF framework.
Initial stakeholder workshops will be held for the purposes of:
Given that FTF has the intention to work with a broader range of partners, including local organizations, it is expected that some partners will have more limited reporting capacity. These organizations will need greater assistance, and it may be necessary to delegate the responsibility for some monitoring and reporting to external entities.
For higher level objectives, tracking performance will be beyond the manageable interest of individual projects. In particular, changes in incomes, nutritional status, and some community-level variables among others will be more appropriately measured across the program areas. The FTF Team is developing a consortium of stakeholders to assess existing data sources, and intends to identify an external entity to coordinate baseline and periodic data collection for specific indicators.
An FTF M&E plan will be finalized by the end of Fiscal Year 2011, outlining all indicators and the reporting responsibilities by all USAID/Zambia’s partners. Key FTF required indicators to be tracked and reported are listed in Annex B. Additional project-specific and other relevant indicators not included in the FTF required indicators will be added. It is important to note that all appropriate indicators will be sex-disaggregated.
EVALUATION
In line with the new evaluation policy, the FTF program intends to conduct a number of performance evaluations and impact evaluations. Evaluations of two programs closing in 2011, PROFIT and C-FAARM, will be useful for the FTF learning agenda. The USG FTF has a unique opportunity with a defined geographic focus and the initiation of new activities to establish an impact assessment framework to assess high level impact, as well as to identify the relative contribution of different intervention, such as value chain upgrading versus household level management skills. USAID/Zambia will work with partners and other agencies to develop an impact assessment methodology that is consistent with and contributes to the project performance monitoring framework, but will also test several development hypotheses.
An initial baseline survey will be conducted in Eastern province to establish current levels of key variables including incomes, nutritional status, household production and asset patterns, and agriculture technology levels. This baseline will draw from the latest survey methodologies, particularly recent work on gender and asset control24. An appropriate sampling framework will be established to assess impact, most likely on a biannual basis. A randomized approach will be considered for a sub-sample to maintain the integrity of the impact assessment; however, flexibility will be needed to consider mid-term correction in order to ensure the greatest impact over the period of the strategy.
In the context of the development challenges and opportunities identified in Zambia and outlined in Section 1.1, several development hypotheses are of interest for the impact assessment. In particular, the relative contribution will be assessed of community-level versus household-level interventions to reducing poverty and undernutrition, as well as the additional value of the co-location of interventions. Another hypothesis of interest to be tested is: By increasing productivity, improving household food security and linking smallholders to markets for agriculture commodities, FTF interventions will reduce the incentives for exploiting the natural resource base.
Performance Evaluation
The FTF program will schedule performance evaluations to focus on descriptive and normative questions including: project or program achievements (either at an intermediate point in execution or at the conclusion of an implementation period); program implementation; program perception and value; and other questions pertinent to program design, management and operational decision-making. These performance evaluations will incorporate before-after comparisons whenever feasible.
Impact Evaluation
The FTF program will conduct impact evaluations to measure the change in development outcomes attributable to FTF interventions. Impact evaluations will be based on cause-effect models and will require a credible and rigorously-defined counterfactual control. Impact evaluations with treatment and control groups help provide the strongest evidence of a relationship between interventions and measured outcomes. One hypothesis to be explored includes identifying increased benefits from combined interventions, particularly income-augmenting and nutrition-related activities. In the nutrition portfolio, the differential effect of geographically co-locating health programs active in nutrition with agriculture programs working on the productivity and diversity side of the nutrition equation can be tested.
LINK TO GOVERNMENT MONITORING SYSTEMS
USAID/Zambia has provided extensive support to the Government of Zambia in monitoring the agricultural sector, and in analyzing government data through the Food Security Research Project (FSRP). This support will continue and can be drawn upon to monitor agricultural trends. In addition, FSRP has expertise in analyzing surveys such as the biannual Living Conditions Monitoring Survey (LCMS) which tracks poverty levels, and the Supplemental Surveys, which provide quality agricultural data. This expertise can be leveraged for improved performance monitoring by the GRZ, as well as for FTF performance.
The CAADP framework focuses largely on performance in the agricultural sector. For national performance toward other MDGs, particularly those related to nutrition and gender impacts, the FTF team will work with additional partners to identify appropriate data sources and performance monitoring modalities. For example, the Nutrition Cooperating Partners sub-group may be instrumental in the creation of a data monitoring platform according to the SUN Movement principles. However, the Zambia FTF framework will focus its efforts largely on performance for the targeted FTF areas and the contribution of these changes to national levels.
","Feed the future aims to help an estimated 263,000 vulnerable Zambian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 173,000 children will be reached with services to improve their nutrition and prevent s","","","Number of people trained in child health and nutrition through USG-supported programs; Anemia among women of reproductive age (%); Number of health facilities with established capacity to manage acute undernutrition; Prevalence of anemia among children 6-59 months; Number of children under five years of age who received Vitamin A from USG-supported programs; Number of children under five reached by USG-supported nutrition programs.","Number of people trained in child health and nutrition through USG-supported programs; Anemia among women of reproductive age (%); Number of health facilities with established capacity to manage acute undernutrition; Prevalence of anemia among children 6-59 months; Number of children under five years of age who received Vitamin A from USG-supported programs; Number of children under five reached by USG-supported nutrition programs.","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Oilseeds
This program will facilitate the development of long-term linkages between smallholders that produce groundnuts, sesame, and/or soybeans and input and output markets. This will include efforts to bring better farming practices and inputs to the farm level, as well as linking production to markets through aggregation and farmer organizations. Specific activities include:
Technical assistance and grants to farmer associations/ cooperatives and agro-service centers, to enable them to provide
Support to build mentoring business relationships between commercial and emerging farmers, which are farmers that overcame size and productivity constraints and farm sizes between10 and 50 hectares. These commercial farmers provide some or all of the following to the emerging farmers:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.","Zambesia and Nampula Provinces","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Cashews
This investment builds on USAID/Mozambique‘s history of successful cashew sector development. This experience includes USAID Title II support to nurseries in seedling production and distribution and DA support to the local cashew processing industry – the latter resulting in one of the most vibrant cashew processing sectors in Africa. Building on this track record, FTF will now invest in a major supply-side constraint: renewing the existing stock of cashew plants. Mozambique has the oldest population of cashew trees in Africa (some trees are more than 80 years old) and overall productivity is decreasing rapidly. Thus, our FTF investment in cashews focuses on the expansion of cashew nurseries to supply new cashew seedlings and to extend pruning and crafting practices for existing trees.
Specific activities include:
Technical assistance and grants to existing nurseries or other investors (e.g., cashew processors, entrepreneurs) to incentivize establishing nurseries and supply seedlings and extension (nurseries to offer a package of seedlings, and training in seedling maintenance, crafting, and pruning; farmers to pay for this service).
Technical assistance and support to farmer and community organizations for them to support smallholders in grafting, pruning, and seedling care monitoring, and pass on processor-financed incentive payments for tree care.
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Fruit
Fruit is farmed by more than a million households in the focus regions, but currently provides very limited income opportunities. FTF will primarily focus on improving the income potential of domestic fruit, by supporting the development of a domestic processing sector. The underlying hypothesis is that upon successful development of the domestic fruit sector, smallholders can play an increasing role in a viable export market (e.g. through outgrower schemes). Nutrition activities will be co-located to ensure improved consumption of fruits on a household level.
Specific activities include:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The second set of core investments will focus on scaling up the delivery of key nutrition interventions in the focus regions, acting on both the demand and supply side. On the demand side, FTF will invest in documenting and reinforcing improved nutrition behaviors through district and community based nutrition activities including growth monitoring and promotion (building on USAID Title II support in Zambezia and Nampula) and the promotion of optimal nutrition-related behaviors (building on PEPFAR infrastructure in Sofala and Manica). On the supply side, FTF will encourage the availability of nutritious foods through a Nutrition Challenge Fund.
Community-Based Nutrition Activities
FTF/Mozambique will address Mozambique‘s high undernutrition rates through a comprehensive, standard program of activities at the community level that includes growth monitoring, promotion of optimal infant and young child feeding practices, and dietary diversity and quality for pregnant and lactating women. Specific activities include:
","
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2012","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The second set of core investments will focus on scaling up the delivery of key nutrition interventions in the focus regions, acting on both the demand and supply side. On the demand side, FTF will invest in documenting and reinforcing improved nutrition behaviors through district and community based nutrition activities including growth monitoring and promotion (building on USAID Title II support in Zambezia and Nampula) and the promotion of optimal nutrition-related behaviors (building on PEPFAR infrastructure in Sofala and Manica). On the supply side, FTF will encourage the availability of nutritious foods through a Nutrition Challenge Fund.
Nutrition Challenge Fund
FTF Mozambique will also stimulate the supply of nutritious, diverse, and quality foods. FTF/Mozambique will do this through a Nutrition Challenge Fund: a competitive grant scheme that encourages innovations in agro-processing (e.g. fortification, food processing) that reach a large share of the vulnerable population to improve nutrition. The competitive grant will be available to the private sector or community organizations, who will be selected based primarily on impact, innovation, and sustainability of the business model. Other potential criteria for selection include financial leverage, number of suppliers and consumers reached, and synergies with USG programs. FTF/Mozambique plans to leverage at least as much funding as will be contributed, although the aspiration is to leverage double our funding. The grants will provide up-front financing and technical assistance to ensure a successful venture.
","Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality..",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Urban|Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
USG/Mozambique will support FTF objectives and program activities through cross-cutting investments in policy analysis and advocacy, as well as research and technology transfer.
Policy
Policy analysis and advocacy is targeted to support an accelerated CAADP process, business and trade policy reform (particularly in the fruit sector), an integrated policy agenda for agriculture and nutrition, and policy supporting growth monitoring and nutrition. Specific initiatives include:
","
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Urban|Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
USG/Mozambique will support FTF objectives and program activities through cross-cutting investments in policy analysis and advocacy, as well as research and technology transfer.
Research and Technology Transfer
USG/Mozambique will leverage its comparative advantage in research and technology transfer, focusing support on the introduction and dissemination of new technologies. FTF/Mozambique will achieve this through support to the Mozambique Platform for Agricultural Research and Technology Innovation, which engages International Agricultural Research Centers (IARCs) and Brazil‘s national agricultural research enterprise (EMBRAPA). Main initiatives include:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 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.
Supporting women in agriculture and household nutrition is essential to the success of this strategy. Agriculture employs 90 percent of Mozambique‘s female labor force, and a quarter of all farming households are women-headed. Women are also the leaders on nutrition in the household. USG/Mozambique‘s FTF strategy supports women by:
Training women as trainers of other women in nutrition benefits and improved household processing of soybeans, orange fleshed sweet potato and cowpeas.
",".
","Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11627","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","RWA","Rwanda","Rwanda","Urban|Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. government’s global hunger and food security initiative, is a $3.5 billion commitment to support countrydriven approaches to address the root causes of poverty, hunger and undernutrition. A whole-of-government initiative led by the United States Agency for International Development (USAID), Feed the Future leverages the strengths of multilateral institutions, civil society and the private sector. Globally we aim to assist 18 million vulnerable women, children, and family members – mostly smallholder farmers – escape hunger and poverty. Together, we will increase agricultural productivity, decrease poverty, drive economic growth, and reduce undernutrition to improve millions of lives.
Over the next five years in Rwanda, Feed the Future aims to help an estimated 713,000 vulnerable Rwandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Rwanda is making core investments in three key areas:
1. Systems Transformation
Sustainable Market Linkages
Infrastructure
Nutrition
2. Innovation. Research Capacity Building Program
3. Policy
Concerted U.S. Government engagement at the policy level through the provision of SPA will ensure the FTF initiative in Rwanda has nation-wide impact. The policy dialogue with the GOR will seek to encourage more robust dialogue between the GOR and private sector and focus on key issues that are critical to raising productivity of staple crops and constitute core elements of the FTF strategy: privatization of the fertilizer market, post-harvest management, and land tenure security. The SPA will thus enhance the effectiveness of the technical support provided under the FTF initiative in these areas, and, similarly, the technical support will enhance the effectiveness of the SPA.
While the SPA will focus specifically on a few key measures to raise agricultural productivity, it can be expected to help strengthen the GOR-donor policy dialogue in the agriculture sector more generally and even to provide a platform for discussing other issues, such as food safety standards and climate change policy.62 According to the FAO, the core elements of a strengthened dialogue include: more detailed annual planning and budgeting, strengthening existing monitoring arrangements such as the JSRs, and a strengthened M&E system so that discussions are grounded in reliable performance information.63 Complementary technical support will therefore be provided to strengthen M&E capacity, including through the (re-)establishment of the Famine Early Warning System (FEWS) in Rwanda to strengthen data collection and analytical capacity on a number of issues that affect food security, such as climate change.
Because SPA resources will be channeled through GOR systems, it is important to have a full understanding of the risks the systems present so they can be mitigated. As previously mentioned, the general environment for making use of host-country systems in Rwanda is quite sound, with low levels of corruption and high levels of performance on various measures of the quality of public administration. The recent PEFA assessment found that substantial progress was made in the area of public financial management over the past three years, findings that were confirmed in the first phase application of USAID’s fiduciary risk assessment tool. The second phase application of the tool, performed with the support the internationally recognized accounting firm, Deloitte, involved a detailed analysis of agriculture sector institutions’ financial management systems and found that all identified risks can be mitigated through a targeted public financial management capacity building program within MINAGRI.64 Such a program will complement planned support to strengthen the human and institutional capacity of selected GOR institutions and civil society organizations that have a role in providing oversight of public expenditure and program performance.
",".
","PERFORMANCE MONITORING
USAID’s existing Performance Management Plan (PMP) for its Economic Growth SO already includes several FTF indicators or indicators closely related to them. Efforts to strengthen the PMP’s alignment with the initiative are underway while FTF nutrition indicators will be incorporated into the GHI/BEST PMP. USAID has developed a web-based performance monitoring tool that facilitates reporting from its implementing partners as a key element of its M&E system. This same system will be utilized to collect activity-level data on FTF indicators.
For many of the high-level FTF indicators, baselines will be established through two national surveys currently underway. Results from the Demographic and Health Survey (DHS), for which the U.S. Government is providing focused technical support to the National Institute of Statistics (NISR), will be available in late 2011 while results from a household survey, providing data on poverty levels, are scheduled to be released in early 2012. Consideration is being given to the regular application of an adapted version of USAID’s Poverty Assessment Tool in order to obtain some indication of poverty trends between household surveys, which typically only take place every five years, while an interim DHS planned for 2013/14 and a Knowledge, Attitudes, and Practices survey will document changes in nutritional status and feeding practices. Efforts will also be made to utilize the Ministry of Health database to which community health workers report cases of malnutrition via mobile phone.
As previously noted, given identified gaps in data collection and performance monitoring in MINAGRI, the U.S. Government will seek to strengthen its M&E capacity through the establishment of a FEWS field presence and additional M&E technical support. Other donors, including DFID, the EC, and the World Bank, are helping to strengthen the NISR, including its collection and analysis of agricultural data. Improvement of agricultural statistics is a core element of the GOR’s PSI program with the IMF, as data collection procedures that systematically over-estimated agricultural production were thought to compromise the reliability of the GOR’s national income accounts data.
Given Rwanda’s limited size and population, as well as planned U.S. Government engagement on several key policy issues that will have broad, national impact on agricultural development and nutrition, FTF assistance can be expected to substantively contribute to reductions in Rwanda’s rural poverty and malnutrition rates. Through FTF in Rwanda more than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. An estimated 713,000 vulnerable Rwandan women, children and family members will receive targeted assistance to escape hunger and poverty.
IMPACT EVALUATION
Periodic impact evaluations conducted over the course of the strategy period will help identify the contributions of FTF investments to progress observed through regular performance monitoring, as well as programmatic adjustments that may be required. As an example, a recent impact evaluation of the U.S. Government’s investments in the coffee sector over the past decade was used to inform a decision about whether continued support to the sector was warranted under the FTF initiative.66 An evaluation of USAID’s dairy competiveness program, undertaken in early 2011, likewise informed a decision to re-compete the program.
In addition, the Integrated Improved Livelihoods Program was selected for inclusion in USAID’s FY 2012 Evaluation Initiative, requiring a rigorous impact evaluation of the program’s central hypothesis that integrating microfinance with non-financial services, such as health and education, has the potential to address the multiple needs of the poor with greater efficiency and impact. The evaluation’s design will commence with program start-up to ensure the necessary baseline data is collected from treatment and control groups. The evaluation itself is planned to take place during the program’s third year of implementation so that lessons learned can be applied during its remaining two years.
","estimated 713,000 vulnerable Rwandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","","","Socio-economic status","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11627","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","RWA","Rwanda","Rwanda","Urban","on-going","01-2011","12-2015","Feed the Future, the U.S. government’s global hunger and food security initiative, is a $3.5 billion commitment to support countrydriven approaches to address the root causes of poverty, hunger and undernutrition. A whole-of-government initiative led by the United States Agency for International Development (USAID), Feed the Future leverages the strengths of multilateral institutions, civil society and the private sector. Globally we aim to assist 18 million vulnerable women, children, and family members – mostly smallholder farmers – escape hunger and poverty. Together, we will increase agricultural productivity, decrease poverty, drive economic growth, and reduce undernutrition to improve millions of lives.
Over the next five years in Rwanda, Feed the Future aims to help an estimated 713,000 vulnerable Rwandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Rwanda is making core investments in three key areas:
1. Systems Transformation
Sustainable Market Linkages
Infrastructure
Nutrition
2. Innovation. Research Capacity Building Program
3. Policy
It is well known that research generates some of the highest average returns to public investment in agriculture.60 In Rwanda, where research capacity is extremely limited – it is estimated there are only about 30 people actively engaged in agriculture-related research with PhDs61 – the returns are likely to be even higher. As a result, the country is not adequately prepared to meet the demands of producers for improved agricultural inputs and respond to emerging threats to agricultural productivity and food security, such as crop disease and climate change. Developing such capacity is all the more important in light of the GOR’s policy to encourage land use consolidation. FTF assistance will therefore invest in strengthening Rwandan research capacity, with priority given to actionable, demand-driven research in support of priority value chains and nutrition objectives, such as maize and bean varieties that are more resistant to extreme weather events and post-harvest technologies that can be commercialized.
The program will aim to strengthen the capacity of the Rwandan Agriculture Research Institute (ISAR) to produce relevant research and develop systems, in cooperation with Belgian assistance, to ensure research results are disseminated to the field through an improved extension network. Drawing on USAID’s extensive experience with higher education partnerships in Africa, the program will also provide cost-effective, long-term degree training by forging partnerships between U.S. and Rwandan universities so that the country begins to produce a steady stream of qualified agricultural researchers and extension agents. Consistent with the recommendations of the gender strategy for the agriculture sector, special efforts will be made to encourage female enrollment in agricultural universities as a means of ensuring the different needs of women are considered in the country’s agricultural research and extension agendas.
","Improved agricultural productivity
","PERFORMANCE MONITORING
USAID’s existing Performance Management Plan (PMP) for its Economic Growth SO already includes several FTF indicators or indicators closely related to them. Efforts to strengthen the PMP’s alignment with the initiative are underway while FTF nutrition indicators will be incorporated into the GHI/BEST PMP. USAID has developed a web-based performance monitoring tool that facilitates reporting from its implementing partners as a key element of its M&E system. This same system will be utilized to collect activity-level data on FTF indicators.
For many of the high-level FTF indicators, baselines will be established through two national surveys currently underway. Results from the Demographic and Health Survey (DHS), for which the U.S. Government is providing focused technical support to the National Institute of Statistics (NISR), will be available in late 2011 while results from a household survey, providing data on poverty levels, are scheduled to be released in early 2012. Consideration is being given to the regular application of an adapted version of USAID’s Poverty Assessment Tool in order to obtain some indication of poverty trends between household surveys, which typically only take place every five years, while an interim DHS planned for 2013/14 and a Knowledge, Attitudes, and Practices survey will document changes in nutritional status and feeding practices. Efforts will also be made to utilize the Ministry of Health database to which community health workers report cases of malnutrition via mobile phone.
As previously noted, given identified gaps in data collection and performance monitoring in MINAGRI, the U.S. Government will seek to strengthen its M&E capacity through the establishment of a FEWS field presence and additional M&E technical support. Other donors, including DFID, the EC, and the World Bank, are helping to strengthen the NISR, including its collection and analysis of agricultural data. Improvement of agricultural statistics is a core element of the GOR’s PSI program with the IMF, as data collection procedures that systematically over-estimated agricultural production were thought to compromise the reliability of the GOR’s national income accounts data.
Given Rwanda’s limited size and population, as well as planned U.S. Government engagement on several key policy issues that will have broad, national impact on agricultural development and nutrition, FTF assistance can be expected to substantively contribute to reductions in Rwanda’s rural poverty and malnutrition rates. Through FTF in Rwanda more than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. An estimated 713,000 vulnerable Rwandan women, children and family members will receive targeted assistance to escape hunger and poverty.
IMPACT EVALUATION
Periodic impact evaluations conducted over the course of the strategy period will help identify the contributions of FTF investments to progress observed through regular performance monitoring, as well as programmatic adjustments that may be required. As an example, a recent impact evaluation of the U.S. Government’s investments in the coffee sector over the past decade was used to inform a decision about whether continued support to the sector was warranted under the FTF initiative.66 An evaluation of USAID’s dairy competiveness program, undertaken in early 2011, likewise informed a decision to re-compete the program.
In addition, the Integrated Improved Livelihoods Program was selected for inclusion in USAID’s FY 2012 Evaluation Initiative, requiring a rigorous impact evaluation of the program’s central hypothesis that integrating microfinance with non-financial services, such as health and education, has the potential to address the multiple needs of the poor with greater efficiency and impact. The evaluation’s design will commence with program start-up to ensure the necessary baseline data is collected from treatment and control groups. The evaluation itself is planned to take place during the program’s third year of implementation so that lessons learned can be applied during its remaining two years.
",".",".","","","","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11627","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","RWA","Rwanda","Rwanda","Urban|Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. government’s global hunger and food security initiative, is a $3.5 billion commitment to support countrydriven approaches to address the root causes of poverty, hunger and undernutrition. A whole-of-government initiative led by the United States Agency for International Development (USAID), Feed the Future leverages the strengths of multilateral institutions, civil society and the private sector. Globally we aim to assist 18 million vulnerable women, children, and family members – mostly smallholder farmers – escape hunger and poverty. Together, we will increase agricultural productivity, decrease poverty, drive economic growth, and reduce undernutrition to improve millions of lives.
Over the next five years in Rwanda, Feed the Future aims to help an estimated 713,000 vulnerable Rwandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Rwanda is making core investments in three key areas:
1. Systems Transformation
Sustainable Market Linkages
Infrastructure
Nutrition
2. Innovation. Research Capacity Building Program
3. Policy
While nutritional value was a key criteria in selecting priority value chains, planned value chain investments will be designed to ensure their nutritional benefits are maximized. Increasing the focus of post-harvest investments on the household level, as noted above, and targeting women with the Integrated Improved Livelihoods Program are expected to contribute to the FTF nutrition objective and are part of the NSEM’s plan to strengthen and scale-up CBNP.
Interestingly, recent evaluative evidence suggests access to microfinance may contribute more to maintaining basic food security and nutrition than raising incomes due to its consumption-smoothing effects and the flexibility it offers in dealing with unexpected health emergencies.58 Research also suggests that integrating microfinance with nonfinancial services, such as education on improved feeding and consumption practices, as is planned in the Integrated Improved Livelihoods Program, offers great potential to address the multiple needs of the poor in a more efficient manner.
It is important to note that achieving the FTF nutrition objective in Rwanda will require investments beyond those which can be integrated into investments in priority value chains. Illustrative activities and expected results in each of these areas are as follows:
FTF assistance will support improvements in the quality of routine reporting to monitor mild, moderate, and acute malnutrition among young children and pregnant and lactating women. For example, the Ministry of Health has introduced a system for providing community health workers with health and nutrition information and promptly reporting cases of malnutrition via mobile phone.
PERFORMANCE MONITORING
USAID’s existing Performance Management Plan (PMP) for its Economic Growth SO already includes several FTF indicators or indicators closely related to them. Efforts to strengthen the PMP’s alignment with the initiative are underway while FTF nutrition indicators will be incorporated into the GHI/BEST PMP. USAID has developed a web-based performance monitoring tool that facilitates reporting from its implementing partners as a key element of its M&E system. This same system will be utilized to collect activity-level data on FTF indicators.
For many of the high-level FTF indicators, baselines will be established through two national surveys currently underway. Results from the Demographic and Health Survey (DHS), for which the U.S. Government is providing focused technical support to the National Institute of Statistics (NISR), will be available in late 2011 while results from a household survey, providing data on poverty levels, are scheduled to be released in early 2012. Consideration is being given to the regular application of an adapted version of USAID’s Poverty Assessment Tool in order to obtain some indication of poverty trends between household surveys, which typically only take place every five years, while an interim DHS planned for 2013/14 and a Knowledge, Attitudes, and Practices survey will document changes in nutritional status and feeding practices. Efforts will also be made to utilize the Ministry of Health database to which community health workers report cases of malnutrition via mobile phone.
As previously noted, given identified gaps in data collection and performance monitoring in MINAGRI, the U.S. Government will seek to strengthen its M&E capacity through the establishment of a FEWS field presence and additional M&E technical support. Other donors, including DFID, the EC, and the World Bank, are helping to strengthen the NISR, including its collection and analysis of agricultural data. Improvement of agricultural statistics is a core element of the GOR’s PSI program with the IMF, as data collection procedures that systematically over-estimated agricultural production were thought to compromise the reliability of the GOR’s national income accounts data.
Given Rwanda’s limited size and population, as well as planned U.S. Government engagement on several key policy issues that will have broad, national impact on agricultural development and nutrition, FTF assistance can be expected to substantively contribute to reductions in Rwanda’s rural poverty and malnutrition rates. Through FTF in Rwanda more than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. An estimated 713,000 vulnerable Rwandan women, children and family members will receive targeted assistance to escape hunger and poverty.
IMPACT EVALUATION
Periodic impact evaluations conducted over the course of the strategy period will help identify the contributions of FTF investments to progress observed through regular performance monitoring, as well as programmatic adjustments that may be required. As an example, a recent impact evaluation of the U.S. Government’s investments in the coffee sector over the past decade was used to inform a decision about whether continued support to the sector was warranted under the FTF initiative.66 An evaluation of USAID’s dairy competiveness program, undertaken in early 2011, likewise informed a decision to re-compete the program.
In addition, the Integrated Improved Livelihoods Program was selected for inclusion in USAID’s FY 2012 Evaluation Initiative, requiring a rigorous impact evaluation of the program’s central hypothesis that integrating microfinance with non-financial services, such as health and education, has the potential to address the multiple needs of the poor with greater efficiency and impact. The evaluation’s design will commence with program start-up to ensure the necessary baseline data is collected from treatment and control groups. The evaluation itself is planned to take place during the program’s third year of implementation so that lessons learned can be applied during its remaining two years.
","estimated 713,000 vulnerable Rwandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 174,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","","","Vulnerable groups","","Multiple micronutrient powders for home fortification of foods consumed by children 6–23 months of age>>>Multiple micronutrient powders for home fortification of foods consumed by children 6–23 months of age>>http://www.who.int/elena/titles/micronutrientpowder_infants","","","","","","","","","","","","","","","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17803","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child","6-59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
OTP Outcome
Cured % (#)
> 75%
Died % (#)
< 10%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (June-Dec)
74.5 (1540)
0.7 (14)
6.9 (143)
17.9 (371)
Niamey (Aug-Dec)
83.3 (445)
0.4 (2)
3.6 (19)
12.7 (68)
Tahoua (Aug-Dec)
86.6 (453)
1.0 (5)
10.3 (54)
2.1 (11)
Tillaberi (Jan-Dec)
86.4 (912)
1.5 (16)
11.0 (116)
1.1 (12)
Zinder (Jan-Dec)
83.6 (799)
4.3 (41)
10.0 (96)
2.1 (20)
Reporting Period: Jan - Dec, 2011
Maradi
93.5 (4510)
0.3 (16)
4.9 (235)
1.3 (62)
Niamey
NA
NA
NA
NA
Tahoua
84.2 (1054)
0.8 (10)
5.8 (72)
9.3 (116)
Tillaberi
85.5 (1484)
1.6 (27)
10.8 (187)
2.1 (37)
Zinder
94.8 (1803)
0.5 (9)
3.2 (61)
1.5 (29)
Reporting Period: Jan - Dec, 2012
Maradi
97.7 (2651)
0.1 (3)
1.5 (41)
0.7 (18)
Niamey
86.9 (839)
0.3 (3)
5.4 (52)
7.5 (72)
Tahoua
84.7 (762)
1.6 (14)
10.4 (94)
3.3 (30)
Tillaberi
89.1 (886)
1.7 (17)
8.4 (83)
0.8 (8)
Zinder
98.8 (4200)
0.3 (12)
0.1 (6)
0.8 (32)
Reporting Period: 2013
Maradi (Jan-Apr)
94.6 (546)
0.5 (3)
3.3 (19)
1.6 (9)
Niamey (Jan-May)
70.1 (129)
0.0 (0)
18.5 (34)
11.4 (21)
Tahoua (Jan-May)
92.7 (281)
0.0 (0)
4.6 (14)
2.6 (8)
Tillaberi (Jan-Mar)
95.8 (46)
0.0 (0)
4.2 (2)
0.0 (0)
Zinder (Jan-May)
99.6 (1254)
0.2 (3)
0.1 (1)
0.1 (1)
","
Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805 ","Zinder: April-May 2007, point coverage = 21.4% and period coverage = 36.1%. ","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% MAY, 2013:TILLABERRI GAM 13.3%, SAM 3.1%ZINDER GAM 11.7%, SAM 2.3%MARADI GAM 16.3%, SAM 3.0%TAHOUA GAM 13.1%, SAM 2.3%NIAMEY GAM 11.0%, 1.6%","See above","Vulnerable groups","","Treatment of dehydration in children with severe acute malnutrition>>>Treatment of dehydration in children with severe acute malnutrition>>http://www.who.int/elena/titles/dehydration_sam","Supplies","Problem: There had been some difficulties in ensuring a consistent supply of RUTF. The nutritional commodities for the treatment of SAM are supplied via UNICEF through the MOH supply structure. But there were some challenges due to logistical and organisational issues, including the local/global availability of RUTF. Solution: WV established a buffer stock to resolve the issue. ","Supplies","Problem: A lack of consistent supply of medicines to the CSIs risks the increase in morbidity and mortality from illnesses such as pneumonia and malaria which are major causes of mortality in malnourished children. The care of children under the age of five are free in Niger. However, there are frequent shortage in medicinal supply. Because of the exemption of the fee and the system of cost recovery are in place, in principle UNICEF does not provide for the medicines for activities related to CMAM program although some spot supplies are available they are often inadequate. Solution: WVN is, already involved in the provision of medicines through the activities of ADP and, in case of need, the support will be intensified during this period of crisis. In addition to the routine medicines used for the treatment of the children admitted in the OTP, it would be important that WVN also considers to provide, in the event of rupture, the medicines needed to treat the pathologies associated with malnutrition.","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program.Solution: WV developed an Instituational Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities.Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff"," Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","","","","Zeinaba Abdoulahi lost her second child five years ago at the age of 4; his death is still a source of grief for this young Nigerien mother. Earlier this year, her fourth child, Tinoumoune, was close to death. The eight-month old girl was dehydrated and losing weight. After treating her with traditional herbal remedies, Tinoumoune continued to become physically weaker and weaker and had a fever for eight days. Zeinaba says “My child was between life and death. She was fading away. I had not a droplet of hope.” Zeinaba bundled her daughter on her back and left early in the morning to walk the seven kilometres from her village to the closest health centre, which runs a community-based management of acute malnutrition (CMAM) programme supported by World Vision. Tinoumoune was diagnosed with severe acute malnutrition and admitted to the nutrition programme, where she was treated with ready-to-use therapeutic food. “In two weeks, she regained weight and became stronger and healthier. I’m very happy.” explains Zeinaba. The family has been spared the grief of a second lost child.
©2010 Ann Birch/World Vision ©2010 Gebregziabher Hadera/World
Mma Halima is a CMAM community volunteer in Niger. She started in this role after caring for her own malnourished son until he graduated from World Vision's CMAM programme. Mma Halima screens and refers malnourished children in her nomadic community and provides health and nutrition education. She describes the ripple effect of her son's rehabilitation through CMAM: ""Now in my community all the mothers are using mosquito nets and our children are not getting sick as before. Now I have only two malnourished children in my community. It is impressive.""
","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17821","","Management of moderate malnutrition","","","","MAM child|Preschool-age children (Pre-SAC)","6 - 59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","SFP Outcome
Cured % (#)
> 75%
Died % (#)
< 3%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (Sept-Dec)
88.5 (491)
0.4 (2)
8.6 (48)
2.5 (14)
Niamey (Jan-Dec)
88.6 (194)
0.0 (0)
1.4 (3)
10.0 (22)
Tahoua (Aug-Dec)
86.4 (248)
0.0 (0)
13.6 (39)
0.0 (0)
Tillaberi (June-Dec)
88.4 (501)
0.7 (4)
10.2 (58)
0.7 (4)
Zinder (Jan-Dec)
90.8 (640)
2.6 (18)
5.4 (38)
1.3 (9)
Reporting Period: Jan - Dec, 2011
Maradi
97.0 (7069)
0.0 (3)
2.2 (162)
0.7 (51)
Niamey
85.8 (1949)
0.2 (5)
7.7 (175)
6.3 (143)
Tahoua
92.1 (1413)
0.0 (0)
6.3 (96)
1.6 (25)
Tillaberi
93.7 (4413)
0.2 (9)
5.1 (242)
0.9 (44)
Zinder
95.6 (4825)
0.4 (18)
2.4 (119)
1.7 (84)
Reporting Period: Jan - Dec, 2012
Maradi
99.0 (9559)
0.0 (0)
0.4 (38)
0.6 (54)
Niamey
81.3 (1886)
0.0 (0)
10.0 (233)
8.7 (201)
Tahoua
90.1 (984)
0.2 (2)
7.7 (84)
2.0 (22)
Tillaberi
88.7 (2065)
0.2 (4)
9.7 (226)
1.4 (33)
Zinder
94.9 (5508)
0.1 (3)
2.6 (148)
2.5 (143)
Reporting Period: 2013
Maradi (Jan-Apr)
97.1 (1501)
0.1 (1)
2.7 (42)
0.1 (2)
Niamey (Jan-Apr)
73.9 (241)
0.0 (0)
18.7 (61)
7.4 (24)
Tahoua (Jan-May)
88.7 (344)
0.0 (0)
9.0 (35)
2.3 (9)
Tillaberi
NA
NA
NA
NA
Zinder (Jan-May)
99.7 (2910)
0.0 (0)
0.2 (6)
0.1 (2)
","Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805","Zinder: April-May 2007, point coverage = 28.5% and period coverage = 49.0%.","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","See above","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","Supplies","Problem: The lack of a consistent supply of nutritional commodities for SFP has put children suffering from MAM at an increased risk for relapse, non-response, deterioration in status (into SAM) and defaulting. This lack of consistency has also negatively affected the credibility of the SFP program within the community. In turn, this has reduced the overall number of caregivers accessing the SFP services and thus has become a barrier to access.Solution: Contingency planning by the Food Commodity Department and logistics within WV to avoid stock shortage. For example add an extra percentage onto projected estimations each month in order to always have stock in place. ","Communication","Problem: The lack of clarity over the use of RUSF (Ready-to-Use Supplementary Food) and the target group has introduced increased risks for MAM cases in more vulnerable age groups. These cases were not being treated properly, thereby reducing effectiveness of the SFP program. Solution: Clarification with written protocols on the use of RUSF and other nutritional commodities for MAM and the target groups should be made available in the CSIs. It is also essential that there is community sensitization/awareness in the CSI catchment communities on the MAM aspect of CMAM.","External factors","Problem - Conflicting admission criteria: Community Volunteers (Femmes Relais) screen children for MAM in the communities using MUAC. However, upon arrival to the CSI/CS, the same children are admitted into the program on the basis of W/H criteria (outlined in National Protocol). Due to the discrepancies between W/H and MUAC screening, children are rejected from the program. This can reduce the effectiveness of community mobilization because of the problem of rejection.Solution: In order to increase coverage of the program a mass screening was carried out in the 5 regions covered by WV. Over 40,000 children were screened which resulted in a subsequent increase in the SFP admission. ","External factors","Problem: Distance as a barrier to access. Some of the CSI are located very far from the communities that they are serving. Solution: Expand MAM treatment (i.e. SFP) to Health Posts (CS) in order to reduce distance travelled for beneficiaries thus helping to improve the program accessibility as well as reducing the work load in CSIs (however the program capacity must be assured before decentralising these services to health posts).","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program. Solution: WV developed an Institutional Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities. Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff","Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","01-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17823","","Food distribution/supplementation for prevention of acute malnutrition","","","","Lactating women (LW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS","","Zinder, Maradi, Niamey, Tahoua","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17824","","Nutrition education and counselling","","","","Adolescents|Adult men and women|Elderly|Family ( living in same household)|Females|Lactating women (LW)|Males|Non-pregnant women (NPW)|Non-pregnant, non-lactating women (NPNLW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS|Women of reproductive age (WRA)","","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","Once the main components of the CMAM programme (e.g. OTP and SFP) have been well implemented in the existing MOH and community structures, a focus was given to address the negative behavioural and adaptive issues around IYCF in order to prevent further malnutrition. Depending on the priorities and funding availability, some ADPs were able to integrate IYCF activities in the CMAM. These included carrying out weekly health and nutrition session on CMAM days at the CSIs (Health Centers) and reactivating PD Hearth approach to develop menus using new types of locally available foods for complementary feeding promotion. Additional objectives of IYCF included strengthening existing nutrition systems and capacity building through training of health workers and community volunteers on IYCF and carrying out a baseline survey on IYCF and quarterly monitoring of changes in behaviour (e.g. EBF rates, diversity of food groups in complementary feeding). However, apart from the weekly nutrition education sessions at the CSIs, some of the activities did not translate into action at the community level. For example, the training of national WV staff on IYCF did not cascade down to the community level with community volunteers and also did not translated into activities or development of monitoring tools at community level. Additionally, no baseline IYCF information was available and quarterly monitoring data had not been collected or was unavailable at community level.
NB: This program was funded for a year therefore continuation of the activities beyond the funding period is likely be sporadic as it will depend on various factors including staff and volunteer capacity and motivation.
","For Tillaberi and Niamey regions in July 2010-July 2011:
Nutrition education (incl. IYCF): Target 24,700; Achieved (by the 3rd quarter) 14,234
Number and percentage of infants 0-6 mos who are exclusively breastfed: Target 310 (10%); Achieved N/A
Number and percentage of children aged 6-24 mos who receive foods daily from 4 or more food groups: Target 3045 (40%); Achieved N/A
","Due to a lack of monitoring and reporting it was not possible to report on Infant and Young Child Feeding activities apart from nutrition education sessions at the health centers even if these activities had been occurring in an informal manner in the communities. But it appears that these activities had been strengthened and expanded towards the end of the programme cycle.
","See outcome indicator section","NA","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","Same as above","Vulnerable groups","","","Management","","","","","","","","","","","","","","","","","","","","","WV Niger’s implementation of IYCF activities into the ongoing CMAM program started late in the program period. Due to the high resource (human & financial) intensity of implementing a CMAM program, it was not feasible to introduce IYCF activities until the latter program stages. At the beginning of the program, the MOH staff were trained in providing nutrition education sessions at CSIs on OTP/SFP days which included IYCF messages. Later on, national WV staff were trained on IYCF with the aim that they would cascade this training to the ADP level and then to the community level. However, the training did not continue to the community level (with community volunteers) until near end of the program period.
To strengthen IYCF component of CMAM including monitoring activities, the following activities are recommended:
1. Recruit community mobilisers at ADP level who will work with district Community Focal Points, WV ADP and National Community Mobiliser. The lack of WV community mobilisers at ADP level to work alongside the Nutrition Coordinators has risked a delay in training community volunteers and may have also prevented the implementation of community mobilization activities including IYCF activities and monitoring of these activities.
2. Ensure women are represented in nutrition programs. During the IYCF investigation the 50/50 presence of women as interviewers for the IYCF investigation ensured better access to women and thus the provision of more rigorous information regarding IYCF practices.
3. Develop monitoring tools for IYCF. E.g. How many IYCF sessions held and how many participated?
4. Carry out a representative and statistically significant baseline and final IYCF survey – for EBF rates and diversity of food groups.
","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","01-1978","01-1989","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Internal provision supplementary feeding
","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year). ","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","01-1978","01-1989","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year). ","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","01-1978","01-1989","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year). ","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","01-1978","01-1989","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Internal provision supplementary feeding
","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Weight-for-age z-score (WAZ)
","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","There was a reduction in underweight from 28.3% (1983) to 18.7% (1985) (3.2 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23111","Barangay Integrated Development Approach for Nutrition Improvement (BIDANI)","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The Barangay Integrated Development Approach for Nutrition Improvement (BIDANI) programme ran in the Philippines from 1978 to 1989
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of BIDANI is retrieved from the ENA Part II where BIDANI is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 2/child per year","UN","United Nations Children's Fund (UNICEF)","Although the programme showed positive impact on weight for age, implementation was found to be a consistent restraint
","","70 % coverage of children under 5 years","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11445","Iodin deficiency disorders control programme","English","National","","GHA","Ghana","Accra, Greater Accra, Ghana|Kumasi, Ashanti, Ghana|Takoradi, Western, Ghana|Sunyani, Brong Ahafo, Ghana|Cape Coast, Central, Ghana|Wa, Ghana|Tamale, Ghana|Bolgatanga, Ghana|Koforidua, Eastern, Ghana|Ho, Volta, Ghana","Urban|Rural|Peri-urban","on-going","01-1996","","The programme focuses on the promotion of iodised salt consumption to elimate IDDs which are highly prevalent in Ghana. This done through sensitization of the public, training of salt producers and law enforcement agencies.
","Total goitre rates, household iodised salt consumption, market coverage of iodised salt, urinary and salt iodine concentrations
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Awareness creation of policy makers on the need to make funds available for IDD programms","Stakeholder","Ineffective collaboration is also dealt with by creating awareness of the importance of the programme to get them to include IDD in their work plan","Supplies","Removal of tax exemption on the import of potassium iodate to reduce the cost salt iodisation in the factories and cottage salt producers","","","","","","","","","","","","","","","","The programme focusses on the promotion of iodised salt consumption to eliminate IDDs which are prevalent in Ghana. This is done through enforcement of the Public Health Amendment law 2012 Act 851, which states that salts for human and animal cosumption must be iodised. The programme also trains salt producers on effective ways of iodising salt.
","Total goitre rates, urinary and salt iodine concentrations,Household iodated salt consumption coverageMarket coverage of iodated salt
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Creating awareness of the importance of the program in policy makers to make funds available for the programme","Stakeholder","Lyasing with international organizations to inculcate IDD in their programms","Supplies","Imposing tax exemption on the importation of potassium iodate to reduce the cost of salt iodisation","","","","","","","","","","","","","","","","Establishment of salt banks at salt producing areas to mop up salts produce by small scale salt producers
","","English" "23287","The Child Pastorate Programme (CPP) ","English","Large scale programmes","","BRA","Brazil","","","on-going","","","The Child Pastorate Programme (CPP) is an ongoing large-scale programme in Brazil. In 2001 CPP coverage by area was about 63% (5140/8159 parishes), providing services to 32 265 communities. Coverage by population for the same year was about 1.6 million children less than 6 years of age (9.8% of total population for age group), in addition to more than 77 000 pregnant women.
The programme also included micronutrient supplementation to lactating women and children below 6 years of age, and referral through at home visits by community worker.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of CCP is retrieved from the ENA Part II where CCP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrit...
","","","","","","","","","","","","","","","","","","","Other","Catholic Church of Brazil","Resource intensity for the CPP is US$ 4/person per year and personnel intensity is 1 community worker: 37 children less than 6 years of age. Total funding for the programme for 1999-2000 was US$ 6.9 million.","Government","Health","Ministry of Health","Government","Education and research","Ministry of Education","Private sector","Private sector","GLOBO TV Network","UN","United Nations Children's Fund (UNICEF)","At home visits by community worker
","Exclusive breastfeeding
Weight
Increased weight
Malnoursihment
","Internal evaluation were conducted from 1988 - 2001 reported an increase in EBF during the first 4 months (from 60% to 80%), decreases in malnourished children (from 18% to 4%) and pregnant women (from 20% to 4%). External evaluation data are unavalable.
","","In 2001: 77000 pregnant women ","","","Participants' sustained rate of underweight reduction: 1.1 ppt/year
","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23287","The Child Pastorate Programme (CPP) ","English","Large scale programmes","","BRA","Brazil","","","on-going","","","The Child Pastorate Programme (CPP) is an ongoing large-scale programme in Brazil. In 2001 CPP coverage by area was about 63% (5140/8159 parishes), providing services to 32 265 communities. Coverage by population for the same year was about 1.6 million children less than 6 years of age (9.8% of total population for age group), in addition to more than 77 000 pregnant women.
The programme also included micronutrient supplementation to lactating women and children below 6 years of age, and referral through at home visits by community worker.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of CCP is retrieved from the ENA Part II where CCP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrit...
","","","","","","","","","","","","","","","","","","","Other","Catholic Church of Brazil","Resource intensity for the CPP is US$ 4/person per year and personnel intensity is 1 community worker: 37 children less than 6 years of age. Total funding for the programme for 1999-2000 was US$ 6.9 million.","Government","Health","Ministry of Health","Government","Education and research","Ministry of Education","Private sector","Private sector","GLOBO TV Network","UN","United Nations Children's Fund (UNICEF)","At home visits by community worker
","Weight
Increased Weight
Malnourishment
","Internal evaluations from 1988 - 2001 reported decreases in malnourished children (from 18% to 4%) and low birth weight (from 14% to 6%). External evaluations are not available.
","","1.6 million children less than 6 years of age (9.8% of total population for age group)","","","Participants' sustained rate of underweight reduction: 1.1 ppt/year
","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23287","The Child Pastorate Programme (CPP) ","English","Large scale programmes","","BRA","Brazil","","","on-going","","","The Child Pastorate Programme (CPP) is an ongoing large-scale programme in Brazil. In 2001 CPP coverage by area was about 63% (5140/8159 parishes), providing services to 32 265 communities. Coverage by population for the same year was about 1.6 million children less than 6 years of age (9.8% of total population for age group), in addition to more than 77 000 pregnant women.
The programme also included micronutrient supplementation to lactating women and children below 6 years of age, and referral through at home visits by community worker.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of CCP is retrieved from the ENA Part II where CCP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrit...
","","","","","","","","","","","","","","","","","","","Other","Catholic Church of Brazil","Resource intensity for the CPP is US$ 4/person per year and personnel intensity is 1 community worker: 37 children less than 6 years of age. Total funding for the programme for 1999-2000 was US$ 6.9 million.","Government","Health","Ministry of Health","Government","Education and research","Ministry of Education","Private sector","Private sector","GLOBO TV Network","UN","United Nations Children's Fund (UNICEF)","At home visits by community worker
","Weight
Increased weight
Malnourishment
","Internal evaluations were conducted from 1988–2001 with reported decreases in malnourished children (from 18% to 4%) and pregnant women (from 20% to 4%), as well
as low birth weight (from 14% to 6%). External evaluation data are unavailable.
","","1.6 million children less than 6 years of age (9.8% of total population for age group). More than 77 000 pregnant women.","","","Participants' sustained rate of underweight reduction: 1.1 ppt/year
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23287","The Child Pastorate Programme (CPP) ","English","Large scale programmes","","BRA","Brazil","","","on-going","","","The Child Pastorate Programme (CPP) is an ongoing large-scale programme in Brazil. In 2001 CPP coverage by area was about 63% (5140/8159 parishes), providing services to 32 265 communities. Coverage by population for the same year was about 1.6 million children less than 6 years of age (9.8% of total population for age group), in addition to more than 77 000 pregnant women.
The programme also included micronutrient supplementation to lactating women and children below 6 years of age, and referral through at home visits by community worker.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of CCP is retrieved from the ENA Part II where CCP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrit...
","","","","","","","","","","","","","","","","","","","Other","Catholic Church of Brazil","Resource intensity for the CPP is US$ 4/person per year and personnel intensity is 1 community worker: 37 children less than 6 years of age. Total funding for the programme for 1999-2000 was US$ 6.9 million.","Government","Health","Ministry of Health","Government","Education and research","Ministry of Education","Private sector","Private sector","GLOBO TV Network","UN","United Nations Children's Fund (UNICEF)","At home vists by community worker
","Weight
Increased weight
Malnourishement
","Internal evaluations were conducted from 1988–2001 with reported decreases in malnourished children (from 18% to 4%) and pregnant women (from 20% to 4%), as well as low birth weight (from 14% to 6%). An increase in EBF during the first 4 months was also reported (from 60% to 80%). External evaluation data are unavailable.
","","More than 77 000 pregnant women","","","Participants' sustained rate of underweight reduction: 1.1 ppt/year
","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23312","Productive Safety Net Programme (PSNP)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Productive Safety Net Programme (PSNP) provides direct budgetary support through a multi-donor trust fund. Outside of South Africa, PSNP is the largest social protection programme in sub-Saharan Africa. PSNP employs geographic, administrative and community-based targeting to identify chronically food-insecure populations. The objective of the programme is to improve food security and prevent vulnerable households from having to sell assets (nutrition is not explicitly addressed).
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of PSNP is retrieved from the ENA Part II where PSNP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Resource intensity estimated at US$ 47,37/hd/year. The annual budget is around US$ 360 million. Per capita, cash and food transfers totaled US$ 32.8 for male-headed households and US$ 37.1 for female-headed households in 2007.","Government","","Government of Ethiopia","UN","Other","Other donors providing direct budgetary support through a multi-donor trust fund","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23311","","Conditional cash transfer","","","","Family ( living in same household)","","","Community-based","","Cash and/or in-kind support is provided to targeted households in exchange for labour-intensive public works to build community assets.
Labourpoor households (i.e. female-headed households with young children, the elderly, pregnant or lactating women (PLWs)) receive unconditional transfers
","Anthropometry
","An impact evaluation in 2008 found no significant change in anthropometric status of children in PSNP households compared to non-PSNP households. However, participation had positive effects on use of education and health services and household food security, caloric acquisition, and asset protection.
","","Nearly 10% of the country (7.6 million people), covering more than 40% of the woredas.","","","No change in anthropometric status of children.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23315","Enhanced Outreach Strategy/Extended Enhanced Outreach Strategy (EOS/EEOS)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The EOS/Targeted Supplementary Feeding (TSF) programme began in 2004 as a pilot, and quickly scaled up to cover 6.8 million children in 365 drought-prone woredas. In 2005/6, the programme was expanded through the EEOS, which covers additional woredas with a reduced package of only vitamin A supplementation and deworming. National coverage by EOS and EEOS has expanded to reach around 95% of children under 5. In 2008, the programme covered 163 food-insecure woredas.
Under the Health Extention Programme (HEP) the EOS programme is currently phasing out and being replaced by Community Health Days. These events will offer the same inputs as EOS but will move away from the regionally-supported biannual mobilizations and instead be carried out quarterly, supported by the district health structures and Health Extention Workers (HEWs)
Children 6-59 months of age were screened using mid-upper arm circumference (MUAC) cutoff 12.0 cm.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of EOS/EEOS is retrieved from the ENA Part II where EOS/EEOS is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 43 million.Estimated cost of US$ 1.14 per child (with measles vaccination, US$ 0,57 without).","UN","United Nations Children's Fund (UNICEF)","The EOS/Targeted Supplementary Feeding (TSF) programme began in 2004 as a pilot, and quickly scaled up to cover 6.8 million children in 365 drought-prone woredas. In 2005/6, the programme was expanded through the EEOS, which covers additional woredas with a reduced package of only vitamin A supplementation and deworming. National coverage by EOS and EEOS has expanded to reach around 95% of children under 5. In 2008, the programme covered 163 food-insecure woredas.
Under the Health Extention Programme (HEP) the EOS programme is currently phasing out and being replaced by Community Health Days. These events will offer the same inputs as EOS but will move away from the regionally-supported biannual mobilizations and instead be carried out quarterly, supported by the district health structures and Health Extention Workers (HEWs)
Children 6-59 months of age were screened using mid-upper arm circumference (MUAC) cutoff 12.0 cm.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of EOS/EEOS is retrieved from the ENA Part II where EOS/EEOS is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 43 million.Estimated cost of US$ 1.14 per child (with measles vaccination, US$ 0,57 without).","UN","United Nations Children's Fund (UNICEF)","Measles vaccination
","","","","2.9 million children 6–59 months in 163 food insecure Woredas","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23315","Enhanced Outreach Strategy/Extended Enhanced Outreach Strategy (EOS/EEOS)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The EOS/Targeted Supplementary Feeding (TSF) programme began in 2004 as a pilot, and quickly scaled up to cover 6.8 million children in 365 drought-prone woredas. In 2005/6, the programme was expanded through the EEOS, which covers additional woredas with a reduced package of only vitamin A supplementation and deworming. National coverage by EOS and EEOS has expanded to reach around 95% of children under 5. In 2008, the programme covered 163 food-insecure woredas.
Under the Health Extention Programme (HEP) the EOS programme is currently phasing out and being replaced by Community Health Days. These events will offer the same inputs as EOS but will move away from the regionally-supported biannual mobilizations and instead be carried out quarterly, supported by the district health structures and Health Extention Workers (HEWs)
Children 6-59 months of age were screened using mid-upper arm circumference (MUAC) cutoff 12.0 cm.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of EOS/EEOS is retrieved from the ENA Part II where EOS/EEOS is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 43 million.Estimated cost of US$ 1.14 per child (with measles vaccination, US$ 0,57 without).","UN","United Nations Children's Fund (UNICEF)","Insecticide-treated bednets in malarial areas
","","","","2.9 million children 6–59 months in 163 food insecure Woredas","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23315","Enhanced Outreach Strategy/Extended Enhanced Outreach Strategy (EOS/EEOS)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The EOS/Targeted Supplementary Feeding (TSF) programme began in 2004 as a pilot, and quickly scaled up to cover 6.8 million children in 365 drought-prone woredas. In 2005/6, the programme was expanded through the EEOS, which covers additional woredas with a reduced package of only vitamin A supplementation and deworming. National coverage by EOS and EEOS has expanded to reach around 95% of children under 5. In 2008, the programme covered 163 food-insecure woredas.
Under the Health Extention Programme (HEP) the EOS programme is currently phasing out and being replaced by Community Health Days. These events will offer the same inputs as EOS but will move away from the regionally-supported biannual mobilizations and instead be carried out quarterly, supported by the district health structures and Health Extention Workers (HEWs)
Children 6-59 months of age were screened using mid-upper arm circumference (MUAC) cutoff 12.0 cm.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of EOS/EEOS is retrieved from the ENA Part II where EOS/EEOS is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 43 million.Estimated cost of US$ 1.14 per child (with measles vaccination, US$ 0,57 without).","UN","United Nations Children's Fund (UNICEF)","The EOS/Targeted Supplementary Feeding (TSF) programme began in 2004 as a pilot, and quickly scaled up to cover 6.8 million children in 365 drought-prone woredas. In 2005/6, the programme was expanded through the EEOS, which covers additional woredas with a reduced package of only vitamin A supplementation and deworming. National coverage by EOS and EEOS has expanded to reach around 95% of children under 5. In 2008, the programme covered 163 food-insecure woredas.
Under the Health Extention Programme (HEP) the EOS programme is currently phasing out and being replaced by Community Health Days. These events will offer the same inputs as EOS but will move away from the regionally-supported biannual mobilizations and instead be carried out quarterly, supported by the district health structures and Health Extention Workers (HEWs)
Children 6-59 months of age were screened using mid-upper arm circumference (MUAC) cutoff 12.0 cm.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of EOS/EEOS is retrieved from the ENA Part II where EOS/EEOS is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","US$ 43 million.Estimated cost of US$ 1.14 per child (with measles vaccination, US$ 0,57 without).","UN","United Nations Children's Fund (UNICEF)","Moderately malnourished children 6 - 59 months, and moderately malnoursihed pregnant or lactating women, are referred to Targeted Supplementary Feeding (TSF) for 3-month supplementary food rations
","","","","720 000 children 6-59 months and 420 000 pregnant or lactating women ","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23322","National Nutrition Programme/Community-based Nutrition (NNP/CBN)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:
1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level
2. Promotion of Essential Nutrition Actions
3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.
4. Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).
5. Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.
Quarterly screening for acute malnutrition through Community Health Days
Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.","UN","Other","Multi-donor support","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23321","","Growth monitoring and promotion","","","","Adolescents|Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)","","","Community-based","","Monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems,
","Underweight
","Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010
","86 % of woredas","Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%","","","Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23322","National Nutrition Programme/Community-based Nutrition (NNP/CBN)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:
1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level
2. Promotion of Essential Nutrition Actions
3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.
4. Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).
5. Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.
Quarterly screening for acute malnutrition through Community Health Days
Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.","UN","Other","Multi-donor support","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23324","","Vitamin A supplementation","","Vitamin A","","Adolescents|Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)","","","Community-based","","Biannual vitamin A supplementation
","Underweight
","Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010
","86 % of wordeas","Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%","","","Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23322","National Nutrition Programme/Community-based Nutrition (NNP/CBN)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:
1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level
2. Promotion of Essential Nutrition Actions
3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.
4. Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).
5. Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.
Quarterly screening for acute malnutrition through Community Health Days
Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.","UN","Other","Multi-donor support","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23325","","Deworming","","","","Infants and young children|Preschool-age children (Pre-SAC)","","","Community-based","","","Underweight
","Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010
","86 % of wordeas","Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%","","","Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23322","National Nutrition Programme/Community-based Nutrition (NNP/CBN)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:
1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level
2. Promotion of Essential Nutrition Actions
3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.
4. Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).
5. Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.
Quarterly screening for acute malnutrition through Community Health Days
Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.","UN","Other","Multi-donor support","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23326","","Breastfeeding promotion and/or counselling","","","","Lactating women (LW)|Pregnant women (PW)","Mothers of children under two","","Community-based","","","Underweight
","Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010
","86 % of wordeas","Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%","","","Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23322","National Nutrition Programme/Community-based Nutrition (NNP/CBN)","English","Large scale programmes","","ETH","Ethiopia","","","on-going","","","The Government of Ethiopia launched the National Nutrition Programme (NNP) in 2008. NNP has many relevant components to reduce the magnitude of malnutrition in Ethiopia by reorienting the focus away from emergency and food security interventions and mainstreaming nutrition into community-based health and development programmes. Key nutrition activities of the NNP include:
1. Health Extension Programme (HEP): The core strategy for universal primary health service coverage. It aims to improve family health status through disease prevention and control at the community level
2. Promotion of Essential Nutrition Actions
3. Therapeutic Feeding Programme (TFP): Children with complicated SAM receive care through therapeutic feeding units, and children with uncomplicated SAM are managed in the community through Outpatient Therapeutic Programmes (OTP) at decentralized sites. There are more than 5000 OTP sites across 200 woredas.
4. Enhanced Outreach Strategy (EOS)/ Extended Enhanced Outreach Strategy (EEOS) and Targeted Supplementary Feeding (TSF).
5. Community-based Nutrition (CBN). The CBN was launched in 2008 and will expand to cover 35% of Ethiopia’s total population (228 woredas). CBN is focused on children under two and uses monthly growth monitoring and promotion to involve families and community members in assessing health and nutrition-related problems, analysing causes of these problems, taking action and monitoring progress.
Quarterly screening for acute malnutrition through Community Health Days
Referral of severely underweight children to Therapeutic Feeding Programme (TFPs) and/or Targeted Supplementary Feeding (TSFs) as required;
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of NNP/CBN is retrieved from the ENA Part II where NNP/CBN is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","CBN: Intensity of Community health workers (CHWs) is about 1:23 children, estimated as 0,2 Full-time equivalents (FTE), i.e. 86:1000 households. Per capita costs are not available.HEP: Government of Ethiopia aimed for a ratio of 1 health extension worker (HEW):2500 persons, and 1 health post:5000 persons. Government of Ethiopia spending on health is only 7.5% of the total government budget,and total per capita public health expenditure was US$ 3.00 in 2008, below the target expenditure of US$ 4.80 per capita estimated for full implementation of the HEP.","UN","Other","Multi-donor support","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23327","","Food distribution/supplementation for prevention of acute malnutrition","","","","Infants and young children|Preschool-age children (Pre-SAC)","","","Community-based","","Internal provision supplementary feeding for severely underweight children.
","Underweight
","Initial analysis of routine programme data from 1.5 million under-2 children weighed in 4 regions showed a decline in underweight from 30% in January 2009 to 20% in March 2010
","86 % of wordeas","Population coverage in target areas (now approximately 250/640 woredas (districts)) is approximately 40%","","","Participants' initial rate of underweight reduction: 8.0 ppt/year. Participants’ sustained rate of underweight reduction: 5.0 ppt/year, with estimated 40% coverage this gives a sustained population rate of 2.0 ppt/year.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23419","The Tanzania Iringa Joint Nutrition Support Programme (JNSP)","English","Large scale programmes","","TZA","United Republic of Tanzania","tanzania","","completed","","01-1970","The Tanzania Iringa Joint Nutrition Support Programme (JNSP) ran from 1984–1991. Children less than 5 years of age and women were targeted, and selection was not based on socioeconomic status.
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of LHW is retrieved from the ENA Part II where LHW is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
The programme also included referral of children under 5 years of age.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of JNSP is retrieved from the ENA Part II where JNSP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Resource intensity of the JNSP ranged from US$ 8–US$ 17/child per year (US$ 30/child per year total cost, equivalent to US$ 6 million). Intensity as measured by personnel was 2 village health workers/village (1220 total) or 1:40 children.","UN","World Health Organization (WHO)","Underweight
","The JNSP had components such as systems development and support, health services and water facilities, but these were not in place when the initial improvements in nutritional outcomes were seen. The reduction in malnutrition was attributed to increased feeding frequency, especially of severely underweight children at established child feeding posts, improved health care in families and communities and provision of information.
","","The JNSP operated in 6/7 districts covering about 250 000 persons, 46 000 of whom were children (73% participation). ","","","Population sustained rate of underweight reduction: 0,8 ppt/year
","None","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23419","The Tanzania Iringa Joint Nutrition Support Programme (JNSP)","English","Large scale programmes","","TZA","United Republic of Tanzania","tanzania","","completed","","01-1970","The Tanzania Iringa Joint Nutrition Support Programme (JNSP) ran from 1984–1991. Children less than 5 years of age and women were targeted, and selection was not based on socioeconomic status.
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of LHW is retrieved from the ENA Part II where LHW is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
The programme also included referral of children under 5 years of age.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of JNSP is retrieved from the ENA Part II where JNSP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Resource intensity of the JNSP ranged from US$ 8–US$ 17/child per year (US$ 30/child per year total cost, equivalent to US$ 6 million). Intensity as measured by personnel was 2 village health workers/village (1220 total) or 1:40 children.","UN","World Health Organization (WHO)","Internal provision supplementary feeding
","Underweight
","The JNSP had components such as systems development and support, health services and water facilities, but these were not in place when the initial improvements in nutritional outcomes were seen. The reduction in malnutrition was attributed to increased feeding frequency, especially of severely underweight children at established child feeding posts, improved health care in families and communities and provision of information.
","","The JNSP operated in 6/7 districts covering about 250 000 persons, 46 000 of whom were children (73% participation). ","","","Population sustained rate of underweight reduction: 0,8 ppt/year
","None","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23419","The Tanzania Iringa Joint Nutrition Support Programme (JNSP)","English","Large scale programmes","","TZA","United Republic of Tanzania","tanzania","","completed","","01-1970","The Tanzania Iringa Joint Nutrition Support Programme (JNSP) ran from 1984–1991. Children less than 5 years of age and women were targeted, and selection was not based on socioeconomic status.
WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of LHW is retrieved from the ENA Part II where LHW is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
The programme also included referral of children under 5 years of age.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of JNSP is retrieved from the ENA Part II where JNSP is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","","","","","","","","","","","","","","","","","","","Resource intensity of the JNSP ranged from US$ 8–US$ 17/child per year (US$ 30/child per year total cost, equivalent to US$ 6 million). Intensity as measured by personnel was 2 village health workers/village (1220 total) or 1:40 children.","UN","World Health Organization (WHO)","Underweight
","The JNSP had components such as systems development and support, health services and water facilities, but these were not in place when the initial improvements in nutritional outcomes were seen. The reduction in malnutrition was attributed to increased feeding frequency, especially of severely underweight children at established child feeding posts, improved health care in families and communities and provision of information.
","","The JNSP operated in 6/7 districts covering about 250 000 persons, 46 000 of whom were children (73% participation). ","","","Population sustained rate of underweight reduction: 0,8 ppt/year
","None","","","","","","","","","","","","","","","","","","","","","","","","","","English"