"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" "8930","Assistance to Ghanaian Food-Insecure Households in Northern Ghana","English","Community/sub-national","","GHA","Ghana","Tongo, Bolgatanga Municipal, Upper East, Ghana|Danko, Wa Municipal, Upper West, Ghana|Zuorugu, Tamale, Ghana","Rural","on-going","01-2010","01-2014","
The project supports the Government of Ghana in its efforts to improve the protection of vulnerable populations in northern Ghana from the devastating impacts of floods and droughts, and also to ensure that the immediate food needs of the most severely food-insecure households are met. The project aims to improve agriculture, water and land resources; create strategic reserves to protect the nutritional status of at-risk groups (including children under five, pregnant and lactating women and people living with HIV/AIDS); and support the rehabilitation and recovery of agricultural livelihoods. This project contributes to alleviating chronic food security amongst vulnerable groups, targeting and assisting poverty reduction in the most susceptible areas of northern Ghana.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZEn/503DAC11D7D8F3AD85...
","8488","","","","World Food Programme (WFP)","","","","","","","","","","","","","","","","CA$ 20,000,000","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8929","","Food distribution/supplementation for prevention of acute malnutrition","","","","HIV cases|Infants and young children|Lactating women (LW)|Pregnant women (PW)","","The 3 Northern regions (Upper East, Upper West, Northern region)","Community-based","","Results as of May 2012 include: the World Food Program (WFP) has distributed food to 327,982 beneficiaries out of the 423,250 planned. In particular, the targets for supplementary feeding of malnourished children under five and pregnant and lactating women are close to being achieved, and will likely be exceeded by the end of the project. The project has already exceeded the targets for the number of beneficiaries on its components Food for Assets (FFA) and Food for Training (FFT), and has reforested some 7,357 ha of land and rehabilitated 250 dams/dugouts.
","It is anticipated that all expected outcomes of increasing equitable access to food aid and prevention of malnutrition, particularly among children under five, pregnant and lactating women, including refugees; as well as to improving food consumption over the assistance period for targeted households, and people living with HIV/AIDS and their families; and increasing the targeted communities equitable access to livelihood assets, including assets for environmental conservation will be achieved.
","","423,250","327,982 beneficiaries (for distributed food); ","","","","Vulnerable groups","","Micronutrient supplementation in children with severe acute malnutrition>>>Micronutrient supplementation in children with severe acute malnutrition>>http://www.who.int/elena/titles/micronutrients_sam","","","","","","","","","","","","","","","","","","","","","","","","English" "8933","The Leyaata (“Rescue Us”) Project to Reduce Maternal, Infant and Child Mortality","English","Community/sub-national","","GHA","Ghana","Kintamp, Ghana|Bole, Ghana","Rural","on-going","01-2011","01-2015","The project aims to reduce maternal, infant and child mortality in 50 marginalized villages in the north Kintampo and south Bole districts of Ghana by directly addressing key health issues. Reaching approximately 10,000 beneficiaries, the project addresses care during pregnancy and childbirth, neonatal care, and malaria control as critical health concerns in these communities. Key project components include establishing a prenatal and neonatal home visit system for pregnant women and infants, and launching a malaria control program that prioritizes mothers and infants.
Specific activities include: distributing neonatal care kits; training community-based volunteers and local health professionals; providing mosquito nets for all village residents; conducting malaria control workshops; and supplying local clinics with rapid malaria test kits. Ghana Rural Integrated Development is working in partnership with the Northern Empowerment Association to implement this project.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZen/index.html7E4DFE9C...
","8111","","","","","","","","","","","","National NGOs","Ghana Rural Integrated Development, Northern Empowerment Association","","","","","","","CA$ 643,464.00","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8932","","Distribution of insecticide-treated bednets","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)","","North Kintampo & South Bole Districts","Community-based","","Specific activities include: distributing neonatal care kits; training community-based volunteers and local health professionals; providing mosquito nets for all village residents; conducting malaria control workshops; and supplying local clinics with rapid malaria test kits.
","Maternal, infant and child mortality
","","10,000 beneficiaries","50 marginalized villages in the north Kintampo and south Bole districts of Ghana","","","","Vulnerable groups","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010In Eastern Cape Province, IYCN supported PATH’s efforts to improve the quality, availability, and uptake of PMTCT services by strengthening under-resourced PMTCT sites and mobilizing communities to increase the uptake of those services. To prevent malnutrition and ensure HIVfree survival of children, IYCN contributed to integrating infant and young child feeding activities into PMTCT interventions. Specifically, the project helped develop atraining package for lay counselors and community health workers and supported the training of 100 community health workers on infant and young child feeding. In addition, the project assisted the provincial health department to develop tools for surveying facility-based nutritionservices.By adapting a regional, community-based planning tool for use locally, IYCN worked with private-sector partner, J & J Trust, South Africa’s Ekurhuleni Municipality, and Ward 86 within the municipality’s Nigel District to conduct a pilot program that integrated nutrition interventions into economic and community development planning. This model approach can be scaled up throughout the district and beyond to enhance awareness of the nutritional status of young children and dietary and feeding practices that can improve their health. Through this approach, IYCN trained community volunteers to engage the community in nutrition activities. The community response was overwhelming, and community leaders included nutrition activities in development plans. These new activities included establishing a support group for pregnant and lactating mothers and their parents and initiating an awareness campaign on available structures to support lactation.
","x
","","x","x","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","The use of existing structures and processes made planning community nutrition activities and allocating resources feasible. The community in Ward 86 continues to implement nutrition activities based on their community development plans. Although the project did not fund the implementation of these activities, community leaders were able to leverage existing structures and resources.Engagement with communities revealed that people are aware of nutrition and related issues, but that technical support is needed to develop creative behavior change interventions. It is possible to build better linkages between the community and health services by engaging the municipal planning system.
","“I have seen the level of interest in nutrition in the community increase, and now ward members are empowered to influence the development plans of the municipality and the district to prioritize support for nutrition.”— Benny Sikhakhane, IYCN Project consultant
","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","Urban|Rural|Peri-urban","completed","01-2009","01-2011","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of MAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Management of SAM was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9691","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZAF","South Africa","South Africa","","","","","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","South Africa’s HIV burden is the greatest in the world. From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition Project worked to prevent HIV from reaching the next generation and to improve the nutritional status of mothers and children. The project informed a new set of national guidelines on infant and young child feeding in the context of HIV, and with national and international partners, identified opportunities for integrating nutrition assessment, counseling, and support services into programs focusing on prevention of mother-to-child transmission (PMTCT) of HIV. The project also worked in one district to mobilize communities and local government to integrate nutrition activities into community development plans. All of the project’s efforts have contributed to strengthening programs that seek to improve the nutrition of infants and young children, pregnant and lactating women, and orphans and vulnerable children (OVC), particularly populations at risk of contracting HIV.
","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Nutritional care and support for people living with HIV/AIDS was reported to the Global Nutrition Policy Review (GNPR) 2009-2010IYCN took a comprehensive approach to addressing nutrition assessment, counseling, and support in Zambia by working with stakeholders at the national, district, provincial, and community levels to assess needs, enhance national policies, build the capacity of health providers, implement behavior change communication strategies, strengthen monitoring and evaluation systems, and identify and share good practices. Here is a snapshot of the project’s key activities and accomplishments.
","x
","","x","National coverage","","","","Vulnerable groups","","Infant feeding for the prevention of mother-to-child transmission of HIV>>>Infant feeding for the prevention of mother-to-child transmission of HIV>>http://www.who.int/elena/titles/hiv_infant_feeding","","","","","","","","","","","","","","","","","","","","","","Taking a comprehensive approach to addressing nutrition assessment, counseling, and support will help ensure a continuum of care and prevent nutritionally vulnerable mothers and children from falling through the cracks.Building the capacity of provincial teams as trainers is an efficient and cost-effective way to increase the number of trained infant feeding counselors.Community health volunteers can fill a key role in counseling and supporting mothers at health facilities, where health workers are often overwhelmed. When trained, volunteers can provide high-quality infantand young child feeding counseling for mothers.Building upon existing resources available in health facilities and communities can ensure government support and sustainability.
","“With IYCN’s support, we have been able to meet our objective of conducting high-quality training workshops for more health workers in our own province.” —Sydney Kambobe, Eastern Province Nutrition Specialist“Now I conduct cooking demonstrations to teach mothers to mix some of the nutritious local foods to give to the child. We pound meat and add it to the porridge.” —Lucy, Community health volunteer“I didn’t know that I could use the foods from my garden to make more nutritious meals for my child.” —Mother in Kabwe
","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Providing maternal supplements of balanced energy and protein was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Distribution of complementary foods was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","Urban|Rural","completed","01-2008","01-2011","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Distribution of insecticide-treated bednets was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Maternal deworming in pregnancy was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Preventive treatment of malaria in women was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "9703","Infant and Young Child Nutrition (IYCN) Project ","English","Multi-national","","ZMB","Zambia","Zambia","","","","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","For the past three years, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project has supported the Ministry of Health and the National Food and Nutrition Commission to strengthen policies, programs, and health systems to improve the nutrition—and thereby prolong the lives— of mothers and their children younger than 2 years of age, including those affected by HIV. IYCN has collaborated with a wide range of partners to support mothers in adopting healthy feeding practices and to ensure a better future for Zambian communities and families.
The project focused on strengthening nutrition interventions within prevention of mother-to-child transmission of HIV programs and child health services and conducting supportive community-based activities. Since 2008, when the project began, health workers and community health volunteers in several districts have developed the skills and knowledge to help mothers improve nutrition for themselves and their babies. Formative research on maternal nutrition and child feeding practices has enabled stakeholders to understand beliefs and behaviors that contribute to poor nutrition. Structures are now in place for assessing the quality and consistency of health worker counseling. Additionally, messages to encourage changes in the way mothers feed their children have been disseminated through mass media.
","","8152","","","","","","","","","","","","","","Research/academia","University Research Co., LL C.","Private sector","The Manoff Group","","","","Bilateral and donor agencies and lenders","","Deworming of children 0-2 years was reported to the Global Nutrition Policy Review (GNPR) 2009-2010
","","","","National coverage","","","","","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "11454","Maternal, Infant and Young Child Nutrition Project","English","Multi-national","","MWI","Malawi","Salima District, Central Region, Malawi","Urban|Rural|Peri-urban","completed","01-2010","01-2011","From 2010 through 2011, the Infant & Young Child Nutrition (IYCN) Project supported Malawi’s Office of the President and Cabinet (OPC) to develop community-based nutrition services targeting mothers, infants, and young children, including HIV-positive populations. The project increased understanding of feeding behaviors, supported enhanced national policies, played a key role in shaping the country’s Scaling Up Nutrition (SUN) strategy, developed a package of training materials for a new cadre of community nutrition workers, and increased the capacity of community-based workers to improve infant and young child nutrition. We piloted capacity-building activities in Salima District, which will be scaled up nationally to improve the growth, nutritional status, health, and HIV-free survival of infants and young children.
","Examined caregivers’ feeding practices
IYCN conducted a joint research project with Bunda College of Agriculture and the World Bank to generate information that can be used to improve infant and young child nutrition activities within Malawi’s existing programs. The study was conducted in two phases: phase one was exploratory, and gathered information about feeding practices from 60 mothers with children 6 through 23 months of age and 18 key informants. In phase two, or the Trials of Improved Practices phase, counselors offered 100 mothers of children 0 through 23 months of age one to three improved feeding practices that they could try for about one week and gathered results from trying those practices.
","In a joint study with the World Bank, IYCN identified key infant feeding problems and tested practical solutions to inform new behavior change communication materials for community nutrition workers. Findings revealed that mothers could adopt new, improved practices, such as:
Formative research findings can help motivate stakeholders to take action.
The project’s formative research demonstrated that it is feasible for mothers in Malawi to make small changes in feeding practices that go a long way toward preventing malnutrition. These powerful findings influenced several national strategies and contributed to the country’s focus on prevention of stunting.
Training materials should meet the needs of community-based workers.
Because community-based workers selected for IYCN’s trainings lacked knowledge about the basic principles of nutrition, adapting the training materials to include this basic information, along with building counseling skills, led to the development of more effective tools for counseling caregivers. Mentoring and supportive supervision are a great way to reinforce concepts learned during a training session. We found that community workers were motivated to do the work when they received regular supervision and mentoring.
","“Indeed biscuits are expensive…and with the same amount of money, I can buy eight bananas.”
—Mother, Salima
Royce’s story: Small changes, big growth
When Gladys, a community health worker trained by IYCN, first met Linnes during a home visit, the young mother was concerned that her nine-month-old baby, Royce, had remained the same weight for the past three months. Sitting in the shade outside of Linnes’ mudbrick home in Nthiwatiwa village, Gladys asked her how she had been feeding her baby and used a set of illustrated counseling cards to suggest feeding changes. She advised that increasing the frequency of breastfeeding, making thicker porridge, and diversifying Royce’s meals could improve her growth and health. During several more home visits, Gladys found that Linnes was able to make these small feeding improvements; and after just two months, the baby’s growth improved significantly. Now, Linnes proudly shares her story with other mothers in the village.
","English" "11464","Improving Maternal, Newborn and Child Nutrition in Northern Nigeria","English","Community/sub-national","","NGA","Nigeria","Kebbi, Nigeria|Katsina State, Nigeria|Jigawa State, Nigeria|Zamfara, Nigeria|Yobe, Nigeria","Rural|Peri-urban","on-going","01-2011","01-2017","One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11461","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child|Stunted child","Children under 5 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. ","Primary health care center","","
","
One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11462","","Breastfeeding promotion and/or counselling","Infant and Young Child Feeding","","","Infants and young children|Lactating women (LW)","Infants and young children below 2 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe.","Community-based|Primary health care center","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "11464","Improving Maternal, Newborn and Child Nutrition in Northern Nigeria","English","Community/sub-national","","NGA","Nigeria","Kebbi, Nigeria|Katsina State, Nigeria|Jigawa State, Nigeria|Zamfara, Nigeria|Yobe, Nigeria","Rural|Peri-urban","on-going","01-2011","01-2017","One million children under five die every year in Nigeria, 35% of them due to causes attributed to malnutrition. This makes Nigeria one of the six countries that accounts for half of all child deaths from malnutrition worldwide. In the north, half of all children under five are stunted, and one in five suffers from acute malnutrition. This has profound implications for health and for human development, and presents a major obstacle to attainment of Millennium Development Goals in the country and globally. To date, the Nigerian government has not provided the necessary leadership or response to the crisis. Coupled with this, is a weak and fragmented health system which is unable to provide the most basic, cost-effective services for the prevention and management of common health problems. Primary health care level remains the weakest link in effective health delivery.
The programme will deliver a number of evidence-based, highly cost-effective direct interventions for the prevention and treatment of malnutrition, including community-based management of acute malnutrition (CMAM), vitamin A supplementation and deworming, and promotion of improved infant and young child feeding (IYCF) practices. The scaled up delivery will be used to raise the political profile of undernutrition in Nigeria and leverage government to coordinate and fund nutrition programmes. Independent operational research will examine the wider determinants and structural barriers of undernutrition. Impact evaluation will measure progress, quality and advise on critical elements required for a sustainable strategy.
A UNICEF and an INGO consortium of Save the Children (SC UK) and Action Against Hunger / Action Against Hunger (AAH/ACF) will deliver the interventions. Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts.
Results: This programme will reduce the incidence and prevalence of undernutrition in children under five across selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe. By 2017, DFID will improve the nutritional status of 6.2 million children under five in northern Nigeria. At least 140,000 children with severe acute malnutrition will receive treatment. The programme will contribute to National targets of reducing underweight and stunting by 20% (absolute reduction) and exclusive breast feeding rates will increase by 15% in the selected five northern states.
It is anticipated that the programme advocacy component will have some impact on improved government commitment and health system strengthening. Delivering services through government facilities, primary health care workers and community-led interventions will embed a culture of government ownership. Additionally, the design places high importance on support for government policies and strategic planning.
Irrespective of long term, systemic changes there is a strong economic and efficacy argument for DFID investment in nutrition. The direct nutrition interventions delivered through the health sector are evidence-based, cost effective and present a key opportunity for achievement of MDGs (1,4,5).
","http://projects.dfid.gov.uk/project.aspx?Project=201874
","7944|7943","","","","United Nations Children's Fund (UNICEF)","","","","","","","","","","","","","","Other","Operational research and impact evaluation will be conducted by independent nutrition researchers and evaluation experts","Project budget: £50 millionBudget spent to Date: £11,090,293","Bilateral and donor agencies and lenders","Department of International Development (DFID)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11463","","Deworming","Micronutrients and Deworming","","","Preschool-age children (Pre-SAC)","Children under 5 years","Selected Northern States with high rates of undernutrition: Kebbi, Katsina, Jigawa, Zamfara, and Yobe.","Hospital/clinic|Primary health care center","","","
.
","
Impact, outcome and output indicators will be monitored throughout the lifetime of the programme. Data will be obtained through programme monitoring tools and through routine surveillance instruments such as the Demographic Health Survey. An independent impact evaluation will be embedded within delivery. This will assess the overall effectiveness, cost efficiency and equity of the programme.
","6.2 million children under five in northern Nigeria","6.2 million children under five in 5 states of northern Nigeria","","","","Vulnerable groups","","Deworming to combat the health and nutritional impact of soil-transmitted helminths>>>Deworming to combat the health and nutritional impact of soil-transmitted helminths>>http://www.who.int/elena/titles/deworming","","","","","","","","","","","","","","","","","","","","","","","","English" "11470","Integrated Family Health Program (IFHP)","English","National","","ETH","Ethiopia","Addis Ababa, Ethiopia|Amhara, Ethiopia|Benishangul-Gumuz, Ethiopia|Oromia, Ethiopia|Southern Nations, Nationalities, and People's Region, Ethiopia|Tigray, Ethiopia","Rural|Peri-urban","on-going","01-2008","01-2013","
The Integrated Family Health Program (IFHP) supports the Government of Ethiopia’s Health Extension Program (HEP) and reaches over 32 million people—40% of the Ethiopian population—in 300 districts. Through assistance to over 13,000 health extension workers (HEWs) and thousands of community volunteers, USAID supports the delivery of key maternal, neonatal and child health services at the community level. These services include:
Goal:
Improve family health, especially for mothers, newborns, and children.
Project Objectives:
IFHP emphasizes a continuum of care approach at household/family, community and health facility levels through the provision of selected evidence-based and high-impact packages of services. This project plays an integral role in assisting the Ministry of Health to develop and change national policies, such as the use of antibiotics at the community level. The project supports the Government of Ethiopia in its Health Sector Development Plan and enhancing the Government’s management capacity as decentralization continues, leaving behind a well-functioning health system. By increasing the quality of health workers at the primary health care level and increasing demand for quality services, IFHP improves health behaviors and utilization of services. Additionally, IFHP also strengthens the promotion of essential nutrition actions with a strong focus on behavior change at both the community and facility level.
","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 lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will make investments in nutrition across three critical sectors; agriculture, health, and social protection, with nutrition as the lynchpin between these sectors. As such, the USG will implement a comprehensive approach that maximizes all three sectors and strengthens and links the nutrition components of each. These investments will be underpinned by a core set of nutrition indicators that are common across all programs, and will be supported by policy investments that mirror the comprehensive nature of nutrition programming by working with the Office of the President’s Cabinet (OPC) and the Ministries of Agriculture and Food Security, Health, and Gender.
Building on lessons and experiences from current programs implementing preventive nutrition activities (e.g., the WALA and BASICS projects), USG resources will scale up prevention of undernutrition and resiliency of communities, while maintaining critical investments in treatment and nutrition service delivery. The rationale for this shift is due to the overall high prevalence of chronic undernutrition (47 percent) and the low prevalence of acute undernutrition (4 percent), the latter of which has been achieved by sustained commitment to scaling up CMAM. As a result, the USG will aim to drive a decrease in stunting as the highest level objective in FTF. The USG plans to focus on cost-effective preventive nutrition interventions targeting the 1,000 days window of development (pregnancy through two years), including maternal nutrition; early and exclusive breastfeeding through six months; use of appropriate, diverse foods beginning at six months of age; targeted micronutrient supplementation; and improved hygiene and sanitation. Activities will be integrated into health, HIV, and agriculture platforms, taking full advantage of the resources that these programs have. These investments leverage funding from health (Global Health and Child Survival), agriculture (Development Assistance), and Title II to advance nutrition objectives. The Care Group model encompasses a combined FTF and GHI approach to reduce poverty, hunger, and undernutrition by joining two complementary lines of investment at an operational level:
The objectives of the Care Groups complement value chain development activities by building capacity of:
Community-Level Organizations and Integration with Government of Malawi Systems for Health and Agricultural Extension
The Care Group in the context of this model is notable in that it supports a sustainable and simultaneous approach to agriculture, nutrition, and microfinance. Cross-fertilization of nutrition and agricultural messaging and skill building, as well as the opportunity to create cross-sector targets and results frameworks allows for a uniquely comprehensive approach.
Volunteers are trained and facilitated to conduct community outreach and follow-up in both agricultural- and health-focused nutrition interventions, thus supporting an operational link between nutrition and agriculture programming. Each volunteer takes on responsibility for conducting outreach and follow-up to some 10-12 nearby households. Care Group volunteers also have access to agricultural inputs to start and maintain community gardens, as well as engage in income-diversification through activities such as establishing voluntary savings and loan activities. Access to these inputs provides motivation and support for implementing targeted nutrition-focused interventions focused on behavior change, including:
Linking the agriculture and value chain components of the project with health and nutrition promotion at the community level is especially advantageous in that it provides opportunities to address two key crosscutting areas:
Prevention Linked with Health Service Delivery
The USG’s approach to service delivery covers community level action, improvement of quality at all levels of facilities, and strengthening the central and district level systems of management. This provides a common platform for multi-thematic messages and programs, ensuring that there are ―no missed opportunities‖. It also ensures a focused yet comprehensive basic package accessible to the Malawian population that stretches across the continuum of care from community to facility and from facility to community. At the community level, the Health Surveillance Assistants (HSAs) and health volunteers will continue to focus on interpersonal counseling, limited preventive and curative care through village clinics and drug boxes, and to create demand for services at the health facilities across family planning, maternal and neonatal health, child health, nutrition, malaria and HIV areas. At the facility level, the USG will support improved quality of care for existing interventions that target integrated and comprehensive primary health care provision and performance based incentives. At the national, zonal and district levels, USG programs will continue to strengthen the financial, management and leadership capabilities of the Ministry of Health staff. Also, programs will work closely with the technical staff to provide technical assistance and work toward meaningful policy changes. At all levels, USG resources will focus on integration of social and behavior change communication efforts through community and facility level entry points.
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","Although the main focus will be on preventing childhood undernutrition, USAID/Malawi will continue to support CMAM, building on past investments. Since 2005, USAID has supported the integration of CMAM in existing health care services. Partners are working at both the policy and community levels to ensure this integration. As of December 2009, 24 out of 28 districts are implementing CMAM in over 240 health facilities. The USG will support one additional year of the MoH’s CMAM Advisory Service to finalize the transition of complete CMAM scale-up to the GoM. An evaluation in 2012 will help inform the USG on the areas needing further investment.
Through two GDAs with Project Peanut Butter, a local producer of ready-to use therapeutic food (RUTF), USAID/Malawi’s support has resulted in an annual production capacity of over 1,200 MT of RUTF, which, when combined with production from a second local producer of RUTF, more than meets the total requirements of RUTF for Malawi, with capacity to export to neighboring countries. The USG will take advantage of this existing capacity to explore the development and promotion of ready to use supplementary and complementary foods.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will support GoM's efforts towards fortification of prioritized centrally processed foods, namely: sugar, oil, wheat and maize flour, and complementary baby foods. Data from the National Micronutrient Survey shows that the consumption of these foods has increased over the last ten years. USAID health funding will continue to support the universal salt iodization program in order to sustain the gains made with previous investments. Although not sufficient to forestall stunting in children under five, one necessary input is a high quality, low-cost complementary food. The legume and dairy value chains present a unique opportunity for the development of such a product. Malawi will take advantage and work with existing food processors (e.g., Rab processors, Project Peanut Butter and Valid Nutrition) to develop a suitable product.
Prevention and control of micronutrient malnutrition will require a concerted effort by all USAID/Malawi’s health programs, namely, malaria, family planning, maternal, neonatal and child health, HIV/AIDS and nutrition. Possible USG support to SUN for specific activities with deliverables in FY11 include the following:
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","USG investments in legume and dairy value chains are designed to boost competitiveness and promote diversification into higher-return value chains that will also spawn non-farm employment opportunities. While these investments in economic growth will be necessary to reduce poverty and hunger, they will be insufficient by themselves. Beyond growth, poverty reduction will require targeted interventions that address the needs of smallholder farmers (the rural poor) as well as more vulnerable populations. A significant smallholder need is to produce more from a very limited resource base. Conservation farming practices offer promise in this regard, by increasing yields, soil fertility and soil moisture content per unit area. Importantly CF offers a window of opportunity to increase yield from a fixed unit area, freeing up land for diversification of both other cereals and legumes. Improving market and input access and the affordability of business development and financial services tailored to the needs of smallholders is critical in order to ―pull‖ rural households into income-raising activities.
Integrating Nutrition with Value Chains (INVC)
INVC is designed to combine the livelihood benefits of an agricultural value chain approach with the nutrition benefits of increased dietary diversification. This centerpiece of Malawi’s FTF strategy will invest in the competitiveness of food staple value chains in which large numbers of smallholders, over 56 percent of whom are below the poverty line, participate, and link increased household production of nutritious crops to household consumption and improved nutritional status. INVC will link value chain development and increased household income to improved nutrition through diet diversification, and improvements in food storage, preparation, and consumption practices at the household level.
INVC’s value chain approach will focus on legumes (groundnuts and soy) and dairy, and is designed to facilitate change in both the individual value chains and the broader market and household-farming systems, looking for synergies across value chains such as common constraints and/or actors. A strong emphasis will be placed on improving the demand side of the value chain, by working to improve market linkages between input and output dealers through improved and more reliable services, including financial, business development, agronomic and livestock-related services. While most of INVC’s efforts will further develop and strengthen Malawi’s existing input and output markets serving the legumes and dairy value chains, the program will also include strengthening the capacity of processors and agribusinesses to meet export market demands, as well as building the capacity of smallholder suppliers to meet buyer demands. At the same time, INVC will work to mitigate the risks for rural households to diversify their income and food sources beyond maize through an option of conducting a vulnerability assessment for its target population and to access nutritional education that will help them translate a more diverse basket of food into improved nutrition. INVC will place a particular emphasis on women’s economic empowerment across all of its activities, including additional support and guidance to women owned businesses and women producers.
INVC will spur investment and innovation in the legume and dairy value chains through an Innovation and Investment Facility meant to provide INVC a tool to identify and support specific opportunities that can further strengthen the selected value chains and market systems within which they operate. An important use of the facility will be to buy down risk for a firm, farmer, or other value chain actor in order to encourage early adoption of new technologies, such as CF by smallholders, and spur sector-wide innovation. Facility partners may include private firms, GoM agencies, research institutes, NGOs or other local organizations, as well as other donors best placed to identify new solutions to key value chain and systemic43 constraints. This Innovation and Investment Facility will be a key instrument for developing the capacity of the private sector and will also have targets and incentives for the participation of women-owned enterprises or individuals.
A core principle of INVC will also be to build the capacity of the key value chain actors to address the competitiveness of their value chain through their own projects and interventions. As such, INVC will place a strong emphasis on building local capacity to contribute to and invest in agricultural transformation. While Malawi has numerous small businesses, local NGOs and private sector and civil society organizations, few, if any, have both the technical and administrative capacity to implement USAID projects without support. As such, INVC’s approach to capacity building will be to invest resources in local partners while leveraging their local knowledge and capacity to generate results. The project will have a target for graduating local partners to independent status that would allow them to receive USAID funds directly. As partners reach this independent status, they would take on current functions of INVC.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","A significant constraint to the development of competitive groundnut and soybean value chains is the inadequate production of breeder seed. Ten years ago, USAID/Malawi established a $250,000 revolving fund to support ICRISAT in contracting out groundnut breeder seed production, but the FISP addition of legume seed packs the significant gross margins of legumes has driven demand far beyond local seed production capacity. Given the importance of reliable input supplies to Malawi’s FTF strategy, USAID and Irish Aid will partner to expand local capacity for production of quality, certified legume seed. USAID will invest in expanding the existing revolving fund and link in the International Institute of Tropical Agriculture to enable the expansion of their efforts in soy breeder seed production. Irish AID will expand its assistance to small and medium sized enterprises to develop their capacity of to multiply groundnut seed – currently only one company (Seed Co.) is involved in soybean seed production using privately developed germplasm.","Infrastructure","Malawi also lacks an International Organization for Standardization (ISO) certified laboratory for testing and certifying groundnuts and soybeans, which limits access by exporters to broader export markets. Currently, companies that export groundnuts send samples to South Africa for testing, which is costly and limits export capacity. With Irish Aid support, ICRISAT and NASFAM are developing a low cost, rapid testing technology; however, achieving ISO certification will be costly. The EU and UNDP will also begin work next year on a project designed to support the processing and exports side of legume value chains, a major component of which will focus on bringing the Malawi Bureau of Standards up to ISO certification. USG resources will support GoM efforts to establish a national sanitary/phyto-sanitary (SPS) strategy and achieve COMESA SPS compliance, as well as to build the capacity of Bunda College and the MoAFS research stations to conduction aflatoxin mitigation research.","Financial resources","Access to finance remains a major constraint to smallholders investing in productivity enhancing technologies due to weak financial sector infrastructure, inadequate financial services options, and GoM regulatory capacity. USAID will jointly develop a Financial Sector Technical Assistance Project with the World Bank and DfID.","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","In view of the capacity challenges that exist, USAID will strengthen the capacity of the GoM to plan, implement, monitor and evaluate nutrition programs. With substantial funding increases anticipated through the FTF, USAID/Malawi will ensure that GoM institutions have adequate capacity to implement the various programs that will be designed under the initiative. This activity is in line with Strategic Objective Three of the NNPSP, which clearly outlines the capacity gaps and needs for the nutrition sector in Malawi. The USG will strengthen capacity of its partners, both government and non- governmental, as well as the private sector. USG support will be at three levels: community, institutional and tertiary. Irish Aid, the World Bank, CIDA, and the EU are all key donors in capacity building.
Strategic Analysis and Knowledge Support System (SAKSS)
Since 2008, USAID/Malawi has supported a SAKSS unit implemented through the International Food Policy Research Institute (IFPRI) at the MoAFS. The objectives of this activity are threefold: 1) generate demand-driven diagnostic and strategic research to fill key knowledge gaps, 2) establish an information and knowledge support system, in cooperation with the Southern Africa Regional Strategic Analysis and Knowledge Support System that has been set up to help promote peer and progress review of the CAADP, and 3) strengthen the capacity of national institutions, such as the MoAFS, in policy and strategy research. The Malawi Mission plans to extend the work of the SAKSS unit as part of capacity building support under FTF.
Malawi Agriculture Policy Strengthening (MAPS)
Strong civil society and private sector networks are critical to implementing the ASWAp in a way that responds to the evolving needs of its stakeholders. In recent decades, weak capacity and declining GoM interest in inclusive policy making is leading Malawi’s CAADP process towards a Government-owned rather than Country-owned process. Grounded in the CAADP principles of increasing stakeholder participation in the policy making process,44 the Malawi Agriculture Policy Strengthening (MAPS) program is designed to increase the participation of private sector and civil society stakeholders in agriculture policy dialogue.
MAPS will increase the profile, capacity and engagement of civil society and private sector stakeholders in agriculture policy development and implementation through a combination of capacity building interventions and establishing linkages between producers and consumers, including state and non-state actors, of high quality policy research. Though not exclusively, MAPS will focus on key stakeholders along the proposed FTF value chains.
MAPS capacity building activities will focus on improving organizational ability to meet its goals and objectives by strengthening administrative and financial management, organizational structure and strategic planning. The second focus of the project will strengthen policy analysis and advocacy capacity through building linkages between Malawian farmers and private sector associations and regional networks and research institutions, such as local and regional universities among civil society groups. MAPS will similarly link GoM counterparts to those research institutions to improve their ability to become informed consumers of stakeholder policy advocacy. These two components will account for the varying levels of development and readiness of organizations and associations in Malawi to take on advocacy activities. MAPS will also focus on elevating the voices of women in policy dialogue by targeting women-led civil-society/public service organizations for organizational capacity building and providing additional women-focused leadership training and gender equity sensitization to facilitate women taking on leadership roles within larger organizations.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "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" "11629","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","UGA","Uganda","Northern Uganda |central “Maize Belt|Southwest Uganda","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 country-driven 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, hildren, 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 Uganda, Feed the Future aims to help an estimated 709,000 vulnerable Ugandan women, children and family members—mostly mallholder farmers—escape hunger and poverty. More than 450,000 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 Uganda is making core investments in three key areas:
1. Nutrition
2. Agriculture. The maize, coffee and bean belt are in Southwest and Central Uganda. The choice to focus on these value chains represents considerations regarding Ugandan government priorities, division of donor labor, and the highest impact interventions for the expected scale of Feed the Future resources.
3. Connecting Nutrition to Agriculture
USAID will build on previous strategic investments in nutrition and take them to scale in the areas and populations of greatest need to support the GOU and private sector to reduce chronic undernutrition in the country with a primary focus on prevention. Through these interventions an estimated 709,000 vulnerable Ugandan women, children, and family members—mostly smallholder farmers—will receive targeted assistance to escape hunger and poverty. More than 450,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. The core investments in nutrition will focus on community and facility based prevention and treatment, targeted nutrition service delivery, the enabling environment for nutrition and capacity building.
Community and Facility-Base Prevention and Treatment
By emphasizing prevention, FTF programs will help to reduce not only chronic undernutrition, but should also reduce the number of severely/acutely malnourished children as well, resulting in fewer children outside HIV and emergency situations needing treatment for severe acute malnutrition. For the treatment of acute malnutrition, Uganda has adopted a national protocol for the Integrated Management of Acute Malnutrition (IMAM). Through a ommunity and facility based approach to treating under nutrition, therapeutic and/or supplementary food is provided to severe or moderately malnourished children, with medical support, nutrition education, and at-home follow up through community based volunteers. FTF and PEPFAR’s partnership on the production, distribution, and management of RUTF support the larger national IMAM protocols.
Capacity Building
Capacity building at the national and district level is critical. Nutrition has only recently become a priority in the health sector, and without strong nutrition champions and policies centrally, nutrition priorities will not be realized. USAID will continue to train health workers in new IMAM guidelines for use in health facilities and will expand technical assistance and capacity building at the national level beyond the health sector to include Agriculture and other ministries who can contribute to a national action plan on nutrition.
","Some key outputs of nutrition activities are: nutrition officers placed in a majority of districts; active Food and Nutrition Councils organized in districts; mandatory fortification of major manufactured foods; therapeutic food reconstituted from locally available foods developed and distributed to district and regional hospitals; and community behavior changes to prevent undernutrition.
","PERFORMANCE MONITORING
Through an interactive approach across Mission teams and in collaboration with other donors and the GOU, the USG FTF effort will go beyond the status quo of performance monitoring. At the basic level, data will be collected by implementing partners and reported to USAID/Uganda through quarterly reports while quality will be assessed via Data Quality Assessment visits to the field.
IMPACT EVALUATION
To build an evidence base to adjust ongoing projects and inform future programs, we will design rigorous impact evaluations for select FTF programs. We have already identified such an opportunity with our Community Connector program, which fully integrates agriculture and nutrition activities at the household level. Discussions have been held with partners within the MIT Poverty Action Lab consortium on the use of Randomized Control Trial (RCT) experiments. We will use the results of these impact evaluations to test the hypotheses of our FTF strategy and make mid-stream adjustments to programs if necessary, or scale up programs that are working well. Using the earning component of FTF programs like Community Connector is in line with the Mission’s continuing CLA component. We will also partner with other donors to disseminate and promote lessons learned. USAID/Uganda, through unbiased and independent impact evaluations, will identify interventions that work; we will be an active contributor to the greater discourse in testable development hypotheses and our programs will benefit from our increased understanding
CAPACITY BUILDING/SUPPORT TO DATA COLLECTION
A key component of our Feed the Future program will be capacity building of the Government of Uganda in the collection, analysis, and use of agriculture and nutrition data for planning, monitoring, and evaluation. We will work with all relevant government agencies and ministries including the Uganda Bureau of Statistics, the Ministry of Agriculture, Animal Industry and Fisheries, and the Ministry of Health. We will work in partnership with the National Planning authority as they attempt to convene the multisectoral Food and Nutrition Council as a cohesive and functional unit. We will seek to build local academic institutions’ capacity in nutrition through improved pre-service and in-service training, and enhanced research capacity. In addition to training in data collection and assistance in improving data systems, we will build analytical capacity in the Ministry of Agriculture by establishing a Strategic Analysis and Knowledge Support System (SAKSS) node.
NUTRITION COLLABORATIVE RESEARCH AND SUPPORT PROGRAM (CRSP)
We will use the Nutrition CRSP to assist us with specific research questions that tell us about the impact of our nutrition-related FTF programs. We have already had preliminary discussions with a Nutrition CRSP team. The Nutrition CRSP is intended to investigate effective ways of translating research results into widespread development practice. The CRSP anticipates the development of a well-balanced research strategy that is both innovative and problem solving, responds to the food and nutrition scientific needs, and to the capacity development requirements of Uganda. USAID/Uganda, through the CRSP, will be better positioned to build more effective strategies and programs, while establishing a research capacity within the Mission and the country as a whole. As programs continue to be developed and procured in the coming months, the CRSP will assist in collecting the relevant local and international knowledge base needed to better implement, evaluate, and learn from our programs. Within individual programs, the CRSP will be an active participant in identifying and rigorously measure testable hypotheses related to food security.
","estimated 709,000 vulnerable Ugandan women, children, and family members—mostly smallholder farmers—will receive targeted assistance to escape hunger and poverty. More than 450,000 children will be reached with services to improve their nutrition","This component will reach children in 47 districts in the Southwest and North of Uganda","","","Prevalence of households with moderate or severe hunger;Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Number of health facilities with established capacity to manage acute under nutrition; Prevalence of anemia among children 6-59 months; Prevalence of Poverty: Percent of people living on less than $1.25/day; Expenditures of rural households;Prevalence of stunted children under five; Change in average score on Household Hunger index; Percent of children 6-23 months who received a Minimum Acceptable Diet.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11629","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","UGA","Uganda","Northern Uganda |central “Maize Belt|Southwest Uganda","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 country-driven 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, hildren, 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 Uganda, Feed the Future aims to help an estimated 709,000 vulnerable Ugandan women, children and family members—mostly mallholder farmers—escape hunger and poverty. More than 450,000 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 Uganda is making core investments in three key areas:
1. Nutrition
2. Agriculture. The maize, coffee and bean belt are in Southwest and Central Uganda. The choice to focus on these value chains represents considerations regarding Ugandan government priorities, division of donor labor, and the highest impact interventions for the expected scale of Feed the Future resources.
3. Connecting Nutrition to Agriculture
USAID will build on previous strategic investments in nutrition and take them to scale in the areas and populations of greatest need to support the GOU and private sector to reduce chronic undernutrition in the country with a primary focus on prevention. Through these interventions an estimated 709,000 vulnerable Ugandan women, children, and family members—mostly smallholder farmers—will receive targeted assistance to escape hunger and poverty. More than 450,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. The core investments in nutrition will focus on community and facility based prevention and treatment, targeted nutrition service delivery, the enabling environment for nutrition and capacity building.
Targeted Nutrition Service Delivery – Fortification and Supplementation
Targeted nutrition service delivery is focused primarily on approaches to reduce specific micronutrient
deficiencies in Uganda. FTF will continue to support vitamin A supplementation and de-worming for
children and iron folic acid supplementation and de-worming for pregnant women at the facility level,
through district-level health programs in target geographical areas. In addition, food fortification
activities will be supported to improve the necessary vitamin and mineral content of staple foods that
will reach a larger target audience, primarily in urban and peri-urban areas where fortified foods are
more accessible. This will build on previous work supported by the USG that has resulted in cooking
oil fortification with vitamin A that now covers more than 85 percent of the country’s market and the
fortification of maize and wheat flour with vitamin A, iron, zinc, folic acid and vitamin B12 and. New food fortification vehicles will be added that include sugar fortification with vitamin A.
The agriculture team is also looking at improved seed varieties to increase micronutrient content such as the orange-fleshed sweet potato, which has increased levels of beta-carotene (Vitamin A). The introduction of fortification of foods will be combined with educational activities that promote dietary diversity through the community and facility based programs.
As previously mentioned, a key component to treatment of undernutrition in Uganda is the production of therapeutic and complementary foods. USG’s Feed the Future will expand on previous investments in local ready-to-use therapeutic food production to increase availability and distribution in health facilities across the country to treat acute undernutrition.
Enabling Environment
Our program will work to leverage other sectors (e.g., agriculture, water, public/private, etc) to create demand for fortified foods, adopt good nutrition behaviors, and activities like exclusive breastfeeding and integrated nutrition/WASH/food hygiene. Advocacy efforts will continue to emphasize the importance of nutrition among key stakeholders. Uganda is one of the countries that is taking on the Scaling Up Nutrition (SUN) initiative spear headed globally by the Irish Government, U.S. Government and the UN. SUN focuses on integration of relevant sectors with a view to addressing the window of opportunity within the 1,000 days (from minus 9 months to 24 months). We will work to harmonize FTF and SUN activities to maximize efficiency and national coverage in close consultation with MOH, MAAIF and other stakeholders. Through the existing micronutrient fortification program that has successfully enriched common staples such as oil and flour, FTF will continue to advocate for mandatory fortification of manufactured foods.
","Some key outputs of nutrition activities are: nutrition officers placed in a majority of districts; active Food and Nutrition Councils organized in districts; mandatory fortification of major manufactured foods; therapeutic food reconstituted from locally available foods developed and distributed to district and regional hospitals; and community behavior changes to prevent undernutrition.
","PERFORMANCE MONITORING
Through an interactive approach across Mission teams and in collaboration with other donors and the GOU, the USG FTF effort will go beyond the status quo of performance monitoring. At the basic level, data will be collected by implementing partners and reported to USAID/Uganda through quarterly reports while quality will be assessed via Data Quality Assessment visits to the field.
IMPACT EVALUATION
To build an evidence base to adjust ongoing projects and inform future programs, we will design rigorous impact evaluations for select FTF programs. We have already identified such an opportunity with our Community Connector program, which fully integrates agriculture and nutrition activities at the household level. Discussions have been held with partners within the MIT Poverty Action Lab consortium on the use of Randomized Control Trial (RCT) experiments. We will use the results of these impact evaluations to test the hypotheses of our FTF strategy and make mid-stream adjustments to programs if necessary, or scale up programs that are working well. Using the earning component of FTF programs like Community Connector is in line with the Mission’s continuing CLA component. We will also partner with other donors to disseminate and promote lessons learned. USAID/Uganda, through unbiased and independent impact evaluations, will identify interventions that work; we will be an active contributor to the greater discourse in testable development hypotheses and our programs will benefit from our increased understanding
CAPACITY BUILDING/SUPPORT TO DATA COLLECTION
A key component of our Feed the Future program will be capacity building of the Government of Uganda in the collection, analysis, and use of agriculture and nutrition data for planning, monitoring, and evaluation. We will work with all relevant government agencies and ministries including the Uganda Bureau of Statistics, the Ministry of Agriculture, Animal Industry and Fisheries, and the Ministry of Health. We will work in partnership with the National Planning authority as they attempt to convene the multisectoral Food and Nutrition Council as a cohesive and functional unit. We will seek to build local academic institutions’ capacity in nutrition through improved pre-service and in-service training, and enhanced research capacity. In addition to training in data collection and assistance in improving data systems, we will build analytical capacity in the Ministry of Agriculture by establishing a Strategic Analysis and Knowledge Support System (SAKSS) node.
NUTRITION COLLABORATIVE RESEARCH AND SUPPORT PROGRAM (CRSP)
We will use the Nutrition CRSP to assist us with specific research questions that tell us about the impact of our nutrition-related FTF programs. We have already had preliminary discussions with a Nutrition CRSP team. The Nutrition CRSP is intended to investigate effective ways of translating research results into widespread development practice. The CRSP anticipates the development of a well-balanced research strategy that is both innovative and problem solving, responds to the food and nutrition scientific needs, and to the capacity development requirements of Uganda. USAID/Uganda, through the CRSP, will be better positioned to build more effective strategies and programs, while establishing a research capacity within the Mission and the country as a whole. As programs continue to be developed and procured in the coming months, the CRSP will assist in collecting the relevant local and international knowledge base needed to better implement, evaluate, and learn from our programs. Within individual programs, the CRSP will be an active participant in identifying and rigorously measure testable hypotheses related to food security.
","estimated 709,000 vulnerable Ugandan women, children, and family members—mostly smallholder farmers—will receive targeted assistance to escape hunger and poverty. More than 450,000 children will be reached with services to improve their nutrition","This component will reach children in 47 districts in the Southwest and North of Uganda.","","","Prevalence of households with moderate or severe hunger;Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Number of health facilities with established capacity to manage acute under nutrition; Prevalence of anemia among children 6-59 months; Prevalence of Poverty: Percent of people living on less than $1.25/day; Expenditures of rural households;Prevalence of stunted children under five; Change in average score on Household Hunger index; Percent of children 6-23 months who received a Minimum Acceptable Diet.","Vulnerable groups","","Multiple micronutrient powders for home fortification of foods consumed by pregnant women>>>Multiple micronutrient powders for home fortification of foods consumed by pregnant women>>http://www.who.int/elena/titles/micronutrients_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "11629","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","UGA","Uganda","Northern Uganda |central “Maize Belt|Southwest Uganda","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 country-driven 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, hildren, 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 Uganda, Feed the Future aims to help an estimated 709,000 vulnerable Ugandan women, children and family members—mostly mallholder farmers—escape hunger and poverty. More than 450,000 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 Uganda is making core investments in three key areas:
1. Nutrition
2. Agriculture. The maize, coffee and bean belt are in Southwest and Central Uganda. The choice to focus on these value chains represents considerations regarding Ugandan government priorities, division of donor labor, and the highest impact interventions for the expected scale of Feed the Future resources.
3. Connecting Nutrition to Agriculture
Priority Value Chains
Our investments will focus on value chains with the greatest market potential, the highest number of farmers, and the greatest income potential for farmers. Impact on nutrition and role of gender were also critical considerations in our value chain focus, as was the potential for sector-wide impact and maximum return on investment. Many of the value chain components have integrated nutrition and agriculture dimensions. The starting point for this strategy is the Government of Uganda’s Agriculture Sector Development Strategy and Investment Plan (DSIP) where ten priority value chains were selected. In looking at each commodity, maize and coffee stood out as key drivers for conomic growth in terms of number of farmers, market demand, and income potential. Most of the Ugandan staple diet is built around other staples like beans, cassava, and banana – leaving maize to function more as a cash crop that responds to regional food security and trade demands, rather than as a household staple. Fish, dairy and livestock were also considered. However all three present a number of challenges that would require substantially higher levels of investment to address and would deliver a much lower rate of return for dollar invested.
Value-chain Investments
Policy - The USG FTF strategy will support a five-year policy reform initiative in agriculture, trade, health and gender equity. Some examples of policy priorities include the passage of Uganda’s Biotechnology and Bio-safely bill, effective implementation of the Agricultural Chemicals Control Act (1989, amended in 2006) which establishes a licensing regime for insecticides, herbicides, fungicides and fertilizers, and controls and regulates the manufacture, storage, distribution, trade, import, and export of agricultural chemicals, effective implementation of the Agriculture Seeds and Plant Act (1994) which regulates seed companies operating or importing plant material into Uganda, and passage of the Food and Nutrition Bill and related Health, Nutrition and Sanitation policies for a proposed National Food and Drug Authority. Review of Uganda’s marriage and family act lays out the ownership and control of assets for women. It is critical to address key gender components of legislation.
Capacity Building - Support to strengthen key public and private sector institutions at the national and district levels is essential to the overall success of our Feed the Future activities. This five-year set of activities will focus on building capacity within the Uganda Bureau of Statistics, and Ministries of Health and Agriculture to collect and analyze data, and to monitor and evaluate the effectiveness of their programs. There will also be a short, medium, and long-term training and education component to develop the next generation of Uganda decision makers.
Agriculture Research – Feed the Future will support continued research in three areas:Biotechnology to protect food security crops from serious disease threat – specifically cassava (Cassava MOSAIC) and banana (Banana Wilt (BXW) and Black Sigatoka Disease); breeding to increase stress tolerance and disease resistance for Feed the Future focus crops (maize, coffee and beans); and partnership with Harvest Plus to scale-up the production and mainstream marketing of bio-fortified/nutritionally enhanced crop varieties - specifically Orange-fleshed Sweet Potato and high zinc/iron beans.
Increased Quality and Production – USG will contribute to a $50 million partnership with DANIDA, the EU, Belgium, and Sweden to address farm-level constraints to quality and production in maize, beans and coffee. The program will also focus on increasing farmer access to financial services and supporting trade-related sanitary and phytosanitary standards and quality management systems. Agro-Input Supply - A five-year program to increase the quality, availability, and use of inputs. This program will build the capacity of the Uganda National Agriculture Input Dealers Association (UNADA) and private sector retailers.
Farm-level Aggregation and Market Linkages - This program will work to build the capacity of farmer organizations to enter into agreements with major buyers, access finance, purchase inputs, bulk, clean, and process their commodities. The program will work in conjunction with the Abi-Trust Partnership (DANIDA) and emphasize linkages to the WFP's Purchase for Progress efforts and the Uganda Commodity Exchange.
Market-Information System - This program will work with local partners to utilize the latest in information and communications technology to address market information gaps for smallholder farmers.
","Some key outputs include:
PERFORMANCE MONITORING
Through an interactive approach across Mission teams and in collaboration with other donors and the GOU, the USG FTF effort will go beyond the status quo of performance monitoring. At the basic level, data will be collected by implementing partners and reported to USAID/Uganda through quarterly reports while quality will be assessed via Data Quality Assessment visits to the field.
IMPACT EVALUATION
To build an evidence base to adjust ongoing projects and inform future programs, we will design rigorous impact evaluations for select FTF programs. We have already identified such an opportunity with our Community Connector program, which fully integrates agriculture and nutrition activities at the household level. Discussions have been held with partners within the MIT Poverty Action Lab consortium on the use of Randomized Control Trial (RCT) experiments. We will use the results of these impact evaluations to test the hypotheses of our FTF strategy and make mid-stream adjustments to programs if necessary, or scale up programs that are working well. Using the earning component of FTF programs like Community Connector is in line with the Mission’s continuing CLA component. We will also partner with other donors to disseminate and promote lessons learned. USAID/Uganda, through unbiased and independent impact evaluations, will identify interventions that work; we will be an active contributor to the greater discourse in testable development hypotheses and our programs will benefit from our increased understanding
CAPACITY BUILDING/SUPPORT TO DATA COLLECTION
A key component of our Feed the Future program will be capacity building of the Government of Uganda in the collection, analysis, and use of agriculture and nutrition data for planning, monitoring, and evaluation. We will work with all relevant government agencies and ministries including the Uganda Bureau of Statistics, the Ministry of Agriculture, Animal Industry and Fisheries, and the Ministry of Health. We will work in partnership with the National Planning authority as they attempt to convene the multisectoral Food and Nutrition Council as a cohesive and functional unit. We will seek to build local academic institutions’ capacity in nutrition through improved pre-service and in-service training, and enhanced research capacity. In addition to training in data collection and assistance in improving data systems, we will build analytical capacity in the Ministry of Agriculture by establishing a Strategic Analysis and Knowledge Support System (SAKSS) node.
NUTRITION COLLABORATIVE RESEARCH AND SUPPORT PROGRAM (CRSP)
We will use the Nutrition CRSP to assist us with specific research questions that tell us about the impact of our nutrition-related FTF programs. We have already had preliminary discussions with a Nutrition CRSP team. The Nutrition CRSP is intended to investigate effective ways of translating research results into widespread development practice. The CRSP anticipates the development of a well-balanced research strategy that is both innovative and problem solving, responds to the food and nutrition scientific needs, and to the capacity development requirements of Uganda. USAID/Uganda, through the CRSP, will be better positioned to build more effective strategies and programs, while establishing a research capacity within the Mission and the country as a whole. As programs continue to be developed and procured in the coming months, the CRSP will assist in collecting the relevant local and international knowledge base needed to better implement, evaluate, and learn from our programs. Within individual programs, the CRSP will be an active participant in identifying and rigorously measure testable hypotheses related to food security.
","estimated 709,000 vulnerable Ugandan women, children and family members—mostly smallholder farmers—escape hunger and poverty. ","This component will reach farmers in 62 districts in the maize, coffee, and beans belt in Southwest and Central Uganda.","","Uganda National Household Survey, 2009/2010; Demographic Health Survey, 2006; The 2008 Uganda Food Consumption Survey; 2007 Uganda Service Provision Survey; The Uganda National Household Survey 2008/2009","Percent growth in agricultural GDP of maize and coffee; Percent change in value of intra-regional exports of targeted agricultural commodities as a result of USG assistance; Post-harvest losses as a percentage of overall harvest, for selected commodities; Value of new private sector investment in the agriculture sector or food chain leveraged by FTF.implementationCapacity of relevant national statistical office to collect high-quality agricultural data","Socio-economic status","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","","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" "23147","Third Community Health and Nutrition Project (CHN 3)","English","Large scale programmes","","IDN","Indonesia","","Urban|Rural|Peri-urban","completed","","2001","CHN 3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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. Additionally, there is a section describing findings from cash transfer programmes. This summary of CHN 3 is retrieved from the ENA Part II where CHN 3 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$ 3.6 million investment by the World Bank. US$ 0.6 million by the Government of Indonesia.","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23144","","Food distribution/supplementation for prevention of acute malnutrition","","","","Infants and young children|Preschool-age children (Pre-SAC)","","Five provinces in Indonesia","Community-based","","Internal provision supplementary feeding
","Weight-for-age z-score (WAZ)
","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birth-rate in the lowest quintile of the population.
","Five provinces in Indonesia","Five provinces in Indonesia","","","","None","","","","","","","","","","","","","","","","","","","","","","","","Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define.
","","English" "23147","Third Community Health and Nutrition Project (CHN 3)","English","Large scale programmes","","IDN","Indonesia","","Urban|Rural|Peri-urban","completed","","2001","CHN 3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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. Additionally, there is a section describing findings from cash transfer programmes. This summary of CHN 3 is retrieved from the ENA Part II where CHN 3 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$ 3.6 million investment by the World Bank. US$ 0.6 million by the Government of Indonesia.","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23145","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)","","Five provinces in Indonesia","Community-based","","","Weight-for-age z-score (WAZ)
","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birth-rate in the lowest quintile of the population
","Five provinces in Indonesia","Five provinces in Indonesia","","","","None","","","","","","","","","","","","","","","","","","","","","","","","Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define.
","","English" "23147","Third Community Health and Nutrition Project (CHN 3)","English","Large scale programmes","","IDN","Indonesia","","Urban|Rural|Peri-urban","completed","","2001","CHN 3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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. Additionally, there is a section describing findings from cash transfer programmes. This summary of CHN 3 is retrieved from the ENA Part II where CHN 3 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$ 3.6 million investment by the World Bank. US$ 0.6 million by the Government of Indonesia.","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23146","","Nutrition education and counselling","","","","Lactating women (LW)|Pregnant women (PW)","","Five provinces in Indonesia","Community-based","","","Weight-for-age z-score (WAZ)
","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birth-rate in the lowest quintile of the population.
","Five provinces in Indonesia","Five provinces in Indonesia","","","","None","","","","","","","","","","","","","","","","","","","","","","","","Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define.
","","English" "23299","Bolsa Alimentacão (BA)","English","Large scale programmes","","BRA","Brazil","","","completed","","01-1970","Bolsa Alimentacão (BA) was a conditional cash transfer programme that ran from 2001 - 03. Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly, for up to 3 children. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. In 2003 BA merged with several programmes to form the current Bolsa Familia Programme (BFP).
","
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 Bolsa Alimentacão is retrieved from the ENA Part II where Bolsa Alimentacão 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...
","","","Health","Ministry of Health ","","","","","","","","","","","","","","","","","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly. Resource intensity: US$ 84/hd/year","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23298","","Conditional cash transfer","","","","Family ( living in same household)","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42","","Community-based","","Families who met the inclusion criteria received US$ 7 per child monthly, for up to 3 children.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Initial evaluation data from Bolsa Alimentacão showed worsening height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) for beneficiaries compared to non-beneficiaries, though results were not statistically significant. This result was despite a reported increase in food consumption, which may have been due to beneficiary mothers assuming they would be ineligible for benefits if children were healthy.
","","1.5 million persons (about 1% of the population)","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23299","Bolsa Alimentacão (BA)","English","Large scale programmes","","BRA","Brazil","","","completed","","01-1970","Bolsa Alimentacão (BA) was a conditional cash transfer programme that ran from 2001 - 03. Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly, for up to 3 children. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. In 2003 BA merged with several programmes to form the current Bolsa Familia Programme (BFP).
","
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 Bolsa Alimentacão is retrieved from the ENA Part II where Bolsa Alimentacão 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...
","","","Health","Ministry of Health ","","","","","","","","","","","","","","","","","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly. Resource intensity: US$ 84/hd/year","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23300","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)|School age children (SAC)","Children below 7 years of age","","Community-based","","Regular growth monitoring
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Initial evaluation data from Bolsa Alimentacão showed worsening height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) for beneficiaries compared to non-beneficiaries, though results were not statistically significant. This result was despite a reported increase in food consumption, which may have been due to beneficiary mothers assuming they would be ineligible for benefits if children were healthy.
","","1.5 million persons (about 1% of the population)","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23299","Bolsa Alimentacão (BA)","English","Large scale programmes","","BRA","Brazil","","","completed","","01-1970","Bolsa Alimentacão (BA) was a conditional cash transfer programme that ran from 2001 - 03. Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly, for up to 3 children. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. In 2003 BA merged with several programmes to form the current Bolsa Familia Programme (BFP).
","
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 Bolsa Alimentacão is retrieved from the ENA Part II where Bolsa Alimentacão 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...
","","","Health","Ministry of Health ","","","","","","","","","","","","","","","","","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly. Resource intensity: US$ 84/hd/year","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23301","","Nutrition education and counselling","","","","Family ( living in same household)|Lactating women (LW)|Pregnant women (PW)","amilies with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42","","Community-based","","Regular participation in nutritio-education seminars
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Initial evaluation data from Bolsa Alimentacão showed worsening height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) for beneficiaries compared to non-beneficiaries, though results were not statistically significant. This result was despite a reported increase in food consumption, which may have been due to beneficiary mothers assuming they would be ineligible for benefits if children were healthy.
","","1.5 million persons (about 1% of the population)","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23299","Bolsa Alimentacão (BA)","English","Large scale programmes","","BRA","Brazil","","","completed","","01-1970","Bolsa Alimentacão (BA) was a conditional cash transfer programme that ran from 2001 - 03. Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly, for up to 3 children. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. In 2003 BA merged with several programmes to form the current Bolsa Familia Programme (BFP).
","
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 Bolsa Alimentacão is retrieved from the ENA Part II where Bolsa Alimentacão 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...
","","","Health","Ministry of Health ","","","","","","","","","","","","","","","","","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42 received US$ 7 per child monthly. Resource intensity: US$ 84/hd/year","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23302","","Vaccination","","","","Family ( living in same household)","Families with pregnant or lactating women and/or children less than 7 years of age with a monthly per capita income below US$ 42","","Community-based","","","","","","1.5 million persons (about 1% of the population)","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23304","Bolsa Familia Programme (BFP)","English","Large scale programmes","","BRA","Brazil","","","on-going","","","Bolsa Familia Programme (BFP) is an ongoing conditional cash programme where families with pregnant and lactating mothers and/or children less than 7 years of age, with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor), receive monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. BFP coverag in 2006 was approximately 100% of the poor and 25% of the total Brazilian population.
","
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 BFP is retrieved from the ENA Part II where BFP 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...
","","","","","","","","","","","","","","","","","","","","","US$ 84-540/hd/year.Public expenditure for the BFP in 2005 was US$ 3.2 billion, equivalent to 0.36% of GDP. World Bank support for the programme was about US$ 562 million from 2003–2009, or approximately US$ 93.7 million/year(Monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income)","Bilateral and donor agencies and lenders","The World Bank","","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23303","","Conditional cash transfer","","","","Family ( living in same household)","Families with pregnant and lactating mothers and children less than 7 years of age with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor).","","Community-based","","Monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor).
","Height-for-age z-score (HAZ)
","Evaluation data from the BFP is limited, but a positive impact has been reported; stunting among beneficiary children aged 6–11 months was 3.3 ppt lower (2 versus 5.3) than nonbeneficiary children. However, the results are questionable due to selection bias. Study results may also be limited (especially for children aged 12–36 months) by supply-side constraints restricting health services, irregular growth monitoring despite the conditionality, and lack of information on timing of enrollment.
","","in 2006 was 11.1 million families (46 million persons), approximately 100% of the poor and 25% of the total Brazilian population.","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23304","Bolsa Familia Programme (BFP)","English","Large scale programmes","","BRA","Brazil","","","on-going","","","Bolsa Familia Programme (BFP) is an ongoing conditional cash programme where families with pregnant and lactating mothers and/or children less than 7 years of age, with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor), receive monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. BFP coverag in 2006 was approximately 100% of the poor and 25% of the total Brazilian population.
","
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 BFP is retrieved from the ENA Part II where BFP 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...
","","","","","","","","","","","","","","","","","","","","","US$ 84-540/hd/year.Public expenditure for the BFP in 2005 was US$ 3.2 billion, equivalent to 0.36% of GDP. World Bank support for the programme was about US$ 562 million from 2003–2009, or approximately US$ 93.7 million/year(Monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income)","Bilateral and donor agencies and lenders","The World Bank","","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23305","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)|School age children (SAC)","Children below 7 years of age","","Community-based","","Regular growth monitoring in order to receive cash transfer
","Height-for-age z-score (HAZ)
","Evaluation data from the BFP is limited, but a positive impact has been reported; stunting among beneficiary children aged 6–11 months was 3.3 ppt lower (2 versus 5.3) than nonbeneficiary children. However, the results are questionable due to selection bias. Study results may also be limited (especially for children aged 12–36 months) by supply-side constraints restricting health services, irregular growth monitoring despite the conditionality, and lack of information on timing of enrollment.
","","11.1 million families (46 million persons), approximately 100% of the poor and 25% of the total Brazilian population","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23304","Bolsa Familia Programme (BFP)","English","Large scale programmes","","BRA","Brazil","","","on-going","","","Bolsa Familia Programme (BFP) is an ongoing conditional cash programme where families with pregnant and lactating mothers and/or children less than 7 years of age, with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor), receive monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. BFP coverag in 2006 was approximately 100% of the poor and 25% of the total Brazilian population.
","
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 BFP is retrieved from the ENA Part II where BFP 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...
","","","","","","","","","","","","","","","","","","","","","US$ 84-540/hd/year.Public expenditure for the BFP in 2005 was US$ 3.2 billion, equivalent to 0.36% of GDP. World Bank support for the programme was about US$ 562 million from 2003–2009, or approximately US$ 93.7 million/year(Monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income)","Bilateral and donor agencies and lenders","The World Bank","","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23306","","Nutrition education and counselling","","","","Lactating women (LW)|Pregnant women (PW)","Caretakers of children below the age of 7","","Community-based","","Regular participation in nutrition education seminars
","Height-for-age z-score (HAZ)
","Evaluation data from the BFP is limited, but a positive impact has been reported; stunting among beneficiary children aged 6–11 months was 3.3 ppt lower (2 versus 5.3) than nonbeneficiary children. However, the results are questionable due to selection bias. Study results may also be limited (especially for children aged 12–36 months) by supply-side constraints restricting health services, irregular growth monitoring despite the conditionality, and lack of information on timing of enrollment.
","","11.1 million families (46 million persons), approximately 100% of the poor and 25% of the total Brazilian population","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23304","Bolsa Familia Programme (BFP)","English","Large scale programmes","","BRA","Brazil","","","on-going","","","Bolsa Familia Programme (BFP) is an ongoing conditional cash programme where families with pregnant and lactating mothers and/or children less than 7 years of age, with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor), receive monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income. Conditions for receipt of the transfer included regular pre- and postnatal care, growth monitoring, immunization, and participation in nutrition education seminars. BFP coverag in 2006 was approximately 100% of the poor and 25% of the total Brazilian population.
","
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 BFP is retrieved from the ENA Part II where BFP 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...
","","","","","","","","","","","","","","","","","","","","","US$ 84-540/hd/year.Public expenditure for the BFP in 2005 was US$ 3.2 billion, equivalent to 0.36% of GDP. World Bank support for the programme was about US$ 562 million from 2003–2009, or approximately US$ 93.7 million/year(Monthly cash transfers range from US$ 7–US$ 45 per family depending upon eligibility as determined by monthly per capita income)","Bilateral and donor agencies and lenders","The World Bank","","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23307","","Vaccination","","","","Family ( living in same household)","Families with pregnant and lactating mothers and children less than 7 years of age with monthly per capita income ceilings of US$ 57 (moderately poor) and US$ 29 (extremely poor).","","Community-based","","","","","","11.1 million families (46 million persons), approximately 100% of the poor and 25% of the total Brazilian population","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23330","National Nutrition Program (NNP)","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The NNP was a follow-up of the The Bangladesh Integrated Nutrition Programme ((BINP) - which was completed in 2002). The implementation of the NNP started in 2004.
","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 is retrieved from the ENA Part II where NNP 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/
","","","Health","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23329","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)|School age children (SAC)","Children below 6 years","","Community-based","","","","The NNP had implementation problems; the baseline survey was delayed and the end survey never conducted. Thus, no estimate of effect is available.
","Intended coverage: 105/464 thanas","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23330","National Nutrition Program (NNP)","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The NNP was a follow-up of the The Bangladesh Integrated Nutrition Programme ((BINP) - which was completed in 2002). The implementation of the NNP started in 2004.
","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 is retrieved from the ENA Part II where NNP 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/
","","","Health","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23331","","Food distribution/supplementation for prevention of acute malnutrition","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)|School age children (SAC)","Children below 6 years","","Community-based","","Internal provision supplementary feeding
","","NNP had implementation problems; the baseline survey was delayed and the end survey never conducted. Thus, no estimate of effect is available.
","Intended coverage: 105/464 thanas","","","","","Other","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23330","National Nutrition Program (NNP)","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The NNP was a follow-up of the The Bangladesh Integrated Nutrition Programme ((BINP) - which was completed in 2002). The implementation of the NNP started in 2004.
","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 is retrieved from the ENA Part II where NNP 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/
","","","Health","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23332","","Nutrition education and counselling","","","","Lactating women (LW)|Pregnant women (PW)","","","Community-based","","","","NNP had implementation problems; the baseline survey was delayed and the end survey never conducted. Thus, no estimate of effect is available.
","Intended coverage: 105/464 thanas","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23334","The Bangladesh Integrated Nutrition Programme (BINP) ","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The Bangladesh Integrated Nutrition Project (BINP) represented the first large-scale government intervention in nutrition. The BINP operated from 1995 to 2002. By targeting pragnent and lactating women, as well as children under two years, the project's components included growth monitoring, internal provision of sepplementary feeding and nutrition education/councelling.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, whichprovides a compact of WHO guidance on nutrition interventions targeting the first 1,000 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 BINP is retrieved from Part II where BINP is one of 32 community-based large-scale programmes that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","Health","","","","","","","","","","National NGOs","","","","","","","","Intensity of community health and nutrition worker (CHNW) was reported as 1:200 children, i.e. about 5:100 households. Resource intensity was estimated at approximately US$ 18/household per year, including supplementary feeding.","Bilateral and donor agencies and lenders","The World Bank","Monthly growth monitoring and promotion (GMP) for children under two years of age and pregnant and lactating women (PLW)
","Height-for-age z score (HAZ), weight-for-age z score (WAZ), weight-for-height z score (WHZ)
","Various evaluations of BINP’s nutritional impact were conducted by both internal and external reviewers.
","","15% coverage by area",""," ","Participants' initial rate: 14,5 ppt/year change in underweight. Participants' sustained rate: 0,3 ppt/year change in underweight.
","","","","","","","","","","","","","","","","","","","","","","","","","Reasons for low effectiveness may include:
BINP itself was of low effectiveness and did not lead to a sustainable set of actions. In part this was due to the project design and inadequate intensity, and in part to complexities in implementation (institutional and otherwise)
","","English" "23334","The Bangladesh Integrated Nutrition Programme (BINP) ","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The Bangladesh Integrated Nutrition Project (BINP) represented the first large-scale government intervention in nutrition. The BINP operated from 1995 to 2002. By targeting pragnent and lactating women, as well as children under two years, the project's components included growth monitoring, internal provision of sepplementary feeding and nutrition education/councelling.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, whichprovides a compact of WHO guidance on nutrition interventions targeting the first 1,000 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 BINP is retrieved from Part II where BINP is one of 32 community-based large-scale programmes that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","Health","","","","","","","","","","National NGOs","","","","","","","","Intensity of community health and nutrition worker (CHNW) was reported as 1:200 children, i.e. about 5:100 households. Resource intensity was estimated at approximately US$ 18/household per year, including supplementary feeding.","Bilateral and donor agencies and lenders","The World Bank","Supplementary feeding (SF) of malnourished PLW and malnourished and growth-faltered children under 2 years of age.
","Height-for-age z score (HAZ), weight-for-age z score (WAZ), weight-for-height z score (WHZ).
","Various evaluations of BINP’s nutritional impact were conducted by both internal and external reviewers.
","","15% by area","","","Participants' initial reduction rate: 14.5 ppt/year change in underweight. Participants' sustained rate: 0.3 ppt/year change in underweight.
","","","","","","","","","","","","","","","","","","","","","","","","","Reasons for low effectiveness may include:
BINP itself was of low effectiveness and did not lead to a sustainable set of actions. In part this was due to the project design and inadequate intensity, and in part to complexities in implementation (institutional and otherwise).
","","English" "23334","The Bangladesh Integrated Nutrition Programme (BINP) ","English","Large scale programmes","","BGD","Bangladesh","","","completed","","01-1970","The Bangladesh Integrated Nutrition Project (BINP) represented the first large-scale government intervention in nutrition. The BINP operated from 1995 to 2002. By targeting pragnent and lactating women, as well as children under two years, the project's components included growth monitoring, internal provision of sepplementary feeding and nutrition education/councelling.
","WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, whichprovides a compact of WHO guidance on nutrition interventions targeting the first 1,000 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 BINP is retrieved from Part II where BINP is one of 32 community-based large-scale programmes that has been reviewed in detail and evaluated.
http://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/
","","","Health","","","","","","","","","","National NGOs","","","","","","","","Intensity of community health and nutrition worker (CHNW) was reported as 1:200 children, i.e. about 5:100 households. Resource intensity was estimated at approximately US$ 18/household per year, including supplementary feeding.","Bilateral and donor agencies and lenders","The World Bank","Nutrition education for pregnant women, mothers of children under two, and adolescent girls
","Height-for-age z score (HAZ), weight-for-age z score (WAZ), weight-for-height z score (WHZ)
","Various evaluations of BINP’s nutritional impact were conducted by both internal and external reviewers.
","","15% by area","","","Participants' initial rate: 14,5 ppt/year change in underweight. Participants' sustained rate: 0,3 ppt/year change in underweight.
","","","","","","","","","","","","","","","","","","","","","","","","","Reasons for low effectiveness may include:
BINP itself was of low effectiveness and did not lead to a sustainable set of actions. In part this was due to the project design and inadequate intensity, and in part to complexities in implementation (institutional and otherwise).
","","English" "23363","Family Nutrition Improvement programme (UPGK)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","The Family Nutrition Improvement programme (UPGK), also known as the Posyandu (weighing post) programme, started around 1979 and expanded to national coverage, continuing until constrained by an economic crisis in the late 1990s. The UPGK (centred on Posyandus) projects were based on the strategy of consistent monthly weight gain in healthy children targeting children under five and their mothers. The activities included weighing, education, micronutrient supplementation and supplementary feeding in combination with other health interventions through weighing posts managed by community leaders and volunteers
","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 UPGK is retrieved from the ENA Part II where UPGK is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
","","","","","","","","","","","","","","","","","","","","","The cost per beneficiary was US$ 2 for weighing-screening and US$ 11 per beneficiary for weighing-feeding. Recurrent costs, which may be seen as those needed for sustained activities, were estimated at approximately US$ 1/household per year, but may not include all local costs. The number of children per posyandu (weighing post) was about 60. 4 community health and nutrition workers (CHNWs) per posyandu, this gives 66 CHNWs/1000.","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23362","","Growth monitoring and promotion","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)|School age children (SAC)","","","Community-based","","","Protein-energy malnutrition
Underweight
","Both process and impact evaluations were performed on UPGK.
","","Approximately 90% by area. (58000/65000 villages). Coverage reached 80 % of the population under 5 years ","","","The level of severe protein-energy malnutrition declined from 3%–5% to 1%. The reduction in underweight ascribed to UPGK activities based on previous research was approximately 1.0 ppt/year","","","","","","","","","","","","","","","","","","","","","","","","","Inclusion of too many other health issues may have diluted the nutrition interventions). Other evaluation results indicate high programme access and initial coverage above 80% but reduced active participation over time. A lack of baseline data makes impact difficult to assess.
CHNWs had limited training (3 days) and high turnover, and on evaluation only a small percentage was able to provide meaningful counselling.
","","English" "23363","Family Nutrition Improvement programme (UPGK)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","The Family Nutrition Improvement programme (UPGK), also known as the Posyandu (weighing post) programme, started around 1979 and expanded to national coverage, continuing until constrained by an economic crisis in the late 1990s. The UPGK (centred on Posyandus) projects were based on the strategy of consistent monthly weight gain in healthy children targeting children under five and their mothers. The activities included weighing, education, micronutrient supplementation and supplementary feeding in combination with other health interventions through weighing posts managed by community leaders and volunteers
","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 UPGK is retrieved from the ENA Part II where UPGK is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
","","","","","","","","","","","","","","","","","","","","","The cost per beneficiary was US$ 2 for weighing-screening and US$ 11 per beneficiary for weighing-feeding. Recurrent costs, which may be seen as those needed for sustained activities, were estimated at approximately US$ 1/household per year, but may not include all local costs. The number of children per posyandu (weighing post) was about 60. 4 community health and nutrition workers (CHNWs) per posyandu, this gives 66 CHNWs/1000.","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23364","","Nutrition education and counselling","","","","Lactating women (LW)|Pregnant women (PW)","","","Community-based","","","Protein-energy malnutrition
Underweight
","Both process and impact evaluations were performed on UPGK
","","Approximately 90% by area. (58000/65000 villages). Coverage reached 80 % of the population under 5 years ","","","The level of severe protein-energy malnutrition declined from 3%–5% to 1%. The reduction in underweight ascribed to UPGK activities based on previous research was approximately 1.0 ppt/year","","","","","","","","","","","","","","","","","","","","","","","","","Inclusion of too many other health issues may have diluted the nutrition interventions). Other evaluation results indicate high programme access and initial coverage above 80% but reduced active participation over time. A lack of baseline data makes impact difficult to assess.
CHNWs had limited training (3 days) and high turnover, and on evaluation only a small percentage was able to provide meaningful counselling
","","English" "23363","Family Nutrition Improvement programme (UPGK)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","The Family Nutrition Improvement programme (UPGK), also known as the Posyandu (weighing post) programme, started around 1979 and expanded to national coverage, continuing until constrained by an economic crisis in the late 1990s. The UPGK (centred on Posyandus) projects were based on the strategy of consistent monthly weight gain in healthy children targeting children under five and their mothers. The activities included weighing, education, micronutrient supplementation and supplementary feeding in combination with other health interventions through weighing posts managed by community leaders and volunteers
","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 UPGK is retrieved from the ENA Part II where UPGK is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.
","","","","","","","","","","","","","","","","","","","","","The cost per beneficiary was US$ 2 for weighing-screening and US$ 11 per beneficiary for weighing-feeding. Recurrent costs, which may be seen as those needed for sustained activities, were estimated at approximately US$ 1/household per year, but may not include all local costs. The number of children per posyandu (weighing post) was about 60. 4 community health and nutrition workers (CHNWs) per posyandu, this gives 66 CHNWs/1000.","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23365","","Food distribution/supplementation for prevention of acute malnutrition","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)|School age children (SAC)","","","Community-based","","Internal provision supplementary feeding
","Protein-energy malnutrition
Underweight
","Both process and impact evaluations were performed on UPGK.
","","Approximately 90% by area. (58000/65000 villages). Coverage reached 80 % of the population under 5 years ","","","The level of severe protein-energy malnutrition declined from 3%–5% to 1%. The reduction in underweight ascribed to UPGK activities based on previous research was approximately 1.0 ppt/year","","","","","","","","","","","","","","","","","","","","","","","","","Inclusion of too many other health issues may have diluted the nutrition interventions). Other evaluation results indicate high programme access and initial coverage above 80% but reduced active participation over time. A lack of baseline data makes impact difficult to assess.
CHNWs had limited training (3 days) and high turnover, and on evaluation only a small percentage was able to provide meaningful counselling.
","","English" "23368","Third Community Health and Nutrition Project (CHN3)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","CHN3 picked up where UPGK left off. CHN3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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 CHN3 is retrieved from the ENA Part II where CHN3 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$ 3.6 million investment by the World Bank. US$ 0.6 million investment by the Government of Indonesia","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23367","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)","Children below 5 years","","Community-based","","","
Weight-for-age z-score (WAZ)
","A World Bank evaluation of the project determined that design made the project difficult to supervise and that poor monitoring and evaluation of performance made assessment of project effectiveness difficult to determine
","","Focus on five provinces","","","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birthrate in the lowest quintile of the population.","","","","","","","","","","","","","","","","","","","","","","","","","
Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define.
","","English" "23368","Third Community Health and Nutrition Project (CHN3)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","CHN3 picked up where UPGK left off. CHN3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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 CHN3 is retrieved from the ENA Part II where CHN3 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$ 3.6 million investment by the World Bank. US$ 0.6 million investment by the Government of Indonesia","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23369","","Nutrition education and counselling","","","","Lactating women (LW)|Pregnant women (PW)","","","Community-based","","","
Weight-for-age z-score (WAZ)
","A World Bank evaluation of the project determined that design made the project difficult to supervise and that poor monitoring and evaluation of performance made assessment of project effectiveness difficult to determine
","","Focus on five provinces","","","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birthrate in the lowest quintile of the population.","","","","","","","","","","","","","","","","","","","","","","","","","Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define.
","","English" "23368","Third Community Health and Nutrition Project (CHN3)","English","Large scale programmes","","IDN","Indonesia","","","completed","","01-1970","CHN3 picked up where UPGK left off. CHN3 focused on capacity building, health information systems, education and service delivery in a province-based model in five provinces.
","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 CHN3 is retrieved from the ENA Part II where CHN3 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$ 3.6 million investment by the World Bank. US$ 0.6 million investment by the Government of Indonesia","Bilateral and donor agencies and lenders","The World Bank","Government of Indonesia","Government","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23370","","Food distribution/supplementation for prevention of acute malnutrition","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)|Preschool-age children (Pre-SAC)|School age children (SAC)","","","Community-based","","
Internal provision supplemetary feeding
","Weight-for-age z-score (WAZ)
","A World Bank evaluation of the project determined that design made the project difficult to supervise and that poor monitoring and evaluation of performance made assessment of project effectiveness difficult to determine
","","Focus on five provinces","","","From 1989 to 2003 underweight (<-2 SD WAZ) decreased from 37.5% to 27.5% (0.71 ppt/year) despite the financial crisis of the early 1990s. This decrease may be partially attributed to a reduction in birthrate in the lowest quintile of the population.","","","","","","","","","","","","","","","","","","","","","","","","","Attempts to decentralize health interventions to the provincial level with CHN3 faced challenges of implementation and monitoring. Lack of baseline and surveillance data made effectiveness of these projects difficult to define
","","English" "23382","Oportunidades","English","Large scale programmes","","MEX","Mexico","","Urban|Rural","on-going","","","Oportunidades (known as Progresa from 1997–2002) is a conditional cash transfer (CCT) programme in operation at the time of writing. It was initiated in rural areas and expanded to include urban areas beginning in 2002, although approximately 70% of programme participants reside in rural areas. Targeting for Oportunidades is based on both geography, through identification of localities with high marginality indices, and socioeconomic status, through proxy means testing. Approximately 60 % of households in the bottom decile of per capita expenditures are participants, suggesting effective targeting of the poorest.
","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 Oportunidades is retrieved from the ENA Part II where Oportunidades 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 health and nutrition transfer component of Oportunidades is US$ 15/household per month, about 20% of average monthly household expenditures. Receipt of transfer is conditional upon regular health visits for all children in which growth monitoring is included, pre- and postnatal care for women, and adult (greater than 15 years of age) participation in health and nutrition education sessions.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Multiple evaluations of Oportunidades have been conducted with data demonstrating significant improvements in nutritional outcomes.
","","5 million families, approximately 20 % of the population","","","Increase in height in children 0–6 months of 1.1 cm (26.4 cm versus 25.3 cm) in programme beneficiaries compared to a control group. In rural children ages 12–24 months, a significant increase in mean hemoglobin of 0.37 g/dl was found after 12 months in the programme; 11.12 g/dl in the treatment group compared to 10.75 g/dl in the controls. Corresponding anaemia prevalence among beneficiary children was 44.3% compared to 54.9% among control children, a significant 10.6 ppt decrease. Even with improvement, nearly half of beneficiary children were still anaemic.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23382","Oportunidades","English","Large scale programmes","","MEX","Mexico","","Urban|Rural","on-going","","","Oportunidades (known as Progresa from 1997–2002) is a conditional cash transfer (CCT) programme in operation at the time of writing. It was initiated in rural areas and expanded to include urban areas beginning in 2002, although approximately 70% of programme participants reside in rural areas. Targeting for Oportunidades is based on both geography, through identification of localities with high marginality indices, and socioeconomic status, through proxy means testing. Approximately 60 % of households in the bottom decile of per capita expenditures are participants, suggesting effective targeting of the poorest.
","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 Oportunidades is retrieved from the ENA Part II where Oportunidades 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/
Regular health visits for all children in which growth monitoring is included
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Multiple evaluations of Oportunidades have been conducted with data demonstrating significant improvements in nutritional outcomes.
","","5 million families, approximately 20 % of the population","","","Increase in height in children 0–6 months of 1.1 cm (26.4 cm versus 25.3 cm) in programme beneficiaries compared to a control group","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23382","Oportunidades","English","Large scale programmes","","MEX","Mexico","","Urban|Rural","on-going","","","Oportunidades (known as Progresa from 1997–2002) is a conditional cash transfer (CCT) programme in operation at the time of writing. It was initiated in rural areas and expanded to include urban areas beginning in 2002, although approximately 70% of programme participants reside in rural areas. Targeting for Oportunidades is based on both geography, through identification of localities with high marginality indices, and socioeconomic status, through proxy means testing. Approximately 60 % of households in the bottom decile of per capita expenditures are participants, suggesting effective targeting of the poorest.
","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 Oportunidades is retrieved from the ENA Part II where Oportunidades 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/
Adult (greater than 15 years of age) participation in health and nutrition education sessions
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Multiple evaluations of Oportunidades have been conducted with data demonstrating significant improvements in nutritional outcomes.
","","5 million families, approximately 20 % of the population","","","Increase in height in children 0–6 months of 1.1 cm (26.4 cm versus 25.3 cm) in programme beneficiaries compared to a control group (35). In rural children ages 12–24 months, a significant increase in mean hemoglobin of 0.37 g/dl was found after 12 months in the programme; 11.12 g/dl in the treatment group compared to 10.75 g/dl in the controls. Corresponding anaemia prevalence among beneficiary children was 44.3% compared to 54.9% among control children, a significant 10.6 ppt decrease. Even with improvement, nearly half of beneficiary children were still anaemic","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23382","Oportunidades","English","Large scale programmes","","MEX","Mexico","","Urban|Rural","on-going","","","Oportunidades (known as Progresa from 1997–2002) is a conditional cash transfer (CCT) programme in operation at the time of writing. It was initiated in rural areas and expanded to include urban areas beginning in 2002, although approximately 70% of programme participants reside in rural areas. Targeting for Oportunidades is based on both geography, through identification of localities with high marginality indices, and socioeconomic status, through proxy means testing. Approximately 60 % of households in the bottom decile of per capita expenditures are participants, suggesting effective targeting of the poorest.
","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 Oportunidades is retrieved from the ENA Part II where Oportunidades 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 nutrition supplement is intended to provide 20% of daily caloric and 100% of daily micronutrient requirements.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Multiple evaluations of Oportunidades have been conducted with data demonstrating significant improvements in nutritional outcomes.
","","5 million families, approximately 20 % of the population","","","An increase in height in children 0–6 months of 1.1 cm (26.4 cm versus 25.3 cm) in programme beneficiaries compared to a control group. In rural children ages 12–24 months, a significant increase in mean hemoglobin of 0.37 g/dl was found after 12 months in the programme; 11.12 g/dl in the treatment group compared to 10.75 g/dl in the controls. Corresponding anaemia prevalence among beneficiary children was 44.3% compared to 54.9% among control children, a significant 10.6 ppt decrease. Even with improvement, nearly half of beneficiary children were still anaemic.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23382","Oportunidades","English","Large scale programmes","","MEX","Mexico","","Urban|Rural","on-going","","","Oportunidades (known as Progresa from 1997–2002) is a conditional cash transfer (CCT) programme in operation at the time of writing. It was initiated in rural areas and expanded to include urban areas beginning in 2002, although approximately 70% of programme participants reside in rural areas. Targeting for Oportunidades is based on both geography, through identification of localities with high marginality indices, and socioeconomic status, through proxy means testing. Approximately 60 % of households in the bottom decile of per capita expenditures are participants, suggesting effective targeting of the poorest.
","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 Oportunidades is retrieved from the ENA Part II where Oportunidades 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/
Mean haemoglobin
Anemia prevalence
","Multiple evaluations of Oportunidades have been conducted with data demonstrating significant improvements in nutritional outcomes.
","","5 million families, approximately 20 % of the population","","","In rural children ages 12–24 months, a significant increase in mean hemoglobin of 0.37 g/dl was found after 12 months in the programme; 11.12 g/dl in the treatment group compared to 10.75 g/dl in the controls. Corresponding anaemia prevalence among beneficiary children was 44.3% compared to 54.9% among control children, a significant 10.6 ppt decrease. Even with improvement, nearly half of beneficiary children were still anaemic","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23388","","Conditional cash transfer","","","","Infants and young children|Preschool-age children (Pre-SAC)","Children below 5 years","","Community-based","","RPS participants received a nutrition/food security transfer equivalent to US$ 18/month upon confirmation that conditions were met. The transfer was equivalent to approximately 18% average monthly household expenditure. Conditions for receipt of the transfer included: monthly growth monitoring for children less than 24 months (every other month for children ages 2–5 years), participation in nutrition and health education sessions on topics such as breastfeeding, hygiene and feeding practices, regular vaccinations for children, and routine care for pregnant women. Antiparasitic medications and iron supplements were also provided.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","","","165 000 persons (approximately 3 % of the population)","","","An increase in HAZ of 0.17 was reported for beneficiary children and stunting decreased in RPS versus control groups by 5.5 ppt. A significant change in underweight was also reported; it decreased in RPS areas (13.7% to 9.8%) while it increased in control areas (14.3% to 16.6%). ","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23390","","Growth monitoring and promotion","","","","Infants and young children|Preschool-age children (Pre-SAC)","Children below 5 years","","Community-based","","Monthly growth monitoring for children less than 24 months (every other month for children ages 2–5 years)
","","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","","165 000 persons (approximately 3 % of the population)","","","An increase in HAZ of 0.17 was reported for beneficiary children and stunting decreased in RPS versus control groups by 5.5 ppt. A significant change in underweight was also reported; it decreased in RPS areas (13.7% to 9.8%) while it increased in control areas (14.3% to 16.6%).","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23391","","Breastfeeding promotion and/or counselling","","","","Lactating women (LW)|Pregnant women (PW)","Mothers of children under two","","Community-based","","Participation in nutrition and health education on breastfeeding in order to receive ransfer
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","","","165 000 persons (approximately 3 % of the population)","","","An increase in HAZ of 0.17 was reported for beneficiary children and stunting decreased in RPS versus control groups by 5.5 ppt. A significant change in underweight was also reported; it decreased in RPS areas (13.7% to 9.8%) while it increased in control areas (14.3% to 16.6%).","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23392","","Complementary feeding promotion and/or counselling","","","","Infants and young children","Mothers of children under two years of age","","Community-based","","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","","","165 000 persons (approximately 3 % of the population)","","","An increase in HAZ of 0.17 was reported for beneficiary children and stunting decreased in RPS versus control groups by 5.5 ppt. A significant change in underweight was also reported; it decreased in RPS areas (13.7% to 9.8%) while it increased in control areas (14.3% to 16.6%). ","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23393","","Promotion of improved hygiene practices including handwashing","","","","Women of reproductive age (WRA)","","","Community-based","","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23394","","Iron supplementation","","Iron","","Infants and young children|Preschool-age children (Pre-SAC)","Children below 5 years","","Community-based","","","","","","165 000 persons (approximately 3 % of the population)","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23389","Red de Proteccion Social Program (RPS)","English","Community/sub-national","","NIC","Nicaragua","nicaragua","","completed","","01-1970","The Red de Protección Social Programme (RPS) ran from 2000–2005. It was a small-scale CCT programme. Both geographical and household targeting was used for implementation in departments and municipalities with high rates of extreme poverty.
","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 RPS is retrieved from the ENA Part II where RPS I 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/
","","","","","","","","","","","","","","","","","","","","","Total funding was US$ 38 million.RPS participants received a nutrition/food security transfer equivalent to US$ 18/month","Bilateral and donor agencies and lenders","Inter American Development Bank","Government of Nicaragua ","Government","","","Bilateral and donor agencies and lenders","The World Bank","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23395","","Nutrition education and counselling","","","","Women of reproductive age (WRA)","Mothers of children under five years of age","","Community-based","","Participation in nutrition and health education sessions in order to receive conditional cash transfer
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","","","165 000 persons (approximately 3 % of the population)","","","An increase in HAZ of 0.17 was reported for beneficiary children and stunting decreased in RPS versus control groups by 5.5 ppt. A significant change in underweight was also reported; it decreased in RPS areas (13.7% to 9.8%) while it increased in control areas (14.3% to 16.6%). ","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","01-1998","01-2005","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Internal provision supplementary feeding
","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change omponents. The programme might have been more successful with better coordination of the CHWs.
","","86 % national coverage. Area coverage for feeding programmes reached 25/36 municipalities","","","From 2001 to 2003 in programme areas, underweight decreased 1.33 ppt/year and wasting decreased 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","01-1998","01-2005","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change omponents. The programme might have been more successful with better coordination of the CHWs.
","","86 % national coverage. ","","","From 2001 to 2003 in programme areas, underweight for age decreased 1.33 ppt/year and wasting decreased. 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","01-1998","01-2005","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change components. The programme might have been more successful with better coordination of the CHWs.
","","86% national coverage. Area coverage for nutrition education reached 36/36 municipalities","","","From 2001 to 2003 in programme areas, underweight for age decreased 1.33 ppt/year and wasting decreased. 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Internal provision supplementary feeding
","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change omponents. The programme might have been more successful with better coordination of the CHWs.
","","86 % national coverage. Area coverage for feeding programmes reached 25/36 municipalities","","","From 2001 to 2003 in programme areas, underweight decreased 1.33 ppt/year and wasting decreased 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change omponents. The programme might have been more successful with better coordination of the CHWs.
","","86 % national coverage. ","","","From 2001 to 2003 in programme areas, underweight for age decreased 1.33 ppt/year and wasting decreased. 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23116","Early Childhood Development (ECD) Project","English","Large scale programmes","","PHL","Philippines","","","completed","","01-1970","The intervention used Community health workers (CHWs) based in health centres and schools, as well as home visits.
The programme also included micronutrient supplementation and fortification
","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 ECD is retrieved from the ENA Part II where ECD 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...
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Weight-for-age z-score (WAZ)
Weight-for-height z-score (WHZ)
Height-for-age z-score (HAZ)
","An evaluation concluded that there were positive results on acute malnutrition due to the feeding programme but negative impact on chronic malnutrition as addressed by the nutrition education and behaviour change components. The programme might have been more successful with better coordination of the CHWs.
","","86% national coverage. Area coverage for nutrition education reached 36/36 municipalities","","","From 2001 to 2003 in programme areas, underweight for age decreased 1.33 ppt/year and wasting decreased. 1.56 ppt/year. No positive impact was found on stunting. From 1993 to 2003, prevalence of underweight for age declined from 28.3% to 20.7% (1.52 ppt/year).
","","","","","","","","","","","","","","","","","","","","","","","","","The ECD programme has had some significant effectiveness and could have potentially had even better results with improved implementation. The ECD programme showed positive evidence for the influence of community-based programmes on improved nutrition status with solid results in reducing prevalence of weight-for-height and wasting through feeding programmes. Long-term behaviour change was less effective due to poor coordination of CHWs.
","","English" "23294","Integrated Management Childhood Illness (IMCI)","English","Large scale programmes","","BRA","Brazil","brazil","","on-going","","","The Integrated Management of Childhood Illness (IMCI) was implemented in Brazil in 1997 and by 2002 had begun in all states, within the context of the Family Health Programme. Coverage reported for the Family Health Programme is variable since municipalities must apply to the federal government and make a financial contribution to join the programme.
The programme also included referral by the community nutrition centre.
","
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 IMCI is retrieved from the ENA Part II where IMCI 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...
","","","","","","","","","","","","","","","","","","","","","Intensity of community health workers is reported as 1 per 100–200 families","Bilateral and donor agencies and lenders","The World Bank","Ministry of health","Government","Health","The impact of IMCI on nutritional status in Brazil has not been reported.
","","N/A","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23294","Integrated Management Childhood Illness (IMCI)","English","Large scale programmes","","BRA","Brazil","brazil","","on-going","","","The Integrated Management of Childhood Illness (IMCI) was implemented in Brazil in 1997 and by 2002 had begun in all states, within the context of the Family Health Programme. Coverage reported for the Family Health Programme is variable since municipalities must apply to the federal government and make a financial contribution to join the programme.
The programme also included referral by the community nutrition centre.
","
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 IMCI is retrieved from the ENA Part II where IMCI 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...
","","","","","","","","","","","","","","","","","","","","","Intensity of community health workers is reported as 1 per 100–200 families","Bilateral and donor agencies and lenders","The World Bank","Ministry of health","Government","Health","The impact of IMCI on nutritional status in Brazil has not been reported.
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23294","Integrated Management Childhood Illness (IMCI)","English","Large scale programmes","","BRA","Brazil","brazil","","on-going","","","The Integrated Management of Childhood Illness (IMCI) was implemented in Brazil in 1997 and by 2002 had begun in all states, within the context of the Family Health Programme. Coverage reported for the Family Health Programme is variable since municipalities must apply to the federal government and make a financial contribution to join the programme.
The programme also included referral by the community nutrition centre.
","
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 IMCI is retrieved from the ENA Part II where IMCI 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...
","","","","","","","","","","","","","","","","","","","","","Intensity of community health workers is reported as 1 per 100–200 families","Bilateral and donor agencies and lenders","The World Bank","Ministry of health","Government","Health","The impact of IMCI on nutritional status in Brazil has not been reported.
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
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 AIN-C is retrieved from the ENA Part II where AIN-C 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/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Monthly growth monitoring of children less than 24 months of age and sick children 24–60 months of age at the community centre, although home visits are provided for children who do not attend.
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C. participants to non-participants.
Mean height-for-age was lower in the AIN-C group as compared to non-participants at less than six months of age. At 6–11 months and 12–23 months of age, there was no difference between AIN-C children and nonparticipants, suggesting a protective effect of AIN-C against growth faltering. Since a pre-/post- comparison was not possible, this conclusion cannot be certain. Intensity of participation in the programme was based on percentage of possible weighings attended by the child; after controlling for household assets and age of child, for every 1% increase in participation intensity, weight-for-age increased 0.005 z-score.
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
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 AIN-C is retrieved from the ENA Part II where AIN-C 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/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Nutrition counselling for EBF less than 6 months of age
","Exclusive breastfeeding (EBF) rates
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C participants to non-participants. Improved caring practices were reported among AIN-C mothers. A 15.8 ppt difference in EBF at 6 months was found (55.8% AIN-C, 40% non- AIN-C).
","","24 of 42 health areas (>50%) in 2006 (18), and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
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 AIN-C is retrieved from the ENA Part II where AIN-C 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/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Micronutrient distribution for children (iron and vitamin A)
","","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C participants to non-participants. With regard to receiving iron and vitamin A supplementation, differences of 36.1 ppt (65.6% AIN-C, 29.5% non-AIN-C) and 6.8 ppt (94.3% AIN-C, 87.5% non-AIN-C) respectively, were reported for children.
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23338","Atención Integral a la Niñez en la Comunidad (AIN-C)","English","Large scale programmes","","HND","Honduras","","","on-going","","","The national Atención Integral a la Niñez en la Comunidad (AIN-C) began in the mid- 1990s and remains in operation at the time of writing as a community-based expansion from the original AIN programme.
Referral to the health facility as needed
","
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 AIN-C is retrieved from the ENA Part II where AIN-C 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/
","","","","","","","","","","","","","","","","","","","","","Intensity as measured by Community Health and Nutrition Workers (CHNWs):children is 3:25, where CHNWs work part-time for 3.5 hours weekly. Financial resource intensity is US$ 6.43/child per year","Government","Health","Ministry of Health","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","Nutrition counselling for complementary feeding less than 24 months of age
","Height-for-age z-score (HAZ)
Weight-for-age z-score (WAZ)
","Evaluation of the AIN-C was planned as a pre- and post-intervention, project and control comparison study, but the design was altered due to extensive contamination of control communities, non-equivalent groups, and reduced intensity of programme implementation due to changes in funding. A cross-sectional study using baseline data compared AIN-C. participants to non-participants. Mean height-for-age was lower in the AIN-C group as compared to non-participants at less than six months of age. At 6–11 months and 12–23 months of age, there was no difference between AIN-C children and nonparticipants, suggesting a protective effect of AIN-C against growth faltering. Since a pre-/ post- comparison was not possible, this conclusion cannot be certain. Intensity of participation in the programme was based on percentage of possible weighings attended by the child; after controlling for household assets and age of child, for every 1% increase in participation intensity, weight-for-age increased 0.005 z-score
","","Coverage of the programme by area was 24 of 42 health areas (>50%) in 2006 and by population was 90% of children less than 24 months of age.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23355","Integrated Child Development Services Project I (ICDS I)","English","Large scale programmes","","IND","India","Andhra Pradesh|Orissa","","completed","","01-1970","ICDS activities carried out in Andhra Pradesh and Orissa between 1990 and 1997.
Referral of infants and young children and pregnant women as needed
","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 ICDS I is retrieved from the ENA Part II where ICDS I 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 intensity of community health and nutrition workers (CHNWs) , known as Anganwadi workers (ANWs) (estimated at 20 % of full-time equivalents) was 1:1000 persons, i.e. approximately 1:200 children or 10:1000 households.","Bilateral and donor agencies and lenders","The World Bank","Internal provision supplementary feeding
","Underweight
","While there are no definitive evaluations, most reports on ICDS 1 estimate that the change in underweight attributable to the programme was slight; the rate is plotted as 0,2 ppt/year.
","","Population coverage of approximately 2,5 %","","","","","","","","","","","","","","","","","","","","","","","","","","","","According to the World Bank, definitive judgments on the effectiveness of ICDS I cannot be made due to a lack of high-quality data. Measham & Chatterjee attribute the ineffectiveness of the project, particularly in Orissa, to issues related to proper implementation of programme activities:
1. inadequate coverage of children < 3 years
2. irregular food supply
3. poor nutrition education
4. inadequate health worker training
5. anganwadi work “overload”
6. poor linkages between ICDS and the health system.
","","English" "23355","Integrated Child Development Services Project I (ICDS I)","English","Large scale programmes","","IND","India","Andhra Pradesh|Orissa","","completed","","01-1970","ICDS activities carried out in Andhra Pradesh and Orissa between 1990 and 1997.
Referral of infants and young children and pregnant women as needed
","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 ICDS I is retrieved from the ENA Part II where ICDS I 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 intensity of community health and nutrition workers (CHNWs) , known as Anganwadi workers (ANWs) (estimated at 20 % of full-time equivalents) was 1:1000 persons, i.e. approximately 1:200 children or 10:1000 households.","Bilateral and donor agencies and lenders","The World Bank","Underweight
","While there are no definitive evaluations, most reports on ICDS 1 estimate that the change in underweight attributable to the programme was slight; the rate is plotted as 0,2 ppt/year.
","","Population coverage of approximately 2,5 %","","","","","","","","","","","","","","","","","","","","","","","","","","","","According to the World Bank, definitive judgments on the effectiveness of ICDS I cannot be made due to a lack of high-quality data. Measham & Chatterjee attribute the ineffectiveness of the project, particularly in Orissa, to issues related to proper implementation of programme activities:
1. inadequate coverage of children < 3 years
2. irregular food supply
3. poor nutrition education
4. inadequate health worker training
5. anganwadi work “overload”
6. poor linkages between ICDS and the health system.
","","English" "23359","Integrated Child Development Services Project II (ICDS II)","English","Large scale programmes","","IND","India","Madhya Pradesh|Bihar","","completed","","01-1970","ICDS II activities were carried out in Madhya Pradesh and Bihar between 1993 - 2001. Components of the programme were identical to those in ICDS I.
","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 ICDS II is retrieved from the ENA Part II where ICDS II 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/
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Underweight
","ICDS II was found to be unsuccessful in improving the nutritional status of children in Madhya Pradesh and Bihar. In Madhya Pradesh, there was found to be a 0.62 ppt/year increase in severe underweight prevalence and a 0.18 ppt/year increase in moderate underweight prevalence. In Bihar, a 0.93 ppt/year decrease in severe underweight prevalence and a 1.37 ppt/year decrease in moderate underweight prevalence were found.
","","","","","Participants' initial rate of underweight reduction: 3,2 ppt/year. Population sustained rate of underweight reduction: 0,05 ppt/year.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23359","Integrated Child Development Services Project II (ICDS II)","English","Large scale programmes","","IND","India","Madhya Pradesh|Bihar","","completed","","01-1970","ICDS II activities were carried out in Madhya Pradesh and Bihar between 1993 - 2001. Components of the programme were identical to those in ICDS I.
","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 ICDS II is retrieved from the ENA Part II where ICDS II 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/
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","The World Bank","Underweight
","ICDS II was found to be unsuccessful in improving the nutritional status of children in Madhya Pradesh and Bihar. In Madhya Pradesh, there was found to be a 0.62 ppt/year increase in severe underweight prevalence and a 0.18 ppt/year increase in moderate underweight prevalence. In Bihar, a 0.93 ppt/year decrease in severe underweight prevalence and a 1.37 ppt/year decrease in moderate underweight prevalence were found.
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23377","Second Surveillance and Education for Schools and Communities on Food and General Nutrition (SEECALINE)","English","Large scale programmes","","MDG","Madagascar","","","completed","","01-1970","The SEECALINE (Second Surveillance and Education for Schools and Communities on Food and General Nutrition) programme began in 1999 and was gradually scaled-up until 2002. Upon completion of scale-up activities, there were 3600 project sites in half the districts in Madagascar. SEECALINE targeted communities with poorer nutritional status as sites for implementation. Thus, communities with the programme had higher baseline levels of malnutrition than communities that did not have the programme. A key feature is that services are contracted out and provided by local NGOs in the target area. The programme objective was to improve the nutritional status of children under three, PLW, and school-aged children.
The programme also included referral of children under 3 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 SEECALINE is retrieved from the ENA Part II where SEECALINE 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/
","","","","","","","","","","","","","","","","","","","","","Intensity of Community health workers(CHWs) was estimated at 1:125 households to 1:225 households, or 60:1000 households.Resource intensity was estimated at US$ 10/household per year.","Bilateral and donor agencies and lenders","The World Bank","Underweight
","Evaluated by the World Bank in two different ways, using both monitoring data to investigate improvements in nutritional status of child participants, and by using two nationally representative surveys to calculate the improvements in child nutritional status in programme areas rather than among programme participants.
","","Coverage rate of approximately 50 % of the population under 3 years in the target areas","","","The rate of underweight reduction was reported as 0,86-1,25 ppt/year, or approximately 1,1 ppt/year for the population sustained rate
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23377","Second Surveillance and Education for Schools and Communities on Food and General Nutrition (SEECALINE)","English","Large scale programmes","","MDG","Madagascar","","","completed","","01-1970","The SEECALINE (Second Surveillance and Education for Schools and Communities on Food and General Nutrition) programme began in 1999 and was gradually scaled-up until 2002. Upon completion of scale-up activities, there were 3600 project sites in half the districts in Madagascar. SEECALINE targeted communities with poorer nutritional status as sites for implementation. Thus, communities with the programme had higher baseline levels of malnutrition than communities that did not have the programme. A key feature is that services are contracted out and provided by local NGOs in the target area. The programme objective was to improve the nutritional status of children under three, PLW, and school-aged children.
The programme also included referral of children under 3 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 SEECALINE is retrieved from the ENA Part II where SEECALINE 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/
","","","","","","","","","","","","","","","","","","","","","Intensity of Community health workers(CHWs) was estimated at 1:125 households to 1:225 households, or 60:1000 households.Resource intensity was estimated at US$ 10/household per year.","Bilateral and donor agencies and lenders","The World Bank","Underweight
","Evaluated by the World Bank in two different ways, using both monitoring data to investigate improvements in nutritional status of child participants, and by using two nationally representative surveys to calculate the improvements in child nutritional status in programme areas rather than among programme participants.
","","Coverage rate of approximately 50 % of the population under 3 years in the target areas","","","The rate of underweight reduction was reported as 0,86-1,25 ppt/year, or approximately 1,1 ppt/year for the population sustained rate
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23377","Second Surveillance and Education for Schools and Communities on Food and General Nutrition (SEECALINE)","English","Large scale programmes","","MDG","Madagascar","","","completed","","01-1970","The SEECALINE (Second Surveillance and Education for Schools and Communities on Food and General Nutrition) programme began in 1999 and was gradually scaled-up until 2002. Upon completion of scale-up activities, there were 3600 project sites in half the districts in Madagascar. SEECALINE targeted communities with poorer nutritional status as sites for implementation. Thus, communities with the programme had higher baseline levels of malnutrition than communities that did not have the programme. A key feature is that services are contracted out and provided by local NGOs in the target area. The programme objective was to improve the nutritional status of children under three, PLW, and school-aged children.
The programme also included referral of children under 3 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 SEECALINE is retrieved from the ENA Part II where SEECALINE 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/
","","","","","","","","","","","","","","","","","","","","","Intensity of Community health workers(CHWs) was estimated at 1:125 households to 1:225 households, or 60:1000 households.Resource intensity was estimated at US$ 10/household per year.","Bilateral and donor agencies and lenders","The World Bank","Internal provision supplementary feeding
","Underweight
","Evaluated by the World Bank in two different ways, using both monitoring data to investigate improvements in nutritional status of child participants, and by using two nationally representative surveys to calculate the improvements in child nutritional status in programme areas rather than among programme participants.
","","Coverage rate of approximately 50 % of the population under 3 years in the target areas","","","The rate of underweight reduction was reported as 0,86-1,25 ppt/year, or approximately 1,1 ppt/year for the population sustained rate
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23424","Child Survival and Development (CSD) Programme","English","Large scale programmes","","TZA","United Republic of Tanzania","tanzania","","completed","","01-1970","The Child Survival and Development (CSD) Programme was initiated in 1985 and ran until 1995.
The programme also included micronutrient supplementation.
","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 CSD is retrieved from the ENA Part II where CSD 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 CSD programme was US$ 2–US$ 3/child per year.","Bilateral and donor agencies and lenders","The World Bank","Underweight
","","The programme aimed for complete coverage","45% (9/20 regions), with approximately 12 million beneficiaries, 2 million of whom were children.","","","An initial reduction in malnutrition of about 8 ppt/year for 1–2 years, then a continued decrease of 1–2 ppt/year following the initial rapid decline.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23424","Child Survival and Development (CSD) Programme","English","Large scale programmes","","TZA","United Republic of Tanzania","tanzania","","completed","","01-1970","The Child Survival and Development (CSD) Programme was initiated in 1985 and ran until 1995.
The programme also included micronutrient supplementation.
","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 CSD is retrieved from the ENA Part II where CSD 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 CSD programme was US$ 2–US$ 3/child per year.","Bilateral and donor agencies and lenders","The World Bank","Underweight
","","The programme aimed for complete coverage","45% (9/20 regions), with approximately 12 million beneficiaries, 2 million of whom were children.","","","An initial reduction in malnutrition of about 8 ppt/year for 1–2 years, then a continued decrease of 1–2 ppt/year following the initial rapid decline.
","","","","","","","","","","","","","","","","","","","","","","","","","","","English"