"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" "6039","Chispitas program","English","National","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","Urban|Rural|Peri-urban","on-going","01-2006","","
Ferrous sulfate syrup has been the major source of iron supplementation until 2006 for the Bolivian children. Although not documented in a systematic fashion, it was generally accepted in the country that acceptance of the syrup was low due to taste and frequently reported side effects. This and the persistently high prevalence of anemia provided the case for seeking alternative approaches to micronutrient supplementation. Stressing the importance of anemia prevention and control among children 6-59 months of age in Bolivia, the Pan American Health Organization (PAHO) and the Micronutrient Initiative (MI) proposed to the Ministry of Health and Sports (MSD) to replace syrup with Micronutrient powder (MNP) at the national level. The free distribution of MNP in Bolivia was integrated into the Desnutricion Cero (Zero Malnutrition) program, an integrated strategy to combat malnutrition in Bolivia, launched by the Morales government in 2006. The Centro de Abastecimiento de Suministros de Salud (CEASS), a national procurement agency for the MSD managed the distribution of the sachets to all 9 departments on behalf of the MSD.
","","","","Health","Ministry of Health and Sport/ Nutrition unit","","","","","","","","","","","","","","","","","Municipalities purchase directly from the manufacturers at prices ranging from 14.50Bs (US$2.07) to 15Bs (US$ 2.15) for a box of 60 sachets.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6038","Iron and/or folic acid","Iron supplementation","","","","Infants and young children","6-23 months","N/A","Commercial|Primary health care center","Free distribution through the government’s universal health care program, Seguro Universal Materno Infantil (SUMI).","Each child is provided with 60 Chispitas sachets every year. Caregivers are recommended to provide one sachet everyday for 60 days to their children.
","Anemia prevalence
","Both qualitative and quantitative information were collected from three different sources to evaluate diverse aspects of the implementation of the Chispitas program with an objective to:1. Asses efficiency of logistics systems management across different departments and health districts,2. Assess the acceptability of Chispitas by the caregivers across urban and rural areas, and 3. Know the adequacy of Chispitas preparation by caregivers. An external evaluation was done by the Asociacion de Instituciones de Promocion y Educacion (AIPE), a private firm, to achieve the first three objectives using the program monitoring data and external survey data in 2008. In addition, a workshop was conducted in September 2009 by researchers from Cornell University, MI and MSD to review the Chispitas program and provide feedback to further strengthen it. Later in 2010, a study was conducted provide data to develop a communications strategy by a private firm (TICs Communications) contracted by MI, and allow a comparison post-implementation (focus groups were also conducted). All studies/reviews only looked at the program from the public health system distribution point of view. The 2010 TICs study collected data from households and public health centers in both rural and urban municipalities in Bolivia, in each of the 9 departments of the country. The sample sizes are not large enough however to be nationally representative.
","400000 (50%)","N/A","","","","None","","Intermittent iron supplementation in preschool and school-age children>>>Intermittent iron supplementation in preschool and school-age children>>http://www.who.int/elena/titles/iron_infants","Staff skills/training","Demonstration of Chispitas preparation at the health center and explaining the benefits of Chispitas to the caregivers were identified as key strategies that could be implemented to improve acceptance among caregivers. Important factors that affect the demand for Chispitas are the capacity of health personnel, availability of promotional material, incentives and support to staff, and availability of the product itself at the local level.","Staff retention","Demonstration of Chispitas preparation at the health center and explaining the benefits of Chispitas to the caregivers were identified as key strategies that could be implemented to improve acceptance among caregivers. Important factors that affect the demand for Chispitas are the capacity of health personnel, availability of promotional material, incentives and support to staff, and availability of the product itself at the local level.","Adherence","Demonstration of Chispitas preparation at the health center and explaining the benefits of Chispitas to the caregivers were identified as key strategies that could be implemented to improve acceptance among caregivers. Important factors that affect the demand for Chispitas are the capacity of health personnel, availability of promotional material, incentives and support to staff, and availability of the product itself at the local level.","Supplies","Demonstration of Chispitas preparation at the health center and explaining the benefits of Chispitas to the caregivers were identified as key strategies that could be implemented to improve acceptance among caregivers. Important factors that affect the demand for Chispitas are the capacity of health personnel, availability of promotional material, incentives and support to staff, and availability of the product itself at the local level.","","","","","","","","","","","","","","Inclusion of Chispitas in the Desnutricion Cero strategy strengthened nutrition policy and dialogue in Bolivia generally and the Chispitas distribution program took advantage of that for immediate national implementation. Smaller scale implementation initially with good quality monitoring may have facilitated the identification and timely resolution of problems related to supply, knowledge, acceptance and utilization. The decision to immediately implement at scale diverted financial and human resources from these necessary start-up activities and left little room for the in-depth monitoring required for the timely identification and resolution of problems with the program design and barriers to appropriate implementation. Because of the national scale of the program, implications and problems need to be identified and potential solutions explored at large scale, resulting in complexities and delays in the public health systematical ability to do so.The legal framework, i.e., change of the regulation and inclusion of Chispitas in the insurance commodity package was an important step towards national implementation of the program.
","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6042","Maternal, infant and young child nutrition","Breastfeeding promotion and/or counselling","","","","Women of reproductive age (WRA)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Train health 69 staff in lactation management, including HIV in relation to breastfeeding; 2. Support the formation of 95 mother-to-mother support groups and men’s groups; 3. Support assessment and designation of 6 facilities as Baby Friendly Health Institutions (BFHI); 4. Support follow up of HIV infected mothers through mother-to-support groups and CBSV to maintain exclusive breastfeeding and monitor nutritional status and growth of the infants; 5. Train HIV infected mothers on breastfeeding techniques to decrease risk of breat inflammation that may increase HIV transmission; 6. Intensify nutrition and health education at facility and community levels monthly
","% of children 0-6 exclusively breastfed in the previous 24 hours. % of infants fed mothers' milk within 1hour after birth % ofchildren(12-23mos) exclusively breastfed for 6 months
","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","79 communities with a total population of 77, 780 children under-five years of age and 19,445 pregnant women living in an area with a population of 388, 902 people and an estimated 64,817 households are benefiting from project interventions.","Missing","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","Staff skills/training","Project and GHS staffs have received training in lactation management. ","Insufficient staff","We have continued to advocate for increased numbers for the beneficiary districts. To meet this gap capacities of Mother-to-mother Supports Groups(MtMSGs),Traditional Birth Attendants(TBAs) and Community Based Surveillance Volunteers(CBSVs) been built to support the action. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this challenge. ","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","Adherence","The slow adoption of appropriate feeding practices by caregivers remains a challenge. Community level education has therefore, been intensified to address the situation.","Financial resources","Government's financial support to District Health Management Teams (DHMTs) is sometimes delayed and this affects the smooth implementation of project interventions.","","","","","","","","","","","","","I have observed that grandmothers' and men's involvement in the action implementation is critical. In some communties for instance, father-to-father support groups have been formed to support the action. Capacity building for groups such as CBSVs, MtMSGs, TBAs, women's and men's groups, faith-based organizations(FBOs) etc at the community could contribute immensely to project outcomes.
","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6044","","Complementary feeding promotion and/or counselling","","","","Women of reproductive age (WRA)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Train 105 GHS staff and CBSVs in Community Based Growth Promotion (CBGP) 2. Institute CBGP in 15 poor and hard to reach communities including visits to OVCs under 5 to make sure these children go for growth monitoring3. Train 60 GHS, World Vision staff in Infant and Young Child Nutrition counselling4. Provide equipment for growth monitoring and counseling5. Carry out quarterly food demonstration sessions including low-labour nutritious meals that can be prepared/managed by mothers who are ill in communities using nutrient and energy dense locally available foods 6. Intensify monthly nutrition and health education for mothers and other caregivers, including appropriate messages for HIV+ve mothers through CBSV, CCC and health staff","% of children< 2 years underweight % of children 12-23 months who are still breastfeeding % of sick children 6-59 month who received increased fluids and continues feeding during an illness in the last 2 weeks % of children 6-59 month attending growth promotion sessions at least once every 3 months % of children 6-59 months who ate solid or semi-solid food at least the minimum recommended no. of times 24hrs preceding survey","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","89447","","","Conducted","Midterm evaluation has been conducted and results are being analysed.","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","Staff skills/training","Project and GHS staffs have received training in lactation management. ","Insufficient staff","We have continued to advocate for increased numbers for the beneficiary districts. To meet this gap capacities of Mother-to-mother Supports Groups(MtMSGs),Traditional Birth Attendants(TBAs) and Community Based Surveillance Volunteers(CBSVs) been built to support the action. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this challenge. ","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","Adherence","The slow adoption of appropriate feeding practices by caregivers remains a challenge. Community level education has therefore, been intensified to address the situation.","Financial resources","Government's financial support to District Health Management Teams (DHMTs) is sometimes delayed and this affects the smooth implementation of project interventions.","","","","","","","","","","","","","Cultural barriers could impede the action as mothers/caregivers who have acquired knowledge and are willing to feed their children appropriately could be prevented from doing so.","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6045","","Management of moderate malnutrition","","","","Infants and young children","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based","","1. Purchase vegetable seeds and citrus seedlings2. Distribute vegetable seeds and seedlings to households and groups3. Purchase small animals 4. Distribute small animals to households and groups5. Train beneficiaries in the raising of small animals and crop production techniques6. Support the processing of vegetables materials)7. Produce/adapt & distribute IEC materials8. Carry out community education on animal husbandry and crop production","% of households producing fruits for their own consumption% of households producing vegetables for their own consumption% of households growing and using nutrient-dense drought-tolerant crops for their food sources e.g. cowpeas, green grams, groundnuts etc% of household rearing and using one or more type of high protein animal/poultry based foods sources eg. Chicken, fish etc.% of households practicing food preservation techniques% of women controlling some household resources e.g. animals, land etc","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","2400","","","Conducted","Midterm evaluation has been conducted and results are being analysed.","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","Financial resources","Government's financial support to District Agriculture Development Unit is sometimes delayed and this affects the smooth implementation of project interventions. We continue to advocate for timely disbursement of funds.","Adherence","","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","","","","","","","","","","","","","","","Although, households with children under-five in particular are targeted, the provision of inputs has been demand-driven. Consquently, the response by households has not been at the level expected.","Continuous community level education by Agriculture Extension Agents (AEAs) has, however, brought about improvement in the implmentation of the action. Land availability for home gardening activities is a challege in some communities. Group garden activities are therefore being considered. ","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6046","Acute malnutrition","Growth monitoring and promotion","","","","Infants and young children","0-59months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1.Support monthly growth monitoring2.Train 105 GHS staff and CBSVs in Community Based Growth Promotion (CBGP) 3.Institute CBGP in 15 poor and hard to reach communities including visits to OVCs under 5 to make sure these children go for growth monitoring","% of boys and girls underweight (WAZ<-2) % of children 6-59 month attending growth promotion sessions at least once every 3 months","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Supplies","","Stakeholder","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6047","Stunting","Vaccination","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Support GHS in increasing immunization coverage among children < 5 years2. Support GHS in carrying out follow-ups on IMNCI activities at health facility and community levels3.Produce/adapt and distribute IEC materials on vaccine preventable diseases4.Carry out education on vaccine preventable diseases in communities
","% of children12-23 months fully immunized
","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Supplies","","","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6048","Acute malnutrition","Oral rehydration solution promotion","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Purchase ORS2. Distribute ORS to CBSVs and health facilities 3. Support GHS in providing quality treatment to children with diarrhoea5.Train GHS and World Vision Staffs in IMNCI4. Support GHS in carrying out follow-ups on IMNCI activities at health facility and community levels5.Produce/adapt and distribute IEC materials on control of diarrhea6.Carry out education on environmental sanitation and personal hygiene in communities","1.% of children with diarrhoea in the previous 2 weeks(or last episode of diarrhoea) who received ORT 2. % of health facilities(or alternative access point) with no stock out for ORT in the previous three months","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Adherence","","Stakeholder","","","","","","","","","","","","","","","","","Mothers/caregivers have difficulties continuing feeding as well as increasing the amount of fluids given their children during illness.","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6049","Acute malnutrition","Distribution of insecticide-treated bednets","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Purchase LITNs2. Distribute LITNs to children under five years and pregnant women3. Support GHS in carrying out follow-ups on IMNCI activities at facility and community level4. Produce/adapt and distribute IEC materials on malaria5. Carry out education on malaria control in communities","% of children Under five sleeping under an LLITN the previous night% of pregnant women who slept under an LLITN the previous night","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","7,460 (children 0-59 months), 2615 PWs","","","Conducted","Midterm evaluation conducted and results are being analysed","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","Adherence","Community level education to encourage households to sleep under insecticide-treated bednets has been intensified.","","","","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6050","","Vitamin A supplementation","","","","Infants and young children","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1.Through monthly routine EPI2. Bi-annual spplementation
","% of children 6-59 months who received vitamin A capsules in previous 6 months
","1.Key performance indicator was baselined to establish coverage at the beginning of the project.2.Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders.3. Midterm and Endterm project evalutions will be conducted.
","","","","","","Vulnerable groups","","Vitamin A supplementation in infants and children 6–59 months of age>>>Vitamin A supplementation in infants and children 6–59 months of age>>http://www.who.int/elena/titles/vitamina_children","Insufficient staff","Insufficient staffing levels of partner institutions particularly of Ghana Health Service(GHS) remains a challenge. We have continued to advocate for increased numbers for the beneficiary districts. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this gap.Occassional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has beed encouraged.","Infrastructure","We have poor roads linking most communities. There are ,however,plans by District Assemblies to improve road infrastructure. Insuffient staffing levels of partner institutions particularly of Ghana Health Service(GHS) remains a challenge. We have continued to advocate for increased numbers for the beneficiary districts. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this gap.Occassional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has beed encouraged.","Supplies","Occasional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has been encouraged.","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6051","Acute malnutrition","Preventive malaria treatment","","","","Pregnant women (PW)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Carry out education on malaria control in communities2.Support education to increase proportion of pregnant women accessing IPT service at health facilities","% of women who received two doses of SP during last pregnancy","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","19445","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Adherence","","","","","","","","","","","","","","","","","","","","","","","English" "8816","Developing Village-based Advisors to improve food Security ","English","National","","KEN","Kenya","Siaya, Kenya|Busia, Kenya|Embu, Kenya|Kitui, Kenya|Machakos, Kenya|Makueni, Kenya","Rural","on-going","01-2012","01-2017","The Village-based Advisors Food Security project is improving productivity by promoting good farming practices among smallholder farmers, with the larger goal of increasing their food security and resilience to environmental shocks. The project identifies keen, hard-working farmers at the village level and develops them into モagro-entrepreneursヤ, called Village-based Advisors who provide inputs (such as improved seed), services (such as livestock vaccination) and advice on good farming practices to their community. These micro-businesses offer the double benefit of creating rural employment opportunities and building a sustainable system for delivering agricultural technologies.
The project is part of the U.S. Global Hunger and Food Security Initiative, also known as モFeed the Futureヤ, which seeks to address the root causes of hunger and poverty and create conditions where food assistance is no longer necessary. ᅠ
","http://kenya.usaid.gov/programs/economic-growth/1272
","","","Other","Farm Input Promotions Africa (FIPS-Africa)","","","","","US Agency for International Development (USAID)","U.S. Global Hunger and Food Security Initiative, also known as モFeed the Futureヤ","","","","","","","","","","","USD 2,000,000.00","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The project is working to mitigate the negative effects of climate change on Kenyaメs smallholder farmers by increasing their use of improved varieties of crops and inputs like fertilizer; building their understanding of and ability to implement good soil and water management techniques, and providing better access to poultry vaccination.
The model relies on the use of モVillage-based Advisorsヤ (VBAs) who earn an income through the provision of improved inputs, advice and services to their fellow farmers. Unlike traditional group-based approaches, VBAs have a target to work with every farmer in their community, meaning thousands of farmers can be reached quickly and cost-effectively. The project builds on the entrepreneurialism and community spirit common among smallholder farmers.
FIPS-Africa is a pioneer of the ムsmall packメ approach ヨ where inputs such as seed are distributed to farmers in small quantities. This allows farmers to experiment on their own farm at a low cost and with minimal risk. Farmers are more likely to adopt if they have seen something work first.
","xx
","By June 2012, the project had trained over 100 VBAs who distributed over 34,000 small packs of seed of improved varieties of key staple crops to farmers and established nearly 4,000 multiplication sites for drought tolerant root tuber crops.","ByMarch 2013, the following additional achievements are expected: 1,800 demonstration plots for improved soil and water management or seed priming established 9,000 households growing improved varieties of root tuber crops; 56,000 more small p","Period","Local food production and consumption levelsFood import and export ratesRates of undernutitionRates of people living &lt; $1/day","Local food production and consumption levelsFood import and export ratesRates of undernutitionRates of people living < $1/day","Socio-economic status","","","Staff skills/training","","Infrastructure","","","","","","","","","","","","","","","","","","","The long drought of 2009 hit both people and ecosystems hard, putting millions of Kenyans on food relief and killing large numbers of animals. However, this environmental stress also dramatically highlighted the payoffs of improved natural-resource management. Over 750,000 hectares of semi-arid woodland and rangeland - brought under improved management thanks to USAID and partners - showed no decline in ecological condition despite the drought. The condition of some areas even improved
","Dorcas Nyangasi of Emuhaya is 22-years-old and successfully self-employed. Like many young people in rural areas, Dorcas had trouble finding work when she finished school: モMy mother thought I was depressed because they could not afford my college, or lonely because most of my friends were leaving the village. But the real reason was that I needed something to do.ヤ
Dorcasメs life was transformed when Farm Input Promotions-Africa (FIPS-Africa) trained her to be a Village-based Advisor (VBA), providing agricultural inputs, services and advice on good farming practices to smallholder farmers in her village. ᅠAs well as distributing seed, Dorcas sells vegetable and tree seedlings from her nurseries and vaccinates poultry against Newcastle disease, which used to devastate local flocks. ᅠAfter two-and-a-half years of being her own boss, Dorcas has more than 2,000 farmers buying her inputs and services. She explains, モwithin the first four months I noticed that I could make more money when I approached more farmers, so I expanded my operations to three more villages.ヤ
Dorcasメ hard work is not only improving her own livelihood ヨ it helps the other farmers in her community too. モI am happy because I have helped my village rise above the problem of hunger, there is poultry in abundance, and we have surplus sweet potatoes and cassava to sell,ヤ she says.
","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","While Tanzania has achieved high vitamin A supplementation coverage over the past few years, there is concern that this achievement is fragile because of decentralization. A2Z is supporting national, zonal, regional, and district health teams to institutionalize twice-yearly distributions through ongoing advocacy and routine planning and budgeting. This activity is conducted in collaboration with the National Program for Extension of Tools and Strategies, the Tanzania Essential Health Interventions Project, Ifakara Health Research and Development Centre, the Tanzania Food and Nutrition Center (TFNC), and UNICEF. To foster sustainable vitamin A supplementation, the A2Z project is supporting behavior change communication through community workers and a popular radio serial. Based on information gathered on sustainability indicators by TFNC with support of A2Z and HKI, those districts that have not yet integrated funding for vitamin A supplementation in their plans are receiving additional technical support. Several resources developed in Tanzania are available to ensure program sustainability.
","Given the twice-yearly nature of the VAS program as well as its historic evolution from immunization campaigns, it is easy for district staff to see the program as separate from their regular day-to-day work. Considering the program to be part of the routine work for the district is critical for sustainability, and is reflected in both attitudes and the support provided to the program. Ninety-one (76%) of the 119 districts regarded implementation of the twice-yearly VAS and deworming program to be a routine activity. About 84% considered VAS and deworming a very important service, and 99% thought the service should continue. Although the majority of the districts viewed VAS/deworming as a routine activity, more than half (55%) had not yet included VAS/deworming services in their routine supervision checklist. Moreover, payment of allowances to staff for VAS/deworming while at their normal duty stations implies that these services were viewed as special rather than routine. The allowance scheme in particular, with an excessive number of supervisors at some distribution sites and inadequate supervision at other sites, may increase a district’s vulnerability to a decline in coverage. Overall, 11 districts (9%) were judged vulnerable with low sustainability related to supervision and monitoring
","Those districts that have not yet integrated funding for vitamin A supplementation ","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Others, please specify below","For an activity to be sustained, it must be considered part of the district’s regular activities, and thus must be included in the annual planning process.","Management","The VAS program requires clear management for effective and efficient implementation, and thoughtful management also reflects the value placed on the program. Poor management may make the program vulnerable, and less likely to be sustained in an effective fashion.","Supplies","The VAS program depends on effective logistics, and capsule and promotional materials must reach distribution sites on time and in adequate quantities for the program to be effective. Poor logistics supply management makes the program vulnerable. Adequate communication between programs and departments within district councils facilitated effective use of available resources in 117 (98%) of the districts assessed.","Financial resources","Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.","Insufficient staff","Twice yearly VAS distribution involves extended outreach to communities, and thus requires significant mobilization of both health staff and community volunteers. Failure to plan for adequate human resources is likely to place districts at risk of not sustaining their coverage achievements.","","","","","","","","","","","","Planning
Districts should be encouraged to budget for the program in their own CCHP budget including the basket fund which is considered the most reliable source of funds. Once basket funds are planned, they cannot be reallocated
Advocacy and community ownership
The program is more likely to continue effectively if it is understood and valued by community members who are involved with planning and implementation.
Management and Leadership
Efforts should be made to protect the current best practices in management and leadership reported in most of the districts.
Logistics Supply
Key actors at the national level need to ensure timely procurement and delivery of supplies to the districts
Supervision and Monitoring
Districts should determine the appropriate number of site supervisors to contain costs and include VAS/deworming in the routine supervision checklist to ensure that children missed during the twice-yearly events are reached through “mop up” actions.
Advocasy and Community Ownership
The successful efforts to date should continue to build community ownership of the program through well-designed, regular sensitization meetings and advocacy to engage the community, mobilize participation, and raise the profile of VAS/deworming events.
Availability of Financial Resources
Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.
Availability of Human Resources
Local councils and the central government need to fill staff positions and find secure mechanisms to ensure mobilization of adequate human resources to sustain service delivery.
Programme Effectiveness
Efforts should be made to maintain the high performance of the majority of districts and help the few low performing districts improve their coverage.
","","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","With advocacy from A2Z/HKI and other donors, the Government of Tanzania in December 2006 adopted a policy for the use of zinc for the treatment of diarrhea. A2Z/HKI provided technical support to the National IMCI coordinator to incorporate zinc therapy as part of diarrhea management and developed modified IMCI guidelines. Zinc treatment and low osmolarity solution oral rehydration salts (ORS) have been incorporated into the National Standard Therapeutic Guidelines. The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University. The formative research also tested the acceptability of zinc treatment for diarrhea among mothers and caretakers. The findings of the study are expected to be used to assist in the development of health worker training modules and behavior change communication materials for use by the Ministry of Health and Social Welfare and the community.
","Under-five mortality rate
","","","","","","","Vulnerable groups","","Zinc supplementation in the management of diarrhoea>>>Zinc supplementation in the management of diarrhoea>>http://www.who.int/elena/titles/zinc_diarrhoea","","","","","","","","","","","","","","","","","","","","","","The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University.
","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Twice a year, at designated times, the three programs distribute capsules to children aged six months to five years. Each program follows a campaign model based upon intensified social mobilization and service delivery over two to seven days. The twice-yearly events have created a cadre of field-tested personnel in the three countries, who are skilled at working with the local communities and at promoting their support and active participation. All three programs have been associated with National Immunization Days (NIDs), a WHO global program to eradicate polio. Since NIDs were held annually, however, they provided an opportunity for only one dose of vitamin A each year. Because children with vitamin A deficiency should receive a supplement at least twice a year (every four to six months), another mechanism was needed for the second dose. Relying exclusively upon facility-based distribution to deliver the second dose was not a viable option for several reasons, but in particular because healthfacility attendance for older children was not high enough to ensure adequate coverage in the one-to-five-year age group.
In Zambia, the first non-NIDs vitamin A supplementation program was launched in August 1999, and later renamed Child Health Week (CHW) to make the focus on the child more explicit. It was also felt that, instead of limiting activities to a vertical vitamin A supplementation program, the opportunity should be seized to deliver an integrated service that included not only vitamin A capsules but also other health services such as de-worming, health education, immunization, family planning, prenatal care, and growth monitoring. Districts were encouraged to provide an integrated package of services commensurate with their local capacity and need — as long as vitamin A supplementation remained the core activity during that week. In Zambia, the first NIDs campaign took place in 1997, and was a nationwide undertaking. The program was scaled down to about half the districts in recent years. Since 1999, the focus has shifted to priority districts, where communities have been at a constant risk of cross-border polio infections due to civil-war-related migrations from neighboring countries. This narrower focus is referred to in Zambia as sub-NIDS.
The first round of vitamin A supplementation in Ghana was integrated into NIDs in 1996. By 1999, a detailed plan was developed to implement a nationwide stand-alone supplementation program for the second round. In 2000, the Ministry of Health (MOH) carried out the first vitamin A standalone capsule distribution in the country’s ten regions. Since that date, the program has become a two- to three-day stand-alone event used to deliver a second dose of vitamin A to all children 6 to 59 months of age. Volunteers from the Ghana Education Service, along with personnel from other decentralized departments, assist with the supervision and capsule-distribution effort. Community-based volunteers are in direct contact with caregivers and children and also work very closely with health workers, assemblymen, chiefs, opinion leaders, gong-gong beaters, and other community leaders to mobilize beneficiaries, administer vitamin A, and maintain distribution records.
In contrast to Zambia and Ghana, Nepal followed a phased approach to program implementation. Integration of vitamin A into NIDs in Nepal was initiated in 1997,
four years after a supplementation program was established in 8 of the country’s 75 districts. The second distribution campaign has since been phased in at a rate of eight to ten districts per year. By 2001, the program covered all but three politically unstable districts. Under the program, high-dose vitamin A capsules are distributed to all children aged 6 to 59 months during a twoday event.
","
Ghana
A monitoring team consisting of national, regional, and district supervisors carries out organized and random spot checks. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. Capsule-distribution teams use all means of transportation available within the region and district, whether these be 4x4 vehicles, 2x4 pickups, motorcycles, or bicycles. MOH, district assemblies, decentralized departments, and local and international NGOs provide fuel and contribute to vehicle maintenance. At the end of each day, tally sheets are counted and summary sheets completed. Data are compiled by sub-district and district health management teams. After all figures are checked for accuracy, district coverage is calculated. District coverage data are sent to the regional nutrition officers and senior medical officers of public health, who compile regional coverage figures before sending them to the Nutrition Unit in Accra. Using regional figures, the Nutrition Unit estimates national coverage.
Zambia
Monitoring teams consisting of national, provincial, and district staff carry out systematic or random observations, depending on what they are monitoring. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. At the end of each day, tally sheets are counted, summary sheets completed, and data compiled. District figures are then checked for accuracy, after which district coverage is calculated and the results forwarded to NFNC.
","Ghana: 3.5 million children ","Ghana: Exceeded target in May 2001; Zambia: 28 percent in 1999, 88 in Febraury 2002","","serum retinol levels of &lt;20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","serum retinol levels of <20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Insufficient staff","In Zambia and Ghana, it has been somewhat more difficult to generate a consistent cadre of volunteers for the vitamin A distribution. In each country, districts mobilize health post and sub-health post staff, identify extended outreach sites (including clinics, schools, and community centers),and then recruit community members to assist them with their activities. In Ghana, this has been relatively successful since there have been adequate clinic staff and a manageable number of outreach sites. In spite of this, many districts have continued to do some house-to-house visits to ensure high coverage. In Zambia, it has been more difficult to recruit community volunteers, and the clinic staff have been stretched to cover outreach sites.","","","","","","","","","","","","","","","","","","","","","Robin Houston (2003). Why They Work: An analysis of three successful public health interventions - Vitamin A supplementation programs in Ghana, Nepal, and Zambia
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Five data collection methods were used:
During the fieldwork, the enumerators worked in pairs. The enumerators were not allowed to use the instruments in the facilities where they worked. Each pair spent a full day at a health facility. Field supervisors supported the enumerators during the data collection and checked the questionnaires for consistency and completeness. This was to ensure that the data collected was accurate as possible.
","""""Many pregnant mothers do not come to ANC because they had several normal pregnancies and think all will continue to go on well always.”
- Health worker, Apac
“ The health worker at the health centre is very rude, she has no time for us; so we fear even asking questions or discussing any issue about our health. So I go all the way to Naguru health clinic and only here if I have no money for transport.”
- A pregnant woman, Kojja, Mukono
“ I think these tablets for blood should be given only to pregnant women who have no blood. It may cause a high blood level and lead to high blood pressure.”
- TBAs, Kyampisi
“ Women with increased blood should not take these tablets (iron and folic acids) because their heartbeats will increase and they will sweat very much.”
- TBAs, Seeta Nazigo
“ Some mothers say it smells and they throw away the tablets soon after the clinic.”
- Pregnant mothers, Kojja
“ Some mothers do not like taking tablets when they are pregnant.”
- Pregnant mothers, Seeta Nazigo
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Ethiopia
MOST is providing technical and implementation support to the Ministry of Health in the development of a national micronutrient program. The program is a cooperative effort between the MOH, USAID/Ethiopia, MOST, and UNICEF. Program components include strengthening of the newly formed nutrition division at the MOH and the micronutrient committee; development of a locally designed vitamin A supplementation strategy and its pilot test; support for initial trials of vitamin A sugar fortification in one of the country's four sugar factories; and support for information, education, and communication activities.
South Africa
MOST is working with counterparts at the University of the Western Cape (UWC) to support and strengthen a new vitamin A supplementation program being started by the Department of Health in Eastern Cape province. MOST is also supporting a pilot initiative by UWC that aims to incorporate micronutrient interventions into the Eastern Cape Integrated Nutrition Program.
.
","","","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Government agencies encouraged the initial development of fortification: NFNC promoted initial research, sponsored meetings, and coordinated activities related to fortification; MOH researched the legal framework; the National Institute for Scientific and Industrial Research (NISIR) provided technical guidance; the Food and Drug Control Laboratory (FDCL) conducted monitoring and evaluation; and the Zambian Revenue Authority (ZRA) examined the tax structure. Industry acceptance allowed planning to begin, but donor support was critical to the development of the program: the U.S. Agency for International Development (USAID) was the lead financer of the project and provided technical assistance, UNICEF provided spare parts, and the Japanese International Cooperation Agency (JICA) provided spectrophotometers for Zambia Sugar and the FDCL.
While legislation was still being developed, Zambia Sugar went ahead with the launch of fortified Whitespoon Sugar on May 15, 1998. Zambia Sugar began its fortification program at 15 mg/kg, but cost considerations led the company to reduce the level to 10 mg/kg within three months. In May 1997, one year before fortification began, a consultant estimated the cost of fortifying 100,000 metric tons of sugar at 16 mg/kg to be around $1 million U.S., while fortifying at 20 mg/kg would cost almost $1.25 million.24 Reducing the level from 16 to 10 mg/kg could thus have reduced costs by approximately $375,000 a year.
","Modified Relative Dose Response Test (MRDR) in children
","The first outside tests of fortificant levels in sugar were controversial. Four months after the launch of fortified sugar, a team consisting of representatives from the MOH, the NFNC, and NISIR visited the Zambia Sugar mill. The team tested samples from the mill at the FDCL; these tests showed far lower levels of vitamin A than those shown in tests by Zambia Sugar. The government’s tests indicated a range of 0–13.6 mg/kg, while Zambia Sugar’s tests indicated a range of 9–21 mg/kg for the same samples. Zambia Sugar believes that the samples suffered sedimentation in the transport to the government laboratory and that this explains the different results.
MOST, the USAID micronutrient program, sponsored the creation of training manuals for health inspectors and Food and Drug enforcement officers, as well as a national training workshop from September 24 to October 7, 2000. The workshop focused on inspection procedures and methods, provided laboratory training where appropriate, and included a trip to the Zambia Sugar plant. Since the implementation of that program, Zambia Sugar has expressed satisfaction with law enforcement efforts. UNICEF subsequently funded workshops at the district level, using reproductions of the training manuals that had been produced with MOST funding.
","nationwide","..","","","","Vulnerable groups","","","Financial resources","","Communication","","Financial resources","","Adherence","","","","","","","","","","","","","","","","","English" "11493","Strengthening Agricultural Technologies among People Living with HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda","English","Multi-national","","KEN|UGA","Kenya|Uganda","Busia, Kenya|Busia, Uganda","Rural|Peri-urban","completed","01-2007","01-2008","The Food and Nutrition Technical Assistance Project (FANTA) of the Academy for Educational Development (AED) and the Ministry of Health (MOH) AIDS Control Programs (ACPs) in Kenya and Uganda worked together between 2007 and 2008 to integrate nutrition into the activities of HIV support groups in the border towns of Busia Uganda and Busia Kenya, funded by USAID/East Africa. The aim was to build skills in nutrition and disseminate national materials on nutrition and HIV developed by the national ACPs. However, PLHIV in the border towns increasingly reported lack of access to adequate food, in terms of quantity and variety, as the main reason they could not apply the dietary practices recommended during counseling sessions. In response, between September 2007 and September 2008 FANTA and the ROADS Project collaborated to facilitate the diffusion and use of appropriate technologies to improve the productivity of PLHIV agricultural activities developed under the ROADS Project in the two border towns.
","http://www.fantaproject.org/downloads/pdfs/FANTA_Busia2008.pdf
","8762|8576|8430|8302|8241|8671|8237","","Food and agriculture","Ministry of Agriculture, Department of Culture and Social Services, Kenya│Ministry of Animal Industry and Fisheries (MAAIF), Uganda│National Agricultural Advisory Services (NAADS), Uganda","","","Family Health International (incl.AED)","","","","","","National NGOs","AIDS Support Organisation; National Agricultural Research Organization (NARO), Uganda","Research/academia","Busia Agricultural Training Centre (BATC) in Kenya, Kenya Agricultural Research Institute (KARI)","","","Other","Africa 2000 Network","","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","East Africa","Other","","Busia Parish Catholic Church, Kenya","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11492","","Promotion of food security and agriculture","","","","Pregnant/lactating women with HIV/AIDS","","Busia , Kenya and Busia Uganda","Community-based","","The process involved identifying simple technologies to increase farm and garden outputs and linking clusters of people living with HIV (PLHIV) with local agricultural institutions including the Ministry of Agriculture (MOA), Department of Culture and Social Services, Kenya Agricultural Research Institute (KARI), and Busia Agricultural Training Centre (BATC) in Kenya and the MOA, Ministry of Animal Industry and Fisheries (MAAIF), National Agricultural Research Organization (NARO), and National Agricultural Advisory Services (NAADS) in Uganda, as well as community development officers, community-based organizations (CBOs), and nongovernmental organizations (NGOs) in the districts. FANTA facilitated the development of a participatory learning process to motivate groups of PLHIV to learn the new technologies to increase farm and garden output.
In phase one of the participatory learning process, FANTA and ROADS helped members of the clusters and agricultural institutions understand the agricultural technologies used in Busia, Kenya and Busia, Uganda to improve productivity. Phase two facilitated a process of linking cluster with agricultural institutions to help cluster members implement existing technologies that they had not widely used and to assess the impact of the process on the adaptation of the technologies. Neither FANTA nor ROADS invested substantial funds in the process, but provide technical assistance and connected the clusters to locally available technical assistance and support.
Three sensitization meetings were held, one joint meeting between cluster representatives, the FHI Cluster Coordinators, and FANTA staff and two meetings with groups on either side of the border. The meetings laid the foundation for agreement on the purpose of the activity and sharing of expectations. Over a period of two weeks, the group representatives identified viable and interesting agricultural technologies used in their localities and discussed how easily they could be implemented by PLHIV living in the towns (urban setting) and how they could improve their food diversity. In meetings with the agricultural institutions (mainly from Kenya), examples of agricultural technologies and activities were identified and discussed. Ministry of Agriculture and BATC extension personnel were available in the meetings to explain the different technologies.
The cross-border learning process was initiated by 14 representatives of the Ugandan clusters, who visited their peers on the Kenyan side of the border in November 2007. For two days they visited homes and training centers to see different agricultural technologies and livelihood activities implemented in Kenya and discussed the
feasibility of their adoption in their own context. At BATC the Ugandan visitors toured all the Group identification of learning content and methodology Preliminary sensitization meetings with cluster groups Group consultative meetings Meetings of Cluster representatives with departments of agriculture, NGOs, research institutions, and farmer training Cross‐border learning and home visits Arrange meetings among ROADS representatives, cluster representatives from Kenya and Uganda, and FANTA. Explain the different technologies that could be used in the locale and by PLHIV. Agree on how groups would implement the technologies and priorities. Group consensus meetings See different technologies in the communities and discuss.
Visits were also made to school gardens, community land (e.g., belonging to clusters of orphans and vulnerable children [OVC] in Kenya), seed multiplication sites, and farmer training centers. The cluster members discussed opportunities for and challenges of implementing similar activities in the urban Uganda context. Group consensus meetings were held to prioritize what the clusters wanted to learn about and the optimal methods of learning.
","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF interventions will encourage employment of women extension agents in the public sector and ensure that they are well represented in extension-related training activities in the public and private sectors. Women typically have more limited access to seeds, tools, credit, and marketing information than men. Liberia FTF MYS activities will give explicit attention to issues of equity in access in order to increase women‘s access and FTF will also provide support for women to participate in producer/marketing groups and associations.
Through private and public sector extension, USAID will provide lead farmers and producer organizations identified as change agents with specialized skills. Change agents will also receive support to acquire planting material and inputs through public and private sector channels. Availability of improved planting materials is facilitated through investments in CARI, private sector players, and CORAF. USAID will promote suppliers of seeds, fertilizers, insecticides, herbicides, tools, and livestock by developing their technical knowledge and skills and through support for increased agricultural credit. These entrepreneurs will provide services to others in their respective value chains. Over the five years of the FTF program, both the public and private provision of extension services will reinforce and expand the skill sets of change agents to increase productivity and coordinate with county and local health service providers to extend the reach of nutrition-related behavior change in order both to raise incomes and to improve health outcomes.
Small-scale rice and cassava processors will be a central focus of FTF interventions. Those interventions will help processors to build a supplier base, acquire equipment, access finance, and implement appropriate business practices. It is expected that they will then provide farmers with technical assistance to assure themselves of sufficient supplies of quality commodities to process. The program will work with and support both processors and traders to invest in processing equipment, storage facilities, and transport. It will work with farmers on improving post-harvest handling practices and on producing a consistent and predictable flow of goods. Over the five years, USAID direct beneficiaries will develop the skills, knowledge, and attitudes - plus have the capital, equipment, clients, and market linkages - to continue to expand their production, processing, and/or marketing businesses.
Given the paucity of reliable data, a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to a series of baseline surveys to collect production, labor, and market information and to facilitate MOA data collection and analysis, especially related to the focus counties. Based on the prioritized constraints that are identified, targeted and sequenced support will be directed to specific steps on the value chain, including to:
Nutritional benefits will accrue from both increased availability of and access to Liberia‘s primary food staples (rice and cassava). Increased commercialization will provide smallholders the increased incomes needed to obtain more and better food and improved processing will promote fortification to enhance the nutritional value of cassava and to improve the quality of rice. Public and private extension change agents will be trained to engage farmers, communities and farmer organizations across the range of behavioral change needed to promote essential nutrition actions.
","The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
There are an additional six indicators which require baselines to measure project-level activity. In collaboration with the MOA, USAID/Liberia IPs will lead baseline data collection on crop and animal production improvements (indicators 9 and 10 in the results framework), on the value of incremental sales (indicator 16 in the results framework), and on the application of improved technologies and practices by individuals and organizations receiving USG assistance (indicators 13 and 15 in the results framework).
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
","Planned interventions targeted at the key value chain constraints and implemented via the actions of private and public change agents will reach over 92,000 rice and cassava farmers in the six target counties","Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa ","","Gross margin per unit of land or animal of selected product (crop/animal varies by county);Percent increases in crop yields; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; &amp; CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Value of agricultural and rural loans; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Gross margin per unit of land or animal of selected product (crop/animal varies by country);Percent increases in crop yields; Number of individuals who have received USG supported short-term ag sector productivity or food security training;Number of new additional ha under improved technologies or management practices as a result of USG assistance; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs receiving USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Kilometers of roads improved or constructed; Value of agricultural and rural loans; Value of new private sector investment in the ag sector or food chain leveraged by FTF implementation; Number new laws and policies implemented to support private enterprise growth; Number of jobs attributed to FTF implementation; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","Promote high-yield seed and related inputs, including demonstration plots to test the use of improved seeds, fertilizer, and pesticides, and to introduce better land and water practices and farming methods;","Staff skills/training","Build capacity in both public (county-level) and private sector extension, including farmer organizations, traders or other private sector actors to invest in small sized processing mills and storage facilities","Financial resources","Provide access to finance and credit guarantees, directed at lead farmers and small processors","Stakeholder","Implement training to capacitate processors to become key change agents in market and credit transactions","Communication","Improve the transparency of market price information to farmers and strengthen business service providers, as an alternative means to make extension type services","","","","","","","","","","","","","","English" "11523","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","LBR","Liberia","Bong County, Liberia|Lofa County, Liberia| Nimba County, Liberia|Grand Bassa County, Liberia|Montserrado County, Liberia|Margibi, Liberia","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF Core Program 2 will undertake investments in horticulture pilots to encourage smallholders in relevant areas of all focus counties over time, but will initially focus on peri-urban locations near Monrovia which are close to the largest and most lucrative market and minimize constraints related to storage and transport. These activities will build on a change agent model similar to that for the rice and cassava value chains by supporting lead traders and lead farmers to acquire equipment for transport and storage and to acquire business and marketing knowledge. Key FTF horticulture interventions will include formation and strengthening of farmer associations, post-harvest management and logistics support, promoting public-private partnerships, and providing information and training for behavior changes to promote improved family nutrition.
FTF investments to develop the goat value chain will implement pilot activities that are closely coordinated with the substantial USDA Food for Progress goat value chain enhancement program that will be working to re-establish breed stock and infrastructure for processing. The change agent focus of investment will be on community animal health workers and Core Program 2 activities will train and lend support to them so that they can directly assist improved breeding through the provision of services and infrastructure, making commercialization profitable. USAID/Liberia will determine the scope and scale of change agent engagement in pilot sites based on local conditions and in close coordination with the USDA program.
The US Government in Liberia will make an estimated 30 percent of FTF MYS investments in Core Program 2, with roughly 60 percent of these directed to interventions to address vegetable value chain pilot activities and the remaining 40 percent for implementation of goat pilots. Reflecting the phased approach to Liberia FTF value chain interventions, only 10 percent of first-year investment will be in the diet diversification value chains, while 63 percent of MYS vegetable and goat value chain investments will be carried out in years four and five. As with Core Program Area 1, given the lack of reliable data a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to ensure relevant baseline surveys to collect production, employment, and market information and to facilitate data collection and analysis, especially related to the focus counties. These investments will be phased to take advantage of opportunities that already exist in peri-urban areas for vegetables and related to the USDA program for goats. Within the proposed total program level, anticipated investment levels in these value chains will be lower in the first two years of strategy implementation and will ramp.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities:
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF investments in Core Program 3 will address selected aspects of the LASIP program for institutional development to support the value chains that are the focus of Core Program Areas 1 and 2. FTF investments in agriculture policy, advocacy support, and research will fund key institutions to carry out actionable research leading to improved land, soil, and water resource management and use and agronomic practices and more productive animal husbandry. FTF Program Area 3 activities will be integrated in the value chain support in order to expand the capacity of civil society groups to analyze and advocate for policy reforms (e.g., in regard to rice pricing and sanitary and food safety standards for food and meat processing) and to help create a more market-friendly policies and an improved trading environment for Liberian smallholders.
The Liberia FTF MYS will assist the MOA to define and implement its decentralized, demand-driven, participatory, pluralistic (i.e., engaging public, private, civil society actors), and accountable agricultural extension system. The critical role of women extension agents will be emphasized and opportunities for them to develop professionally, both in terms of education and field practice, will be supported. Program Area 3 investments will target partnerships with the public and private sectors and other development partners to: accelerate adoption of modern agronomic technologies and practices at the farm level; create effective knowledge distribution mechanisms; and build capacity of the MOA to provide specialized extension services. Revised agricultural extension curricula will provide more effective training in areas such as land use and techniques to reduce soil fertility losses, water resources management, low-cost and organic fertilizers, post-harvest loss reduction, pest management measures, participatory extension methodologies, women‘s participation in extension activities, farmer organization development, participatory rural appraisal, farmer field school methodology, and farmer-to-farmer extension. These investments will support widespread provision of high quality extension to Liberian smallholders. Core Program 3 interventions on market structure development will create opportunities to establish market information systems to support private and public decision making and invest in alternative profit sharing/contract models between change agents and farmers to ensure equitable market exchanges, based on transparent information and rational decision making behavior. These activities will provide the foundation for fair and transparent markets accessible to all Liberian smallholders.
All FTF MYS investments in Core Program 3 will be integrated to support value chain activities in transforming rice and cassava staples value chains and piloting the income and diet diversification vegetable and goat value chains. Thus, these activities to advance the enabling environment and build capacity will contribute to ensure benefits of the value chain investments reach all 142,375 households the program will work with, including the 91,120 poor households.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities: