"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" "8818","Improving nutrition of women and children: the MICAH program ","English","Multi-national","","ETH|GHA|MWI","Ethiopia|Ghana|Malawi","Ethiopia|Ghana|Malawi","Peri-urban","completed","01-1995","01-2005","
The MICronutrient and Health (MICAH) Program contributed to improved quality of life of women and children in five African nations (Ethiopia, Ghana, Malawi, Sénégal and Tanzania) over a 10-year period between 1996 and 2005. The problem of micronutrient deficiencies (vitamin A, iron and iodine) was addressed through integrated strategies and direct interventions that resulted in measurable positive effects. Quantitative and qualitative program results affirm the contribution of MICAH’s achievements towards the Millennium Development Goals, and global nutrition and health targets.
","http://www.wvnutrition.net/home/resources/better-practices/micah-final-d...
","8329|8270|8112|8488|8111|8013|8657|8369|7979|7917","","","","","","World Vision International","","","","","","","","","","","","","","Ethiopia • $4.4 million budget (USD, 2002-2005)Ghana • $745,000 budget (USD, 2002-2005)Malawi • $3.8 million budget (USD, 2002-2005)","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","Working in close cooperation with government, non-government organizations (NGOs), and communities, MICAH built on existing delivery systems within ministries of health, education and agriculture, equipping them to strengthen the coverage and quality of their mandated activities. The foundation for a self-sustaining nutrition and health infrastructure was laid, by empowering communities to take ownership for program activities within their grasp: exclusive breastfeeding, capacity building of community health workers in nutrition and health, establishment of household gardens and revolving funds, and latrine construction.
MICAH also provided education to local populations about the importance of health and nutrition. Thousands of community health workers and volunteers were trained while program staff were equipped with skills to monitor and evaluate the program, gathering valuable information to assess its impact.
","Ethiopia
Ghana
Malawi
ETHIOPIA
Supervision/monitoring visits were routinely made at all levels of Ethiopia’s MICAH projects.The program coordinating office and program partners conducted 86 visits to assess the implementation and progress of various initiatives.Throughout the year, activity reports and evaluation documents were reviewed, site visits made, and ongoing discussions held between MICAH staff and stakeholders. After every visit, copies of feedback reports were sent to the relevant ADPs and NGOs. At the project level, MICAH facilitators conducted joint field visits and reviews with frontline personnel such as government health workers, community health workers, volunteers and school teachers to ensure implementation of activities was proceeding according to plan.
GHANA
Monitoring of MICAH Ghana improved in several ways in Phase 2 as the program team worked closely with Ghana Health Service and community health volunteers. Increased effectiveness was best illustrated by the heightened accuracy of data for iodized salt consumption after changing the method from school-based to houseto-house surveys.The team reinforced this effort by testing the quality of salt in markets as well. To improve monitoring of compliance with iron supplementation, MICAH facilitators worked closely with community health volunteers to assess whether women and children were taking the supplements as prescribed.Throughout the program, monitoring information was shared with all stakeholders at quarterly district and sub-district meetings in an effort to improve implementation and build ownership.
MALAWI
Regular meetings were conducted with government ministry and partner staff to share feedback and resolve issues.Training was provided and follow-up maintained to improve the capacity of field agents and staff. Regular community visits, including meetings with women and local leaders, provided management staff an opportunity to ensure quality implementation. Specific issues were dealt with using results-based management. For example, to obtain a more accurate estimate of deworming coverage in Phase 2, the household listing register was introduced and utilized, to supplement data regarding the de-wormed child. As a result of this new system, household monitoring revealed the extent of infection and enabled appropriate follow-up.To monitor the quality of the flour fortification project, the Malawi Bureau of Standards (MBS) and Chancellor College labs analyzed premix produced at the Domasi Fortification Unit. Each test found the Domasi premix to meet all MBS requirements; recommended levels of iron were found in the flour, and flour samples were free from contaminants.
","Ethiopia (1.8 million beneficiaries); Ghana (150,000 beneficiaries); Malawi (272,391 direct beneficiaries, with indirect benefit extending to 4.7 million people)","x","","","","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","","","","","","","","","","","","","","","","","","","","","","","“The MICAH approach is a good and successful model for the Ministry of Agriculture. Given right training people are ready to follow new habits and change traditional attitudes – for example, by eating rabbits and drinking goat milk. MICAH has provided a learning area for agriculture to reduce hunger.” – Mr. Bbvumbwe, Malawi
""""""""The positive impact of MICAH on the
health of children is a motivation to
continue. With improved knowledge,
good health and nutrition practices will
be sustained with support from chiefs
and elders.""""""""
– Qualitative survey, Ghana
Aa a result of the MICAH program… our children are healthy, alert and active; they look
attractive and beautiful; children are not falling sick with malaria as frequently as they did in the
past; the frequency of diarrhea and intestinal worms has decreased; eye diseases have decreased
because of improved hygiene; the harmful health practices have now been dropped because of
the intensive education given by health workers; and severe malnutrition, blindness, measles and polio have decreased.”
– Focus group discussion, qualitative survey, Ethiopia
","English" "8820","Maziko: Nutrition Foundations for Women and Children ","English","Community/sub-national","","MWI","Malawi","Kasungu, Malawi|Ntchisi, Central Region, Malawi","Rural","on-going","01-2012","01-2015","
This project (Maziko) aims to benefit more than 236,000 women, girls and boys in two districts where stunting and malnutrition are widespread. Addressing under-five child stunting head-on, the project takes an integrated approach to preventing and treating malnutrition by addressing behaviour change in the areas of: feeding practices, agricultural production, water, sanitation and hygiene while also focusing on access to programs at the district and community level. The Maziko Project uses a model of behaviour change that has been proven to reach large numbers of households while also strengthening the community-based referral to health services.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebProjSearchEn/70D2D2C877D0...
","8657|7979","","","","","","CARE","Multi-year award for fiscal years 2011-12 to 2014-15","","","","","National NGOs","Agriteam Canada: Competitively Sourced Contract (Purchase of services for development assistance)","","","","","","","The Canadian International Development Agency (CIDA) will commit CA$6,049,015 for this project.","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Maziko Project uses a model of behaviour change that has been proven to reach large numbers of households while also strengthening the community-based referral to health services.
","Expected results are: improved delivery of nutrition services, nutritional practices among vulnerable households, and an improved local enabling environment to sustain nutrition outcome. This will be achieved through for example: an improved ability of women and caregivers to prepare nutritious and micronutrient rich meals thanks to a deeper understanding of optimal nutrition and illness prevention practices for lactating women and children under five; as well as economic and social empowerment of the vulnerable women through increased access to nutrition services, financial resources, and leadership opportunities in community groups, increasing their role in health and nutrition decision making processes.
","","more than 236,000 ","Two districts (both in central region) out of the 27 with the highest prevalence of stunting","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","NFSI implemented on a pilot basis in primary schools of Cotonou (n=6) and in Ouagadougou (n=6). In Ouagadougou, quasi-experimental approach, with 6 matched control schools. Baseline study conducted on nutritional status of pupils (nearly 900), and hygiene and eating practices. Implementation with Nutrition & Health Committees in schoolds. DFN project trained in nutrition education and surveillance (using anthropometry). Other activities elected by individual schools.
","Nutritional status of pupils after 3 years of NFSI implementation, and their hygiene and eating practices.
","","Undefined","Undefined","","Baseline study in Ouagadougou in 2009","Due in 2013
","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","The Master's program in Public Health Nutrition started at the Regional Institute of Public Health in 2009 and a first cohort of 10 graduates finished in 2011. A new cohort of 10 students started in October 2012. Regarding the 3-year undergraduate professional program in Nutrition and Dietetics, the 3-year program is offered at the Faculty of Health Studies School of Nutrition since 2010. A first cohort of 20 will get their degree (licence) in July 2013.
","Number, sex, and position of graduates
","","N/A","N/A","","","","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8891","Double Burden of Malnutrition: Hub in West Africa","English","Multi-national","","BEN|BFA|MLI","Benin|Burkina Faso|Mali","Benin|Burkina Faso|Mali","Urban","on-going","01-2008","01-2014","The 6-year partnership project (2008-2014) involves TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Developement, academic and research institutions from Benin, Burkina Faso and Mali, Helen Keller International, an international NGO, and WHO as special collaborator. The purpose of the project is to strengthen capacity of partner countries to address the double burden of the coexistence of undernutrition and nutrition-related chronic diseases.The strategy includes: 1) Workforce training in nutrition with two new regional university programs in Benin, a Master's and an undetrgraduate professional program (licence), as well as continuous intensive courses on Nutrition Transition and Chronic Diseases, and Community Management of acute malnutrition; 2) Action research in communities (Benin) and schools (Benin and Burkina Faso), and other studies on the nutrition transition and the double burden of malnutrition; 3) Communication for the public with development of a food guide for Benin, and the development of advocacy tools for policy and programs focusing on diabetes.
","Website: www.poleDFN.org
Publications:
Delisle H. Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Applied Physiol Nutr Metab 2010; 35: 224-8.
Daboné C, Receveur O, Delisle H. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou. Nutrition Journal 2011; Apr 19;10:34.
Delisle H, Ntandou G, Agueh V, Sodjinou R, Fayomi B. Urbanisation, nutrition transition and cardiometabolic risk: the Benin Study. Brit J Nutr 2011; 107: 1534-44 (doi:10.1017/S0007114511004661)
Sossa J, Delisle H, Agueh V, Makoutodé M, Fayomi B. Four-year trends in cardiometabolic risk factors according to baseline abdominal obesity status in West-African adults: The Benin Study. J Obesity 2012 doi: 10.1155/2012/740854
Zeba A, Delisle H, Renier G, Savadogo B, Banza B. The double burden of malnutrition and cardio-metabolic risk widens the gender and socioeconomic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012; 15: 2210-9
Zeba A, Delisle H, Rossier C, Renier G. Association of high-sensitive C-reactive protein (hsCRP) with cardio-metabolic risk factors and micronutrient deficiencies in adults of Ouagadougou; Burkina Faso. Brit J Nutr (Accepted)
Delisle H, Agueh V, Fayomi B. Partnership research on nutrition transition and chronic diseases in West Africa – trends, outcomes and impacts. BMC International Health & Human Rights 2011; 11 (suppl 2): S10 http://www.biomedcentral.com/bmcinthealthhumrights/supplements/11/S2
Delisle H, Agueh V, Fayomi B. Recherche en partenariat sur la transition nutritionnelle et les maladies chroniques en Afrique de l’ouest – évolution, résultats et retombées. CRDI, 2011. Disponible à : http://www.crdi.ca/irsm10etudesdecas
Delisle H, Receveur O, Agueh V, Nishida C. Pilot-testing of the Nutrition-Friendly School Initiative in West Africa in Ouagadougou (Burkina Faso) and Cotonou (Benin). Global Health Promotion (in press)
Sossa C, Delisle H, Agueh V, Makoutodé M, Fayomi B. Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: The Benin Study. (NMCD, in press)
Daboné C, Delisle H, Receveur O. Cardiometabolic risk factors and associated features in 5th grade school children in Ouagadougou, Burkina Faso. Int J Child Health Nut 2012 (In press)
Daboné C, Delisle H, Receveur O. Predisposing, facilitating and reinforcing factors of healthy and unhealthy food consumption in schoolchildren. A study in Ouagadougou, Burkina Faso (West Africa). Global Health Promotion 2012 (in press)
Delisle H. Empowering our profession in Africa. World Nutrition 2012; 3: 269-84: http://www.wphna.org/2012_may_hp6_this_month.htm
","8811|8621|8622|8554","","","","","","Helen Keller International (HKI)","Particularly in Burkina Faso","","","","","National NGOs","Mali: Santé-Diabète (French NGO)","Research/academia","Benin: Regional Public Health Institute (IRSP); Faculty of Health Sciences, Abomey-Calavi University; Appiled Biomedical Science Institute (ISBA); Burkina Faso: Research Institute on Health Sciences (IRSS); Ouagadougou University (Medicine; CRSBAN); Mali: University of Bamako and university hospital; University of Montreal, Canada, TRANSNUT, Department of Nutrition","","","","","Total: ~5 million CAD, including 3 million CAD provided by Canadian International Development Agency","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","University of Montreal contributes ~1.3 million CAD and African partner institution, ~700.000CAD","Research/academia","Research/academia","Food-based dietary guidelines, including an illustrated food guide, is being developed in Benin with partner institutions. The urban population in particular is targeted. These nutrition communication tools were based on WHO/FAO recommendations and on recent dietary intake studies in the southern part of Benin.
","Formal acceptation of dietary guidelines by authorities of Benin
","","Approximately 3 million people (urban and peri-urban population of southern Benin)","Undetermined","","","","None","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8916","Reducing Maternal and Child Undernutrition","English","Community/sub-national","","GHA","Ghana","Bolgatanga, Ghana|Wa, Upper West, Ghana|Tamale, Northern, Ghana","Rural","on-going","01-2012","01-2017","The project’s first aim is to reduce child morbidity and mortality by scaling up proven nutrition interventions to the most vulnerable populations of northern Ghana. The key to the success of these interventions is an early identification of severely malnourished children by trained and appropriately equipped frontline health workers. This allows treating effectively most of the children at home by a simple provision of therapeutic food and micronutrient supplements. To ensure sustainability of the results and to help reduce the number of children facing undernutrition in the long term, the project will also assist the Government of Ghana in the development and implementation of a strong and coherent national nutrition policy. Finally, a gender sensitive nutrition information and surveillance system will be developed in the 3 northern regions to enable the government and development partners to improve monitoring of nutrition programs, decision-making and timely response in the three northern regions.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZEn/4A6A423FA901C7D785...
","","National Nutrition Policy","","","United Nations Children's Fund (UNICEF)"," Multi-year award for fiscal years 2011-12 to 2016-17","","","","","","","","","","","","","","","CA$ 15,000,000","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8915","","Management of severe acute malnutrition","Reducing Maternal and Child Undernutrition","","","Infants and young children|Preschool-age children (Pre-SAC)|SAM child","Children under 5 years","The 3 Northern regions (Upper East, Upper West, Northern region)","Community-based|Kindergarten/school","","","Expected intermediate outcomes include: - Improved treatment and prevention of child undernutrition for boys and girls under 5 and mothers - Improved financial support, gender-sensitive policy coherence and coordination in nutrition sector - Improved monitoring of nutritional indicators and decision making for better nutritional outcomes
","","x","Northern Ghana","","","","Vulnerable groups","","Micronutrient supplementation in children with severe acute malnutrition>>>Micronutrient supplementation in children with severe acute malnutrition>>http://www.who.int/elena/titles/micronutrients_sam","","","","","","","","","","","","","","","","","","","","","","","","English" "8930","Assistance to Ghanaian Food-Insecure Households in Northern Ghana","English","Community/sub-national","","GHA","Ghana","Tongo, Bolgatanga Municipal, Upper East, Ghana|Danko, Wa Municipal, Upper West, Ghana|Zuorugu, Tamale, Ghana","Rural","on-going","01-2010","01-2014","The project supports the Government of Ghana in its efforts to improve the protection of vulnerable populations in northern Ghana from the devastating impacts of floods and droughts, and also to ensure that the immediate food needs of the most severely food-insecure households are met. The project aims to improve agriculture, water and land resources; create strategic reserves to protect the nutritional status of at-risk groups (including children under five, pregnant and lactating women and people living with HIV/AIDS); and support the rehabilitation and recovery of agricultural livelihoods. This project contributes to alleviating chronic food security amongst vulnerable groups, targeting and assisting poverty reduction in the most susceptible areas of northern Ghana.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZEn/503DAC11D7D8F3AD85...
","8488","","","","World Food Programme (WFP)","","","","","","","","","","","","","","","","CA$ 20,000,000","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8929","","Food distribution/supplementation for prevention of acute malnutrition","","","","HIV cases|Infants and young children|Lactating women (LW)|Pregnant women (PW)","","The 3 Northern regions (Upper East, Upper West, Northern region)","Community-based","","Results as of May 2012 include: the World Food Program (WFP) has distributed food to 327,982 beneficiaries out of the 423,250 planned. In particular, the targets for supplementary feeding of malnourished children under five and pregnant and lactating women are close to being achieved, and will likely be exceeded by the end of the project. The project has already exceeded the targets for the number of beneficiaries on its components Food for Assets (FFA) and Food for Training (FFT), and has reforested some 7,357 ha of land and rehabilitated 250 dams/dugouts.
","It is anticipated that all expected outcomes of increasing equitable access to food aid and prevention of malnutrition, particularly among children under five, pregnant and lactating women, including refugees; as well as to improving food consumption over the assistance period for targeted households, and people living with HIV/AIDS and their families; and increasing the targeted communities equitable access to livelihood assets, including assets for environmental conservation will be achieved.
","","423,250","327,982 beneficiaries (for distributed food); ","","","","Vulnerable groups","","Micronutrient supplementation in children with severe acute malnutrition>>>Micronutrient supplementation in children with severe acute malnutrition>>http://www.who.int/elena/titles/micronutrients_sam","","","","","","","","","","","","","","","","","","","","","","","","English" "8933","The Leyaata (“Rescue Us”) Project to Reduce Maternal, Infant and Child Mortality","English","Community/sub-national","","GHA","Ghana","Kintamp, Ghana|Bole, Ghana","Rural","on-going","01-2011","01-2015","The project aims to reduce maternal, infant and child mortality in 50 marginalized villages in the north Kintampo and south Bole districts of Ghana by directly addressing key health issues. Reaching approximately 10,000 beneficiaries, the project addresses care during pregnancy and childbirth, neonatal care, and malaria control as critical health concerns in these communities. Key project components include establishing a prenatal and neonatal home visit system for pregnant women and infants, and launching a malaria control program that prioritizes mothers and infants.
Specific activities include: distributing neonatal care kits; training community-based volunteers and local health professionals; providing mosquito nets for all village residents; conducting malaria control workshops; and supplying local clinics with rapid malaria test kits. Ghana Rural Integrated Development is working in partnership with the Northern Empowerment Association to implement this project.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZen/index.html7E4DFE9C...
","8111","","","","","","","","","","","","National NGOs","Ghana Rural Integrated Development, Northern Empowerment Association","","","","","","","CA$ 643,464.00","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8932","","Distribution of insecticide-treated bednets","","","","Infants and young children|Lactating women (LW)|Pregnant women (PW)","","North Kintampo & South Bole Districts","Community-based","","Specific activities include: distributing neonatal care kits; training community-based volunteers and local health professionals; providing mosquito nets for all village residents; conducting malaria control workshops; and supplying local clinics with rapid malaria test kits.
","Maternal, infant and child mortality
","","10,000 beneficiaries","50 marginalized villages in the north Kintampo and south Bole districts of Ghana","","","","Vulnerable groups","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","","","","","","","","","","","","","","","","","","","","","","","","English" "11451","Food Security and Environment Facility","English","Community/sub-national","","GHA","Ghana","Zuarungu, Bolgatanga,Ghana | Baayiri, Wa, Ghana | Jekeyirili, Tamale, Ghana","Rural","on-going","01-2008","01-2016","This project supports Ghana's efforts to achieve food security through environmentally sound agricultural initiatives in the country's three northern (and poorest) regions. It provides funding for local initiatives developed by Ghanaian non-governmental organizations and the private sector in collaboration with Canadian and international organizations.
This project is expected to:
http://www.acdi-cida.gc.ca/acdi-cida/ACDI-CIDA.nsf/eng/CAR-822151642-QLZ
","8109|8013","","Food and agriculture","","","","","","","","","","","","","","","","","","CA$ 15,000,000","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11450","","Promotion of food security and agriculture","","","","Adult men and women","","3 northern (poorest) regions of Ghana","Community-based","","This project is expected to:
Results as of April 2012 include:
These activities are helping to improve food security in Ghana’s three poorest, northern regions, and to strengthen the capacity of Ghanaian organizations to support both women and men in practising sustainable agriculture.
","","4,020 farmers (1,300 women) as April 2012","The 3 northern (poorest) regions of Ghana","","Awareness farmers on environmentally sound agricultural practices.","Crop yields; new practices such as dry-season gardening in communities with highly degraded lands.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11460","Systems Approach to Improving and Sustaining Food Security in West Africa","English","Multi-national","","GHA|MLI|SEN|SLE","Ghana|Mali|Senegal|Sierra Leone","","Rural","on-going","01-2012","01-2017","The project aims to improve the food security status of people living in poor rural communities in Ghana, Mali, Sierra Leone and Senegal. The project will work to increase the adoption of agricultural practices that promote sustainable livelihoods; improve the utilization of health food especially by women and children; and, increase the effectiveness and use of agricultural extension services. Specific activities include: training farmers on best animal husbandry practices, seed production, pest management and early disease detection; as well as the training of government rural extension service staff in planning, implementing, and monitoring projects together with the participation of local communities and farmers. The project is expected to reach around 45,000 subsistence farmers and their families and around 1,400 members of farmer associations and purchasing groups, as well as local agriculture authorities.
At the country level, World Vision Canada is working in partnership with local farm-based civil society organizations to implement this project.
","http://www.acdi-cida.gc.ca/CIDAWEB/cpo.nsf/vWebCSAZEn/F97D0F095CDFC78985...
","8013|8487|8206|8036|8594|8592|8505|8365|8405|8354","","","","","","World Vision International","","","","","","","","","","","","","","CAD 11,056,793","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11459","","Promotion of food security and agriculture","","","","Women of reproductive age (WRA)","","","Community-based","","Training farmers on best animal husbandry practices, seed production, pest management and early disease detection; as well as the training of government rural extension service staff in planning, implementing, and monitoring projects together with the participation of local communities and farmers
","The expected intermediate outcomes for this project include: Increased adoption of practices, in a gender equitable manner, promoting sustainable livelihoods by the people living in poor rural communities; improved utilization of healthy food in a gender-equitable manner and with a particular focus on children; and, increased use of agricultural services by people living in poor rural communities.
","","The project is expected to reach around 45,000 subsistence farmers and their families and around 1,400 members of farmer associations and purchasing groups, as well as local agriculture authorities.","","","","","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Oilseeds
This program will facilitate the development of long-term linkages between smallholders that produce groundnuts, sesame, and/or soybeans and input and output markets. This will include efforts to bring better farming practices and inputs to the farm level, as well as linking production to markets through aggregation and farmer organizations. Specific activities include:
Technical assistance and grants to farmer associations/ cooperatives and agro-service centers, to enable them to provide
Support to build mentoring business relationships between commercial and emerging farmers, which are farmers that overcame size and productivity constraints and farm sizes between10 and 50 hectares. These commercial farmers provide some or all of the following to the emerging farmers:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.","Zambesia and Nampula Provinces","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Cashews
This investment builds on USAID/Mozambique‘s history of successful cashew sector development. This experience includes USAID Title II support to nurseries in seedling production and distribution and DA support to the local cashew processing industry – the latter resulting in one of the most vibrant cashew processing sectors in Africa. Building on this track record, FTF will now invest in a major supply-side constraint: renewing the existing stock of cashew plants. Mozambique has the oldest population of cashew trees in Africa (some trees are more than 80 years old) and overall productivity is decreasing rapidly. Thus, our FTF investment in cashews focuses on the expansion of cashew nurseries to supply new cashew seedlings and to extend pruning and crafting practices for existing trees.
Specific activities include:
Technical assistance and grants to existing nurseries or other investors (e.g., cashew processors, entrepreneurs) to incentivize establishing nurseries and supply seedlings and extension (nurseries to offer a package of seedlings, and training in seedling maintenance, crafting, and pruning; farmers to pay for this service).
Technical assistance and support to farmer and community organizations for them to support smallholders in grafting, pruning, and seedling care monitoring, and pass on processor-financed incentive payments for tree care.
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The first set of core investments in USG/Mozambique‘s FTF strategy provides smallholders with links to input and output markets in selected value chains. The focus of this set of investments will be on oilseeds (sesame, groundnuts, and soybeans), cashews, and fruit (e.g., pineapple, mango and bananas). The main objective is inclusive agriculture sector growth, which FTF/Mozambique will achieve through increased and sustained agricultural productivity, expanded markets and trade, and increased private sector investment in agriculture and nutrition-related activities. Investment in these value chains will improve income opportunities for smallholders, increase access to nutritious foods, and facilitate competitiveness of small scale farmers in these value chains.
Fruit
Fruit is farmed by more than a million households in the focus regions, but currently provides very limited income opportunities. FTF will primarily focus on improving the income potential of domestic fruit, by supporting the development of a domestic processing sector. The underlying hypothesis is that upon successful development of the domestic fruit sector, smallholders can play an increasing role in a viable export market (e.g. through outgrower schemes). Nutrition activities will be co-located to ensure improved consumption of fruits on a household level.
Specific activities include:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty.",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The second set of core investments will focus on scaling up the delivery of key nutrition interventions in the focus regions, acting on both the demand and supply side. On the demand side, FTF will invest in documenting and reinforcing improved nutrition behaviors through district and community based nutrition activities including growth monitoring and promotion (building on USAID Title II support in Zambezia and Nampula) and the promotion of optimal nutrition-related behaviors (building on PEPFAR infrastructure in Sofala and Manica). On the supply side, FTF will encourage the availability of nutritious foods through a Nutrition Challenge Fund.
Community-Based Nutrition Activities
FTF/Mozambique will address Mozambique‘s high undernutrition rates through a comprehensive, standard program of activities at the community level that includes growth monitoring, promotion of optimal infant and young child feeding practices, and dietary diversity and quality for pregnant and lactating women. Specific activities include:
","
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2012","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
The second set of core investments will focus on scaling up the delivery of key nutrition interventions in the focus regions, acting on both the demand and supply side. On the demand side, FTF will invest in documenting and reinforcing improved nutrition behaviors through district and community based nutrition activities including growth monitoring and promotion (building on USAID Title II support in Zambezia and Nampula) and the promotion of optimal nutrition-related behaviors (building on PEPFAR infrastructure in Sofala and Manica). On the supply side, FTF will encourage the availability of nutritious foods through a Nutrition Challenge Fund.
Nutrition Challenge Fund
FTF Mozambique will also stimulate the supply of nutritious, diverse, and quality foods. FTF/Mozambique will do this through a Nutrition Challenge Fund: a competitive grant scheme that encourages innovations in agro-processing (e.g. fortification, food processing) that reach a large share of the vulnerable population to improve nutrition. The competitive grant will be available to the private sector or community organizations, who will be selected based primarily on impact, innovation, and sustainability of the business model. Other potential criteria for selection include financial leverage, number of suppliers and consumers reached, and synergies with USG programs. FTF/Mozambique plans to leverage at least as much funding as will be contributed, although the aspiration is to leverage double our funding. The grants will provide up-front financing and technical assistance to ensure a successful venture.
","Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality..",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Urban|Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
USG/Mozambique will support FTF objectives and program activities through cross-cutting investments in policy analysis and advocacy, as well as research and technology transfer.
Policy
Policy analysis and advocacy is targeted to support an accelerated CAADP process, business and trade policy reform (particularly in the fruit sector), an integrated policy agenda for agriculture and nutrition, and policy supporting growth monitoring and nutrition. Specific initiatives include:
","
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Urban|Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
USG/Mozambique will support FTF objectives and program activities through cross-cutting investments in policy analysis and advocacy, as well as research and technology transfer.
Research and Technology Transfer
USG/Mozambique will leverage its comparative advantage in research and technology transfer, focusing support on the introduction and dissemination of new technologies. FTF/Mozambique will achieve this through support to the Mozambique Platform for Agricultural Research and Technology Innovation, which engages International Agricultural Research Centers (IARCs) and Brazil‘s national agricultural research enterprise (EMBRAPA). Main initiatives include:
Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "11612","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MOZ","Mozambique","Zambezia Province|Nampula Province|Sofala Province|Manica Province","Rural","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Mozambique, Feed the Future aims to help an estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 346,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
Supporting women in agriculture and household nutrition is essential to the success of this strategy. Agriculture employs 90 percent of Mozambique‘s female labor force, and a quarter of all farming households are women-headed. Women are also the leaders on nutrition in the household. USG/Mozambique‘s FTF strategy supports women by:
Training women as trainers of other women in nutrition benefits and improved household processing of soybeans, orange fleshed sweet potato and cowpeas.
",".
","Using guidance from the January 2011, USAID Evaluation Policy, USAID/Mozambique will employ monitoring and evaluation (M & E) personnel to gather evidence of how FTF Mozambique projects are sustainably reducing poverty and hunger. USAID/Mozambique‘s Agriculture, Trade and Business Office (ATB) staff will be responsible for supervising M & E work. USG/Mozambique will monitor and evaluate overall FTF investments to ensure that they are achieving objectives and maximizing returns. Program activities must be tracked through periodic field visits by Mission staff and through ongoing monitoring and learning by implementing partners. USG/Mozambique‘s approach to M&E will consist of three components:
The integration of agriculture, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Because the Mozambique FTF strategy will be supporting linkages among existing programs, USAID/Mozambique is well positioned to develop a model for harmonizing key agricultural and nutrition indicators relevant across areas of focus. Building on this collaboration, both the Health and Economic Growth teams will work together to integrate M & E systems and processes to track synergies and multiplier effects between the two sectors. The integration of the M & E function may take the form of harmonized M & E plans at the implementer level combined with joint monitoring by Mission, Economic Growth and Health team members.
Reliable and well-defined monitoring, reporting, and evaluation methods, roles, and communication channels result in:
A fully functioning M & E team and system further help to illustrate the Mission‘s value added to overall development not only to key stakeholders in the USG, but also to the Government of Mozambique and other development partners.
","estimated 207,000 vulnerable Mozambican women, children and family members—mostly smallholder farmers—escape hunger and poverty",".","","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","FTF/Mozambique will use the following lead indicators to track progress in implementing this strategy.Reduction in the poverty prevalence rate in Zambezia and Nampula, disaggregated by sex; Reduction in the underweight prevalence rate of children under five years of age in Zambezia and Nampula.Further indicators will be chosen as appropriate, but are expected to include:Value of incremental sales (collected at farm-level) attributed to FTF implementation, disaggregated by sex of household; Prevalence of stunted children under five years of age.","Sex","","","","","","","","","","","","","","","","","","","","","","","","","","English" "13175","GNPR 2009-2010: School-based nutrition","English","National","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","","","","","These programmes and actions were reported by countries for the WHO Global Nutrition Policy Review 2009-2010, Module 4 on School-based nutrition programmes. Please note that for simplicity, all interventions in a thematic module have been combined under the same programme for GINA, while they may not be implemented as a package and may have different partners. These data are currently being updated and completed through the GINA verification process. If you think you can help update and complete any of these data, please sign up to GINA and edit.
","WHO (2013) Global Nutrition Policy Review. What does it take to scale up nutrition action?
http://www.who.int/nutrition/publications/policies/global_nut_policyrevi...
The Global nutrition policy review is based on a questionnaire survey conducted during 2009–2010, in which 119 WHO Member States and 4 territories participated.
","","","","","","","","","","","","","","","","","","","","","","Government","","Iron and folic acid supplements distributed was reported during the WHO Global Nutrition Policy Review (GNPR) 2009-2010.
","","M&E implemented by: Unidad Nutrición MSD , SNISS","","National coverage","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "13175","GNPR 2009-2010: School-based nutrition","English","National","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","","","","","These programmes and actions were reported by countries for the WHO Global Nutrition Policy Review 2009-2010, Module 4 on School-based nutrition programmes. Please note that for simplicity, all interventions in a thematic module have been combined under the same programme for GINA, while they may not be implemented as a package and may have different partners. These data are currently being updated and completed through the GINA verification process. If you think you can help update and complete any of these data, please sign up to GINA and edit.
","WHO (2013) Global Nutrition Policy Review. What does it take to scale up nutrition action?
http://www.who.int/nutrition/publications/policies/global_nut_policyrevi...
The Global nutrition policy review is based on a questionnaire survey conducted during 2009–2010, in which 119 WHO Member States and 4 territories participated.
","","","","","","","","","","","","","","","","","","","","","","Government","","Safe drinking-water was reported during the WHO Global Nutrition Policy Review (GNPR) 2009-2010.
","","M&E implemented by: Min Medio Ambiente y Agua","","National coverage","","","","","","Water, sanitation and hygiene interventions to prevent diarrhoea>>>Water, sanitation and hygiene interventions to prevent diarrhoea>>http://www.who.int/elena/titles/wsh_diarrhoea","","","","","","","","","","","","","","","","","","","","","","","","" "13175","GNPR 2009-2010: School-based nutrition","English","National","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","","","","","These programmes and actions were reported by countries for the WHO Global Nutrition Policy Review 2009-2010, Module 4 on School-based nutrition programmes. Please note that for simplicity, all interventions in a thematic module have been combined under the same programme for GINA, while they may not be implemented as a package and may have different partners. These data are currently being updated and completed through the GINA verification process. If you think you can help update and complete any of these data, please sign up to GINA and edit.
","WHO (2013) Global Nutrition Policy Review. What does it take to scale up nutrition action?
http://www.who.int/nutrition/publications/policies/global_nut_policyrevi...
The Global nutrition policy review is based on a questionnaire survey conducted during 2009–2010, in which 119 WHO Member States and 4 territories participated.
","","","","","","","","","","","","","","","","","","","","","","Government","","Vitamin A supplements distributed was reported during the WHO Global Nutrition Policy Review (GNPR) 2009-2010.
","","M&E implemented by: Unidad de Nutrición ","","National coverage","","","","","","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","","","","","","","","","","","","","","","","","","","","","","","","" "14227","GNPR 2009-2010: School-based nutrition","English","Community/sub-national","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","","","","","These programmes and actions were reported by countries for the WHO Global Nutrition Policy Review 2009-2010, Module 4 on School-based nutrition programmes. Please note that for simplicity, all interventions in a thematic module have been combined under the same programme for GINA, while they may not be implemented as a package and may have different partners. These data are currently being updated and completed through the GINA verification process. If you think you can help update and complete any of these data, please sign up to GINA and edit.
","WHO (2013) Global Nutrition Policy Review. What does it take to scale up nutrition action?
http://www.who.int/nutrition/publications/policies/global_nut_policyrevi...
The Global nutrition policy review is based on a questionnaire survey conducted during 2009–2010, in which 119 WHO Member States and 4 territories participated.
","","","","","","","","","","","","","","","","","","","","","","Government","","Provision of fruit and vegetables was reported during the WHO Global Nutrition Policy Review (GNPR) 2009-2010.
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "14227","GNPR 2009-2010: School-based nutrition","English","Community/sub-national","","BOL","Bolivia (Plurinational State of)","Bolivia (Plurinational State of)","","","","","These programmes and actions were reported by countries for the WHO Global Nutrition Policy Review 2009-2010, Module 4 on School-based nutrition programmes. Please note that for simplicity, all interventions in a thematic module have been combined under the same programme for GINA, while they may not be implemented as a package and may have different partners. These data are currently being updated and completed through the GINA verification process. If you think you can help update and complete any of these data, please sign up to GINA and edit.
","WHO (2013) Global Nutrition Policy Review. What does it take to scale up nutrition action?
http://www.who.int/nutrition/publications/policies/global_nut_policyrevi...
The Global nutrition policy review is based on a questionnaire survey conducted during 2009–2010, in which 119 WHO Member States and 4 territories participated.
","","","","","","","","","","","","","","","","","","","","","","Government","","Provision of milk was reported during the WHO Global Nutrition Policy Review (GNPR) 2009-2010.
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17803","","Management of severe acute malnutrition","","","","Preschool-age children (Pre-SAC)|SAM child","6-59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
OTP Outcome
Cured % (#)
> 75%
Died % (#)
< 10%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (June-Dec)
74.5 (1540)
0.7 (14)
6.9 (143)
17.9 (371)
Niamey (Aug-Dec)
83.3 (445)
0.4 (2)
3.6 (19)
12.7 (68)
Tahoua (Aug-Dec)
86.6 (453)
1.0 (5)
10.3 (54)
2.1 (11)
Tillaberi (Jan-Dec)
86.4 (912)
1.5 (16)
11.0 (116)
1.1 (12)
Zinder (Jan-Dec)
83.6 (799)
4.3 (41)
10.0 (96)
2.1 (20)
Reporting Period: Jan - Dec, 2011
Maradi
93.5 (4510)
0.3 (16)
4.9 (235)
1.3 (62)
Niamey
NA
NA
NA
NA
Tahoua
84.2 (1054)
0.8 (10)
5.8 (72)
9.3 (116)
Tillaberi
85.5 (1484)
1.6 (27)
10.8 (187)
2.1 (37)
Zinder
94.8 (1803)
0.5 (9)
3.2 (61)
1.5 (29)
Reporting Period: Jan - Dec, 2012
Maradi
97.7 (2651)
0.1 (3)
1.5 (41)
0.7 (18)
Niamey
86.9 (839)
0.3 (3)
5.4 (52)
7.5 (72)
Tahoua
84.7 (762)
1.6 (14)
10.4 (94)
3.3 (30)
Tillaberi
89.1 (886)
1.7 (17)
8.4 (83)
0.8 (8)
Zinder
98.8 (4200)
0.3 (12)
0.1 (6)
0.8 (32)
Reporting Period: 2013
Maradi (Jan-Apr)
94.6 (546)
0.5 (3)
3.3 (19)
1.6 (9)
Niamey (Jan-May)
70.1 (129)
0.0 (0)
18.5 (34)
11.4 (21)
Tahoua (Jan-May)
92.7 (281)
0.0 (0)
4.6 (14)
2.6 (8)
Tillaberi (Jan-Mar)
95.8 (46)
0.0 (0)
4.2 (2)
0.0 (0)
Zinder (Jan-May)
99.6 (1254)
0.2 (3)
0.1 (1)
0.1 (1)
","
Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805 ","Zinder: April-May 2007, point coverage = 21.4% and period coverage = 36.1%. ","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% MAY, 2013:TILLABERRI GAM 13.3%, SAM 3.1%ZINDER GAM 11.7%, SAM 2.3%MARADI GAM 16.3%, SAM 3.0%TAHOUA GAM 13.1%, SAM 2.3%NIAMEY GAM 11.0%, 1.6%","See above","Vulnerable groups","","Treatment of dehydration in children with severe acute malnutrition>>>Treatment of dehydration in children with severe acute malnutrition>>http://www.who.int/elena/titles/dehydration_sam","Supplies","Problem: There had been some difficulties in ensuring a consistent supply of RUTF. The nutritional commodities for the treatment of SAM are supplied via UNICEF through the MOH supply structure. But there were some challenges due to logistical and organisational issues, including the local/global availability of RUTF. Solution: WV established a buffer stock to resolve the issue. ","Supplies","Problem: A lack of consistent supply of medicines to the CSIs risks the increase in morbidity and mortality from illnesses such as pneumonia and malaria which are major causes of mortality in malnourished children. The care of children under the age of five are free in Niger. However, there are frequent shortage in medicinal supply. Because of the exemption of the fee and the system of cost recovery are in place, in principle UNICEF does not provide for the medicines for activities related to CMAM program although some spot supplies are available they are often inadequate. Solution: WVN is, already involved in the provision of medicines through the activities of ADP and, in case of need, the support will be intensified during this period of crisis. In addition to the routine medicines used for the treatment of the children admitted in the OTP, it would be important that WVN also considers to provide, in the event of rupture, the medicines needed to treat the pathologies associated with malnutrition.","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program.Solution: WV developed an Instituational Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities.Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff"," Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","","","","Zeinaba Abdoulahi lost her second child five years ago at the age of 4; his death is still a source of grief for this young Nigerien mother. Earlier this year, her fourth child, Tinoumoune, was close to death. The eight-month old girl was dehydrated and losing weight. After treating her with traditional herbal remedies, Tinoumoune continued to become physically weaker and weaker and had a fever for eight days. Zeinaba says “My child was between life and death. She was fading away. I had not a droplet of hope.” Zeinaba bundled her daughter on her back and left early in the morning to walk the seven kilometres from her village to the closest health centre, which runs a community-based management of acute malnutrition (CMAM) programme supported by World Vision. Tinoumoune was diagnosed with severe acute malnutrition and admitted to the nutrition programme, where she was treated with ready-to-use therapeutic food. “In two weeks, she regained weight and became stronger and healthier. I’m very happy.” explains Zeinaba. The family has been spared the grief of a second lost child.
©2010 Ann Birch/World Vision ©2010 Gebregziabher Hadera/World
Mma Halima is a CMAM community volunteer in Niger. She started in this role after caring for her own malnourished son until he graduated from World Vision's CMAM programme. Mma Halima screens and refers malnourished children in her nomadic community and provides health and nutrition education. She describes the ripple effect of her son's rehabilitation through CMAM: ""Now in my community all the mothers are using mosquito nets and our children are not getting sick as before. Now I have only two malnourished children in my community. It is impressive.""
","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","07-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17821","","Management of moderate malnutrition","","","","MAM child|Preschool-age children (Pre-SAC)","6 - 59 months","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","SFP Outcome
Cured % (#)
> 75%
Died % (#)
< 3%
Defaulted % (#)
< 15%
Non-recovered % (#)
Regions
Reporting Period: 2010
Maradi (Sept-Dec)
88.5 (491)
0.4 (2)
8.6 (48)
2.5 (14)
Niamey (Jan-Dec)
88.6 (194)
0.0 (0)
1.4 (3)
10.0 (22)
Tahoua (Aug-Dec)
86.4 (248)
0.0 (0)
13.6 (39)
0.0 (0)
Tillaberi (June-Dec)
88.4 (501)
0.7 (4)
10.2 (58)
0.7 (4)
Zinder (Jan-Dec)
90.8 (640)
2.6 (18)
5.4 (38)
1.3 (9)
Reporting Period: Jan - Dec, 2011
Maradi
97.0 (7069)
0.0 (3)
2.2 (162)
0.7 (51)
Niamey
85.8 (1949)
0.2 (5)
7.7 (175)
6.3 (143)
Tahoua
92.1 (1413)
0.0 (0)
6.3 (96)
1.6 (25)
Tillaberi
93.7 (4413)
0.2 (9)
5.1 (242)
0.9 (44)
Zinder
95.6 (4825)
0.4 (18)
2.4 (119)
1.7 (84)
Reporting Period: Jan - Dec, 2012
Maradi
99.0 (9559)
0.0 (0)
0.4 (38)
0.6 (54)
Niamey
81.3 (1886)
0.0 (0)
10.0 (233)
8.7 (201)
Tahoua
90.1 (984)
0.2 (2)
7.7 (84)
2.0 (22)
Tillaberi
88.7 (2065)
0.2 (4)
9.7 (226)
1.4 (33)
Zinder
94.9 (5508)
0.1 (3)
2.6 (148)
2.5 (143)
Reporting Period: 2013
Maradi (Jan-Apr)
97.1 (1501)
0.1 (1)
2.7 (42)
0.1 (2)
Niamey (Jan-Apr)
73.9 (241)
0.0 (0)
18.7 (61)
7.4 (24)
Tahoua (Jan-May)
88.7 (344)
0.0 (0)
9.0 (35)
2.3 (9)
Tillaberi
NA
NA
NA
NA
Zinder (Jan-May)
99.7 (2910)
0.0 (0)
0.2 (6)
0.1 (2)
","Ongoing monitoring and evaluation of CMAM programs is essential for ensuring program targets are being reached. As of Spring 2010, WV is using a consolidated online database management system for CMAM programs. The system is a positive transformation from the existing Excel spreadsheets (template provided by Valid International) that were used during the first few years of WV CMAM programming by National Offices. A simple and systematic data management system allows multi-level program managers to easily retrieve CMAM data and make quick and accurate decisions based on the data that is available to them. In the early days of WV CMAM implementation, prompt access the Excel database was limited to the field staff throughout the year. However, WV’s online CMAM system aims to facilitate this overall data recovery process for WV Staff located in the National, Regional and Support Offices, and Global Health Centre, as well. The online system is carefully designed to be user friendly and applicable for WV staffs across partnership. Staff members are provided with password protected login identification and can access the different online pages that are relevant to their job responsibilities. In this way, they are able to input their monthly tally sheets, generate clear reports, predict future trends (including resources), provide timely input to all internal/external requests and access raw data sheets for further analysis. Furthermore, the quantitative indicators and data collection tools closely align themselves with what has been developed and used by different MOH, facilitating a simple integrating with existing administrative systems and standards in a particular country. All WV CMAM indicators and data collection tools have been standardized to complement the existing myriad of MOH and National Office requirements, as well as the International benchmarks (e.g. SPHERE). In addition to these standard indicators, the CMAM database also includes WV contextual data (e.g. # Registered Children, # Orphans & Vulnerable Children) that is mandatory with the Partnership’s Integrated Program Management.
","ADP Name Total Population; 6-59 months Kornaka West 68,165; 15,261 Gobir Yamma 56,032; 12,934 Ouallam 572,377; 188,745 Simiri 186,528; 76,805","Zinder: April-May 2007, point coverage = 28.5% and period coverage = 49.0%.","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","See above","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","Supplies","Problem: The lack of a consistent supply of nutritional commodities for SFP has put children suffering from MAM at an increased risk for relapse, non-response, deterioration in status (into SAM) and defaulting. This lack of consistency has also negatively affected the credibility of the SFP program within the community. In turn, this has reduced the overall number of caregivers accessing the SFP services and thus has become a barrier to access.Solution: Contingency planning by the Food Commodity Department and logistics within WV to avoid stock shortage. For example add an extra percentage onto projected estimations each month in order to always have stock in place. ","Communication","Problem: The lack of clarity over the use of RUSF (Ready-to-Use Supplementary Food) and the target group has introduced increased risks for MAM cases in more vulnerable age groups. These cases were not being treated properly, thereby reducing effectiveness of the SFP program. Solution: Clarification with written protocols on the use of RUSF and other nutritional commodities for MAM and the target groups should be made available in the CSIs. It is also essential that there is community sensitization/awareness in the CSI catchment communities on the MAM aspect of CMAM.","External factors","Problem - Conflicting admission criteria: Community Volunteers (Femmes Relais) screen children for MAM in the communities using MUAC. However, upon arrival to the CSI/CS, the same children are admitted into the program on the basis of W/H criteria (outlined in National Protocol). Due to the discrepancies between W/H and MUAC screening, children are rejected from the program. This can reduce the effectiveness of community mobilization because of the problem of rejection.Solution: In order to increase coverage of the program a mass screening was carried out in the 5 regions covered by WV. Over 40,000 children were screened which resulted in a subsequent increase in the SFP admission. ","External factors","Problem: Distance as a barrier to access. Some of the CSI are located very far from the communities that they are serving. Solution: Expand MAM treatment (i.e. SFP) to Health Posts (CS) in order to reduce distance travelled for beneficiaries thus helping to improve the program accessibility as well as reducing the work load in CSIs (however the program capacity must be assured before decentralising these services to health posts).","Staff skills/training","Problem: When CTC/CMAM was launched in Niger in 2005/2006, the national/international capacity available for CTC/CMAM implementation was very limited, resulting in a low quality program. Solution: WV developed an Institutional Agreement with Valid International to build their capacity in the overall management of acute malnutrition.","Staff retention","Problem: Due to the erratic funding cycles associated with CMAM programming, it was very difficult to retain staff (Community Mobilization volunteers, MOH staff and WV Staff) when funding cycles terminate. Furthermore, there are difficulties retaining volunteers and keeping them motivated to continue their activities. Solution: WVN established permanent positions, embedded within their ADP and National management structures, for ongoing CMAM program support, including during funding disruptions. Furthermore, WVN can help improve sustainability of the self governing of CSIs and management of volunteers by building capacity of the village health committees (COGES) as an ongoing development commitment. ","Insufficient staff","Problem: In order to respond to the increased case load of SAM, the capacity of MOH (e.g. staff at CSIs) had to be increased. Solution: Rather than placing WV staff to manage the increased caseload, WV provided training and on-going support to strengthen volunteer capacity to manage SFP which will reduce workload of the health staff in the CSI thereby enabling them to address the more severe cases of malnutrition. This strategy appeared to be very effective in helping the MOH to cope with the case load. For Example: In three of the four CSIs sampled, it was found that the volunteers managed SFP completely thus relieving the existing CSI staff to manage SAM cases. ","","","","","","","","","","English" "17804","Community-based Management of Acute Malnutrition (CMAM) Programme in Niger ","English","National","","NER","Niger","Zinder, Niger|Maradi, Niger|Niamey, Niger|Tillabéry, Niger|Tahoua, Niger","Urban|Rural","on-going","01-2005","","The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17823","","Food distribution/supplementation for prevention of acute malnutrition","","","","Lactating women (LW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS","","Zinder, Maradi, Niamey, Tahoua","Community-based","","World Vision works with communities through Area Development Programs (ADPs) that have been identified and implemented based on a series of development criteria. The ADPs serve as the basic intervention unit of the WV's multi-sectoral programs/projects (e.g. in education, water and sanitation, health, income-generating activities and sponsorship of children etc.), but the geographical areas of the ADPs do not necessarily align with administrative boundaries of the country. The whole ADP and program management structure is geared toward long-term development programming, into which the nutritional activities/programs such as Community-based Management of Acute Malnutrition (CMAM) are integrated.
Since July/August 2005, WV Niger has been implementing and supporting the following four components of a CMAM program:
All programmatic activities are implemented through the local health structures and systems and their respective catchment areas. The majority of the OTP and SFP activities are implemented in the Integrated Health Centers (CSI) but in order to achieve greater coverage and to bring supplementary facilities closer to communities, WV has also implemented the programs in Health Posts (CS) which are satellites of CSI. Most OTP take place together with SFP in CSI but few are located in CS as well. The OTP activities, including the provision of Ready-to-Use Therapeutic Food (Plumpy Nut) and the systematic treatments are conducted on a weekly basis, whereas the SFP activities, including the distribution of Fortified Blended Food (Premix with CSB (Corn Soya Based), oil, sugar) for MAM children and moderately malnourished PLWs are carried out bi-monthly basis. The numbers of OTP and SFP sites and staff per ADP differ depending on the target population size and needs.
The technical (nutrition related) and managerial structure of WV in Niger (WVN) includes two nutrition coordinators (East and West) and six regional nutrition supervisor mangers (one per region) who coordinate and harmonize nutritional activities through the different locations. All of them are supported by a relief-nutrition country manager based in Niamey. In each ADP, there is also a health-nutrition manager who is responsible for overseeing ADP related health and nutrition programs and staff. As the national health system is WV's principle partner, WVN staff always work in partnership/collaboration with Ministry of Health (MOH) staff. Currently, WVN staff mainly act as technical facilitators and help with the general management of the program activities such as site organization, training of the community volunteers who help during distributions, channeling food and medical supplies coming from UNICEF and WFP, and program monitoring. Depending on the ADP, there is also either one or two nurses who provides support to the MOH staff in the field.
","
The Community-Based Management of Acute Malnutrition (CMAM) is one of World Vision’s core project models in nutrition. The CMAM approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition (SAM) in the home using Ready-to-Use-Therapeutic Foods (RUTF) and receiving routine medical care at a local health facility. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programs also work to integrate treatment with a variety of other longer-term interventions such as Nutrition Education, Infant and Young Child Feeding and Food Security. These interventions are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
There are four key components to the CMAM approach: Community Mobilisation, Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Stabilisation Centre/In-patient Care (SC). On the most part, World Vision does not set up Stabilisation Centres but instead works closely with existing local health institutions or medical NGOs to provide these services.
World Vision has been operational in Niger for almost two decades – implementing a wide range of long-term development activities across the country. Their work is structured alongside the model of comprehensive area development programs (known internally as ADPs). Each ADP has a Health & Nutrition component which seeks to deliver support through (while simultaneously strengthening) local health structures. In July 2005 and as a result of the 2005 food crisis in Niger that year, World Vision launched a community-based management of acute malnutrition (CMAM) program based on the National Protocol for the Management of Acute Malnutrition. At that time, contacts were made with Valid International – aimed at establishing a partnership for an effective and quality delivery of the CMAM program. An institutional agreement between World Vision and Valid International was reached in July 2006, thus paving the way for the provision of technical support to the Niger CTC (now called CMAM) program.
As a part of the national nutrition strategy, WV is currently implementing CMAM in many decentralized government health centers throughout the country, with the support of partner NGOs (ex. Medecins Sans Frontieres). From the onset of CMAM program implementation, It has been integrated within the Ministry of Health structures such as the CSIs (Integrated Health Centers) with regular trainings of MOH health staff at national, regional and CSI levels based on the most revised version of the National Protocol, ultimately leading to the final version (i.e. Protocole Nationale de prise en Charge de la Malnutrition. MOH Publique/UNICEF/OMS. Juin 2009).
","Evaluation of World Vision Niger Emergency Nutrition Programme, Tillaberi and Niamey Regions (Jul 2010 - Jul 2011), Bernadette Feeney, Technical Advisor, Valid International.
Evaluation Semi-Quantitative de l’Accessibilité et de la Couverture (SQUEAC) CSI appuyés par World Vision ADP de Kornaka West, Gobir Yamma, Chadakori et Goulbi Kaba Région de Maradi, République du Niger, (22 mars au 15 avril, 2011), Allie Norris, Consultante Mobilisation, Valid International.
Rapport De La Mobilisation Sociale Dans Le Cadre Du Redémarrage des Activités Du Programme De World Vision de Prise en charge Communautaire de la Malnutrition Aiguë Régions de Zinder, Maradi et Tillabéri, Niger (13 Juin au 8 Juillet, 2010), Allie Norris et Gabriele Walz Techniciennes de Mobilisation Sociale, Valid International.
Formation sur la “Prise en charge Communautaire de la Malnutrition Aiguë” (PCMA) ADP de Zinder & de Tillabéri (20 juin au 19 juillet, 2010); ADP de Maradi (20 Juin au 8 Juillet, 2010), Lionella Fieschi, Consultante PCMA et Bernadette Feeneey, Valid International.
Evaluation Finale Du Programme CTC Dans La Région De Zinder World Vision, Niger (06 au 18 Juin, 2008), El Hadji Issakha Diop, CTC Advisor, Valid International.
Rapport De L’enquête De Couverture Du Projet CTC Exécuté Par World Vision ADPs De Kassama, DTk Et Gamou Région De Zinder Niger (Avril- Mai, 2007), Lionella Fieschi, Consultante CTC, Valid International.
Programme CTC de World Vision dans la région de Zinder, Niger : Evaluation à mi- parcours (11- 18 Mai, 2007), El Hadji Issakha Diop, Consultant CTC, Valid International.
Visite au programme CTC Région de Zinder (WV Niger), (13 – 24 Février, 2007) Montse Saboya, Valid International.
Mobilisation Communautaire Visite Technique au Programme de CTC Zinder, Niger, (20 février – 2 mars, 2007), Saul Guerrero & Nyauma Nyasani, Consultants de développement communautaire et social, Valid International.
Community Mobilisation aspects of the World Vision CTC Programme, Zinder Region, Niger (Aug 4 - 18, 2006), Saul Guerrero, Valid International.
Assessment for CTC World Vision in Niger (Jul - Aug, 2006), Valid International.
Community-based Management of Acute Malnutrition Model: http://www.wvi.org/nutrition/project-models/cmam
","","","Health","Gouvernement du Niger et la Direction Departementale de la Sante Publique et la Direction de la Nutrition (DN/MSP)","","","","","","","","","","","","","","","","","Currency: US Dollars (USD)Purposes: Salaries & Benefits; Supplies & Materials; Travel & Transportation; Training & Consulting; Monitoring & Evaluation; Occupancy; Communications; Equipment.Action: Covers all actions","International NGOs","World Vision International","World Vision is a global Christian relief, development and advocacy organisation dedicated to working with children, families and communities to overcome poverty and injustice. http://www.wvi.org (WV Canada, WV US, WV Taiwan, WV UK, WV New Zealand, WV Germany, and WV Switzerland are support offices)","Bilateral and donor agencies and lenders","","The Disasters Emergency Committee (DEC) brings 14 leading UK aid charities together in times of crisis: Action Aid, Age International, British Red Cross, CAFOD, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision; all collectively raising money to reach those in need quickly. http://www.dec.org.uk/about-dec","UN","World Food Programme (WFP)","The World Food Programme (WFP) is the United Nations' frontline agency in the fight against hunger. It responds to emergencies, saving lives by getting food to the hungry fast, and it also works to help prevent hunger in the future. http://www.wfp.org (The WFP provides WVN direct supply of food for SFP in different CSI).","UN","United Nations Children's Fund (UNICEF)","The United Nations Children's Fund (UNICEF) is the main UN organization defending, promoting and protecting children's rights. UNICEF works to improve the social and economic conditions of children by increasing children's access to health care, safe drinking water, food, and education; protecting children from violence and abuse; and providing emergency relief after disasters. http://www.unicef.org","Bilateral and donor agencies and lenders","Canadian International Development Agency (CIDA)","The Canadian International Development Agency (CIDA) is Canada's lead agency for development assistance. http://www.acdi-cida.gc.ca/home","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The United States Agency for International Development (USAID) is the United States federal government agency primarily responsible for administering civilian foreign aid. http://www.usaid.gov (The fund is provided through the Office of U.S. Foreign Disaster Assistance (OFDA))","Bilateral and donor agencies and lenders","Australian Agency for International Development (AUSAID)","The Australian Agency for International Development (AusAID) is the Australian Government agency responsible for managing Australia's overseas aid programme. http://www.ausaid.gov.au/Pages/home.aspx","Bilateral and donor agencies and lenders","Swedish International Development Cooperation Agency (SIDA)","The Swedish International Development Cooperation Agency (Sida) is a government organization under the Swedish Foreign Ministry responsible for administering approximately half of Sweden's budget for development aid. http://www.sida.se/English/","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","17824","","Nutrition education and counselling","","","","Adolescents|Adult men and women|Elderly|Family ( living in same household)|Females|Lactating women (LW)|Males|Non-pregnant women (NPW)|Non-pregnant, non-lactating women (NPNLW)|Pregnant women (PW)|Pregnant/lactating women with HIV/AIDS|Women of reproductive age (WRA)","","5 regions (Zinder, Maradi, Niamey, Tillabéri, Tahoua)","Community-based","","Once the main components of the CMAM programme (e.g. OTP and SFP) have been well implemented in the existing MOH and community structures, a focus was given to address the negative behavioural and adaptive issues around IYCF in order to prevent further malnutrition. Depending on the priorities and funding availability, some ADPs were able to integrate IYCF activities in the CMAM. These included carrying out weekly health and nutrition session on CMAM days at the CSIs (Health Centers) and reactivating PD Hearth approach to develop menus using new types of locally available foods for complementary feeding promotion. Additional objectives of IYCF included strengthening existing nutrition systems and capacity building through training of health workers and community volunteers on IYCF and carrying out a baseline survey on IYCF and quarterly monitoring of changes in behaviour (e.g. EBF rates, diversity of food groups in complementary feeding). However, apart from the weekly nutrition education sessions at the CSIs, some of the activities did not translate into action at the community level. For example, the training of national WV staff on IYCF did not cascade down to the community level with community volunteers and also did not translated into activities or development of monitoring tools at community level. Additionally, no baseline IYCF information was available and quarterly monitoring data had not been collected or was unavailable at community level.
NB: This program was funded for a year therefore continuation of the activities beyond the funding period is likely be sporadic as it will depend on various factors including staff and volunteer capacity and motivation.
","For Tillaberi and Niamey regions in July 2010-July 2011:
Nutrition education (incl. IYCF): Target 24,700; Achieved (by the 3rd quarter) 14,234
Number and percentage of infants 0-6 mos who are exclusively breastfed: Target 310 (10%); Achieved N/A
Number and percentage of children aged 6-24 mos who receive foods daily from 4 or more food groups: Target 3045 (40%); Achieved N/A
","Due to a lack of monitoring and reporting it was not possible to report on Infant and Young Child Feeding activities apart from nutrition education sessions at the health centers even if these activities had been occurring in an informal manner in the communities. But it appears that these activities had been strengthened and expanded towards the end of the programme cycle.
","See outcome indicator section","NA","","Sept - Oct, 2005: National GAM 15.3%, SAM 1.8%; Zinder GAM 16.1%, SAM 1.2%.Sept, 2006: Maradi GAM 8.2%, SAM 0.8%, U5M 1.3/10,000. Oct - Nov, 2006: National GAM 10.3%, SAM 1.4%, U5M 1.08/10,000, Exclusive breastfeeding 2.2%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 9.7%, SAM 1.7%; Maradi GAM 6.8%, SAM 0.6%; Tahoua GAM 12.5%, SAM 1.1%; Tillaberi GAM 11.2%, SAM 1.9%; Niamey GAM 9.2%; SAM 0.5%. June, 2007: National GAM 11.2%, SAM 1%, U5M 0.71/10,000; Tillaberi GAM 11.2%Oct - Nov, 2007: National GAM 11.0%, SAM 0.8%, U5M 1.81/10,000, Exclusive breastfeeding 9.0%, Complementary feeding (6-9mos) 78.4%; Zinder GAM 11.7%, SAM 1.0%, U5M 3.55/10,000, EB 9.7%, CF 68.2%; Maradi GAM 10.7%, SAM 0.8%, U5M 0.83/10,000, EB 7.6%, CF 73.9%; Tahoua GAM 13.1%, SAM 0.4%, U5M 1.62/10,000, EB 15.7%, CF 89.7%; Tillaberi GAM 7.9%, SAM 1.0%, U5M 3.14/10,000, EB 1.6%, CF 63.5%; Niamey GAM 9.9%, SAM 0.9%, U5M 1.57/10,000, EB 17.1%, CF 40.6%. June-July, 2008: National GAM 10.7%, SAM 0.8%, U5M 1.53/10,000; Zinder GAM 15.7%, SAM 1.9%, U5M 2.13/10,000; Maradi GAM 9.9%, SAM 1.0%, U5M 1.79/10,000; Tahoua GAM 8.4%, SAM 0.6%, U5M 1.67/10,000; Tillaberi GAM 10.1%, SAM 0.1%, U5M 1.11/10,000; Niamey GAM 6.8%, SAM 0.9%, U5M 0.34/10,000. May-June, 2010: National GAM 16.7%, SAM 3.2%; Maradi GAM 19.7%, SAM 3.9%; Zinder GAM 17.8%, SAM 3.6%; Tillaberi GAM 14.8%, SAM 2.7%. June, 2009: National GAM 12.3%, SAM 2.3%.Oct, 2010: Maradi GAM 15.5%, SAM 4.3% ","Same as above","Vulnerable groups","","","Management","","","","","","","","","","","","","","","","","","","","","WV Niger’s implementation of IYCF activities into the ongoing CMAM program started late in the program period. Due to the high resource (human & financial) intensity of implementing a CMAM program, it was not feasible to introduce IYCF activities until the latter program stages. At the beginning of the program, the MOH staff were trained in providing nutrition education sessions at CSIs on OTP/SFP days which included IYCF messages. Later on, national WV staff were trained on IYCF with the aim that they would cascade this training to the ADP level and then to the community level. However, the training did not continue to the community level (with community volunteers) until near end of the program period.
To strengthen IYCF component of CMAM including monitoring activities, the following activities are recommended:
1. Recruit community mobilisers at ADP level who will work with district Community Focal Points, WV ADP and National Community Mobiliser. The lack of WV community mobilisers at ADP level to work alongside the Nutrition Coordinators has risked a delay in training community volunteers and may have also prevented the implementation of community mobilization activities including IYCF activities and monitoring of these activities.
2. Ensure women are represented in nutrition programs. During the IYCF investigation the 50/50 presence of women as interviewers for the IYCF investigation ensured better access to women and thus the provision of more rigorous information regarding IYCF practices.
3. Develop monitoring tools for IYCF. E.g. How many IYCF sessions held and how many participated?
4. Carry out a representative and statistically significant baseline and final IYCF survey – for EBF rates and diversity of food groups.
","","English"