"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" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","
The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6042","Maternal, infant and young child nutrition","Breastfeeding promotion and/or counselling","","","","Women of reproductive age (WRA)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Train health 69 staff in lactation management, including HIV in relation to breastfeeding; 2. Support the formation of 95 mother-to-mother support groups and men’s groups; 3. Support assessment and designation of 6 facilities as Baby Friendly Health Institutions (BFHI); 4. Support follow up of HIV infected mothers through mother-to-support groups and CBSV to maintain exclusive breastfeeding and monitor nutritional status and growth of the infants; 5. Train HIV infected mothers on breastfeeding techniques to decrease risk of breat inflammation that may increase HIV transmission; 6. Intensify nutrition and health education at facility and community levels monthly
","% of children 0-6 exclusively breastfed in the previous 24 hours. % of infants fed mothers' milk within 1hour after birth % ofchildren(12-23mos) exclusively breastfed for 6 months
","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","79 communities with a total population of 77, 780 children under-five years of age and 19,445 pregnant women living in an area with a population of 388, 902 people and an estimated 64,817 households are benefiting from project interventions.","Missing","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","Staff skills/training","Project and GHS staffs have received training in lactation management. ","Insufficient staff","We have continued to advocate for increased numbers for the beneficiary districts. To meet this gap capacities of Mother-to-mother Supports Groups(MtMSGs),Traditional Birth Attendants(TBAs) and Community Based Surveillance Volunteers(CBSVs) been built to support the action. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this challenge. ","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","Adherence","The slow adoption of appropriate feeding practices by caregivers remains a challenge. Community level education has therefore, been intensified to address the situation.","Financial resources","Government's financial support to District Health Management Teams (DHMTs) is sometimes delayed and this affects the smooth implementation of project interventions.","","","","","","","","","","","","","I have observed that grandmothers' and men's involvement in the action implementation is critical. In some communties for instance, father-to-father support groups have been formed to support the action. Capacity building for groups such as CBSVs, MtMSGs, TBAs, women's and men's groups, faith-based organizations(FBOs) etc at the community could contribute immensely to project outcomes.
","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6044","","Complementary feeding promotion and/or counselling","","","","Women of reproductive age (WRA)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Train 105 GHS staff and CBSVs in Community Based Growth Promotion (CBGP) 2. Institute CBGP in 15 poor and hard to reach communities including visits to OVCs under 5 to make sure these children go for growth monitoring3. Train 60 GHS, World Vision staff in Infant and Young Child Nutrition counselling4. Provide equipment for growth monitoring and counseling5. Carry out quarterly food demonstration sessions including low-labour nutritious meals that can be prepared/managed by mothers who are ill in communities using nutrient and energy dense locally available foods 6. Intensify monthly nutrition and health education for mothers and other caregivers, including appropriate messages for HIV+ve mothers through CBSV, CCC and health staff","% of children< 2 years underweight % of children 12-23 months who are still breastfeeding % of sick children 6-59 month who received increased fluids and continues feeding during an illness in the last 2 weeks % of children 6-59 month attending growth promotion sessions at least once every 3 months % of children 6-59 months who ate solid or semi-solid food at least the minimum recommended no. of times 24hrs preceding survey","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","89447","","","Conducted","Midterm evaluation has been conducted and results are being analysed.","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","Staff skills/training","Project and GHS staffs have received training in lactation management. ","Insufficient staff","We have continued to advocate for increased numbers for the beneficiary districts. To meet this gap capacities of Mother-to-mother Supports Groups(MtMSGs),Traditional Birth Attendants(TBAs) and Community Based Surveillance Volunteers(CBSVs) been built to support the action. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this challenge. ","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","Adherence","The slow adoption of appropriate feeding practices by caregivers remains a challenge. Community level education has therefore, been intensified to address the situation.","Financial resources","Government's financial support to District Health Management Teams (DHMTs) is sometimes delayed and this affects the smooth implementation of project interventions.","","","","","","","","","","","","","Cultural barriers could impede the action as mothers/caregivers who have acquired knowledge and are willing to feed their children appropriately could be prevented from doing so.","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6045","","Management of moderate malnutrition","","","","Infants and young children","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based","","1. Purchase vegetable seeds and citrus seedlings2. Distribute vegetable seeds and seedlings to households and groups3. Purchase small animals 4. Distribute small animals to households and groups5. Train beneficiaries in the raising of small animals and crop production techniques6. Support the processing of vegetables materials)7. Produce/adapt & distribute IEC materials8. Carry out community education on animal husbandry and crop production","% of households producing fruits for their own consumption% of households producing vegetables for their own consumption% of households growing and using nutrient-dense drought-tolerant crops for their food sources e.g. cowpeas, green grams, groundnuts etc% of household rearing and using one or more type of high protein animal/poultry based foods sources eg. Chicken, fish etc.% of households practicing food preservation techniques% of women controlling some household resources e.g. animals, land etc","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","2400","","","Conducted","Midterm evaluation has been conducted and results are being analysed.","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","Financial resources","Government's financial support to District Agriculture Development Unit is sometimes delayed and this affects the smooth implementation of project interventions. We continue to advocate for timely disbursement of funds.","Adherence","","Infrastructure","We have poor roads linking most communities. There are ,however,plans by the District Assemblies to improve road infrastructure.","","","","","","","","","","","","","","","Although, households with children under-five in particular are targeted, the provision of inputs has been demand-driven. Consquently, the response by households has not been at the level expected.","Continuous community level education by Agriculture Extension Agents (AEAs) has, however, brought about improvement in the implmentation of the action. Land availability for home gardening activities is a challege in some communities. Group garden activities are therefore being considered. ","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6046","Acute malnutrition","Growth monitoring and promotion","","","","Infants and young children","0-59months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1.Support monthly growth monitoring2.Train 105 GHS staff and CBSVs in Community Based Growth Promotion (CBGP) 3.Institute CBGP in 15 poor and hard to reach communities including visits to OVCs under 5 to make sure these children go for growth monitoring","% of boys and girls underweight (WAZ<-2) % of children 6-59 month attending growth promotion sessions at least once every 3 months","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Supplies","","Stakeholder","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6047","Stunting","Vaccination","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Support GHS in increasing immunization coverage among children < 5 years2. Support GHS in carrying out follow-ups on IMNCI activities at health facility and community levels3.Produce/adapt and distribute IEC materials on vaccine preventable diseases4.Carry out education on vaccine preventable diseases in communities
","% of children12-23 months fully immunized
","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Supplies","","","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6048","Acute malnutrition","Oral rehydration solution promotion","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Purchase ORS2. Distribute ORS to CBSVs and health facilities 3. Support GHS in providing quality treatment to children with diarrhoea5.Train GHS and World Vision Staffs in IMNCI4. Support GHS in carrying out follow-ups on IMNCI activities at health facility and community levels5.Produce/adapt and distribute IEC materials on control of diarrhea6.Carry out education on environmental sanitation and personal hygiene in communities","1.% of children with diarrhoea in the previous 2 weeks(or last episode of diarrhoea) who received ORT 2. % of health facilities(or alternative access point) with no stock out for ORT in the previous three months","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","77780","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Insufficient staff","","Adherence","","Stakeholder","","","","","","","","","","","","","","","","","Mothers/caregivers have difficulties continuing feeding as well as increasing the amount of fluids given their children during illness.","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6049","Acute malnutrition","Distribution of insecticide-treated bednets","","","","Infants and young children","0-59 months","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Purchase LITNs2. Distribute LITNs to children under five years and pregnant women3. Support GHS in carrying out follow-ups on IMNCI activities at facility and community level4. Produce/adapt and distribute IEC materials on malaria5. Carry out education on malaria control in communities","% of children Under five sleeping under an LLITN the previous night% of pregnant women who slept under an LLITN the previous night","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","7,460 (children 0-59 months), 2615 PWs","","","Conducted","Midterm evaluation conducted and results are being analysed","Vulnerable groups","","Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>>Insecticide-treated nets to prevent malaria and anaemia in pregnant women>>http://www.who.int/elena/titles/bednets_malaria_pregnancy","Adherence","Community level education to encourage households to sleep under insecticide-treated bednets has been intensified.","","","","","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6050","","Vitamin A supplementation","","","","Infants and young children","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1.Through monthly routine EPI2. Bi-annual spplementation
","% of children 6-59 months who received vitamin A capsules in previous 6 months
","1.Key performance indicator was baselined to establish coverage at the beginning of the project.2.Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders.3. Midterm and Endterm project evalutions will be conducted.
","","","","","","Vulnerable groups","","Vitamin A supplementation in infants and children 6–59 months of age>>>Vitamin A supplementation in infants and children 6–59 months of age>>http://www.who.int/elena/titles/vitamina_children","Insufficient staff","Insufficient staffing levels of partner institutions particularly of Ghana Health Service(GHS) remains a challenge. We have continued to advocate for increased numbers for the beneficiary districts. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this gap.Occassional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has beed encouraged.","Infrastructure","We have poor roads linking most communities. There are ,however,plans by District Assemblies to improve road infrastructure. Insuffient staffing levels of partner institutions particularly of Ghana Health Service(GHS) remains a challenge. We have continued to advocate for increased numbers for the beneficiary districts. Community Health Planning and Services(CHPS) compounds are expected to be extened by the government to remote communities to address this gap.Occassional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has beed encouraged.","Supplies","Occasional stock out of vitamin A capsules at health facilities. Regular monitoring of stock levels and communication with the logistics department/stores at all levels in timely for support has been encouraged.","","","","","","","","","","","","","","","","","","English" "6043","Integrated Malnutrition, HIV/AIDS & TB (IMHAT) Prevention and Control Project","English","Community/sub-national","","GHA","Ghana","Nadowli, Upper West, Ghana| Tolon, Kumbungu, Northern, Ghana| Kintampo South, Ghana|Brong Ahafo,Ghana|Northern, Ghana","Urban","on-going","01-2009","09-2013","The goal of the IMHAT Project is to contribute to the reduction and prevention of malnutrition, HIV/AIDS, TB and thereby contribute to reduction of child mortality rates in the Nadowli, Kintampo South and Tolon-Kumbungu districts. The specifc objectives of the project include the following: 1.Improved quality of diet for children under-five years and families 2.Improved access to essential health services and a healthy environment 3. Improved household food security 4. Strengthen capacity of World Vision, communities and partner institutions to implement programs to address malnutrition, health(including HIV/TB) and food security issues.
","","","","Cabinet/Presidency","","","","","","","","","","","","","","","","","","Budget(2009-2012)= US$667,757","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6051","Acute malnutrition","Preventive malaria treatment","","","","Pregnant women (PW)","","Nadowli, Tolon-Kumbungu, and Kintampo South districts respectively in the Upper West, Northern and Brong Ahafo regions of Ghana","Community-based|Hospital/clinic|Primary health care center","","1. Carry out education on malaria control in communities2.Support education to increase proportion of pregnant women accessing IPT service at health facilities","% of women who received two doses of SP during last pregnancy","Key performance indicators were baselined to establish coverage at the beginning of the project. Monitoring of project interventions are conducted monthly. Monthly, quarterly, semi-annual and annual reports(narrative and financial) are collated to inform management decisions. These reports are shared with key stakeholders. Midterm and endterm project evalutions will be conducted.
","19445","","","Conducted","Midterm evaluation has been conducted and results are being analysed","Vulnerable groups","","","Adherence","","","","","","","","","","","","","","","","","","","","","","","English" "8816","Developing Village-based Advisors to improve food Security ","English","National","","KEN","Kenya","Siaya, Kenya|Busia, Kenya|Embu, Kenya|Kitui, Kenya|Machakos, Kenya|Makueni, Kenya","Rural","on-going","01-2012","01-2017","The Village-based Advisors Food Security project is improving productivity by promoting good farming practices among smallholder farmers, with the larger goal of increasing their food security and resilience to environmental shocks. The project identifies keen, hard-working farmers at the village level and develops them into モagro-entrepreneursヤ, called Village-based Advisors who provide inputs (such as improved seed), services (such as livestock vaccination) and advice on good farming practices to their community. These micro-businesses offer the double benefit of creating rural employment opportunities and building a sustainable system for delivering agricultural technologies.
The project is part of the U.S. Global Hunger and Food Security Initiative, also known as モFeed the Futureヤ, which seeks to address the root causes of hunger and poverty and create conditions where food assistance is no longer necessary. ᅠ
","http://kenya.usaid.gov/programs/economic-growth/1272
","","","Other","Farm Input Promotions Africa (FIPS-Africa)","","","","","US Agency for International Development (USAID)","U.S. Global Hunger and Food Security Initiative, also known as モFeed the Futureヤ","","","","","","","","","","","USD 2,000,000.00","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","The project is working to mitigate the negative effects of climate change on Kenyaメs smallholder farmers by increasing their use of improved varieties of crops and inputs like fertilizer; building their understanding of and ability to implement good soil and water management techniques, and providing better access to poultry vaccination.
The model relies on the use of モVillage-based Advisorsヤ (VBAs) who earn an income through the provision of improved inputs, advice and services to their fellow farmers. Unlike traditional group-based approaches, VBAs have a target to work with every farmer in their community, meaning thousands of farmers can be reached quickly and cost-effectively. The project builds on the entrepreneurialism and community spirit common among smallholder farmers.
FIPS-Africa is a pioneer of the ムsmall packメ approach ヨ where inputs such as seed are distributed to farmers in small quantities. This allows farmers to experiment on their own farm at a low cost and with minimal risk. Farmers are more likely to adopt if they have seen something work first.
","xx
","By June 2012, the project had trained over 100 VBAs who distributed over 34,000 small packs of seed of improved varieties of key staple crops to farmers and established nearly 4,000 multiplication sites for drought tolerant root tuber crops.","ByMarch 2013, the following additional achievements are expected: 1,800 demonstration plots for improved soil and water management or seed priming established 9,000 households growing improved varieties of root tuber crops; 56,000 more small p","Period","Local food production and consumption levelsFood import and export ratesRates of undernutitionRates of people living &lt; $1/day","Local food production and consumption levelsFood import and export ratesRates of undernutitionRates of people living < $1/day","Socio-economic status","","","Staff skills/training","","Infrastructure","","","","","","","","","","","","","","","","","","","The long drought of 2009 hit both people and ecosystems hard, putting millions of Kenyans on food relief and killing large numbers of animals. However, this environmental stress also dramatically highlighted the payoffs of improved natural-resource management. Over 750,000 hectares of semi-arid woodland and rangeland - brought under improved management thanks to USAID and partners - showed no decline in ecological condition despite the drought. The condition of some areas even improved
","Dorcas Nyangasi of Emuhaya is 22-years-old and successfully self-employed. Like many young people in rural areas, Dorcas had trouble finding work when she finished school: モMy mother thought I was depressed because they could not afford my college, or lonely because most of my friends were leaving the village. But the real reason was that I needed something to do.ヤ
Dorcasメs life was transformed when Farm Input Promotions-Africa (FIPS-Africa) trained her to be a Village-based Advisor (VBA), providing agricultural inputs, services and advice on good farming practices to smallholder farmers in her village. ᅠAs well as distributing seed, Dorcas sells vegetable and tree seedlings from her nurseries and vaccinates poultry against Newcastle disease, which used to devastate local flocks. ᅠAfter two-and-a-half years of being her own boss, Dorcas has more than 2,000 farmers buying her inputs and services. She explains, モwithin the first four months I noticed that I could make more money when I approached more farmers, so I expanded my operations to three more villages.ヤ
Dorcasメ hard work is not only improving her own livelihood ヨ it helps the other farmers in her community too. モI am happy because I have helped my village rise above the problem of hunger, there is poultry in abundance, and we have surplus sweet potatoes and cassava to sell,ヤ she says.
","English" "11493","Strengthening Agricultural Technologies among People Living with HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda","English","Multi-national","","KEN|UGA","Kenya|Uganda","Busia, Kenya|Busia, Uganda","Rural|Peri-urban","completed","01-2007","01-2008","The Food and Nutrition Technical Assistance Project (FANTA) of the Academy for Educational Development (AED) and the Ministry of Health (MOH) AIDS Control Programs (ACPs) in Kenya and Uganda worked together between 2007 and 2008 to integrate nutrition into the activities of HIV support groups in the border towns of Busia Uganda and Busia Kenya, funded by USAID/East Africa. The aim was to build skills in nutrition and disseminate national materials on nutrition and HIV developed by the national ACPs. However, PLHIV in the border towns increasingly reported lack of access to adequate food, in terms of quantity and variety, as the main reason they could not apply the dietary practices recommended during counseling sessions. In response, between September 2007 and September 2008 FANTA and the ROADS Project collaborated to facilitate the diffusion and use of appropriate technologies to improve the productivity of PLHIV agricultural activities developed under the ROADS Project in the two border towns.
","http://www.fantaproject.org/downloads/pdfs/FANTA_Busia2008.pdf
","8762|8576|8430|8302|8241|8671|8237","","Food and agriculture","Ministry of Agriculture, Department of Culture and Social Services, Kenya│Ministry of Animal Industry and Fisheries (MAAIF), Uganda│National Agricultural Advisory Services (NAADS), Uganda","","","Family Health International (incl.AED)","","","","","","National NGOs","AIDS Support Organisation; National Agricultural Research Organization (NARO), Uganda","Research/academia","Busia Agricultural Training Centre (BATC) in Kenya, Kenya Agricultural Research Institute (KARI)","","","Other","Africa 2000 Network","","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","East Africa","Other","","Busia Parish Catholic Church, Kenya","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11492","","Promotion of food security and agriculture","","","","Pregnant/lactating women with HIV/AIDS","","Busia , Kenya and Busia Uganda","Community-based","","The process involved identifying simple technologies to increase farm and garden outputs and linking clusters of people living with HIV (PLHIV) with local agricultural institutions including the Ministry of Agriculture (MOA), Department of Culture and Social Services, Kenya Agricultural Research Institute (KARI), and Busia Agricultural Training Centre (BATC) in Kenya and the MOA, Ministry of Animal Industry and Fisheries (MAAIF), National Agricultural Research Organization (NARO), and National Agricultural Advisory Services (NAADS) in Uganda, as well as community development officers, community-based organizations (CBOs), and nongovernmental organizations (NGOs) in the districts. FANTA facilitated the development of a participatory learning process to motivate groups of PLHIV to learn the new technologies to increase farm and garden output.
In phase one of the participatory learning process, FANTA and ROADS helped members of the clusters and agricultural institutions understand the agricultural technologies used in Busia, Kenya and Busia, Uganda to improve productivity. Phase two facilitated a process of linking cluster with agricultural institutions to help cluster members implement existing technologies that they had not widely used and to assess the impact of the process on the adaptation of the technologies. Neither FANTA nor ROADS invested substantial funds in the process, but provide technical assistance and connected the clusters to locally available technical assistance and support.
Three sensitization meetings were held, one joint meeting between cluster representatives, the FHI Cluster Coordinators, and FANTA staff and two meetings with groups on either side of the border. The meetings laid the foundation for agreement on the purpose of the activity and sharing of expectations. Over a period of two weeks, the group representatives identified viable and interesting agricultural technologies used in their localities and discussed how easily they could be implemented by PLHIV living in the towns (urban setting) and how they could improve their food diversity. In meetings with the agricultural institutions (mainly from Kenya), examples of agricultural technologies and activities were identified and discussed. Ministry of Agriculture and BATC extension personnel were available in the meetings to explain the different technologies.
The cross-border learning process was initiated by 14 representatives of the Ugandan clusters, who visited their peers on the Kenyan side of the border in November 2007. For two days they visited homes and training centers to see different agricultural technologies and livelihood activities implemented in Kenya and discussed the
feasibility of their adoption in their own context. At BATC the Ugandan visitors toured all the Group identification of learning content and methodology Preliminary sensitization meetings with cluster groups Group consultative meetings Meetings of Cluster representatives with departments of agriculture, NGOs, research institutions, and farmer training Cross‐border learning and home visits Arrange meetings among ROADS representatives, cluster representatives from Kenya and Uganda, and FANTA. Explain the different technologies that could be used in the locale and by PLHIV. Agree on how groups would implement the technologies and priorities. Group consensus meetings See different technologies in the communities and discuss.
Visits were also made to school gardens, community land (e.g., belonging to clusters of orphans and vulnerable children [OVC] in Kenya), seed multiplication sites, and farmer training centers. The cluster members discussed opportunities for and challenges of implementing similar activities in the urban Uganda context. Group consensus meetings were held to prioritize what the clusters wanted to learn about and the optimal methods of learning.
","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a 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 Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","MAIZE AND DROUGHT-TOLERANT STAPLE CROP VALUE CHAIN
Kenya’s maize sub sector is approaching a critical time when input supply characteristics, land reform, availability of supporting factors of production, and market price dynamics will define the competitiveness of the industry in the mid- to long term. This environment presents an opportune moment for the USG’s current and future investments. At the same time, there has been a dearth of investment in alternative staple crops and, as a result, there is a lack of data. In collaboration with the private sector, FTF will support value chain assessments that deepen and fill gaps in existing knowledge – especially related to these crops in SA2 – to inform the FTFS’ further implementation and private sector investments.
As noted, yields of staple crops in Kenya are low relative to regional averages. Addressing productivity issues in maize and drought-tolerant staples will be a key focus. Promoting improved transfer of technologies will require investment in agricultural research to develop improved technologies. This will be especially important for the neglected drought-tolerant crops. Equally important is the dissemination of knowledge of these technologies, accompanying management practices, the extension services to transfer knowledge on how best to use technologies, and the commercialization and dissemination of technologies to farmers who need them. Consequently interventions will leverage private sector partners in concert with public sector extension services (although limited in certain counties of the two focus areas) to disseminate and commercialize improved technologies through ―smart‖ extension methods, e.g., ICT.
Achieving productivity growth also will require program investments to promote improved access to high-quality inputs that are affordable and provide the knowledge (extension services) on how to use them optimally, including improving input use efficiency through proper soil and water management techniques. Seed and fertilizer companies and agro-dealers will play key roles in setting up demonstration plots and holding ―farmer field days‖ so that farmers can learn about different varieties and practices. Efforts will be made by the Mission to incorporate gender awareness and nutrition- and food preparation-related messaging during those ―field days.‖ The seed and fertilizer companies have also begun to package inputs into smaller quantities, thereby more affordable to poor farmers. The current KMDP is working through its sub-grantees, like Farm Input Promotions (FIPS) – which uses samples of inputs (i.e., seeds, fertilizers, etc.) donated by private companies – for demonstration on farmers’ fields, provides extension information, and sells inputs in small affordable packages, an approach that has been effective in increasing access to inputs and extension services to women.
Market access will be essential to increasing smallholder incomes. The Mission will facilitate a more structured market for staple food crops by: 1) increasing smallholder farmers’ understanding of end-market requirements; 2) facilitating access to training to meet end-market requirements; and 3) improving farmers’ market intelligence and capacity to make informed decisions. Public and private sector investments in storage and centralized market infrastructure will improve the benefits smallholders gain from market engagement and lead to increases in rural household incomes.
Regarding sorghum, market outlets seek varieties with high milling and brewing qualities, and subsistence farmers require high-yielding varieties with specific taste, color and cooking characteristics. The segmentation of these varieties and products to meet the specific market demands has not been done and, as a result, farmers’ marketing strategies are ―hit or miss.‖ Hence, the program will segment the market niches and match the niches to sorghum varieties and products. This approach will highlight the opportunities for farmer organizations to deliver to the segmented market outlets through the segmented sorghum varieties and products.
Fostering investments by the private sector as well as access to rural finance will be essential to the sustainability and scalability of productivity improvements. Kenya has a vibrant private sector hungry for profitable opportunities. To both meet the development challenges and make a profit, USAID/K will use its new Innovation Engine (see below) to buy down the risks for private sector investments in innovative areas. To improve access to rural finance, the Mission’s program, along with USAID/EA's FTFS program-related activities, will:
By tapping into the networks of EAGC, the activities will help build regional linkages for traders. In addition, access to rural finance will be further improved through USAID's recently commenced Financial Inclusion for Rural Microenterprises (FIRM) project which – in collaboration with the U.K. Department for International Development (DFID) – will improve productivity and growth of agricultural value chains through expanded financial services to underserved groups, geographic locations and new product areas. FIRM will facilitate opportunities for agribusiness development and overall market efficiencies through a package of financial services to vulnerable groups, including young and female smallholder farmers in rural and agricultural sectors.
Value chain development in HR1 and SA2 will require the aggregation of farmers in order to facilitate access to markets, services, financing and technology transfer. Previously, the KMDP contributed to the development of farmer associations, including women associations, in the Western Province and Rift Valley and will continue to do so in the targeted FTFS counties of those provinces. Consequently, the FTFS program will strengthen farmer groups, associations and cooperatives where they can effectively benefit their members.
A key outcome of KMDP from 2002-2010 was to foster a more responsive policy environment for the maize sub-sector. Despite KMDP's involvement in a relatively successful decade of reform, the maize sector and, to a large extent, other staple crops are still characterized by highly guarded value chain positions and often distorted policy. Consequently, the FTFS program will be a strong advocate of a market-driven approach at the national level, providing a key voice to discussions regarding GOK agricultural policies and simultaneously strengthening value chain players to advocate for better policies. The planned continuation of USAID support to the Tegemeo Institute, for example, will play a key role in advocacy based upon empirical evidence to further bolster the GOK policy dialogue.
Finally, promoting NRM and adaptation to climate change will be needed to support the sustainability of impacts under FTF. This will involve the inclusion of sustainable intensification practices (―climate smart‖ practices) in staple crop production including: 1) soil management techniques, such as conservation agriculture and integrated soil fertility management; 2) the inclusion of fertilizer and fodder trees into annual crop production systems (―evergreen agriculture‖); 3) water efficiency measures, such as rainwater capture and storage; and 4) integrated pest management. The ―climate smart‖ practices will be used in combination with drought-tolerant varieties of seeds and inputs to increase productivity, fertilizer use efficiency and climate resilience. While access to and sustainable management of natural resources will be a central theme regardless of income group or geographic area, it is particularly key to addressing the vulnerability of the poorest and most food insecure.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Financial resources","Business service provider interventions▪Grow market linkages (domestic and regional)▪Facilitate market development including structured trade and transparent transactions▪Link to input suppliers to expand services▪Provide value chain financing","Supplies","Input supplier interventions▪Expand inventory, crop and dairy services, & reach▪Link to business service providers▪Pilot aggregation (e.g., for WFP P4P program)▪Capacity building for business and financial mgmt.▪New business models","Infrastructure","Processor/buyer interventionsProposed Future USG Engagement▪Capacity building in business and finance▪Development of innovative business models▪Development of premium product schemes▪Link to input suppliers, business service providers, and producer organizations","Stakeholder","Producer organization interventions▪Continue capacity building in business, finance, contracts, grades/standards, productivity▪Link to input suppliers, business service providers, processors","","","","","","","","","","","","","","To capture lesons learnt
Combined Evaluation
Impact study
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 Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
"," DAIRY VALUE CHAIN
The FTFS will build on the Kenya Dairy Sector Competitiveness Program (KDSCP), currently running through April 2013, which aims to improve Kenya’s dairy industry competitiveness, and increase the economic benefits to stakeholders in the entire dairy value chain. However, the KDSCP is only operating in the Central, Rift Valley and a small section of Western Provinces due to high density of dairy cattle and favorable agro-ecological conditions necessary for dairy production.
To improve productivity, KDSCP works with male and female dairy farmers to facilitate their transition from loosely organized groups into sustainable business associations able to either access or provide expanded and diversified services to their members. The KDSCP’s BDS approach facilitates service provision to all actors along the value chain, using a wide range of change agents to train farmers on productivity-enhancing technologies to increase production per cow and reduce costs of production. Fodder preservation is the key to smoothing milk flows over the entire year, and new fodder varieties developed by Kenya Agricultural Research Institute (KARI) can improve nutrition and decrease feed costs while increasing milk production. An emerging technology developed by International Center for Insect Physiology and Ecology (ICIPE) to control crops pests has spillover benefits for dairy. Planting of desmodium and napier grass at specific locations in crop fields controls cereal pests; these crops are also excellent fodder for dairy. Interestingly, it appears that women are more likely than men and youth to adopt many of these feed technologies.
Renewed efforts will be required to bring down the cost of high quality semen, so that smallholders can afford to use AI and improve the genetic potential of their animals. Efficiency of AI can be increased by improving farmers’ ability to recognize correct breeding times and improved skills of inseminators.
Milk cooling centers – a key change agent – provide an excellent platform for producers to access goods and services. The centers enable producers to bulk and chill milk as well as consolidate their needs for services and goods, thereby making it more efficient for the private sector to engage with smallholders. Processors are also key change agents whereby, through a ―check off system,‖ farmers are supplied with feed and AI and vet services, and pay for those services by having the processor deduct costs from each producer’s milk sales. Many banks that lend to dairy farmers require that they have contracts with these processors in order to guarantee their loans.
KDSCP currently focuses much of its activities on dairy quality standards, and assisting farmers, traders and processors to adopt practices that will improve the quality of milk. It works through private and public sector service providers to train smallholder dairy farmers on milk testing techniques, disease prevention and testing with modern technologies. Business Development Service (BDS) providers also facilitate farmer associations to negotiate long-term supply contracts with processors, and to receive premiums for chilled milk. More work is required, however, towards establishing premiums for other important attributes, such as butterfat content. Market information is now more widely accessible to producers through working groups that act to better coordinate the local dairy sector.
It will be important to increase the capacity of cooling centers to implement quality control frameworks, such as Hazard Analysis and Critical Control Points (HACCP), and provide assistance to acquire International Standards Organization (ISO) or equivalent quality certification. Achieving these levels of quality will be essential for Kenyan milk to enter COMESA and other international markets. Support to the Kenya Dairy Board (KDB) and the East and Southern African Dairy Association – important partners in moving Kenya towards meeting regional standards for dairy products – will also help expand Kenya’s reach into COMESA markets.
With increased organization of producers into business associations, producers will be able to increase their investments in herds through upgrading breed quality and investing in feed and animal health technologies. Service providers will have expanded demand for their goods and services (e.g., silage making equipment and forage choppers) and some, such as processors, will have an incentive to invest in expanded facilities. Some examples of investment include Nestlé’s investment in upgrading a milk powder plant at the Kenya Creameries Cooperative (KCC), while the Brookside Dairy has set up a new powder plant. Farmer-owned chilling plants have invested in trucks to transport milk to processors, and two Kenyan insurance agencies are offering insurance products to farmers.
As banks become more knowledgeable about the risks and opportunities in the dairy sector, they are increasingly lending to the sector. Several banks have come forward to finance dairy investments by using guarantee mechanisms to decrease their risk. Access to rural finance will be further improved through USAID’s FIRM Project which, in collaboration with DFID, has established a Value Chain Finance Center to promote financial access through the rural areas for firms all along the value chain.
The FIRM Project (currently running through CY 2013) has conducted a dairy value chain finance analysis that identified profitability at key parts of the value chain. Banks will increase lending in those areas of the value chain that have the most banking potential, thereby increasing investment in the sector. It will be important to identify the less bankable parts of the value chain, such as the dairy feed sector, and concentrate support to improve bankability in those parts to further develop the dairy industry.
The dairy sector also has great potential to contribute to improved NRM practices, so current and future implementers will incorporate best management practices for improved grazing, pasture management, and ―cut and carry‖ techniques to enhance productivity and ecosystem function. This will include encouraging farmers to grow fodder varieties that are complementary to annual crop production, e.g., varieties that are nitrogen fixing or important for biological control of crop pests. Such practices can have co-benefits to staple crop production since inter-cropping certain fodder varieties with annual crops (―evergreen agriculture‖) can increase crop productivity. Manure and run-off from dairy can become environmental and health hazards, but properly managed manure can contribute greatly to improved soil fertility and soil quality, including the retention of water and important soil nutrients. Use of manure is a critical component of integrated soil fertility management and thus, for dairy farmers who also cultivate crops, this is another important co-benefit. Additionally, the generation of biogas will become increasingly important as a source of energy for households as electricity and kerosene become more expensive. Consequently, the nexus between dairy farming and agriculture and ―clean energy‖ will be another area of opportunity to be addressed during the course of the Strategy’s implementation.
These interventions will be particularly important as one aspect of adapting to climate change, and producers will need training in these technologies and practices.
More dairy products available at lower costs encourage increased consumption of this nutrition rich product among lower-income groups. KDSCP works in the informal milk chain where women, the youth and very-poor dominate. Gender sensitive programming and improving quality standards naturally fits with increasing nutritional opportunities in the informal milk chain because mothers often are responsible for child rearing. Not only availing more dairy products and improving milk quality, but increasing messaging about the nutritional benefits of dairy products will encourage consumption of this nutritionally packed food product. Also, improving the informal milk chain will enhance economic benefits for women who dominate informal milk trade and rural youth engaged in off-farm milk transport services.
New support to and capacity building of various GOK and stakeholder organizations will be important to identify issues constraining Kenya’s dairy sector competitiveness. The ongoing KDSCP, however, is building capacity of the Dairy Task Force, with a focus on policy advocacy. The rejuvenated Task Force is currently leading the implementation of policy changes and action plans that are critical to the dairy sector. Assessments of key issues have provided the necessary analyses to inform stakeholders and GOK decision makers. The Task Force is increasing the interaction among value chain actors, the GOK and development partners, and has seen increased efficiencies in the sector, both for donor projects as well as private sector investments. The Dairy Master Plan – which was initially shelved due to inadequate collaboration – is now back on track.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Socio-economic status","","","Supplies","","Financial resources","","Infrastructure","","Stakeholder","","","","","","","","","","","","","","","To capture lessons learned
Combined Evaluation
Impact study
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 Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","HORTICULTURE VALUE CHAIN
Horticulture has a distinct link to decreasing under-nutrition. Promoting production and marketing of high-nutrition horticultural crops and increasing messaging about the nutritional benefits associated with highly nutritious horticultural products will encourage increased consumption of these foods. For example, kitchen and community gardens provide excellent sources of nutrition for those who have limited access to land and/or resources. These gardens are also often managed by women. Decision-making over products from ―kitchen gardens‖ is often relegated to women for household consumption. Also, women earn direct income from marketing of surpluses from kitchen gardens.
KHCP is currently working in seven zones, including the HR1 and SA2 regions. Consequently, during the course of the FTFS implementation but in a deliberate timed fashion, the KHCP will evolve its program of activities to focus on the HR1 and SA2 regions.
Currently, KHCP expects to have the following impacts by February 2015, but these will be revised in accordance with the smooth transition to the new focus areas:
The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. ",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Sex","","","Supplies","","Financial resources","","Stakeholder","","Infrastructure","","","","","","","","","","","","","","","To capture lessons learnt
Combined Evaluation
Impact study
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 Kenya, Feed the Future aims to help an estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Kenya is making core investments in three key areas:
Target Regions
Feed the Future is targeting high-rainfall areas with dense populations, high poverty and malnourishment, as well as semi-arid areas. Both areas have great potential for raising agricultural productivity. These target areas also encompass the highest concentrations of malnourished children, female-headed households, and rural poor.
Highlights
Science and Technology. U.S. support to the Kenya Agricultural Research Institute focuses on research on crops for the semi-arid zone, including improved seeds, pest control, and food safety for maize, sorghum, millet, sweet potato, cowpea, and pigeon pea. Feed the Future also works with the Kenya Plant Health Inspectorate Services to increase quality and availability of drought-tolerant crops and varieties.
Engaging Women and Youth. Feed the Future supports activities that empower women and improve the nutritional status of women and children. Women manage an estimated 44 percent of Kenya’s smallholder households and are active at every point in the food chain. Their contribution to commodities, grown mainly in home gardens, is quite significant, providing essential nutrients and often the only food available during the lean seasons or when the main harvest fails. Feed the Future will also engage youth in farming, processing and trading to relieve high levels of youth unemployment. More than 67 percent of the under- and unemployed in Kenya are young women and men of 15 to 30 years of age.
Value Chains. Feed the Future is focusing its efforts on improving several key agricultural value chains: horticulture, dairy and maize for the High Rainfall (HR) areas; and drought-tolerant crops (sorghum/millet and root crop systems), drought-tolerant maize, horticulture, and pulses for Semi-Arid (SA) areas. Attention is focused on every “link” in the value chain—from inputs like fertilizer and seeds, to credit, to production methods, storage, transport, processing, farmers’ cooperatives, and markets in Kenya, East Africa and overseas.
","Women will form a core target group in the s FTFS because of their critical role in food production and nutrition in Kenya. It is estimated that nearly half or 44 percent of Kenya’s smallholder households are managed by women. This is largely attributed to rapid rural to urban migration by men in search of employment. Women are active at every point in the food chain and are often responsible for protecting the safety and wholesomeness of food in their households. Their contribution to food commodities such as pulses, potatoes, legumes, sorghum, fruits and vegetables is quite significant. Grown mainly in home gardens, they provide essential nutrients and are often the only food available during the lean seasons or when the main harvest fails.
In the dairy sector, women and the ultra-poor predominate in the informal milk chain. A gender value chain assessment completed by USAID in High Rainfall Zone 1 found that while the ―morning‖ milk is sold to processors, the ―evening‖ milk is often left for family consumption under the control of women in the majority of male-headed households. Most surpluses after consumption are sold in the informal chain, generating income directly for women in these households.
By FY10, female-headed households comprised 49 percent of households that benefited from USAID/K assistance. Strategies that contributed to increased women’s participation included decentralized extension approaches that are tailored to suit women’s time schedules, promotion of ―gender-balanced‖ crops and leadership training for women, and use of embedded business development service (BDS). The horticulture program recorded the highest number of women beneficiaries by supporting nutritious crops – including leafy vegetables, sweet potatoes, beans and butternut squash – where women predominate in production and marketing, and where they have greater control over revenues. Horticulture marketing contracts between women’s groups and buyers were established, allowing women to receive their payments directly.
The Kenyan FTFS will support activities that economically empower women and improve the nutritional status of women and children. Building on USAID/K’s past successes in gender and value chains, the FTFS will: Increase women’s gains by expanding support to nutritious horticultural and staple food crops; Promote private sector response by which small improvements to the informal milk chain, where women and the poor and ultra-poor predominate, could lead to healthier and more affordable options; Through the FTF Innovation Engine, seek innovations that promote local-level processing of fortified foods, such as through ―posho mills,‖ that are easily accessible and affordable to rural women; Catalyze social innovation approaches that reduce gender inequalities in agricultural production and benefits from production – such as innovations in agricultural labor saving technologies and practices to reduce women’s labor burden, linking women to extension and markets and promoting farming as a family business; Undertake gender-value chain assessments for each of the targeted sub-sectors in FTF geographical areas to guide implementation; and Scale-up training on integration of gender in value chains to all FTFS partners.
","The Mission is currently reviewing options for reinforcing its existing monitoring and evaluation (M&E) framework by establishing a comprehensive knowledge management system that builds links to ongoing initiatives aimed at strengthening U.S. Government, national and regional agriculture sector-wide M&E and knowledge management.
USAID/K will link to the GOK-led and CAADP-mandated ―National Integrated Monitoring and Evaluation System‖ which will serve as a mutually agreed framework for performance monitoring towards the goal of increasing food security. The Mission also will link its knowledge management system to the Regional Strategic Analysis and Knowledge Support System (ReSAKSS), an information and knowledge management initiative, to promote and support effective and sustainable agricultural and rural development strategies across Africa. Through ReSAKSS, the Mission will collaborate with the USAID/EA and other Missions in Africa in tracking intra-regional trade data. The Mission will also use ReSAKSS to provide meta-analyses contributing to synthesized studies suitable for shared learning by numerous stakeholders.
The Mission will utilize the following tools in establishing and maintaining its M&E efforts: The Mission’s FTFS Results Framework which is the conceptual and analytical structure that establishes the goals and objectives of the FTF Initiative in Kenya; A performance monitoring/management plan (PMP) comprised of standard and custom FTF performance indicators to track progress toward desired results. Data systems will be developed and refined based on findings of a Mission-wide data quality assessment (DQA) carried out in March/April 2011; Tegemeo Institute poverty analyses in conjunction with Africa Bureau/Sustainable Development Office (AFR/SD); The Mission will undertake local capacity-building investments to improve the quality and frequency of data collection and use; Biannual independent indicator surveys by Tegemeo Institute to gauge progress made towards achieving results and a feedback loop to improve performance; Mid-term and impact evaluations will be carried out to determine the measureable effects of the FTFS investments; and The Mission will engage in regular knowledge-sharing activities with FTFS development partners and implementers to foster learning and use of M&E findings.
","Estimated 502,000 vulnerable Kenyan women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 230,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality.",".","","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Number of new technologies or management practices made available for transfer as a result of USG assistance; Number of rural households benefiting directly from USG interventions; Number of producers organizations, water users associations, trade and business associations, and community-based organizations (CBOs) receiving USG assistance; Percentage of children < 5 years who are underweight","Sex","","","","","","","","","","","","","","","","","","","","","","","","To capture lessons learnt
Combined Evaluation
Impact study
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will make investments in nutrition across three critical sectors; agriculture, health, and social protection, with nutrition as the lynchpin between these sectors. As such, the USG will implement a comprehensive approach that maximizes all three sectors and strengthens and links the nutrition components of each. These investments will be underpinned by a core set of nutrition indicators that are common across all programs, and will be supported by policy investments that mirror the comprehensive nature of nutrition programming by working with the Office of the President’s Cabinet (OPC) and the Ministries of Agriculture and Food Security, Health, and Gender.
Building on lessons and experiences from current programs implementing preventive nutrition activities (e.g., the WALA and BASICS projects), USG resources will scale up prevention of undernutrition and resiliency of communities, while maintaining critical investments in treatment and nutrition service delivery. The rationale for this shift is due to the overall high prevalence of chronic undernutrition (47 percent) and the low prevalence of acute undernutrition (4 percent), the latter of which has been achieved by sustained commitment to scaling up CMAM. As a result, the USG will aim to drive a decrease in stunting as the highest level objective in FTF. The USG plans to focus on cost-effective preventive nutrition interventions targeting the 1,000 days window of development (pregnancy through two years), including maternal nutrition; early and exclusive breastfeeding through six months; use of appropriate, diverse foods beginning at six months of age; targeted micronutrient supplementation; and improved hygiene and sanitation. Activities will be integrated into health, HIV, and agriculture platforms, taking full advantage of the resources that these programs have. These investments leverage funding from health (Global Health and Child Survival), agriculture (Development Assistance), and Title II to advance nutrition objectives. The Care Group model encompasses a combined FTF and GHI approach to reduce poverty, hunger, and undernutrition by joining two complementary lines of investment at an operational level:
The objectives of the Care Groups complement value chain development activities by building capacity of:
Community-Level Organizations and Integration with Government of Malawi Systems for Health and Agricultural Extension
The Care Group in the context of this model is notable in that it supports a sustainable and simultaneous approach to agriculture, nutrition, and microfinance. Cross-fertilization of nutrition and agricultural messaging and skill building, as well as the opportunity to create cross-sector targets and results frameworks allows for a uniquely comprehensive approach.
Volunteers are trained and facilitated to conduct community outreach and follow-up in both agricultural- and health-focused nutrition interventions, thus supporting an operational link between nutrition and agriculture programming. Each volunteer takes on responsibility for conducting outreach and follow-up to some 10-12 nearby households. Care Group volunteers also have access to agricultural inputs to start and maintain community gardens, as well as engage in income-diversification through activities such as establishing voluntary savings and loan activities. Access to these inputs provides motivation and support for implementing targeted nutrition-focused interventions focused on behavior change, including:
Linking the agriculture and value chain components of the project with health and nutrition promotion at the community level is especially advantageous in that it provides opportunities to address two key crosscutting areas:
Prevention Linked with Health Service Delivery
The USG’s approach to service delivery covers community level action, improvement of quality at all levels of facilities, and strengthening the central and district level systems of management. This provides a common platform for multi-thematic messages and programs, ensuring that there are ―no missed opportunities‖. It also ensures a focused yet comprehensive basic package accessible to the Malawian population that stretches across the continuum of care from community to facility and from facility to community. At the community level, the Health Surveillance Assistants (HSAs) and health volunteers will continue to focus on interpersonal counseling, limited preventive and curative care through village clinics and drug boxes, and to create demand for services at the health facilities across family planning, maternal and neonatal health, child health, nutrition, malaria and HIV areas. At the facility level, the USG will support improved quality of care for existing interventions that target integrated and comprehensive primary health care provision and performance based incentives. At the national, zonal and district levels, USG programs will continue to strengthen the financial, management and leadership capabilities of the Ministry of Health staff. Also, programs will work closely with the technical staff to provide technical assistance and work toward meaningful policy changes. At all levels, USG resources will focus on integration of social and behavior change communication efforts through community and facility level entry points.
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Breastfeeding – exclusive breastfeeding>>>Breastfeeding – exclusive breastfeeding>>http://www.who.int/elena/titles/exclusive_breastfeeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","Although the main focus will be on preventing childhood undernutrition, USAID/Malawi will continue to support CMAM, building on past investments. Since 2005, USAID has supported the integration of CMAM in existing health care services. Partners are working at both the policy and community levels to ensure this integration. As of December 2009, 24 out of 28 districts are implementing CMAM in over 240 health facilities. The USG will support one additional year of the MoH’s CMAM Advisory Service to finalize the transition of complete CMAM scale-up to the GoM. An evaluation in 2012 will help inform the USG on the areas needing further investment.
Through two GDAs with Project Peanut Butter, a local producer of ready-to use therapeutic food (RUTF), USAID/Malawi’s support has resulted in an annual production capacity of over 1,200 MT of RUTF, which, when combined with production from a second local producer of RUTF, more than meets the total requirements of RUTF for Malawi, with capacity to export to neighboring countries. The USG will take advantage of this existing capacity to explore the development and promotion of ready to use supplementary and complementary foods.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","eLENA titles related to prevention or treatment of moderate acute malnutrition in children>>>Supplementary feeding in community settings for promoting child growth>>http://www.who.int/elena/titles/child_growth|Food supplementation in children with moderate acute malnutrition>>http://www.who.int/elena/titles/food_children_mam","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","The USG will support GoM's efforts towards fortification of prioritized centrally processed foods, namely: sugar, oil, wheat and maize flour, and complementary baby foods. Data from the National Micronutrient Survey shows that the consumption of these foods has increased over the last ten years. USAID health funding will continue to support the universal salt iodization program in order to sustain the gains made with previous investments. Although not sufficient to forestall stunting in children under five, one necessary input is a high quality, low-cost complementary food. The legume and dairy value chains present a unique opportunity for the development of such a product. Malawi will take advantage and work with existing food processors (e.g., Rab processors, Project Peanut Butter and Valid Nutrition) to develop a suitable product.
Prevention and control of micronutrient malnutrition will require a concerted effort by all USAID/Malawi’s health programs, namely, malaria, family planning, maternal, neonatal and child health, HIV/AIDS and nutrition. Possible USG support to SUN for specific activities with deliverables in FY11 include the following:
An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Prevalence of stunted children under five years of age; Prevalence of wasted children under five years of age; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under 6 months; Prevalence of households with moderate or severe hunger","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","","","","","","","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","USG investments in legume and dairy value chains are designed to boost competitiveness and promote diversification into higher-return value chains that will also spawn non-farm employment opportunities. While these investments in economic growth will be necessary to reduce poverty and hunger, they will be insufficient by themselves. Beyond growth, poverty reduction will require targeted interventions that address the needs of smallholder farmers (the rural poor) as well as more vulnerable populations. A significant smallholder need is to produce more from a very limited resource base. Conservation farming practices offer promise in this regard, by increasing yields, soil fertility and soil moisture content per unit area. Importantly CF offers a window of opportunity to increase yield from a fixed unit area, freeing up land for diversification of both other cereals and legumes. Improving market and input access and the affordability of business development and financial services tailored to the needs of smallholders is critical in order to ―pull‖ rural households into income-raising activities.
Integrating Nutrition with Value Chains (INVC)
INVC is designed to combine the livelihood benefits of an agricultural value chain approach with the nutrition benefits of increased dietary diversification. This centerpiece of Malawi’s FTF strategy will invest in the competitiveness of food staple value chains in which large numbers of smallholders, over 56 percent of whom are below the poverty line, participate, and link increased household production of nutritious crops to household consumption and improved nutritional status. INVC will link value chain development and increased household income to improved nutrition through diet diversification, and improvements in food storage, preparation, and consumption practices at the household level.
INVC’s value chain approach will focus on legumes (groundnuts and soy) and dairy, and is designed to facilitate change in both the individual value chains and the broader market and household-farming systems, looking for synergies across value chains such as common constraints and/or actors. A strong emphasis will be placed on improving the demand side of the value chain, by working to improve market linkages between input and output dealers through improved and more reliable services, including financial, business development, agronomic and livestock-related services. While most of INVC’s efforts will further develop and strengthen Malawi’s existing input and output markets serving the legumes and dairy value chains, the program will also include strengthening the capacity of processors and agribusinesses to meet export market demands, as well as building the capacity of smallholder suppliers to meet buyer demands. At the same time, INVC will work to mitigate the risks for rural households to diversify their income and food sources beyond maize through an option of conducting a vulnerability assessment for its target population and to access nutritional education that will help them translate a more diverse basket of food into improved nutrition. INVC will place a particular emphasis on women’s economic empowerment across all of its activities, including additional support and guidance to women owned businesses and women producers.
INVC will spur investment and innovation in the legume and dairy value chains through an Innovation and Investment Facility meant to provide INVC a tool to identify and support specific opportunities that can further strengthen the selected value chains and market systems within which they operate. An important use of the facility will be to buy down risk for a firm, farmer, or other value chain actor in order to encourage early adoption of new technologies, such as CF by smallholders, and spur sector-wide innovation. Facility partners may include private firms, GoM agencies, research institutes, NGOs or other local organizations, as well as other donors best placed to identify new solutions to key value chain and systemic43 constraints. This Innovation and Investment Facility will be a key instrument for developing the capacity of the private sector and will also have targets and incentives for the participation of women-owned enterprises or individuals.
A core principle of INVC will also be to build the capacity of the key value chain actors to address the competitiveness of their value chain through their own projects and interventions. As such, INVC will place a strong emphasis on building local capacity to contribute to and invest in agricultural transformation. While Malawi has numerous small businesses, local NGOs and private sector and civil society organizations, few, if any, have both the technical and administrative capacity to implement USAID projects without support. As such, INVC’s approach to capacity building will be to invest resources in local partners while leveraging their local knowledge and capacity to generate results. The project will have a target for graduating local partners to independent status that would allow them to receive USAID funds directly. As partners reach this independent status, they would take on current functions of INVC.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Percent change in agricultural GDP (monitor national trend); Per Capita expenditures of rural households (proxy for income) of USG targeted beneficiaries; Gender index; Gross margin per unit of land or animal of selected product; Value of incremental sales (collected at farm- level) attributed to FTF; Percent change in diversity of agricultural commodities produced by households; Number of newly created jobs attributed to FTF Value of new private sector investment in the agriculture sector or food chain leveraged by FTF","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","A significant constraint to the development of competitive groundnut and soybean value chains is the inadequate production of breeder seed. Ten years ago, USAID/Malawi established a $250,000 revolving fund to support ICRISAT in contracting out groundnut breeder seed production, but the FISP addition of legume seed packs the significant gross margins of legumes has driven demand far beyond local seed production capacity. Given the importance of reliable input supplies to Malawi’s FTF strategy, USAID and Irish Aid will partner to expand local capacity for production of quality, certified legume seed. USAID will invest in expanding the existing revolving fund and link in the International Institute of Tropical Agriculture to enable the expansion of their efforts in soy breeder seed production. Irish AID will expand its assistance to small and medium sized enterprises to develop their capacity of to multiply groundnut seed – currently only one company (Seed Co.) is involved in soybean seed production using privately developed germplasm.","Infrastructure","Malawi also lacks an International Organization for Standardization (ISO) certified laboratory for testing and certifying groundnuts and soybeans, which limits access by exporters to broader export markets. Currently, companies that export groundnuts send samples to South Africa for testing, which is costly and limits export capacity. With Irish Aid support, ICRISAT and NASFAM are developing a low cost, rapid testing technology; however, achieving ISO certification will be costly. The EU and UNDP will also begin work next year on a project designed to support the processing and exports side of legume value chains, a major component of which will focus on bringing the Malawi Bureau of Standards up to ISO certification. USG resources will support GoM efforts to establish a national sanitary/phyto-sanitary (SPS) strategy and achieve COMESA SPS compliance, as well as to build the capacity of Bunda College and the MoAFS research stations to conduction aflatoxin mitigation research.","Financial resources","Access to finance remains a major constraint to smallholders investing in productivity enhancing technologies due to weak financial sector infrastructure, inadequate financial services options, and GoM regulatory capacity. USAID will jointly develop a Financial Sector Technical Assistance Project with the World Bank and DfID.","","","","","","","","","","","","","","","","","","English" "11605","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","MWI","Malawi","Dedza|Mchinji|Lilongwe|Ntcheu|Mangochi|Balaka|Machinga","Rural|Peri-urban","on-going","01-2011","12-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a lasting foundation for progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while also reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Malawi, Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
","In view of the capacity challenges that exist, USAID will strengthen the capacity of the GoM to plan, implement, monitor and evaluate nutrition programs. With substantial funding increases anticipated through the FTF, USAID/Malawi will ensure that GoM institutions have adequate capacity to implement the various programs that will be designed under the initiative. This activity is in line with Strategic Objective Three of the NNPSP, which clearly outlines the capacity gaps and needs for the nutrition sector in Malawi. The USG will strengthen capacity of its partners, both government and non- governmental, as well as the private sector. USG support will be at three levels: community, institutional and tertiary. Irish Aid, the World Bank, CIDA, and the EU are all key donors in capacity building.
Strategic Analysis and Knowledge Support System (SAKSS)
Since 2008, USAID/Malawi has supported a SAKSS unit implemented through the International Food Policy Research Institute (IFPRI) at the MoAFS. The objectives of this activity are threefold: 1) generate demand-driven diagnostic and strategic research to fill key knowledge gaps, 2) establish an information and knowledge support system, in cooperation with the Southern Africa Regional Strategic Analysis and Knowledge Support System that has been set up to help promote peer and progress review of the CAADP, and 3) strengthen the capacity of national institutions, such as the MoAFS, in policy and strategy research. The Malawi Mission plans to extend the work of the SAKSS unit as part of capacity building support under FTF.
Malawi Agriculture Policy Strengthening (MAPS)
Strong civil society and private sector networks are critical to implementing the ASWAp in a way that responds to the evolving needs of its stakeholders. In recent decades, weak capacity and declining GoM interest in inclusive policy making is leading Malawi’s CAADP process towards a Government-owned rather than Country-owned process. Grounded in the CAADP principles of increasing stakeholder participation in the policy making process,44 the Malawi Agriculture Policy Strengthening (MAPS) program is designed to increase the participation of private sector and civil society stakeholders in agriculture policy dialogue.
MAPS will increase the profile, capacity and engagement of civil society and private sector stakeholders in agriculture policy development and implementation through a combination of capacity building interventions and establishing linkages between producers and consumers, including state and non-state actors, of high quality policy research. Though not exclusively, MAPS will focus on key stakeholders along the proposed FTF value chains.
MAPS capacity building activities will focus on improving organizational ability to meet its goals and objectives by strengthening administrative and financial management, organizational structure and strategic planning. The second focus of the project will strengthen policy analysis and advocacy capacity through building linkages between Malawian farmers and private sector associations and regional networks and research institutions, such as local and regional universities among civil society groups. MAPS will similarly link GoM counterparts to those research institutions to improve their ability to become informed consumers of stakeholder policy advocacy. These two components will account for the varying levels of development and readiness of organizations and associations in Malawi to take on advocacy activities. MAPS will also focus on elevating the voices of women in policy dialogue by targeting women-led civil-society/public service organizations for organizational capacity building and providing additional women-focused leadership training and gender equity sensitization to facilitate women taking on leadership roles within larger organizations.
","An important element of the multi-year FTF Strategy is monitoring and evaluation, which is an iterative learning process that will put into place the principle of a sustained and accountable delivery approach. Program activities must be monitored through periodic field visits by Mission staff and ongoing monitoring and learning by implementing partners. Mission staff has a key role to play in monitoring and learning from partners both through oversight and input to design of project level M&E plans and systems and also through follow-up on quarterly reports and other communication with partners.
The integration of agricultural, nutrition, and health elements into a joint strategic plan provides a unique opportunity to innovate, document, and demonstrate best practices associated with a concurrent multi-sector investment model. Also, the Malawi FTF Strategy will foster linkages among existing programs, which will harmonize key agriculture and nutrition and indicators across relevant areas of focus.
Building on this collaboration, both the Health and Sustainable Economic Growth (SEG) teams at USAID/Malawi will work together to integrate M&E systems and processes in order to track synergies and multiplier effects between the two sectors not captured through the agriculture/nutrition overlap. There is currently significant USG investment on the part of USAID through PEPFAR and GHI in health systems strengthening, family planning, and malaria and tuberculosis reduction among others in the geographic areas targeted through FTF. We believe it is critical to capture at the highest level the combined impact of FTF and GHI/PEPFAR in order to reduce duplication, increase the applicability of data across interventions and most importantly, learn across programs in order to improve and increase efficiency and impact of all USAID investments in Malawi. This integration of M&E function may take the form of harmonized M&E plans at the implementer level combined with joint monitoring visits by SEG and Health team members.
Reliable and well-defined monitoring, reporting and evaluation methods, roles and communication channels result in improved project and program management, promote ongoing learning and testing of development hypotheses and ensure accountability. A fully functioning M&E team and system further help to illustrate the Mission’s value added to overall development not only to key stakeholders in the USG, but also to the GoM and other development partners.
USAID/Malawi is currently refining Mission processes in line with the requirements and recommendations of the newly announced USAID Evaluation Policy. To that end, and in preparation for the Country Development Cooperation Strategy (CDCS), SEG will identify further impact evaluation questions and set aside funds for impact evaluation in 2011. This will serve as solid preparation for FTF-focused evaluation activities in subsequent years.
","Feed the Future aims to help an estimated 281,000 vulnerable Malawian women, children, and family members—mostly smallholder farmers—escape hunger and poverty. More than 293,000 children will be reached with services to improve their nutrition","Central and southern regions","","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Number of institutions/organizations undergoing capacity /competency assessments as a result of USG assistance; Number of institutions/organizations mature/viable in the competency areas strengthened as a result of USG assistance Frequency of GoM consultation with civil society/private sector on relevant policies; Comparison of programmatic objectives Pre and post FtF funding distribution; Number of new funding mechanisms","Vulnerable groups","","","","","","","","","","","","","","","","","","","","","","","","","","English" "23176","ACF-France programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Manni","English","Community/sub-national","","BFA","Burkina Faso","Manni, Burkina Faso","Rural","completed","05-2012","05-2014","Action Contre la Faim - France (ACF-F) intervient dans la région de l´Est du Burkina Faso depuis 2008 et dans la province de la Gnagna (le district sanitaire (DS) de Bogandé et Manni) depuis 2009. Le projet d’appui à la Prise en charge de la malnutrition aigüe (PCIMA) a commencé en mai 2012 puis reconduit en juillet 2013 et prendra fin en mai 2014 et a pour objectif de contribuer à la réduction de la morbidité et de la mortalité liées à la malnutrition aigüe. L’appui donné au district de Manni est fait depuis la Base d’ACF située dans le district de Bogandé.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Manni (2013 and 2014):
","8806","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","OFDA ( U.S. Office of Foreign Disaster Assistance)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23175","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Manni","Community-based|Primary health care center","","Les activités de prise en charge de la Malnutrition Aigüe (PCIMA) sont assurées dans tous les centres de santés du district sanitaire de Manni. Cela concerne aussi bien la prise en charge en ambulatoire (PCA) pour la MAS/MAM et la prise en charge en interne (PCI) pour les cas de MAS avec complications.
Les activités d’appui consistent essentiellement à la formation et au recyclage des agents de santé, les visites d’appuis techniques à travers des supervisions régulières pour la PCA et la PCI, appui en équipements médico-techniques et en intrants pour la prise en charge. Au niveau de la PCI ACF-F fait la subvention des repas des accompagnant(e)s depuis septembre 2012 ainsi que les soins médicaux (médicaments, consommables et examens biologiques) et évacuations des malades des CSPS vers les CREN.
","La SQUEAC c´est une évaluation semi-quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","ACF effectue des évaluations périodiques de la couverture du programme PCIMA, la dernière évaluation a été réalisée en mai 2013. Pour voir l’évolution de la couverture et la mise en route des recommandations de l’évaluation passée, une seconde évaluation a été réalisée en février 2014, huit mois après la précédente évaluation qui avait montré un taux de couverture actuelle de de 26,1% [IC 95% : 17,1- 37,7%]. L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
Etape 1: Identification des zones de couverture élevée ou faible et des barrières à l’accessibilité
Etape 2: Vérification des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
Etape 3: Estimation de la couverture globale
","La population du district sanitaire de Manni est estimee a 168 963 habitants en 2014 (RGPH 2006) dont les enfants de 6 a 59 mois representent 18,55% (31 343).","52,4% [IC 95% : 43,1 - 61,8%]","Point","Les prévalences selon l’indice Poids/Taille de la malnutrition dans la province de la Gnagna étaient estimées en septembre 2013 à 7,5% [5,8-9,6%] pour la Malnutrition Aigüe Globale (MAG) et à 1,2% [0,6-2,6%] pour la Malnutrition Aigüe Sévère (MAS).","","None","","","Others, please specify below","","Management","","Communication","","Infrastructure","","Others, please specify below","","","","","","","","","","","","","Les résultats indiquent une forte évolution de la couverture car elle est le double de celle retrouvée à la dernière évaluation. Cette situation est à mettre en lien avec une forte amélioration des activités de dépistages passifs au niveau des centres de santé ainsi que l’implication des animateurs communautaires pour la sensibilisation et la recherche des absents (personnels du GRET ONG partenaire qui se charge du volet communautaire). La disponibilité et l’implication des personnels surtout au niveau des CSPS pourraient être un point fort du district sanitaire ce qui contribue beaucoup à l’amélioration de sa couverture. L’absence des hameaux de culture, présents dans les autres districts sanitaires, notamment Bogandé, permet d’éviter les déplacements des populations pendant les périodes des récoltes, et serait grandement responsable pour cette forte couverture.
","","English" "23187","ACF-France programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Bogande","English","Community/sub-national","","BFA","Burkina Faso","Bogande, Burkina Faso","Rural","completed","05-2012","05-2014","Action Contre la Faim – France (ACF-F) intervient dans la région de l´Est du Burkina Faso depuis 2008 et dans la province de la Gnagna depuis 2009. Le projet d’appui à la Prise en charge de la malnutrition aigüe (PCIMA) a commencé en mai 2012 puis reconduit en juillet 2013 et prendra fin en mai 2014. L´appui donné au district de Bogandé est fait depuis la Base d’ACF située à Bogandé. Le projet actuel, financé par OFDA a pour objectif de contribuer à la réduction de morbidité et mortalité associées à la malnutrition aigüe au Burkina Faso.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Bogande (2013 and 2014):
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","Bureau du Foreign Disaster Assistance des États-Unis (OFDA) ","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23186","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Bogande","Primary health care center","","Les activités de prise en charge de la Malnutrition Aigüe (PCIMA) sont assurées dans les centres de santés publiques et confessionnelles du district sanitaire de Bogandé. Cela concerne aussi bien la prise en charge en ambulatoire (PCA) pour la MAS/MAM et la prise en charge en interne (PCI) pour les cas de MAS avec complications.
Les activités d’appui d’ACF consistent essentiellement à la formation et au recyclage des agents de santé, les visites d’appuis techniques à travers des supervisions régulières pour la PCA et la PCI, appui en équipements médico-techniques et en intrants pour la prise en charge. Au niveau de la PCI ACF-F fait la subvention des repas des accompagnantes depuis septembre 2012 ainsi que les soins médicaux (médicaments, consommables et examens biologiques) et évacuations des malades vers les CREN.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","ACF effectue des évaluations périodiques de la couverture du programme PCIMA, la dernière évaluation a été réalisée en mai 2013, dans la province de la Gnagna (District sanitaire Bogandé). Pour voir l’évolution de la couverture et la mise en route des recommandations de l’évaluation passée, une seconde évaluation a été réalisée en février 2014 (03 au 23 février 2014), huit mois après la précédente évaluation qui avait montré un taux de couverture actuelle de 30,2% [IC 95% : 20,8- 41,6%].
L' investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
","Les enfants de 6 à 59 mois représentent 17,85% (61736) du population du district sanitaire de Bogande","38,8% [IC 95% : 29,8 - 48,6%]","Point","","","None","","","Others, please specify below","","Management","","Others, please specify below","","Infrastructure","","Others, please specify below","","","","","","","","","","","","","Cette couverture faible est à mettre en lien avec les préoccupations des mères (charge de travail) ainsi qu’une méconnaissance de l’importance des soins nutritionnels (malnutrition perçue souvent comme maladie traditionnelle) entrainant un recours de première intention au traitement traditionnel, limitant ainsi l’accès aux soins en dépit de sa gratuité pour les enfants malnutris. L’investigation a par ailleurs mis en évidence une faiblesse du système de dépistage actif et de suivi des absents au traitement, ce qui pose la question de la pérennisation de ces activités en l’absence de soutien technique continu.
En plus de ces barrières à l’accessibilité communes dans l’ensemble du District Sanitaire de Bogandé, la distance est ressortie comme un frein supplémentaire à l’accessibilité dans les zones concernées.
Nonobstant ces barrières et la faible évolution de la couverture il faut rappeler que des efforts considérables sont mis en oeuvre sur le terrain par les différents acteurs dans le cadre des activités de PCIMA, tant au niveau communautaire que sur le plan de la prise en charge dans les structures de santé. Dans le contexte actuel et pour espérer un désengagement total d’ACF dans le District Sanitaire de Bogandé quant aux activités de prise en charge de la malnutrition, il apparaît aujourd’hui impératif d’entreprendre des mesures correctrices afin de consolider les acquis et continuer d’améliorer la couverture et l’accessibilité au traitement pour les malnutris.
","","English" "23199","CICR programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Gorom Gorom","English","Community/sub-national","","BFA","Burkina Faso","gorom gorom, burkina faso","Rural","on-going","","","La Croix Rouge de Belgique, en partenariat avec la Croix Rouge burkinabè et les autorités sanitaires ont mis en oeuvre depuis 2007 un programm d’appui aux structures sanitaires dans neuf provinces réparties dans 3 régions (Sahel, Nord, Centre Ouest).Pour la région du Sahel, le passage à l’échelle s’est fait à partir de 2011 par des phases successives sous financement ECHO (European Community Humanitarian aid Office). Aujourd’hui, le programme couvre les 18 Centre de Santé et de Promotion Sociale (CSPS) du District Sanitaire de Gorom Gorom. Le programme est actuellement en phase 6, phase ayant débutée en mars 2013 qui prendra fin en janvier 2014. Cette phase prévoit de consolider l’appui au système de santé de la région du Sahel en vue d’accroitre son efficacité dans la prise en charge ambulatoire de la malnutrition aigüe à travers des appuis techniques et financiers touchant à la fois la qualité, la couverture, le suivi/évaluation et la capitalisation de la prise en charge de la malnutrition aigüe.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Gorom Gorom:
","","","","","","","International Committee of the Red Cross (ICRC)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23198","","Management of severe acute malnutrition","","","","SAM child","Enfants de 0 à 59 mois","District de Gorom Gorom","Community-based|Primary health care center","","Le cadre approprié pour la prise en charge de la malnutrition aiguë modérée est constitué des Centres de Santé et de Promotion Sociale (CSPS), des Centres Médicaux avec Antenne Chirurgicale (CMA) ou tout autre structure menant des activités de supplémentation alimentaire. En période d’urgence des Centres de Supplémentation Nutritionnelle (CSN) pourront être ouverts à cet effet.
Le cadre approprié de la prise en charge de la malnutrition sévère est le centre de récupération et d’éducation nutritionnelle (CREN). Son rôle principal est le traitement de la malnutrition sévère et l’éducation des familles en matière de nutrition.
Là où il n’existe pas de CREN, les CSPS doivent assurer une prise en charge en externe des cas adaptés à ce mode de traitement.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 1 au 20 novembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Aux recommandations ci-dessus sont ajoutées des recommandations spécifiques à l’attention:
De la Croix Rouge de Belgique:
-Evaluation des Centre d’Accueil Pour Nutrition (CAPN),
-Définition de la stratégie communautaire sur plusieurs années,
-Réflexion de concert avec la DRS et les DS (en impliquant les CISSE et les Points Focaux Nutrition) au concept CAPN et ses orientations en vue d’une meilleure intégration dans le système sanitaire,
-Travail conjoint avec la Direction Régionale de la Santé et les District Sanitaire sur un système harmonisé de collecte des données communautaires incluant tous les paramètres de suivi de la MAS (base de données complémentaires)
-Renforcement des ressources humaines des formations sanitaires en personnel additionnel,
-Révision de l’organisation terrain depuis le pôle technique jusqu’au positionnement des agents de terrain.
De la Direction régionale de la Santé du Sahel:
-Suivi de la mise en oeuvre des recommandations,
-Accompagnement du district dans la mise en oeuvre des recommandations,
-Mise en place d’un système harmonisé de collecte des données communautaires incluant tous les paramètres de suivi de la MAS (base de données complémentaires)
-Augmentation des ressources humaines dans les centres de santé,
-Recherche d’un système de motivation des agents de santé des CSPS (FBR, primes) conjointement avec les districts.
Du District sanitaire de Gorom Gorom :
-Restitution formelle des résultats de la SQUEAC,
-Evaluation de la mise en oeuvre des recommandations de la SQUEAC dans les cadres de concertation périodiques,
-Renforcement de la concertation entre acteurs de mise en oeuvre du programme,
-Recherche d’un système de motivation des Agents de santé communautaire (ASBC),
-Renforcement des compétences des agents de santé (formation, supervision),
-Renforcement des ressources humaines des CSPS,
-Amélioration des connaissances des populations sur la malnutrition et le programme de PEC,
-Recherche d’un système de motivation des agents de santé des CSPS (FBR, primes),
-Recherche des moyens pour faire face aux barrières géographiques.
L’Association de Solidarité et Coopération Internationale (LVIA) et son partenaire Medicus Mundi Italie (MMI) apportent un soutien à la Direction Régionale de la Santé du Centre-Ouest et au District sanitaire de Réo depuis mai 2012 pour la mise en oeuvre de la Prise en Charge Intégrée de la Malnutrition Aiguë (PCIMA). L’appui de LVIA-MMI au District Sanitaire (DS) de Réo porte principalement sur le renforcement des capacités des agents de santé pour la mise en oeuvre de la PCIMA, l’appui au DS pour la réalisation des campagnes de dépistage trimestrielles, la subvention totale de la prise en charge des complications en interne (frais de transport, traitement diététique et médical, alimentation de l’accompagnant), l’acheminement et le stockage des ATPE, et la fourniture de farines enrichies pour la consolidation après guérison des cas de MAS.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Pama:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/SQUEAC_Rapport_REO_2014.pdf
","","","","","","","Other","Medicus Mundi Italie (MMI)","","","","","National NGOs","Association de Solidarité et Coopération Internationale (LVIA)","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23211","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Réo","Primary health care center","","Sur le plan sanitaire, le District sanitaire de Réo est divisé en 40 aires de santé, et comporte 36 CSPS, 4 CM et 5 CREN.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 17 février au 14 mars 2014 en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Les actions de mobilisation communautaire entreprises pour soutenir le passage à l’échelle de la PCIMA ont favorisé une bonne connaissance de l’existence du traitement au niveau de la communauté. L’influence des cas guéris favorise par ailleurs une perception positive de l’efficacité du traitement, encourageant le recours aux soins spontané.
Au total, le faible niveau de couverture mis en évidence au cours de cette investigation souligne la nécessité de consolider les actions entreprises dans le cadre du passage à l’échelle. Les réorientations devront notamment prendre en compte les défis posés par les difficultés d’accessibilité géographique,
","","English" "23214","CICR programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Sebba","English","Community/sub-national","","BFA","Burkina Faso","Sebba, burkina faso","Rural","on-going","07-2007","","Le Croix Rouge de Belgique (CRB) et la Croix Rouge Burkinabè travaillent en partenariat avec le service de la santé depuis 2007 dans la région du Sahel au Burkina Faso. Ce partenariat est orienté vers le renforcement des capacités en ce qui concerne la Prise en Charge de la Malnutrition Aiguë sous financement ECHO. Aujourd’hui, le programme couvre les 13 CSPS dans le district du Sebba aussi que 23 CAPN (Centre d’Accueil Pour Nutrition). Le programme est actuellement en phase 6, phase ayant débutée en mars 2013 qui prendra fin en janvier 2014. Cette phase prévoit de consolider l’appui au système de santé de la région du Sahel en vue d’accroitre son efficacité dans la prise en charge ambulatoire de la malnutrition aigüe à travers des appuis techniques et financiers touchant à la fois la qualité, la couverture, le suivi/évaluation et la capitalisation de la prise en charge de la malnutrition aigüe.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Sebba:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/RAPPORT-SQUEAC-SEBBA.pdf
","","","","","","","International Committee of the Red Cross (ICRC)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23213","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Sebba","Primary health care center","","Le cadre approprié pour la prise en charge de la malnutrition aiguë modérée est constitué des Centres de Santé et de Promotion Sociale (CSPS), des Centres Médicaux avec Antenne Chirurgicale (CMA) ou tout autre structure menant des activités de supplémentation alimentaire. En période d’urgence des Centres de Supplémentation Nutritionnelle (CSN) pourront être ouverts à cet effet.
Le cadre approprié de la prise en charge de la malnutrition sévère est le centre de récupération et d’éducation nutritionnelle (CREN). Son rôle principal est le traitement de la malnutrition sévère et l’éducation des familles en matière de nutrition. Là où il n’existe pas de CREN, les CSPS doivent assurer une prise en charge en externe des cas adaptés à ce mode de traitement.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
","Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du 1 au 20 novembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d´identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Points forts:
- Les ASC / AV sont actifs avec leurs activités
- Le CSPS est le premier recours aux soins
- Il existe une bonne connaissance et une appréciation du traitement ATPE.
Barrières à l’accessibilité des soins qui limitent la couverture:
- La distance et l’inaccessibilité géographique des certains villages, surtout en saison des pluies.
- La qualité de la prise en charge de la Malnutrition Aigüe Sévère au niveau CSPS : Pas de dépistage systématique aux cours des consultations, temps d’attente trop long, manque de communication entre les AS et les mères concernant le traitement, mauvais accueil au CSPS.
- Manque de connaissance de la malnutrition et du programme : les mères voient que l’enfant est malade mais ne savent pas de quelle maladie l’enfant souffre ni pourquoi. Elles vont au CSPS car c’est là où elles soignent les enfants malades mais pas parce qu’elles connaissent le programme.
Action Contre la Faim Espagne (ACF-E) met en place un programme de renforcement des capacités de prise en charge de la malnutrition aiguë dans tout le cercle sanitaire de Kita depuis juillet 2012 (une partie seulement du cercle était couvert depuis 2011). La prise en charge de la malnutrition aigüe sur Kita se fait au niveau du CSRef (Centre de santé de référence, situé à Kita) pour les enfants MAS avec complications (en URENI), au niveau des CScom (centres de santé communautaires) pour les enfants MAS sans complications (en URENAS) et MAM (en URENAM). Il est aussi à noter que des Agents de santé communautaire (65) ont été formés en 2012 au dépistage et à la prise en charge de la MAM.
ACF-E supporte techniquement et logistiquement les autorités sanitaires pour le dépistage et la PEC de la malnutrition aigüe sur toutes les aires de santé fonctionnelles du cercle de Kita à travers 2 projets: un financé par ECHO depuis 2012 (35 CScom) et un autre nommé PASAN, financé par AECID depuis 2011 (6 CScom8) et pour lequel ACF-E est en appui à une ONG nationale (Stop Sahel).
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Kita:
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","Spanish Agency for International Development Cooperation (AECID)","Bilateral and donor agencies and lenders","Other","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23243","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Kita","Primary health care center","","Le District sanitaire de Kita est constitué de 46 aires de santé. 3 sont toujours considérés comme non fonctionnelles6 (Kolé, Niantasso, Sanko). L’aire de santé de Sibikily vient d’être dotée en personnel et ACF-E leur a fait une formation sur la PEC de la malnutrition aigüe.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite en decembre 2013 en utilisant la méthodologie « Semi Quantitative Evaluation of Access and Coverage » (SQUEAC). Une première évaluation de la couverture du programme nutritionnel a été menée en mars 2013 et montrait des taux de couverture actuelle de 24,9% [IC95% : 14,5%-39,2%]. L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Au total, cette investigation met en avant le besoin de poursuivre le travail entrepris par les équipes d’ACF-E en collaboration avec les autorités sanitaires, le personnel des CScom et les relais communautaires. L’implication des ASC dans la PEC de la MAS est à envisager.
L’hypothèse d’hétérogénéité de la couverture a été confirmée, avec des zones de plus haute couverture dans les villages proches des CScom (<5kms) où des RC mènent des activités de dépistage et de sensibilisation et des zones de plus faible couverture dans les villages éloignés des CScom, d’autant plus si peu de dépistage des enfants malnutris aigus est effectué.
Le programme santé/nutrition IRC (International Rescue Committee) appui le district sanitaire de Ménaka dans la prise en charge de la malnutrition aigüe (modère et sévère) chez les enfants de 6-59 mois. Ce programme a démarré effective en octobre 2013 et a été mis en oeuvre dans 11 aires de santé de 3 communes (Ménaka, Andeboukane et Alata) du district. Il soutient les activités nutritionnelles dans les centres fonctionnels.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Ménaka:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/Rapport-SQUEAC_M%C3%A9naka_VF1.pdf
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23247","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Ménaka","Primary health care center","","Ce programme PECIMA appuie 5 centres de santé communautaires (CSCom) fonctionnels et 6 aires non-fonctionnelles à travers des cliniques mobiles pour la pris en charge ambulatoire des enfants MAS/MAM (URENAS/URENAM) et pour administrer les soins primaires à la population.
Les autorités sanitaires et leaders communautaires sont parties prenantes dans la mise en oeuvre et le suivi des activités programmées á traves divers rencontres organisées. Ce partenariat est matérialise par une convention signé par IRC, le District sanitaire et le président de l’ASACO.
Le programme s’articule autour des stratégies suivantes:
- Les CSCom bénéficient d’un appui en ressources humaines qualifiées, en matériel et intrants pour assurer une prise en charge de la malnutrition aigüe gratuite et de qualité en respectant les protocoles au Mali. Les activités sont suivies par un Médecin Superviseur et appuyé par un Infirmier Polyvalent en charge de la réception et stockage des médicaments, et de l’approvisionnement des CSCom et des équipes mobiles - les médicaments sont commandés à l’UNICEF intrants nécessaires á la prise en charge de la MAS; pour la MAM, les commandes d’intrants sont faites au PAM. Certaines réhabilitations au niveau des structures sanitaires appuyées ont et réalisées afin d’améliorer le circuit des patients et les conditions de travail/d’accueil.
- Référencement au CSRef de Ménaka des enfants présentant les complications lors du suivi. Apres stabilisation, ces enfants sont ramenés dans leurs CSCom d’origine pour poursuivre leurs traitements en ambulatoire. Le transport aller-retour est assuré par IRC.
- Dépistage systématique de tous les enfants consultant les structures sanitaires appuyées par IRC est fait par le périmètre brachial, le Z-score et la recherche des oedèmes.
- Un réseau de relais communautaires est mis en place au niveau des 5 CSCom en collaboration avec les leaders communautaires et l’équipe du CSCom. Ces relais communautaires sont formés sur la sensibilisation, le dépistage de la malnutrition aigüe et référencement des cas suspects (jaune/rouge/oedème). Les relais sont supervisés par 2 Officiers Activités Communautaires qui organisent le planning des campagnes de dépistage, des messages de sensibilisation en fonction des problèmes rencontrés et tiennent des réunions mensuelles pour la planification des activités.
La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du du 14 mars au 9 avril 2014 en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Les barrières identifiées lors de l´étude ont soulevé les faiblesses du volet communautaire du programme PECIMA d´IRC. Le manque total de relais communautaires dans les aires de santé non-fonctionnelles et l´insuffisance d´activité, tant sur le plan du dépistage que de la sensibilisation, sont déterminants pour diminuer des barrières comme la méconnaissance du programme et de la malnutrition et palier le recours tardive aux soins des enfants.
La distance, avec toutes les facteurs liés comme le temps, le cout et la disponibilité de moyens pour se déplacer, c´est une barrière qui ressorti dans les aires de santé fonctionnelles. Mais également, dans les aires où les cliniques mobiles se déplacent, les communautés sont éloignés entre eux et avec un difficile accès ce qui fait que les équipes n´arrivent à toutes les zones et donc les populations doivent se déplacer.
Au niveau de la prise en charge, les barrières comme les ruptures d´intrants ainsi que certaines déficiences dans l´application du protocole, qui certainement ont un impact direct sur la couverture du programme, ont été soulevés. Le dépistage passive n´est pas systématique pour les enfants en consultation et par rapport aux enfants qui sont admis dans le programme, le suivi de cas au niveau individuel, surtout des cas problématiques comme des absences et abandons est presque inexistant. Finalement, il faut remarquer l´importance du suivi au niveau programme: assurer la qualité des données pour pouvoir faire un monitorage de routine des indicateurs.
","","French" "23250","IRC programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Nara","English","Community/sub-national","","MLI","Mali","Nara, Mali","Rural","on-going","09-2013","","L´IRC (International Rescue Committee) a démarré en septembre 2013 un programme d´appui au district sanitaire que comprends, entre autres activités, la prise en charge de la malnutrition aigüe sévère. Ce programme PECIMA a été mis en oeuvre dans 10 aires de santé fonctionnelles de 8 communes du district.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Nara:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/Rapport-SQUEAC_Nara_VF1.pdf
","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23249","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Nara","Primary health care center","","Le programme à Nara s’articule autour des stratégies suivantes:
- Gratuité des soins dans les CSCom: Assurer une gratuite de soins chez les enfants de moins de 5 ans souffrant de MAS. Les CSCom bénéficient d’un appui en ressources humaines (équipe mobile qui passe dans les CSCom selon le jour d’affluence (Foire/Marché hebdomadaire): une fois par CSCom par semaine), en matériel et intrants pour assurer de façon optimale les activités de prise en charge en respectant le protocole national du Mali. Aussi la réhabilitation des espaces d’accueil dans les CSCom appuyés afin de faciliter la réalisation des activités, suivies par le Médecin Superviseur.
- Référence et contre référence des cas compliqués: Les enfants présentant des complications lors du suivi sont référés au CSRéf de Nara pour une meilleure prise en charge. Après la stabilisation, ces enfants retournent dans leur CSCom d’origine pour poursuivre leur traitement. Le transport aller-retour de ces patients est assuré par IRC.
- Dépistage systématique au niveau des CSCom: Tous les enfants consultés dans les structures sanitaires appuyées par IRC bénéficient d’un dépistage systématique fait par le Périmètre brachial, le Z score et la recherche des oedèmes.
- Renforcement du volet communautaire: Le dépistage de la malnutrition aigüe, la reference des cas, la sensibilisation, la recherche des absents et des abandons sont des activités développées par lesanimateurs communautaires du projet en synergie avec les agents terrain du partenaire local CSPEEDA et les relais communautaires. Le réseau de relais communautaires est mis en place au niveau
La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du du 14 mars au 3 avril 2014 en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Les barrières identifiées auprès de l´étude ont soulevées les faiblesses du volet communautaire du programme PECIMA d´IRC. La méconnaissance de la malnutrition, en termes de non reconnaissance des signes ainsi que des causes ou conséquences de la maladie, c´est une barrière qu´a ressorti auprès de toutes les étapes de l´investigation et ce qui semble gagner de l’importance dans les zones plus éloignés des CSCom, comme a été constaté à travers l’enquête dans les petites zones. La méconnaissance du programme est beaucoup ressortie, mais uniquement dans les zones plus distantes. En effet, dans le contexte de Nara, la distance n´est pas seulement une barrière essentielle à l’accès pour les bénéficiaires (mais aussi pour le programme: les activités de sensibilisation et de dépistage, que sont déjà globalement insuffisantes –ni continus ni régulières ni à niveau communautaire ni des CSCom- sont Presque inexistants dans les aires reculées.
Ces barrières que contribuent à la présentation tardive des admissions expliquent la sévérité des cas qu´arrivent aux centres ainsi que le faible niveau de couverture, et sont en plus augmentés par autres aspects déficitaires de la prise en charge (application correcte du protocole) et du suivi: suivi de cas au niveau individuel (des absences, recherche des abandons) et au niveau programme (qualité des données, monitorage des indicateurs de routine).
","","English" "23252","IMC programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Amdam","French","Community/sub-national","","TCD","Chad","Sila, Chad","Rural","on-going","07-2010","","L’histoire de la PCIMA dans le district d’Amdam avait commencé avec l’arrivée de MSF-Hollande, Septembre 2007 avec un programme de soins de santé primaire (consultation curative, CPN), nutrition sous clinique mobile et appui en personnel à l’hôpital du district. En 2010, avec l’appui d’ECHO, International Medical Corps redémarrera la PCIMA avec 16 sites et depuis Novembre 2012 jusqu'à nos jours, le district compte actuellement 19 sites de prise en charge CNA/CNS et 1 centre de stabilisation à l’hôpital du District. Parmi les 19 sites CNA/CNS, 3 sont fixes et 16 cliniques mobiles.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/.
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Amdam:
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23251","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Amdam","Community-based|Primary health care center","","Le District d’Amdam compte 4 zones de responsabilité et selon les possibilités du financement International Medical Corps était en mesure de mettre en oeuvre son programme de nutrition dans toutes les zones de responsabilité d’Amdam avec 2 CNA fixes et 11 cliniques mobiles (des Juillet 2010 jusqu’en Octobre 2012) Depuis Novembre le réseau de clinique mobile a été augmentée avec l’ouverture de 6 nouveaux sites, ce qui donne un total de 16 cliniques mobiles et 3 CNA fixe sur l’ensemble du District.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du du 14 mars au 3 avril 2014 en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). Une première enquête utilisant la méthodologie SQUEAC était réalisée par International Medical Corps en Avril 2012 et avait trouvé un taux de couverture de 34%. L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Certaines insuffisances ont été identifiées lors de cette enquête notamment l’insuffisance d’engagement du personnel soignant du Ministère de la sante travaillant dans les centres de santé fonctionnels pour le succès du programme. Ceux-ci nous ont semblé considérer le programme de Nutrition comme étant une affaire des ONG. Le travail mené par les relais communautaires nécessite un suivi rapproché bien qu’il y a nécessité d’augmenter leur nombre il faut d’abord encadrer ceux qui existent déjà afin d’améliorer leur performance dans le travail.
Il y a une certaine adéquation entre les tendances des admissions et le calendrier saisonnier. Ce qui signifierait que le programme répond d’une manière ou d’une autre aux besoins mais cela est à prendre avec réserve parce qu’étant donné que l’hypothèse de la distance et l’inaccessibilité font partie des barrières majeures au programme il y a lieu de penser que ces tendances d’admissions traduiraient juste une indication sur la réalité.
L’amélioration de la sensibilisation communautaire à travers une augmentation du nombre des relais communautaires, l’augmentation de sites dans les villages lointains ainsi que le renforcement de la clinique mobile surtout dans les zones éloignées: Teleguey et Koutoufare constituent pour le moment des solutions incontournables pour l’amélioration de la couverture nutritionnelle dans le district d’Amdam.
","","French" "23254","IMC programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Iriba","French","Community/sub-national","","TCD","Chad","Iriba, Chad","Rural","on-going","07-2010","","L’histoire du PCIMA dans le district d’Iriba a débuté avec l’arrivée des réfugiés Soudanais en 2004. Il était mis en oeuvre par les humanitaires dans les centres de santé des camps d’Amnaback, Touloum et Iridimi. Depuis Juillet 2010, en plus des centres nutritionnels des camps, International Medical Corps avait ouvert pour la population hôte 1 CNS et CNA fixe dans le centre de santé d’Iriba ainsi que 20 sites CNA et CNS de clinique mobile dans la zone de responsabilité d’Iriba soit dans un rayon d’environ 25 km autour de la ville d’Iriba depuis. A partir d’octobre 2012, International Medical Corps a élargi son rayon d’action dans le district d’Iriba couvrant 13 zones de responsabilité dont 5 fonctionnelles et 8 non fonctionnelles sous le financement ECHO.
","Ce programme a été identifié par le biais du projet «Coverage Monitoring Network» (CMN). Le projet CMN est une initiative inter-agence qui vise à accroître et d'améliorer le suivi de la couverture de la gestion communautaire de la malnutrition aiguë (CMAM) programmes à l'échelle mondiale, et renforce les capacités des professionnels nationaux et internationaux de la nutrition. Sa vocation est de fournir un support technique et des outils aux programmes de PCMA afin de les aider à évaluer leur impact, de partager et capitaliser les leçons apprises sur les facteurs influençant leur performance. Le projet met l'accent sur le renforcement des compétences en méthodologie SQUEAC et SLEAC. Il est mis en œuvre par un consortium dirigé par ACF International, et comprend Save the Children, Concern Worldwide, International Medical Corps, Helen Keller International et Valid International. Le projet est financé par la Commission européenne, Direction générale de l'aide humanitaire et de la protection civile (ECHO) et le Bureau du Foreign Disaster Assistance des États-Unis (OFDA) de l'USAID. Pour en savoir plus, s'il vous plaît visitez le site Web de la CMN à
http://www.coverage-monitoring.org/.
Veuillez suivre le lien ci-dessous pour accéder au rapport complet du CMN sur la couverture du projet PCMA dans le district de Iriba:
","","","","","","","","","","","","","","","","","","","","","","Bilateral and donor agencies and lenders","European Commission Humanitarian Aid & Civil Protection (ECHO)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23253","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Iriba","Community-based|Primary health care center","","Le District d’Iriba compte 22 zones de responsabilité et selon les possibilités du financement International Medical Corps n’était en mesure de mettre en oeuvre son programme de nutrition que dans la seule zone de responsabilité d’Iriba et ses environs soit dans un rayon de plus ou moins 25 km autour de la ville d’Iriba depuis Juillet 2010 jusqu’en Octobre 2012 à travers un CNA fixe et des sites de cliniques mobiles. Depuis Octobre 2012, le programme a commencé à être étendu vers toutes les zones de responsabilité du District.
","La SQUEAC c´est une évaluation semi‐quantitative parce que combinant des données quantitatives et qualitatives:
Données quantitatives: données de routine (admissions, abandons, indicateurs de performance) et données collectées (cas couverts et cas non couverts) au cours d’enquêtes sur petites et grandes zones.
Données qualitatives: informations (opinions, connaissances sur la malnutrition, connaissances du programme de PEC, perception de la malnutrition, recours aux soins, facteurs limitant la PEC…) collectées auprès la communauté, des acteurs et bénéficiaires impliqués dans le service.
Une investigation de la couverture du programme de prise en charge de la MAS dans le district a été conduite du du 14 mars au 3 avril 2014 en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). Une première enquête utilisant la méthodologie SQUEAC était réalisée par International Medical Corps en Avril 2012 et avait trouvé un taux de couverture de 36%. L´outil SQUEAC permet d´assurer à moindre coût un monitoring régulier des programmes et d’identifier les zones de couverture faible ou élevée ainsi que les raisons expliquant ces situations. L’ensemble de ces informations permet de planifier des actions spécifiques et concrètes dans le but d’améliorer la couverture des programmes concernés.
La méthodologie SQUEAC se compose de trois étapes principales:
L’étape 1 consiste à identifier les zones de couverture élevée ou faible et des barrières à l’accessibilité
L’étape 2 permet de vérifier des hypothèses sur les zones de couverture faible ou élevée au moyen d’enquêtes sur petites zones
L’étape 3 permet d’estimer la couverture globale à travers la construction d’un « a priori » (basé sur les barrières et les boosters), de l’Évidence Vraisemblable et d’un « post priori » basé sur la recherche de cas.
Certaines insuffisances ont été identifiées lors de cette enquête notamment l’insuffisance d’engagement du personnel soignant du Ministère de la sante travaillant dans les centres de santé fonctionnels pour le succès du programme. Celui-ci nous a semblé considérer le programme de Nutrition comme étant une affaire des ONG. Le travail mené par les relais communautaires nécessite un suivi rapproché bien qu’il y a nécessité d’augmenter leur nombre il faut d’abord encadrer ceux qui existent déjà afin d’améliorer leur performance dans le travail. Une certaine négligence dans la complétude des fiches individuelles des cas était relevée notamment le non enregistrement systématique des villages d’origine ainsi que la mesure du périmètre Brachial des enfants.
Il y a une certaine adéquation entre les tendances des admissions et le calendrier saisonnier. Ce qui signifierait que le programme répond d’une manière ou d’une autre aux besoins mais cela est prendre avec réserve parce qu’étant donné que l’hypothèse de la distance et l’inaccessibilité font partie des barrières majeures au programme il y a lieu de penser que ces tendances d’admissions ne traduiraient pas la réalité.
L’amélioration de la sensibilisation communautaire à travers une augmentation du nombre des relais communautaires ainsi que la mise en oeuvre de la stratégie de cliniques mobiles surtout dans les zones non fonctionnelles constituent pour le moment des solutions incontournables pour l’amélioration de la couverture nutritionnelle dans le district d’Iriba.
","","French"