"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" "8900","Suplementaion de Micronutrientes Espolvoreados","English","National","","GTM","Guatemala","Guatemala","Urban|Rural|Peri-urban","planned","01-2012","","Programa de suplementacion con micronutrientes espolvoreados a los niños y niñas de 6 meses a menores de cinco años, con entrega semestral de 60 sobres de 1 gramo de micronutriente espolvoreado para agregar a la comida principal del niño o niña, consumo de un sobre al dia.
","","","Plan Hambre Cero 2012-2016","Health","Ministerio de Salud Publica y Asistencia Social/PROSAN y Direcciones de Areas de Salud","","","","","","","","","","","","","","","","","El costo por sobre de micronutriente es de Q0.29, lo que hace de Insumo al año por niño suplementado un costo de Q34.80. El programa incluye el costo por arrendamiento de Bodegas y logística o entrega del Insumo al puesto de atención, estos ultimos no se han estimado por ser el primer año de implementación a Nivel Nacional. El costo del Recurso Humano no se estima porque son los mismos proveedores de los servicios de salud del MSPAS.El programa se estimó una cobertura del 60% de la poblacion menor de cinco años.","Government","Finance","Ministerio de Finanzas Publicas","UN","United Nations Children's Fund (UNICEF)","UNICEF Guatemala","UN","United Nations Relief and Works Agency (UNRWA)","PMA Guatemala","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8899","","Multiple micronutrients supplementation","","Folic acid|Vitamin A|Iron|Zinc|Vitamin C","Sobre de un gramo con •Vitamina A como acetato -USP-FCC de 300 microgramos RE (Equivalente de Retinol).•Hierro 12.5 mg como Fumarato Ferroso encapsulado (Descote TH, Fumarato Ferroso 60% Ultra código de producto 94842, de Particle Dynamics USA), o como 12.5mg de Hierro Glicinoquelado.•Zinc como Gluconato de Zinc -USP-FCC de 10.0mg.•Vitamina C como Acido Ascórbico USP-FCC- 30mg.•Acido Fólico - USP-FCC 160microgramos. ","Infants and young children","Niños y niñas de 6 a 59 meses","Pais Guatemala","Primary health care center","","Entrega de 60 sobres cada seis meses por niño
","Total de niños niños/as menores de cinco años con segunda entrega de micronutrientes espolvoreados/ total de niños menores de cinco años
","Reporte Sistema de Informacion Gerencial en Salud -SIGSA- Formato VME
","1,265,023 niños y niñas","60%","Period","80% de cobertura de niños suplementados","Reduccion de Prevalencia de anemia
","Vulnerable groups","","","Others, please specify below","","","","","","","","","","","","","","","","","","","","","","","English" "8904","Suplementacion con Vitamina A","Spanish","National","","GTM","Guatemala","Guatemala","Urban|Rural|Peri-urban","on-going","","","Programa de Suplementacion con megadosis de Vitamina A a los niños de 6 a 60 meses de edad
","","","Plan Hambre Cero","Health","Direcciones de Areas de Salud con su red de servicios","","","","","","","","","","","","","","","","","El costo de la Perla es de Q0.40 Se administran dos perlas al año por niño, a partir de los seis meses.El costo de la logística y del Recurso Humano es parte del presupuesto del Ministerio de Salud Publica y es el mismo personal de salud que brinda la atención en lo servicios. ","UN","United Nations Children's Fund (UNICEF)","La vitamina A es donada por la Iniciativa de Micronutrientes de Canada a travéz de UNICEF Guatemala","Government","Health","El Ministerio de Salud Publica asume la logística y la administración de las perlas","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8903","","Vitamin A supplementation","","Vitamin A","Perlas de 200,000 Unidades Internacionales de Vitamina APerlas de 100,000 Unidades Internacionales de Vitamina A","Infants and young children","Niños y niñas de 6 a 60 meses de edad","Guatemala","Primary health care center","","A los niños y niñas de 6 meses a menores de un año se le administra una dosis unica de 100,000 unidades Internacionales de Vitamina
A los niños y niñas de un año a menores de cinco años se le administra cada seis meses una perla de 200,000 unidades Internacionales de Vitamina.
Esta actividad la realiza el personal de los servicios de salud
","Numero de niños y niñas de 6 meses a menores de cinco años suplementados con Vitamina A * 100
Numero de niños y niñas menores de cinco años
","","1,581,280 correspondiente al 60% de la poblacion","90% de cobertura","Period","Niños y niñas menores de 60 meses con deficiencia de Vitamina A ","Niños y niñas menores de 60 meses Sin deficiencia de Vitamina A","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","Others, please specify below","Embalar en frascos de 100 perlas y detectar puntos críticos en la logística del Insumo","","","","","","","","","","","","","","","","","","","","","","Spanish" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","While Tanzania has achieved high vitamin A supplementation coverage over the past few years, there is concern that this achievement is fragile because of decentralization. A2Z is supporting national, zonal, regional, and district health teams to institutionalize twice-yearly distributions through ongoing advocacy and routine planning and budgeting. This activity is conducted in collaboration with the National Program for Extension of Tools and Strategies, the Tanzania Essential Health Interventions Project, Ifakara Health Research and Development Centre, the Tanzania Food and Nutrition Center (TFNC), and UNICEF. To foster sustainable vitamin A supplementation, the A2Z project is supporting behavior change communication through community workers and a popular radio serial. Based on information gathered on sustainability indicators by TFNC with support of A2Z and HKI, those districts that have not yet integrated funding for vitamin A supplementation in their plans are receiving additional technical support. Several resources developed in Tanzania are available to ensure program sustainability.
","Given the twice-yearly nature of the VAS program as well as its historic evolution from immunization campaigns, it is easy for district staff to see the program as separate from their regular day-to-day work. Considering the program to be part of the routine work for the district is critical for sustainability, and is reflected in both attitudes and the support provided to the program. Ninety-one (76%) of the 119 districts regarded implementation of the twice-yearly VAS and deworming program to be a routine activity. About 84% considered VAS and deworming a very important service, and 99% thought the service should continue. Although the majority of the districts viewed VAS/deworming as a routine activity, more than half (55%) had not yet included VAS/deworming services in their routine supervision checklist. Moreover, payment of allowances to staff for VAS/deworming while at their normal duty stations implies that these services were viewed as special rather than routine. The allowance scheme in particular, with an excessive number of supervisors at some distribution sites and inadequate supervision at other sites, may increase a district’s vulnerability to a decline in coverage. Overall, 11 districts (9%) were judged vulnerable with low sustainability related to supervision and monitoring
","Those districts that have not yet integrated funding for vitamin A supplementation ","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Others, please specify below","For an activity to be sustained, it must be considered part of the district’s regular activities, and thus must be included in the annual planning process.","Management","The VAS program requires clear management for effective and efficient implementation, and thoughtful management also reflects the value placed on the program. Poor management may make the program vulnerable, and less likely to be sustained in an effective fashion.","Supplies","The VAS program depends on effective logistics, and capsule and promotional materials must reach distribution sites on time and in adequate quantities for the program to be effective. Poor logistics supply management makes the program vulnerable. Adequate communication between programs and departments within district councils facilitated effective use of available resources in 117 (98%) of the districts assessed.","Financial resources","Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.","Insufficient staff","Twice yearly VAS distribution involves extended outreach to communities, and thus requires significant mobilization of both health staff and community volunteers. Failure to plan for adequate human resources is likely to place districts at risk of not sustaining their coverage achievements.","","","","","","","","","","","","Planning
Districts should be encouraged to budget for the program in their own CCHP budget including the basket fund which is considered the most reliable source of funds. Once basket funds are planned, they cannot be reallocated
Advocacy and community ownership
The program is more likely to continue effectively if it is understood and valued by community members who are involved with planning and implementation.
Management and Leadership
Efforts should be made to protect the current best practices in management and leadership reported in most of the districts.
Logistics Supply
Key actors at the national level need to ensure timely procurement and delivery of supplies to the districts
Supervision and Monitoring
Districts should determine the appropriate number of site supervisors to contain costs and include VAS/deworming in the routine supervision checklist to ensure that children missed during the twice-yearly events are reached through “mop up” actions.
Advocasy and Community Ownership
The successful efforts to date should continue to build community ownership of the program through well-designed, regular sensitization meetings and advocacy to engage the community, mobilize participation, and raise the profile of VAS/deworming events.
Availability of Financial Resources
Ensuring adequate provision for the VAS/deworming program within the basket fund can improve the financial sustainability of the program.
Availability of Human Resources
Local councils and the central government need to fill staff positions and find secure mechanisms to ensure mobilization of adequate human resources to sustain service delivery.
Programme Effectiveness
Efforts should be made to maintain the high performance of the majority of districts and help the few low performing districts improve their coverage.
","","English" "11473","A2Z: The USAID Micronutrient and Child Blindness Project","English","Multi-national","","TZA","United Republic of Tanzania","Dar es Salaam, Tanzania","Urban|Rural|Peri-urban","completed","01-2006","01-2011","A2Z: The USAID Micronutrient and Child Blindness Project consolidates, builds, and expands on USAID's long-term investment in micronutrients, child survival, and nutrition. A2Z takes proven interventions to scale, introduces innovation, expands services, and builds sustainable programs to increase the use of key micronutrient and blindness interventions to improve child and maternal health. With work in vitamin A supplementation of children, newborn vitamin A, food fortification, maternal and child anemia control, monitoring and evaluation, and health systems strengthening, A2Z's focus countries have included Bangladesh, Cambodia, the East, Central and Southern Africa region, India, Nepal, Philippines, Tanzania, Uganda and West Bank.
","With advocacy from A2Z/HKI and other donors, the Government of Tanzania in December 2006 adopted a policy for the use of zinc for the treatment of diarrhea. A2Z/HKI provided technical support to the National IMCI coordinator to incorporate zinc therapy as part of diarrhea management and developed modified IMCI guidelines. Zinc treatment and low osmolarity solution oral rehydration salts (ORS) have been incorporated into the National Standard Therapeutic Guidelines. The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University. The formative research also tested the acceptability of zinc treatment for diarrhea among mothers and caretakers. The findings of the study are expected to be used to assist in the development of health worker training modules and behavior change communication materials for use by the Ministry of Health and Social Welfare and the community.
","Under-five mortality rate
","","","","","","","Vulnerable groups","","Zinc supplementation in the management of diarrhoea>>>Zinc supplementation in the management of diarrhoea>>http://www.who.int/elena/titles/zinc_diarrhoea","","","","","","","","","","","","","","","","","","","","","","The project facilitated formative research to learn about the health-seeking practices of the community around diarrhea by Ifakara Health Research and Development Centre and Johns Hopkins University.
","","English" "11489","Nutritional Improvement for children in urban Chile and Kenya (NICK) Project","English","Multi-national","","KEN","Kenya","Mombasa, Kenya","Urban","on-going","01-2010","01-2013","NICK (Nutritional Improvement for children in urban Chile and Kenya) is a three year study that started in October 2010 with funding from the UK Government Department for International Development (DFID) through the Economic and Social Research Council. This study helps the cities of Mombasa in Kenya and Valparaíso in Chile reduce child malnutrition using participatory action research to broaden stakeholder participation at municipal level to change the social determinants. These determinants control the everyday conditions in which people are living and include education, income, working conditions, housing, neighbourhood and community conditions, and social inclusion. It is envisaged that this study will contribute to existing knowledge and also serve as a useful guide for action not only in Kenya and Chile but also in other countries with high levels of child malnutrition.
The NICK project is being implemented in one Mombasa informal settlement (with one matched control settlement). The project, which started on October 1st 2010 and ends on September 30th 2013, is guided by the following central question: Can child malnutrition amongst families living in poverty in informal settlements and slums in Mombasa and Valparaíso be reduced through broadening community and stakeholder participation to change the social determinants of nutritional status?
The project seeks to address the following research questions:
Given the recognition that the determinants of child malnutrition are systemic and require multi-disciplinary concerted efforts to address, the Kenyan research team decided to explore ways of ensuring that the project is integrated into the national efforts that focus on child nutrition. The initial steps, therefore, involved holding discussions with the Nutrition Division in the Ministry of Public Health and Sanitation (MOPHS). During these discussions (in January 2011), it emerged that there are multiple efforts being put in place to strengthen interventions on child malnutrition and related problems among the urban poor. One such initiative was the proposed formation of Urban Nutrition Working Groups (UNWG).
The Kenyan NICK team considered that establishing an UNWG in Mombasa was critical entry point that would help to make NICK activities an integral part of local initiatives with a high possibility of sustainability. This UNWG would function as the participatory action research (PAR) group that was needed for the NICK Project. The team, therefore, sought the support of the national nutrition office to do the following:
Following the granting of permission to work with the Provincial Nutrition Officer, several meetings were held in Mombasa to plan for an initial meeting with local stakeholders to introduce the project and form a Participatory Action Research (PAR) group. The agreement was that the UNWG would also serve as the PAR group. The research group also met with Dr. Shariff,3 the Director of Medical Services, in the Ministry of Public Health and sanitation (MOPHS) who was supportive of NICK and emphasized the need for the project to enhance the implementation of national nutrition priorities. The team also met with members of the Kenya Food Security Steering Group (KFSSG) who had just completed a national survey on Urban Food Security.
The preparatory phase was also utilized to carry out literature reviews and interviews to consolidate the situational analysis. A research permit was acquired, which was granted by the National Council for Science and Technology. With this permit, the Kenyan research team was able to plan for the baseline survey.
(i) Formation of the Provincial Nutrition Technical Committee and UNWG
This meeting was held in Mombasa on April 29th 2011. It brought together 24 participants who were drawn from the participating government departments and other partners. During this meeting, the team agreed to form the Provincial Nutrition Technical Committee under the leadership of the Provincial Nutritionist. Thirteen members were also nominated to form the UNWG under the leadership of the District Nutrition Officer. The members were supportive of this group due to the potential to have a coordinated approach to addressing child nutrition in the region.
(ii) Conduct of the baseline survey
During the initial meeting, it was agreed that the UNWG would be involved in carrying out the baseline survey. As part of community service, the members agreed that anthropometric measurements would be done for every child up to 5 years in the two study sites of Chaani (intervention) and Kongowea (control). Over 900 children were weighed and measured. Data from children 12-59 months indicate higher than national averages for stunting, with Chaani worse off than Kongowea.
The KDHS indicates high levels of stunting and underweight in the Coastal Province.
A household baseline survey was conducted (between June and July 2011) during which over 800 households were interviewed. The main issues addressed were child nutrition, health seeking behaviour and coping mechanisms. Data analysis is ongoing. The Kenyan team is now facilitating the UNGWA through three 6-monthly cycle of action and reflection to develop, implement and improve a range of small scale multisectiorial action to change the social determinants of child undernutrition.
(iii) 1st UNWG/PAR workshop – July 2011
This was a three-day meeting that was attended by 16 participants including the London-based researchers. A follow-up meeting for the UNWG was held on 20th July during which the first multisectorial action plan was finalised.
(iv) Community level activities
Community sensitization is ongoing. The UNWG has held meetings with health officials and village elders in Chaani (the intervention site). A public meeting was held with the community members on 7th November 2011, which was attended by over 250 people. So far 17 formalized groups have been identified and the next steps are to assess the training and research needs of these groups. Support for this group, in the form of training and provision of seed funds will be initiated in January 2011.
","
","","","Over 800 households; Over 900 children","","Anthropometric measurements","","Vulnerable groups","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","Others, please specify below","Competing interestsThe UNWG members are very busy with multiple responsibilities, which limits the amount of time they have for NICK activities, which are seen as not being directly part of their mandates. The implementation of national level campaigns, such as the polio campaign, interfered with planned programme activities.","Others, please specify below","Time constraints among Government officialsIt was difficult for the research team to interview the district level officers as key respondents for the baseline survey due to time constraints. Although some of them are interested in research they are hard pressed to put aside an hour for an interview.","Management","Managing expectationsIt has been difficult due to the low project budget. In Kenya, there is a tendency for officers to be given allowances when they attend meetings. Doing this would deplete the project budget completely. The research team has shared the project budget with the UNWG and an agreement has been reached to facilitate travel but not to provide ‘sitting allowances’ as a compromise.","Adherence","Balancing between studies and field activitiesCombining the field activities and the research activities of the extension research project on domestic violence and child undernutrition led to some delay in the implementation of community level activities and the 2nd PAR workshop. These activities will be initiated in earnest in January 2012. The PAR workshop will be held in February 2012","","","","","","","","","","","","","","
The current project implementation process introduces a different mechanism of working in partnership at the community level for the implementation partners. Although the project has experienced some challenges, the achievement to-date indicates that with more support and additional training, the UNWG is in a position to implement sustainable interventions to address the social determinants of child nutrition. The baseline survey tools that will be used at the end of the project will be a good measure of whether this approach will have borne the anticipated outcome of multiple implementers working together for the common good.
","","English" "11493","Strengthening Agricultural Technologies among People Living with HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda","English","Multi-national","","KEN|UGA","Kenya|Uganda","Busia, Kenya|Busia, Uganda","Rural|Peri-urban","completed","01-2007","01-2008","The Food and Nutrition Technical Assistance Project (FANTA) of the Academy for Educational Development (AED) and the Ministry of Health (MOH) AIDS Control Programs (ACPs) in Kenya and Uganda worked together between 2007 and 2008 to integrate nutrition into the activities of HIV support groups in the border towns of Busia Uganda and Busia Kenya, funded by USAID/East Africa. The aim was to build skills in nutrition and disseminate national materials on nutrition and HIV developed by the national ACPs. However, PLHIV in the border towns increasingly reported lack of access to adequate food, in terms of quantity and variety, as the main reason they could not apply the dietary practices recommended during counseling sessions. In response, between September 2007 and September 2008 FANTA and the ROADS Project collaborated to facilitate the diffusion and use of appropriate technologies to improve the productivity of PLHIV agricultural activities developed under the ROADS Project in the two border towns.
","http://www.fantaproject.org/downloads/pdfs/FANTA_Busia2008.pdf
","8762|8576|8430|8302|8241|8671|8237","","Food and agriculture","Ministry of Agriculture, Department of Culture and Social Services, Kenya│Ministry of Animal Industry and Fisheries (MAAIF), Uganda│National Agricultural Advisory Services (NAADS), Uganda","","","Family Health International (incl.AED)","","","","","","National NGOs","AIDS Support Organisation; National Agricultural Research Organization (NARO), Uganda","Research/academia","Busia Agricultural Training Centre (BATC) in Kenya, Kenya Agricultural Research Institute (KARI)","","","Other","Africa 2000 Network","","Bilateral and donor agencies and lenders","US Agency for International Development (USAID)","East Africa","Other","","Busia Parish Catholic Church, Kenya","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","11492","","Promotion of food security and agriculture","","","","Pregnant/lactating women with HIV/AIDS","","Busia , Kenya and Busia Uganda","Community-based","","The process involved identifying simple technologies to increase farm and garden outputs and linking clusters of people living with HIV (PLHIV) with local agricultural institutions including the Ministry of Agriculture (MOA), Department of Culture and Social Services, Kenya Agricultural Research Institute (KARI), and Busia Agricultural Training Centre (BATC) in Kenya and the MOA, Ministry of Animal Industry and Fisheries (MAAIF), National Agricultural Research Organization (NARO), and National Agricultural Advisory Services (NAADS) in Uganda, as well as community development officers, community-based organizations (CBOs), and nongovernmental organizations (NGOs) in the districts. FANTA facilitated the development of a participatory learning process to motivate groups of PLHIV to learn the new technologies to increase farm and garden output.
In phase one of the participatory learning process, FANTA and ROADS helped members of the clusters and agricultural institutions understand the agricultural technologies used in Busia, Kenya and Busia, Uganda to improve productivity. Phase two facilitated a process of linking cluster with agricultural institutions to help cluster members implement existing technologies that they had not widely used and to assess the impact of the process on the adaptation of the technologies. Neither FANTA nor ROADS invested substantial funds in the process, but provide technical assistance and connected the clusters to locally available technical assistance and support.
Three sensitization meetings were held, one joint meeting between cluster representatives, the FHI Cluster Coordinators, and FANTA staff and two meetings with groups on either side of the border. The meetings laid the foundation for agreement on the purpose of the activity and sharing of expectations. Over a period of two weeks, the group representatives identified viable and interesting agricultural technologies used in their localities and discussed how easily they could be implemented by PLHIV living in the towns (urban setting) and how they could improve their food diversity. In meetings with the agricultural institutions (mainly from Kenya), examples of agricultural technologies and activities were identified and discussed. Ministry of Agriculture and BATC extension personnel were available in the meetings to explain the different technologies.
The cross-border learning process was initiated by 14 representatives of the Ugandan clusters, who visited their peers on the Kenyan side of the border in November 2007. For two days they visited homes and training centers to see different agricultural technologies and livelihood activities implemented in Kenya and discussed the
feasibility of their adoption in their own context. At BATC the Ugandan visitors toured all the Group identification of learning content and methodology Preliminary sensitization meetings with cluster groups Group consultative meetings Meetings of Cluster representatives with departments of agriculture, NGOs, research institutions, and farmer training Cross‐border learning and home visits Arrange meetings among ROADS representatives, cluster representatives from Kenya and Uganda, and FANTA. Explain the different technologies that could be used in the locale and by PLHIV. Agree on how groups would implement the technologies and priorities. Group consensus meetings See different technologies in the communities and discuss.
Visits were also made to school gardens, community land (e.g., belonging to clusters of orphans and vulnerable children [OVC] in Kenya), seed multiplication sites, and farmer training centers. The cluster members discussed opportunities for and challenges of implementing similar activities in the urban Uganda context. Group consensus meetings were held to prioritize what the clusters wanted to learn about and the optimal methods of learning.
","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF interventions will encourage employment of women extension agents in the public sector and ensure that they are well represented in extension-related training activities in the public and private sectors. Women typically have more limited access to seeds, tools, credit, and marketing information than men. Liberia FTF MYS activities will give explicit attention to issues of equity in access in order to increase women‘s access and FTF will also provide support for women to participate in producer/marketing groups and associations.
Through private and public sector extension, USAID will provide lead farmers and producer organizations identified as change agents with specialized skills. Change agents will also receive support to acquire planting material and inputs through public and private sector channels. Availability of improved planting materials is facilitated through investments in CARI, private sector players, and CORAF. USAID will promote suppliers of seeds, fertilizers, insecticides, herbicides, tools, and livestock by developing their technical knowledge and skills and through support for increased agricultural credit. These entrepreneurs will provide services to others in their respective value chains. Over the five years of the FTF program, both the public and private provision of extension services will reinforce and expand the skill sets of change agents to increase productivity and coordinate with county and local health service providers to extend the reach of nutrition-related behavior change in order both to raise incomes and to improve health outcomes.
Small-scale rice and cassava processors will be a central focus of FTF interventions. Those interventions will help processors to build a supplier base, acquire equipment, access finance, and implement appropriate business practices. It is expected that they will then provide farmers with technical assistance to assure themselves of sufficient supplies of quality commodities to process. The program will work with and support both processors and traders to invest in processing equipment, storage facilities, and transport. It will work with farmers on improving post-harvest handling practices and on producing a consistent and predictable flow of goods. Over the five years, USAID direct beneficiaries will develop the skills, knowledge, and attitudes - plus have the capital, equipment, clients, and market linkages - to continue to expand their production, processing, and/or marketing businesses.
Given the paucity of reliable data, a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to a series of baseline surveys to collect production, labor, and market information and to facilitate MOA data collection and analysis, especially related to the focus counties. Based on the prioritized constraints that are identified, targeted and sequenced support will be directed to specific steps on the value chain, including to:
Nutritional benefits will accrue from both increased availability of and access to Liberia‘s primary food staples (rice and cassava). Increased commercialization will provide smallholders the increased incomes needed to obtain more and better food and improved processing will promote fortification to enhance the nutritional value of cassava and to improve the quality of rice. Public and private extension change agents will be trained to engage farmers, communities and farmer organizations across the range of behavioral change needed to promote essential nutrition actions.
","The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
There are an additional six indicators which require baselines to measure project-level activity. In collaboration with the MOA, USAID/Liberia IPs will lead baseline data collection on crop and animal production improvements (indicators 9 and 10 in the results framework), on the value of incremental sales (indicator 16 in the results framework), and on the application of improved technologies and practices by individuals and organizations receiving USG assistance (indicators 13 and 15 in the results framework).
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
","Planned interventions targeted at the key value chain constraints and implemented via the actions of private and public change agents will reach over 92,000 rice and cassava farmers in the six target counties","Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa ","","Gross margin per unit of land or animal of selected product (crop/animal varies by county);Percent increases in crop yields; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; &amp; CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Value of agricultural and rural loans; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Gross margin per unit of land or animal of selected product (crop/animal varies by country);Percent increases in crop yields; Number of individuals who have received USG supported short-term ag sector productivity or food security training;Number of new additional ha under improved technologies or management practices as a result of USG assistance; Number of farmers and others who have applied new technologies or management practices as a result of USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs receiving USG assistance; Number of private enterprises; producer orgs; water users, trade, business associations; & CBOs that applied new technologies or management practices as a result of USG assistance; Value of incremental sales (collected at farm-level) attributed to FTF implementation; Kilometers of roads improved or constructed; Value of agricultural and rural loans; Value of new private sector investment in the ag sector or food chain leveraged by FTF implementation; Number new laws and policies implemented to support private enterprise growth; Number of jobs attributed to FTF implementation; Prevalence of households with moderate or severe hunger; Prevalence of children 6-23 months receiving a minimum acceptable diet; Prevalence of exclusive breastfeeding of children under six months of age; Prevalence of anemia among women of reproductive age","Vulnerable groups","","Biofortification of staple crops>>>Biofortification of staple crops>>http://www.who.int/elena/titles/biofortification","Supplies","Promote high-yield seed and related inputs, including demonstration plots to test the use of improved seeds, fertilizer, and pesticides, and to introduce better land and water practices and farming methods;","Staff skills/training","Build capacity in both public (county-level) and private sector extension, including farmer organizations, traders or other private sector actors to invest in small sized processing mills and storage facilities","Financial resources","Provide access to finance and credit guarantees, directed at lead farmers and small processors","Stakeholder","Implement training to capacitate processors to become key change agents in market and credit transactions","Communication","Improve the transparency of market price information to farmers and strengthen business service providers, as an alternative means to make extension type services","","","","","","","","","","","","","","English" "11523","Feed the Future: The U.S. Government’s Global Hunger and Food Security Initiative","English","Multi-national","","LBR","Liberia","Bong County, Liberia|Lofa County, Liberia| Nimba County, Liberia|Grand Bassa County, Liberia|Montserrado County, Liberia|Margibi, Liberia","Rural|Peri-urban","on-going","01-2011","01-2015","Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF Core Program 2 will undertake investments in horticulture pilots to encourage smallholders in relevant areas of all focus counties over time, but will initially focus on peri-urban locations near Monrovia which are close to the largest and most lucrative market and minimize constraints related to storage and transport. These activities will build on a change agent model similar to that for the rice and cassava value chains by supporting lead traders and lead farmers to acquire equipment for transport and storage and to acquire business and marketing knowledge. Key FTF horticulture interventions will include formation and strengthening of farmer associations, post-harvest management and logistics support, promoting public-private partnerships, and providing information and training for behavior changes to promote improved family nutrition.
FTF investments to develop the goat value chain will implement pilot activities that are closely coordinated with the substantial USDA Food for Progress goat value chain enhancement program that will be working to re-establish breed stock and infrastructure for processing. The change agent focus of investment will be on community animal health workers and Core Program 2 activities will train and lend support to them so that they can directly assist improved breeding through the provision of services and infrastructure, making commercialization profitable. USAID/Liberia will determine the scope and scale of change agent engagement in pilot sites based on local conditions and in close coordination with the USDA program.
The US Government in Liberia will make an estimated 30 percent of FTF MYS investments in Core Program 2, with roughly 60 percent of these directed to interventions to address vegetable value chain pilot activities and the remaining 40 percent for implementation of goat pilots. Reflecting the phased approach to Liberia FTF value chain interventions, only 10 percent of first-year investment will be in the diet diversification value chains, while 63 percent of MYS vegetable and goat value chain investments will be carried out in years four and five. As with Core Program Area 1, given the lack of reliable data a significant initial activity in the primary implementation mechanism for the Liberia FTF MYS – USAID‘s Food and Enterprise Development program - will be directed to ensure relevant baseline surveys to collect production, employment, and market information and to facilitate data collection and analysis, especially related to the focus counties. These investments will be phased to take advantage of opportunities that already exist in peri-urban areas for vegetables and related to the USDA program for goats. Within the proposed total program level, anticipated investment levels in these value chains will be lower in the first two years of strategy implementation and will ramp.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities:
Feed the Future, the U.S. Government’s global hunger and food security initiative, is establishing a foundation for lasting progress against global hunger. With a focus on smallholder farmers, particularly women, Feed the Future supports partner countries in developing their agriculture sectors to spur economic growth that increases incomes and reduces hunger, poverty, and undernutrition. Feed the Future efforts are driven by country-led priorities and rooted in partnership with governments, donor organizations, the private sector, and civil society to enable long-term success. Feed the Future aims to assist millions of vulnerable women, children, and family members to escape hunger and poverty, while reaching significant numbers of children with highly effective nutrition interventions to prevent stunting and child mortality.
Over the next five years in Liberia, Feed the Future aims to help an estimated 332,000 vulnerable Liberian women, children and family members—mostly smallholder farmers—escape hunger and poverty. More than 96,000 children will be reached with services to improve their nutrition and prevent stunting and child mortality. Significant numbers of additional rural populations will achieve improved income and nutritional status from strategic policy engagement and institutional investments.
To meet its objectives, Feed the Future Liberia is making core investments in three key areas:
1. Transforming Staples’ Value Chains
2. Developing Income and Diet Diversification Value Chains
Target region
The Feed the Future Strategy is focusing on counties with the highest populations, the most farmers, the largest numbers living in poverty, and the greatest potential for agriculture development: Bong, Lofa, Nimba, Grand Bassa, Montserrado, and Margibi. These counties are located along Liberia’s main economic development corridors and collectively include around 75 percent of all Liberian households. Nutrition activities are focused in Bong, Lofa and Nimba counties.
","FTF investments in Core Program 3 will address selected aspects of the LASIP program for institutional development to support the value chains that are the focus of Core Program Areas 1 and 2. FTF investments in agriculture policy, advocacy support, and research will fund key institutions to carry out actionable research leading to improved land, soil, and water resource management and use and agronomic practices and more productive animal husbandry. FTF Program Area 3 activities will be integrated in the value chain support in order to expand the capacity of civil society groups to analyze and advocate for policy reforms (e.g., in regard to rice pricing and sanitary and food safety standards for food and meat processing) and to help create a more market-friendly policies and an improved trading environment for Liberian smallholders.
The Liberia FTF MYS will assist the MOA to define and implement its decentralized, demand-driven, participatory, pluralistic (i.e., engaging public, private, civil society actors), and accountable agricultural extension system. The critical role of women extension agents will be emphasized and opportunities for them to develop professionally, both in terms of education and field practice, will be supported. Program Area 3 investments will target partnerships with the public and private sectors and other development partners to: accelerate adoption of modern agronomic technologies and practices at the farm level; create effective knowledge distribution mechanisms; and build capacity of the MOA to provide specialized extension services. Revised agricultural extension curricula will provide more effective training in areas such as land use and techniques to reduce soil fertility losses, water resources management, low-cost and organic fertilizers, post-harvest loss reduction, pest management measures, participatory extension methodologies, women‘s participation in extension activities, farmer organization development, participatory rural appraisal, farmer field school methodology, and farmer-to-farmer extension. These investments will support widespread provision of high quality extension to Liberian smallholders. Core Program 3 interventions on market structure development will create opportunities to establish market information systems to support private and public decision making and invest in alternative profit sharing/contract models between change agents and farmers to ensure equitable market exchanges, based on transparent information and rational decision making behavior. These activities will provide the foundation for fair and transparent markets accessible to all Liberian smallholders.
All FTF MYS investments in Core Program 3 will be integrated to support value chain activities in transforming rice and cassava staples value chains and piloting the income and diet diversification vegetable and goat value chains. Thus, these activities to advance the enabling environment and build capacity will contribute to ensure benefits of the value chain investments reach all 142,375 households the program will work with, including the 91,120 poor households.
","","
The Feed the Future MYS and Monitoring and Evaluation (M&E) activities will have the following four overarching objectives:
The FTF M&E system is designed flexibly to take into account the systems and indicators being implemented by aligned USG activities, as well as those which the GOL is developing under LASIP reflecting the Government‘s CAADP commitments. The Mission‘s newly-awarded M&E program will facilitate the coordination and collaboration work to build the FTF M&E system with appropriate linkages reflecting WOG activities that impact on the FTF Results Framework.
Collecting, managing, and reporting data to track indicators is a critical component of Liberia‘s FTF M&E activities. There are three basic levels at which data will be collected: at the national, target-county, and project-levels; the latter two being the ‗zones of influence‘ of Liberia‘s FTF program. In general, national-level data will be collected every five or every two years, depending on data source. Typically, target-county level data will be collected every two years or mid-way through the FTF program, depending on data source. Project-level data will be collected annually. Given that much of the data will be for agriculture, data collection will reflect systems, which span growing seasons across more than a single year. The centrally-funded M&E contractor, recently awarded by the Mission, will work with USAID Implementing Partners (IP), GOL, and other entities as appropriate in data collection, management, and reporting as well as in conducting baselines. These will be collective efforts reflecting the importance of data collection and baselines not only for USG priorities but also to partners and other stakeholders in the private sector and GOL.
Ensuring baseline data are available to measure changes resulting from FTF interventions and to contextually monitor the situation in Liberia is essential to the FTF program. For the eight higher-level indicators, USAID/Liberia will coordinate with the centrally-funded contractor to confirm available national-level baseline data for the poverty and agriculture sector GDP indicators. The centrally-funded contractor will lead efforts to obtain baseline data on per capita income at the target county level. Reliable data on underweight, stunted, and wasted children, as well as on underweight women, are available from Liberia‘s Comprehensive Food Security and Nutrition Survey (CFSNS), a bi-annual survey endorsed and led by GOL with World Food Program oversight. These baseline data are given in Annex C. As the indicator on women‘s empowerment is being developed, USAID/Liberia will address baseline needs for it as further information on requirements becomes available.
Gender is a cross-cutting issue in the GOL‘s agriculture sector investment plan and is integrated in the US Government‘s Liberia FTF MYS. To measure FTF gender impacts, USAID/Liberia will disaggregate data as appropriate by gendered household type or by sex and will track data for the women‘s empower index being developed as well as for women specific indicators in the RF. Annex C identifies indicators to be disaggregated by gendered household type or by sex (as well as by other characteristics). Data will be disaggregated by gendered household type for the following indicators: prevalence of poverty, per capita income, gross margin per unit of land/animal, increases in crop yields, and prevalence of households with moderate or severe hunger. There are numerous indicators which will be disaggregated by sex. These are identified in Annex C. The Liberia RF also considers women specific indicators including prevalence of underweight women, women‘s dietary diversity, and prevalence of anemia among women. It is expected that a rich picture of the extent to which the FTF program is achieving positive gender impacts will emerge via this disaggregation. And in particular, the tracking will allow USAID/Liberia to make rapid programming adjustments in this regard if necessary.
Prior to initiation of FTF MYS activities under the FED program, the Mission will initiate a pre- and post-impact evaluation process to articulate the relevant analytical framework for evaluating program impact in the target counties. Current expectations are to utilize a quasi-experimental design for the impact evaluation. However, a final determination has not been made and plans are to further discuss with the Mission‘s M&E program and others. In addition, Liberia is a non-presence, monitored member of the West Africa regional Famine Early Warning System Network (FEWSNET). The FTF M&E activities will utilize these data on food prices, regional trade flows, market development in data frameworks for on-going assessment and monitoring of both impacts and risks.
Currently, Liberia‘s capacity to collect, process, and report data is extremely weak. While USAID/Liberia identified some sources of reliable data, notably that reported in the 2010 CFSNS, there is a paucity of agricultural and trade data available. To address this, USAID will work closely with GOL to build Liberian capacity in this area. The GOL has the primary responsibility to collect poverty, rural and agricultural statistics but the FTF M&E system will support and strengthen the GOL‘s activity in cooperation with other development partners. It will also strengthen the MOA‘s Food Security and Nutrition Unit and the Agriculture Coordination Committee to build compatible and consistent M&E systems for food security related activities. The FTF M&E system will support the capacity of critical national institutions especially the Liberian Institute of Statistics and Geo Information Services (LISGIS) and the MOA to improve the reliability, timeliness, and relevance of data for which they are responsible. It will strengthen these institutions to setup management information systems to inform high-level decision-making and will encourage the involvement of these critical institutions in oversight of FTF activities using the M&E system as the focal point. Furthermore, it will carry these activities to the county level and in particular will emphasize MOA M&E capacity in Bong, Lofa, Nimba, and Grand Bassa counties.
In-line with FTF‘s global knowledge learning agenda, USAID/Liberia will engage in the following activities:
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
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" "23192","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Diapaga","English","Community/sub-national","","BFA","Burkina Faso","Diapaga, Burkina Faso","Rural","on-going","03-2008","","ACF met en oeuvre depuis 2008 un programme d’appui à la prise en charge de la malnutrition aiguë dans le district sanitaire de Diapaga, s’articulant autour de plusieurs volets :
Au niveau du système de santé:
- Un volet d’appui technique et logistique aux formations sanitaires pour la détection et la prise en charge des cas de malnutrition aiguë sans complications dans 30 Centre de Santé et de Promotion Sociale (CSPS) et des cas de malnutrition aiguë sévère avec complications médicales dans 3 Centre de Renutrition et d’Education Nutritionnelle (CREN).
- Un volet « subvention des soins » garantissant une exemption de paiement pour les personnes souffrant de malnutrition aiguë (modérée et sévère) admises dans les structures. Un projet pilote visant à l’exemption totale de paiement pour tous les enfants de moins de 5 ans a par ailleurs été démarré en novembre 2011 dans les 5 aires sanitaires de la commune de Logobou.
Au niveau communautaire:
- Un système de détection, référencement et suivi des cas de malnutrition aiguë s’appuyant sur un réseau d’Agents de Santé à Base Communautaire (ASBC) co-animé en partenariat avec une ONG locale (APDC).
- Des activités de sensibilisation et d’éducation à la santé dans le but d’apprécier et et d’améliorer les performances du programme en termes de couverture et d’accessibilité.
","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 Diapaga (2012-2014):
http://www.coverage-monitoring.org/wp-content/uploads/2013/04/SQUEAC_BURKINA_Diapaga_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23191","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Diapaga ","Community-based|Primary health care center","","","Des evaluations de la couverture ont été realisées chaque annee depuis le debut du programme. Celles-ci ont revele des niveaux de couverture actuelle globalement faibles (couverture 2010: 21,8% [IC 95%: 13,2%-32,2%], couverture 2011: 17,6% [IC 95%: 7,8%-31,6%], couverture 2012: 32,1% [IC 95%: 21,9%-44,4%], couverture 2014: 43,6% [34,2%-53,2%] ), avec cependant une progression relevee au cours de la precedente SQUEAC (Semi-Quantitative Evaluation of Access and Coverage).
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.
","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.
","La population est estimee en 2013 a 444 852 habitants avec 18,32% d’enfants d’age compris entre 6 et 59 mois.","43,6% [34,2%-53,2%]","Point","Les prevalences de la malnutrition selon d’indice Poids/Taille en z-score dans la Region Sanitaire de l´Est etaient estimees en 2013 a 9,3%1(8,3%-10,4%) pour la Malnutrition Aigue Globale (MAG) et a 1,7% (1,3%-2,3) pour la Malnutrition Aigue Severe (MAS)","","None","","","Communication","","Management","","Management","","Others, please specify below","","Others, please specify below","","Communication","","Others, please specify below","","Communication","","","","","","","Le résultat de couverture montre une nette amélioration en quasiment deux ans. Malgré tout, des faiblesses « basiques » (prise du PB au mm, rapportage) identifiés dans les évaluations précédentes sont toujours d’actualité après 3 ans de programmes. Au niveau de la prise en charge de la MA au sein des structures de santé, on note une réelle difficulté d’appropriation et de pérennité. Les activités liées à la prise en charge intégrée de la malnutrition aigue sont souvent perçues comme une charge de travail supplémentaire, et non intégrée au travail quotidien du centre de santé. Ceci peut entrainer un manque d’intérêt de la part des agents de santé, et une difficulté dans la collaboration avec les équipes ACF, ce qui est un frein à la pérennité une fois ACF parti. Un réel travail doit être fait conjointement avec l’ECD afin de pouvoir changer ces perceptions au niveau communautaire, on note que les barrieres sur la connaissance de la communaute sur la malnutrition restent presentent apres plus de 3 ans de programme NAC (Etude Causale de la malnutrition). L’approche NAC doit etre remise en cause avec une plus forte integration des agents de sante et des relais communautaires (ASBC) afin d’en assurer la perennite et un plus fort impact.
","","English" "23194","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Fada N’Gourma","English","Community/sub-national","","BFA","Burkina Faso","Fada N’Gourma, Burkina Faso","Rural","on-going","08-2012","","ACF à travers le programme nutrition santé appuie le DS de Fada à la prise en charge de la malnutrition aigüe depuis août 2012 suite à la crise alimentaire de 2012 au sahel. Ces appuis se font par le renforcement des capacities à travers les formations, les dotations de matériels médico techniques, la subvention des évacuations et des soins médicaux, et des visites d’appuis techniques lors des séances de prise en charge. Au niveau communautaire, ACF travaille en partenariat avec le GRET qui mène des activités de sensibilisations, de dépistage, de Visite à Domicile (VAD) à travers des animateurs.
","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 Fada N’Gourma:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/ACF-SQUEAC-BF-GOURMA-2014-VF.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","Government","Development","L’Agence Suédoise de Développement International (ASDI)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23193","","Management of severe acute malnutrition","","","","SAM child","Enfants de 0 à 59 mois","District de Fada N’Gourma","Community-based|Primary health care center","","Les interventions concernaient au départ deux communes à savoir Matiacoali et Diabo. En mai 2013, l’appui d’ACF au district s’est étendu à l’ensemble des 6 communes dans les 39 Centre de Santé et de Promotion Sociale (CSPS), le CHR et le Centre de Récupération et d’Education Nutritionnelle (CREN) confessionnel toujours avec un financement d’ASDI. Le programme appuie régulièrement le district dans la prise en charge. ACF assure également une approche NAC (Nutrition à Assise Communautaire) à travers son partenaire Groupe de Recherche et d’Echange Technologique (GRET) qui intervient dans le DS de Fada depuis 2009.
","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 15 janvier au 11 février 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 analyses quantitatives et qualitatives ont revele un nombre relativement important de points d’attention en terme de depistage, acces et qualite de soins, freins et pesanteurs socioculturels, difficultes de notification des cas, qui, sans enlever l’appreciation positive de ce resultat meritent neanmoins le renforcement de l’accompagnement des activites de PeC dans le district.
L’implication communautaire: insuffisance de communication des ICP avec les ASBC et faible motivation des ASBC, faible implication des autorites et des leaders dans la PeC, faible interet des hommes dans la sante des enfants…
L’organisation des activités communautaires: bien que la population soit informee du role des ASBC au sein de la communaute, il y a une insuffisance de connaissance sur la malnutrition, le programme de prise en charge. Il devient donc important de revoir l’approche de sensibilisation communautaire pour en ameliorer l’impact et assurer une meilleure implication des agents de santé communautaire.
Les dysfonctionnements au niveau de la prise en charge: long temps d’attente, rejet ou limitation du nombre de cas PeC par jour, mauvais accueil, l’insuffisance de depistage systematique en consultation curative …
Les facteurs socio-culturels, notamment pour le recours aux soins, le refus de certains maris ou des interdictions faites aux meres, le recours a la geomancie, les pratiques ancrees nefastes.
L’occupation des mères: Travaux menagers, travaux champetres, faible implication des hommes…
Les problèmes de distance, d’enclavement ou d’eloignement temporaires dans les hameaux de culture, s’ils n’ont pas ete demontres comme un facteur determinant a la couverture (voir resultats de la petite enquete), peuvent avoir un impact sur la qualite du service, notamment au niveau de la gestion des intrants, et de la disponibilite des agents de sante. En effet, la fluctuation des admissions ne permet pas aux agents de santé d’évaluer correctement les quantités d’intrants nécessaires par mois.
Tous ces facteurs ont un impact négatif sur la fréquentation des services de PCIMA et méritent de se pencher sur l’amélioration de :
- La régularité et la qualité des dépistages
- La qualité de l’accueil et de la PCIMA
- L’identification et la recherche précoce des absents ou abandons
- Les méthodes de communication pour les changements de comportement en pratiques de soins
- La coordination des activités des ONG.
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 Koudougou depuis mai 2013 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 Koudougou 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 Aliment Thérapeutique Prêt à l’Emploi (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 Koudougou:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/SQUEAC_Rapport_KOUDOUGOU_2014.pdf
","","","","","","","Other","Medicus Mundi Italie (MMI)","","","","","National NGOs","Association de Solidarité et Coopération Internationale (LVIA)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23201","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Koudougou","Primary health care center","","La prise en charge ambulatoire des cas de MAS est assurée au niveau des 62 Centre de Santé et de Promotion Sociale (CSPS) du district, ainsi que de 7 Centre de Récupération et d'Education Nutritionnelle (CREN) gérés par des organisations confessionnelles. La prise en charge des complications en interne (PCI) est assurée au niveau du CHR de la ville de Koudougou et du Centre Médical Maximilien Kolbé de Sabou.
","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 principales barrières étaient en lien avec le contexte socio-culturel (méconnaissances sur la malnutrition, stigmatisation et honte, recours à la medicine traditionnelle en lien avec les croyances, voyage et déplacements des mères, manqué d’implication des hommes dans la santé des enfants) et avec des insuffisances au niveau de la qualité de la prise en charge (enfants MAS dans le programme MAM, sous notification des abandons, dépistage passif non systématique, manque d’informations données aux mères).
Parmi les facteurs influençant positivement l’accessibilité, la couverture géographique des formations sanitaires est à souligner. Le niveau de couverture constaté est également le résultat des actions entreprises dans le cadre du passage à l’échelle appuyé par LVIAMMI et les organisations locales : les campagnes de dépistage, la gratuité de la prise en charge, les actions de sensibilisation ont favorisé une bonne connaissance de l’existence du traitement, et une réaction en chaîne face à l’efficacité du celui-ci.
","","English" "23207","LVIA-MMI programme communautaire: Prise en Charge de la Malnutrition Aiguë Sévère dans le district de Nanoro","English","Community/sub-national","","BFA","Burkina Faso","Nanoro, burkina faso","Rural","on-going","05-2012","","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 Nanoro 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 Nanoro 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, la subvention des traitements pour la prise en charge des complications, l’acheminement 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 Nanoro:
http://www.coverage-monitoring.org/wp-content/uploads/2014/05/SQUEAC_Rapport_NANORO_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)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23206","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Nanoro","Primary health care center","","Sur le plan sanitaire, le district est divisé en 20 aires de santé. La structure de santé de référence est le Centre Médical avec Antenne chirurgicale (CMA) de Nanoro, géré par les religieux camiliens.
","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.
Ces différentes barrières soulignent la complémentarité nécessaire entre une prise en charge de qualité au niveau des formations sanitaires et des activités de mobilisation communautaire adaptées au contexte. La poursuite et le réajustement des actions entreprises, sur la base des constats dégagés par l’investigation, permettront d’atténuer les barrières et d’améliorer la couverture de la PCIMAS. Pour être suivies d’effet, les réorientations proposées nécessiteront une implication de tous les acteurs impliqués dans la prise en charge de la malnutrition.
Facteurs positifs (boosters):
- Appréciation de la prise en charge: Gratuité, Perception positive du traitement, Efficacité du traitement
- Recours au CSPS pour le traitement de la malnutrition, traitement connu
- Connaissances sur la malnutrition
- Implication des acteurs clés au niveau de la communauté (ASC, TPS, leaders)
- Activités des ASC : campagnes de dépistage, suivi des cas
Pour assurer les activités de Prise en charge Communautaire de la Malnutrition Aiguë (PCMA), le DS de Pama bénéficie d’un appui de l’ONG Action Contre la Faim-France (ACF-F), aussi bien pour la Prise en Charge Ambulatoire (PCA) que pour la Prise en Charge en Interne (PCI). ACF a marqué sa présence dans la Province en deux phases : 1) un appui à distance à partir de Fada de janvier à Août 2010 et de novembre 2010 à novembre 2011, et 2) l’implantation d’une base à Pama à partir de Mai 2012 avec un personnel permanent sur place. Entre temps, l’ONG a suspendu ses interventions dans la province d’août à novembre 2010 et de novembre 2011 à mars 2012 suite à un manque de financement. Pour un besoin de pérennité, ACF intervient dans le district sanitaire en partenariat avec une ONG locale, TIN TUA (""développons-nous nous-même""). Elle conduit les activités de Nutrition à Assises Communautaire (NAC): mobilisation communautaire, conduite des campagnes de dépistage et de sensibilisation en collaboration avec le DS et implication des leaders communautaires et collectivités.
","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:
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23209","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Pama","Community-based|Primary health care center","","Le DS de Pama compte 11 Centres de Santé et de Promotion Sociale (CSPS) normalisés, un Centre Médical avec Antenne chirurgicale (CMA) avec en son sein un Centre de Récupération et d’Education Nutritionnelle (CREN). Le District met en oeuvre le Paquet Minimum d’Activités (PMA), et la prise en charge de la malnutrition aigüe est assurée dans toutes les formations sanitaires.
Pour un besoin de pérennité, ACF intervient dans le district sanitaire en partenariat avec une ONG locale, TIN TUA (""développons-nous nous-même""). Elle compte 9 facilitateurs communautaires installés dans les trois communes de la province de la Kompienga et d’un coordinateur des activités terrain qui supervise les 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 19 Juin au 02 Juillet 2013en utilisant la méthodologie «Semi Quantitative Evaluation of Access and Coverage» (SQUEAC). Cette investigation intervient 6 mois après la SQUEAC précédente (novembre-décembre 2012) qui avait abouti á une couverture de la période de 40,6% (IC 95%: 28.9 - 54.2). 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 niveau des facteurs qui influencent de façon négative la couverture, l’insuffisance d’informations données aux populations sur la prise en charge, la méconnaissance des signes et des causes de la malnutrition continuent à être les barrières principales identifiées au cours de cette SQUEAC comme l’a déjà été lors de l’investigation de décembre 2012. En plus une nouvelle importante barrière a été identifiée : la stigmatisation (mères avec enfants malnutris). Certaines mères avec enfants MAS sont enceintes et le fait d’avoir eu des naissances rapprochées constituent une honte aux yeux des populations. Par ailleurs les naissances rapprochées ont été identifiées par la communauté comme cause la MA ou appellation du marasme.
Dans les facteurs qui influencent de façon positive la couverture, la bonne opinion de la PCA à travers les guéris MAS qui sont dans la communauté et le dépistage actif trimestriel réalisé par le district avec ses partenaires sont des booster importants signalés dans la SQUEAC. En plus l’admission par le PB pour les moins de 65 cm n’est plus une barrière. En effet seul l’âge de 6 mois est désormais considéré pour les admissions par le PB.
","","English" "23212","LVIA-MMI programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Réo","English","Community/sub-national","","BFA","Burkina Faso","reo, burkina faso","Rural","on-going","05-2012","","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.
ACF a démarré en mars 2011 un programme d’appui au district sanitaire de Danané pour la mise en oeuvre de la PCIMA. Ce programme, débuté dans le cadre de la crise humanitaire consécutive aux violences post-électorales dans l’Ouest de la Côte d’Ivoire, est progressivement passé d’un mode opératoire de «substitution» - justifié par les importants dysfonctionnements du système de santé au plus fort de la crise – à un accent mis sur l’intégration de la prise en charge dans le système de santé existant.
","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 Danané:
http://www.coverage-monitoring.org/wp-content/uploads/2013/02/Ivory_Coats_Danan%C3%A9_Nov_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23231","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Danané","Primary health care center","","Ce programme, initié pendant la période de post-crise immédiate, a d’abord été mis en oeuvre dans 6 aires sanitaires pour la prise en charge des cas MAS en ambulatoire et au niveau de l’hôpital de Danané pour la prise en charge des cas MAS avec complications au niveau de l’UNT. Le programme a ensuite été progressivement étendu jusqu’à couvrir la totalité des aires sanitaires du district (17 structures de santé).
","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 06 au 29 novembre 2012 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.
Au total, cette faible couverture est le reflet de l’impact particulièrement négatif des ruptures en intrants nutritionnels sur l’accessibilité au service. Outre le défaut de prise en charge des cas MAS admis dans le programme, les ruptures d’ATPE répétées et prolongées contribuent en effet à renforcer l’effet des autres barrières à l’accessibilité telles que la distance et les difficultés d’accès géographique, l’indisponibilité des mères pendant la période des travaux agricoles, ainsi que la barrière financière liée aux coûts de transport et aux éventuels frais liés à une consultation. Au niveau des structures de santé, l’absence d’intrants ne permet pas aux agents d’assurer une prise en charge adéquate des cas MAS, entraînant des insuffisances dans la qualité de la prise en charge et une démotivation des agents (sous-notification des abandons, quantité d’ATPE délivrée non adéquate, relâchement ou suspension des activités de dépistage passif).
Le faible niveau de couverture est également à mettre en lien avec la transition difficile entre le dispositif d’appui renforcé mis en oeuvre par ACF pendant la période de post-crise immédiate et l’intégration complète des activités de PCIMA dans le système de santé existant. D’importants moyens ont en effet été déployés lors du démarrage des activités, avec un accent particulier mis sur les activités de sensibilisation et le système de dépistage. Ces efforts ont amélioré la compréhension de la malnutrition dans la communauté et ont permis de traiter un grand nombre de cas : le programme apparaît aujourd’hui bien connu et très apprécié. Les activités communautaires ont cependant connu un relâchement au cours des derniers mois suite à la diminution des modalités d’appui aux ASC, responsable d’une importante démotivation. L’investigation a par ailleurs révélé l’existence d’insuffisances au niveau du monitoring des activités communautaires, ne permettant pas un bon suivi. L’efficacité du volet communautaire apparaît pourtant particulièrement cruciale dans un contexte encore marqué par une méconnaissance de la maladie et un recours de première intention à la médecine traditionnelle.
","","English" "23234","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Toulepleu","English","Community/sub-national","","CIV","Côte d'Ivoire","Toulepleu, cote d'ivoire","Rural","on-going","05-2011","","A la suite de Danané et Zouan Hounien, ACF a démarré en mai 2011 un programme d’appui au district sanitaire de Toulepleu pour la mise en oeuvre de la PCIMA. Le programme, démarré sous forme d’équipes d’ Unité Nutritionnelle Thérapeutique Ambulatoire (UNTA) mobiles, est progressivement passé d’un mode opératoire de «substitution» - justifié par les importants dysfonctionnements du système de santé au plus fort de la crise – à un accent mis sur l’intégration de la prise en charge dans le système de santé existant.
","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 Toulepleu:
http://www.coverage-monitoring.org/wp-content/uploads/2013/02/SQUEAC_Rapport_Toulepleu_RCI_2012.pdf
","","","","","","","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23233","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Toulepleu","Community-based|Primary health care center","","Les cas MAS sans complications sont pris en charge en UNTA au niveau des 8 Etablissement Sanitaire de Premier Contact (ESPC). Une UNT a été ouverte récemment (en octobre) au sein de l’hôpital général pour la prise en charge des cas MAS avec complications, qui jusqu’alors devaient être transférés vers l’UNT de Zouan Hounien. Les intrants thérapeutiques sont fournis par l’UNICEF. Un volet Centre de Nutrition Supplémentaire (CNS) existe également dans les 8 ESPC pour la prise en charge des cas de malnutrition aigüe modérée (MAM), appuyé par le PAM. Outre le support aux structures de santé, ACF a également développé des activités à base communautaire: celles-ci ont pour but de dépister et référer les cas de malnutrition aigüe et de diffuser des messages de sensibilisation et de prévention.
","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 6 au 19 novembre 2012 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.
Other lessons learnt
La régularité de l’approvisionnement en ATPE et l’impact du volet communautaire ont ainsi été relevés parmi les facteurs ayant favorisé une bonne accessibilité.
Malgré des constats encourageants, la couverture est apparue plombée par un certain nombre de barrières. Il s’agit notamment :
- au niveau district et central, de l’insuffisance de la clarification des critères d’entrée et de sortie du programme, de la faible supervision des activités des centres de santé et du volet communautaire ;
- au niveau des structures de santé, du manque d’implication du personnel de santé pour les activités de nutrition tant au niveau des centres de santé que dans les communautés de l’aire de santé, ce qui se traduit par un recrutement des cas non optimal ;
- au niveau communautaire, des contraintes financières, des longues distances à parcourir pour se rendre au centre de santé, l’enclavement de certains villages et campements et enfin de l’insécurité chronique dans la zone ;
Dans le contexte actuel de pérennisation des activités de PCIMA, la question d’une plus grande implication du personnel de santé et celui du renforcement du volet communautaire constituent des enjeux essentiels en vue d’une amélioration de la couverture et de l’accessibilité au traitement.
","","English" "23236","ACF programme communautaire: Prise en Charge de la Malnutrition Aiguë dans le district de Zouan Hounien","English","Community/sub-national","","CIV","Côte d'Ivoire","Zouan Hounien","Rural","on-going","04-2011","","Suite aux résultats de l’enquête nutritionnelle SMART de 2010 faisant état d’une situation préoccupante dans la région de l’Ouest, ACF a démarré en avril 2011 un programme d’appui au district sanitaire de Zouan Hounien pour la mise en oeuvre de la PCIMA dans l’ensemble du district. Ce programme, initié pendant la période de post-crise immédiate, a d’abord été mis en oeuvre dans 7 aires sanitaires pour la prise en charge des cas MAS en ambulatoire en UNTA et au niveau de l’hôpital de Zouan Hounien où une UNT a été créée. Le programme a ensuite été progressivement étendu jusqu’à couvrir la totalité des aires sanitaires du district (15 structures de santé).
","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 Zouan Hounien:
","","","","","","","","","","","","","","","","","","","","","","International NGOs","Action Against Hunger (AAH) / Action contre la faim (ACF)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23235","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Zouan Hounien","Primary health care center","","Ce programme a d’abord été mis en oeuvre dans 7 aires sanitaires pour la prise en charge des cas MAS en ambulatoire en UNTA et au niveau de l’hôpital de Zouan Hounien où une UNT a été créée. Le programme a ensuite été progressivement étendu jusqu’à couvrir la totalité des aires sanitaires (15) 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 15 novembre au 7 décembre 2012 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.
Cette faible couverture est à mettre en lien avec une méconnaissance des signes de malnutrition et un recours de première intention au traitement traditionnel, responsables d’un recours tardif au traitement. Cette situation apparaît favorisée par la barrière financière que représente l’accès aux soins en dépit du système de gratuité ciblée, et par les faiblesses du volet communautaire. La régularité et le suivi des activités de dépistage apparaissent en effet insuffisants et ont été affectés par la baisse des indemnités financières octroyées aux ASC.
Le faible niveau de couverture reflète également l’impact très négatif des ruptures récurrentes en intrants nutritionnels qu’a connu le district au cours des derniers mois: au-delà des conséquences sur les abandons, les ruptures participent en effet à une démotivation des acteurs impliqués dans les activités de PCIMA et à une baisse de la qualité de prise en charge.
Outre ces barrières à l’accessibilité communes à l’ensemble du district, l’implication de la population dans les activités d’exploitation artisanale de l’or est ressortie comme un frein supplémentaire à l’accessibilité dans les zones concernées, caractérisées par une couverture plus faible.
L’importance de ces barrières et le faible niveau de couverture ne doivent cependant pas faire oublier les efforts considérables mis en oeuvre par les différents acteurs pour la mise en oeuvre 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 de pérennisation des activités de PCIMA, il apparaît aujourd’hui primordial d’entreprendre des mesures correctrices afin de consolider les acquis et améliorer la couverture et l’accessibilité au traitement pour les malnutris.
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.
En octobre 2012, Helen Keller International (HKI) a entreprit de mettre en oeuvre le programme de renforcement des activités de prévention et de prise en charge de la malnutrition aigüe à assise communautaire dans le district sanitaire de Koutiala, dans la région de Sikasso. Les deux axes principaux du programme de HKI sont le renforcement des capacités des prestataires sanitaires dans 40 Centre de Santé Communautaire (CSCom) du district et la mobilisation communautaire dans 18 aires de santé. Le but du projet étant de renforcer les compétences des prestataires sanitaires et communautaires pour la prévention, et le traitement 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 Koutiala:
http://www.coverage-monitoring.org/wp-content/uploads/2014/01/Rapport-SQ...
","","","","","","","Helen Keller International (HKI)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","23245","","Management of severe acute malnutrition","","","","SAM child","Enfants de 6 à 59 mois","District de Koutiala","Community-based|Primary health care center","","Le but du projet étant de renforcer les compétences des prestataires sanitaires et communautaires pour la prévention, et le traitement de la malnutrition aigüe en faisant les actions suivantes:
- Formations des prestataires sur le protocole national de la PECIMA qui n’ont pas bénéficiés des dernières formations.
- Formation des prestataires à communiquer avec les mères des enfants sur les bonnes pratiques nutritionnelles à travers la promotion des Actions Essentielles en Nutrition.
- Formation sur le social BCC (Négociation pour le changement de comportement).
- Supervision formative au niveau des CSCom pour maintenir la qualité des services PECIMA offerts.
- Supervision formative Groupes de Mères dans le dépistage des enfants dans les communautés et la référence des cas vers les CSCom.
A Koutiala ces activités se sont traduites par:
- La formation sur le protocole National de 41 agents des CSCom et formation de 122 autres sur les Actions essentielles en nutrition et la communication.
- La supervision formative dans au moins 18 CSCom par mois cela depuis février 2013.
- La formation de 216 membres de groupes de mères pour le dépistage et la référence des enfants souffrant de malnutrition aigüe. Les groupes de mères ont à leur tour organisé des sessions de sensibilisation auxquelles 4687 mères ayant des enfants de moins de 5 ans ont participé.
- Les actions du projet ont aussi porté sur l’organisation de réunions de monitorage des activités PECMA regroupant tous les DTC (Directeur technique de Centre de santé) et l’équipe cadre du district. Au cours de ces réunions, en plus du monitorage, des sessions de formations sur les principales lacunes identifiées par le superviseur et sur les rapports furent tenues
Des réunions communautaires dans les CSCom ayant des groupes de mères ont été organisées dans 18 CSCom. Les principaux responsables des aires de santé ont participé à ces réunions, dont l’un des objectifs était de présenter le travail des membres des groupes de mères et solliciter l’appui des responsables des aires de santé dans la mobilisation communautaire pour le dépistage et la référence des cas de 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 du 24 novembre au 8 décembre 2013en 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.
La méconnaissance de la malnutrition a été ressortie comme première barrière a l’accès aux soins au cours des trois étapes de l´investigation malgré le nombre très élevé de cas de MAS dans le district. Ni les signes de la maladie -spécialement du Kwashiorkor- ni les causes ne sont identifiés. La manque de connaissance sur des aspects de prévention de la malnutrition est en lien avec l’insuffisance de sensibilisation et de communication pour le changement de comportement en matière de pratique de l’alimentation du nourrisson et du jeune enfant, un des points fondamentaux du programme nutrition de HKI.
Le dépistage n´est pas suffisant ni fait de façon routinière: il n´y a pas un dépistage actif régulier dans la communauté, seulement il est fait pendant la campagne de masse, même s´il y a des relais communautaires dans le village. Les GM sont plus actives mais les occupations les empêchent de le faire pendant tout l´année. Au niveau des structures de santé, le dépistage passif des enfants qui arrivent aux CSCom n´est pas systématique dans la plupart des centres. Les activités de dépistage sont essentielles compte tenu la sévérité de l´état des cas admis dans le programme, bien soit par la non reconnaissance de la maladie ou par des autres raisons soulevées comme l´utilisation de la médicine traditionnelle, la distance, les occupations des mères ou le manque de moyens financières. Le suivi des GM et les réunions périodiques avec les leaders communautaires sont essentiels pour diminuer les barrières à la couverture au niveau communautaire.
La problématique des abandons du programme, élevés et précoces, semble être en lien avec divers aspects du service qu´influencent l´opinion des bénéficiaires comme les très communs ruptures d´intrants - même si en termes d´intrants nutritionnelles les ruptures sont plus fréquentes pour le traitement des cas modérés (PPS), la population ne connait pas la différence entre les deux produits (le nom en langue local est le même). En fait la communication au niveau de l´URENAS entre le personnel et les mères est très faible. L´information sur la maladie, le traitement et le fonctionnement du service donnée aux accompagnants des enfants MAS est presque inexistante même quand le temps d´attente est souvent longue. Tous ces aspects appréciés par la communauté et liés à la qualité du service doivent être pris en compte sans oublier les autres faiblesses plus techniques identifiées, comme le non-respect du protocole et la sous notification des abandons, qu’influencent aussi la couverture.
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" "11445","Iodin deficiency disorders control programme","English","National","","GHA","Ghana","Accra, Greater Accra, Ghana|Kumasi, Ashanti, Ghana|Takoradi, Western, Ghana|Sunyani, Brong Ahafo, Ghana|Cape Coast, Central, Ghana|Wa, Ghana|Tamale, Ghana|Bolgatanga, Ghana|Koforidua, Eastern, Ghana|Ho, Volta, Ghana","Urban|Rural|Peri-urban","on-going","01-1996","","The programme focuses on the promotion of iodised salt consumption to elimate IDDs which are highly prevalent in Ghana. This done through sensitization of the public, training of salt producers and law enforcement agencies.
","Total goitre rates, household iodised salt consumption, market coverage of iodised salt, urinary and salt iodine concentrations
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Awareness creation of policy makers on the need to make funds available for IDD programms","Stakeholder","Ineffective collaboration is also dealt with by creating awareness of the importance of the programme to get them to include IDD in their work plan","Supplies","Removal of tax exemption on the import of potassium iodate to reduce the cost salt iodisation in the factories and cottage salt producers","","","","","","","","","","","","","","","","The programme focusses on the promotion of iodised salt consumption to eliminate IDDs which are prevalent in Ghana. This is done through enforcement of the Public Health Amendment law 2012 Act 851, which states that salts for human and animal cosumption must be iodised. The programme also trains salt producers on effective ways of iodising salt.
","Total goitre rates, urinary and salt iodine concentrations,Household iodated salt consumption coverageMarket coverage of iodated salt
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Creating awareness of the importance of the program in policy makers to make funds available for the programme","Stakeholder","Lyasing with international organizations to inculcate IDD in their programms","Supplies","Imposing tax exemption on the importation of potassium iodate to reduce the cost of salt iodisation","","","","","","","","","","","","","","","","Establishment of salt banks at salt producing areas to mop up salts produce by small scale salt producers
","","English"