Nutrition
Kore Lavi Title II Program Haiti – Midterm Evaluation
This reports presents the findings, conclusions and recommendations related to the Kore Lavi mid-term evaluation.
DESCRIPTION OF KORE LAVI. Kore Lavi’s Theory of Change holds that positive and lasting transformation must happen within interrelated domains: (1) where the effective social safety net programming and complementary services reach the most vulnerable populations and protect their access to food while building self-reliance; (2) that achieve breadth and depth in behavior and social change needed to tackle under-nutrition among vulnerable women and children; and (3) that institutionalize accountability, transparency and quality of delivery for mutually reinforcing social protection programs under the leadership of MAST.
EVALUATION METHODOLOGY. The evaluation employed three data collection methodologies: document review, key informant interviews, and focus group discussions.
PRIMARY FINDINGS AND CONCLUSIONS.
At the time of the MTE, Kore Lavi had completed data collection in 16 communes demonstrating the ability to adapt and innovate to address the initial data quality problems that existed at the beginning of the program.
In terms of its implementation on the ground, the food voucher scheme is operating well in identifying voucher recipients and enrolling them in the program, distributing food to beneficiaries via paper or electronic vouchers, recruiting and managing the network of collaborating vendors, enforcing policies governing the scheme and overseeing operations. Food received by beneficiary households from both paper and electronic vouchers is inevitably shared with non-household members, including neighbors and even strangers. The VSLA scheme has effectively provided a mechanism by which large numbers of vulnerable women and men living in program communities can save and access small loans at reasonable interest rates to invest in their businesses or children’s education or for other purposes.
SO3 social behavioral change communications interventions are, on the whole, well designed and well implemented. Care Groups, moreover, appear to be an effective methodology for mobilizing women and communicating critical SBCC messages. Community health agents and Lead Mothers play a critical role in SO3 activities. While they are, for the most part, doing a good job and are satisfied with their roles, they also have a number of legitimate concerns related to the lack of monetary compensation and reimbursement for expenses incurred. The program has done a good job identifying and reaching the targeted women and infants.
Kore Lavi has taken a holistic approach to gender integration from design to implementation and has made a conscious and good faith effort to integrate gender considerations in each of the four program SOs.
Kore Lavi has prioritized information management and has demonstrated a clear institutional interest in improving knowledge and learning.
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DESCRIPTION OF KORE LAVI. Kore Lavi’s Theory of Change holds that positive and lasting transformation must happen within interrelated domains: (1) where the effective social safety net programming and complementary services reach the most vulnerable populations and protect their access to food while building self-reliance; (2) that achieve breadth and depth in behavior and social change needed to tackle under-nutrition among vulnerable women and children; and (3) that institutionalize accountability, transparency and quality of delivery for mutually reinforcing social protection programs under the leadership of MAST.
EVALUATION METHODOLOGY. The evaluation employed three data collection methodologies: document review, key informant interviews, and focus group discussions.
PRIMARY FINDINGS AND CONCLUSIONS.
At the time of the MTE, Kore Lavi had completed data collection in 16 communes demonstrating the ability to adapt and innovate to address the initial data quality problems that existed at the beginning of the program.
In terms of its implementation on the ground, the food voucher scheme is operating well in identifying voucher recipients and enrolling them in the program, distributing food to beneficiaries via paper or electronic vouchers, recruiting and managing the network of collaborating vendors, enforcing policies governing the scheme and overseeing operations. Food received by beneficiary households from both paper and electronic vouchers is inevitably shared with non-household members, including neighbors and even strangers. The VSLA scheme has effectively provided a mechanism by which large numbers of vulnerable women and men living in program communities can save and access small loans at reasonable interest rates to invest in their businesses or children’s education or for other purposes.
SO3 social behavioral change communications interventions are, on the whole, well designed and well implemented. Care Groups, moreover, appear to be an effective methodology for mobilizing women and communicating critical SBCC messages. Community health agents and Lead Mothers play a critical role in SO3 activities. While they are, for the most part, doing a good job and are satisfied with their roles, they also have a number of legitimate concerns related to the lack of monetary compensation and reimbursement for expenses incurred. The program has done a good job identifying and reaching the targeted women and infants.
Kore Lavi has taken a holistic approach to gender integration from design to implementation and has made a conscious and good faith effort to integrate gender considerations in each of the four program SOs.
Kore Lavi has prioritized information management and has demonstrated a clear institutional interest in improving knowledge and learning.
Read More...
Baseline Study of the Title II Development Food Assistance Program in Haiti
In fiscal year 2013, the U.S. Agency for International Development’s (USAID) Office of Food for Peace (FFP) awarded funding to CARE International and its partners, Action Contre La Faim International (ACF) and the U.N. World Food Programme (WFP), to implement a Title II development food assistance program in Haiti.1 The four-year Kore Lavi Program directly supports the Government of Haiti’s (GOH) social protection efforts. The overall objective of the program is to reduce food insecurity and vulnerability by supporting the GOH in establishing a replicable safety net system and expanding capacities for preventing child undernutrition.
KEY FINDINGS.
The Title II program area residents face challenges in all four pillars of food security: (1) availability of food, (2) access to food, (3) utilization of food and (4) stability.
Survey results indicate that 57.5 percent of households suffer from moderate hunger and 13.5 percent of households suffer from severe hunger.
An HDDS of 6.2 indicates that households in the Kore Lavi Program area typically can access and consume 6 of 12 basic food groups. Qualitative data indicate that food consumption is pragmatic at the household level. Individual families eat what is available, what they can grow or what they can afford to purchase. Despite these challenges, many respondents spoke ardently to beliefs about the cultural significance of certain foods, while also holding strong opinions on imported food in comparison to locally produced food.
The household survey data show that 69 percent of all households have an adequate level of food consumption, 22 percent score at the borderline level, and 9 percent score at the poor level.
Across the Kore Lavi Program area, 43.6 percent of households currently live in extreme poverty (less than the international poverty line of USD$1.25 at 2005 prices), with average daily per capita expenditures of constant USD$ 2.10.
The household survey data show that 40 percent of households use an improved drinking water source and 16 percent of households use a non-shared improved sanitation facility.
As measured by body mass index (BMI), the nutritional status of women 15-49 years of age who are not pregnant or two months post-partum is generally satisfactory despite a lack of dietary diversity.
The survey data reveal that 8 percent of children under five years of age in the Kore Lavi Program area show signs of being moderately or severely underweight, and 19 percent of children under five years of age are stunted.
Across the qualitative data, views about gender equality tended to be polarized, rooted historically and in tradition. Read More...
KEY FINDINGS.
The Title II program area residents face challenges in all four pillars of food security: (1) availability of food, (2) access to food, (3) utilization of food and (4) stability.
Survey results indicate that 57.5 percent of households suffer from moderate hunger and 13.5 percent of households suffer from severe hunger.
An HDDS of 6.2 indicates that households in the Kore Lavi Program area typically can access and consume 6 of 12 basic food groups. Qualitative data indicate that food consumption is pragmatic at the household level. Individual families eat what is available, what they can grow or what they can afford to purchase. Despite these challenges, many respondents spoke ardently to beliefs about the cultural significance of certain foods, while also holding strong opinions on imported food in comparison to locally produced food.
The household survey data show that 69 percent of all households have an adequate level of food consumption, 22 percent score at the borderline level, and 9 percent score at the poor level.
Across the Kore Lavi Program area, 43.6 percent of households currently live in extreme poverty (less than the international poverty line of USD$1.25 at 2005 prices), with average daily per capita expenditures of constant USD$ 2.10.
The household survey data show that 40 percent of households use an improved drinking water source and 16 percent of households use a non-shared improved sanitation facility.
As measured by body mass index (BMI), the nutritional status of women 15-49 years of age who are not pregnant or two months post-partum is generally satisfactory despite a lack of dietary diversity.
The survey data reveal that 8 percent of children under five years of age in the Kore Lavi Program area show signs of being moderately or severely underweight, and 19 percent of children under five years of age are stunted.
Across the qualitative data, views about gender equality tended to be polarized, rooted historically and in tradition. Read More...
Emergency Water, Sanitation, Hygiene and Nutrition for Crisis Affected Communities in East Darfur and South Darfur, Sudan, 2017-2019
The project under evaluation was a two-year project implemented in one locality in South Darfur and three localities in East Darfur during the years 2017 and 2019. The Project was implemented by CIS in partnership with two local organizations and in cooperation with the State institutions.
The intervention activities are tailored to address urgent lifesaving needs of the vulnerable communities through improving communities’ access to WASH facilities and nutrition services. Where, the two components are expected to complement each other and the resultant outcomes are expected to reflect on the improvement of maternal and child health in particular.
The ccomparison of the actual implementation with the planned showed that the types of the activities implemented conform to the planned and that planned outputs are almost completed in accordance with the plan in quantitative and qualitative terms. while the number of beneficiaries reached exceeded the target by about 30%.
As immediate outcomes, IDPs and refugees’ camps expressed improvement in their access to safe drinking water, where 98.6% indicated obtaining water from protected sources. They also revealed satisfaction with availability of water by 65% of the HHs and the water distance has been cut to about 320 m in SD and to 106 m in ED, with an average water distance of 213 meter.
Evident progress has been made along communities’ access to and use of latrines, including women, where, 89.3% and 86.1% of target community members indicated their access to and regular use of latrines. The created hygiene awareness has induced the required positive changes in hygiene and sanitation attitude and practices among communities.
In overall, the treatment of malnutrition reached 80% of the cases and for both girls and boys the cure rate is 75% also for both sexes and the Number of MAM cases treated ranges between 10 to 15 daily, while number of PLW treated ranged between 4 to 7 women daily.
Ultimately, The WASH and nutrition interventions the project delivered so far have addressed emergency humanitarian needs of the IDPs and host communities, without which their lives would have been at great risk. The inadequate unsafe water sources are now more accessible, clean and healthy. The personal hygiene and environment has much improved due to increased awareness and positive change in attitude and practices. VSLAs have added a new livelihood means for women and their families by starting to save and becoming economically active and contributing to households’ budget.
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The intervention activities are tailored to address urgent lifesaving needs of the vulnerable communities through improving communities’ access to WASH facilities and nutrition services. Where, the two components are expected to complement each other and the resultant outcomes are expected to reflect on the improvement of maternal and child health in particular.
The ccomparison of the actual implementation with the planned showed that the types of the activities implemented conform to the planned and that planned outputs are almost completed in accordance with the plan in quantitative and qualitative terms. while the number of beneficiaries reached exceeded the target by about 30%.
As immediate outcomes, IDPs and refugees’ camps expressed improvement in their access to safe drinking water, where 98.6% indicated obtaining water from protected sources. They also revealed satisfaction with availability of water by 65% of the HHs and the water distance has been cut to about 320 m in SD and to 106 m in ED, with an average water distance of 213 meter.
Evident progress has been made along communities’ access to and use of latrines, including women, where, 89.3% and 86.1% of target community members indicated their access to and regular use of latrines. The created hygiene awareness has induced the required positive changes in hygiene and sanitation attitude and practices among communities.
In overall, the treatment of malnutrition reached 80% of the cases and for both girls and boys the cure rate is 75% also for both sexes and the Number of MAM cases treated ranges between 10 to 15 daily, while number of PLW treated ranged between 4 to 7 women daily.
Ultimately, The WASH and nutrition interventions the project delivered so far have addressed emergency humanitarian needs of the IDPs and host communities, without which their lives would have been at great risk. The inadequate unsafe water sources are now more accessible, clean and healthy. The personal hygiene and environment has much improved due to increased awareness and positive change in attitude and practices. VSLAs have added a new livelihood means for women and their families by starting to save and becoming economically active and contributing to households’ budget.
Read More...
SUAAHARA II GOOD NUTRITION PROGRAM ANNUAL SURVEY YEAR TWO (2018)
SII aims to reduce the prevalence of stunting, wasting and underweight among children under five years of age and to reduce the prevalence of anemia among WRA and children 6-59 months of age. SII works across thematic areas including nutrition, health and family planning (FP), water, sanitation and hygiene (WASH), agriculture/homestead food
production (HFP), and governance, using a gender equality and social inclusion (GESI) approach for all interventions. CARE is a sub-grantee to Helen Keller International.
Annual surveys are a key component of SII’s monitoring system. The primary purpose is to monitor progress over time related to key SII inputs, outputs, outcomes and impacts in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017. Similar to the first annual survey, data collection for the second SII annual survey was conducted between July to September 2018, again, among a representative sample of households with a child
under five years. Read More...
production (HFP), and governance, using a gender equality and social inclusion (GESI) approach for all interventions. CARE is a sub-grantee to Helen Keller International.
Annual surveys are a key component of SII’s monitoring system. The primary purpose is to monitor progress over time related to key SII inputs, outputs, outcomes and impacts in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017. Similar to the first annual survey, data collection for the second SII annual survey was conducted between July to September 2018, again, among a representative sample of households with a child
under five years. Read More...
SUAAHARA II GOOD NUTRITION PROGRAM ANNUAL SURVEY YEAR ONE (2017)
The Government of Nepal (GoN) is currently rolling out the second phase of a national Multi-Sectoral Nutrition Program (MSNP), with the support of external development partners. Suaahara II is a USAID-funded multisectoral nutrition program, aligned with Nepal’s MSNP, being implemented in 42 of Nepal’s 77 districts from 2016 to 2021. Suaahara II aims to reduce the prevalence of stunting, wasting and underweight among children under 5 years of age and to reduce the prevalence of anemia among WRA and children 6-59 months of age. CARE is sub-grantee to Helen Keller International on this project.
Annual surveys are a key component of Suaahara II’s monitoring system. The primary purpose is to monitor progress over time related to key Suaahara II inputs, outputs, outcomes and impacts in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017 among a representative sample of households with a child under five years, by New Era, a local survey firm. Read More...
Annual surveys are a key component of Suaahara II’s monitoring system. The primary purpose is to monitor progress over time related to key Suaahara II inputs, outputs, outcomes and impacts in intervention areas. The first SII annual monitoring survey was conducted between June to September 2017 among a representative sample of households with a child under five years, by New Era, a local survey firm. Read More...
Mid-Term Strategic Review of the Livelihoods for Resilience Activity
CARE commissioned a Mid-Term Strategic Review (MTSR) of the Livelihoods for Resilience Activity to formulate recommendations for the remaining life of the project to increase effectiveness in achieving sustainable impact. The Livelihoods for Resilience Activity is being implemented in 27 Woredas in the three regions of Tigray, Amhara, and Southern Nations, Nationalities and Peoples and is just over the midway point in its five-year life from December 5, 2016, through December 3, 2021. The purpose of the Livelihoods for Resilience Activity is to reduce food insecurity and increase resilience for 97,900 chronically food insecure households that are enrolled in the fourth cycle of the Government of Ethiopia’s Productive Safety Net Program (PSNP4), enabling them to graduate with resilience from the PSNP4.
The MTSR for the Livelihoods for Resilience Activity was a formative evaluation exercise intended to provide guidance on ways to improve the effectiveness of the program in achieving intended impact.
Relative to the four global learning questions for the MTSR (see page 4), the MTSR found that the model that the Livelihoods for Resilience Activity is implementing is effective for achieving graduation with resilience, but because frontline delivery is constrained by the number of staff, their technical capacities and the degree of supervision and support that they receive, interventions are not always going deeply enough to ensure behavioral change. The program is empowering women both economically and socially through the VESA platform, but there are significant variations between regions; and outside of the VESA, there is some evidence to suggest that women’s empowerment has not yet been well incorporated, especially in value chain participation and MFI linkages. Progress is certainly being made in transferring ideas and knowledge to PSNP counterparts, but that has not yet translated into practice mainly because of resource constraints. Key approaches that need to be added or strengthened in the coming two years include expanding frontline delivery capacities, expanding efforts to ensure that strategies and approaches are well understood by implementation staff at all levels in all partners, ensuring that women’s empowerment is included in all approaches by all partners, and looking for new ways to facilitate access to jobs, either through self-employment or wage employment, for youth from PSNP households.
The Livelihoods for Resilience Activity is already doing some very nice work in starting to achieve sustainable impact. The project has strong potential to be recognized as a “great” project if it can make some adjustments.
Read More...
The MTSR for the Livelihoods for Resilience Activity was a formative evaluation exercise intended to provide guidance on ways to improve the effectiveness of the program in achieving intended impact.
Relative to the four global learning questions for the MTSR (see page 4), the MTSR found that the model that the Livelihoods for Resilience Activity is implementing is effective for achieving graduation with resilience, but because frontline delivery is constrained by the number of staff, their technical capacities and the degree of supervision and support that they receive, interventions are not always going deeply enough to ensure behavioral change. The program is empowering women both economically and socially through the VESA platform, but there are significant variations between regions; and outside of the VESA, there is some evidence to suggest that women’s empowerment has not yet been well incorporated, especially in value chain participation and MFI linkages. Progress is certainly being made in transferring ideas and knowledge to PSNP counterparts, but that has not yet translated into practice mainly because of resource constraints. Key approaches that need to be added or strengthened in the coming two years include expanding frontline delivery capacities, expanding efforts to ensure that strategies and approaches are well understood by implementation staff at all levels in all partners, ensuring that women’s empowerment is included in all approaches by all partners, and looking for new ways to facilitate access to jobs, either through self-employment or wage employment, for youth from PSNP households.
The Livelihoods for Resilience Activity is already doing some very nice work in starting to achieve sustainable impact. The project has strong potential to be recognized as a “great” project if it can make some adjustments.
Read More...
Revue à mi-parcours « Projet d’appui à la filière halieutique (PAFHa) au Mali »
L’objectif global du PAFHa est de « Contribuer à la réduction de l’insécurité alimentaire et nutritionnelle au Mali ». Son objectif spécifique consiste à « Améliorer les revenus par un appui au développement de la filière halieutique ». Pour ce faire, le PAFHa vise à aboutir aux 3 résultats suivants :
- R1. La conservation, la valorisation et la commercialisation des produits halieutiques sont améliorées
- R2. La production halieutique (pêche/pisciculture) est développée par des pratiques durables
- R3. Les services techniques gouvernementaux et les organisations professionnelles sont impliqués dans le programme et leurs capacités sont renforcées.
120 campements de pêche et / ou villages de pêche ont été identifiés avec la DNP comme sites d’intervention du projet. Read More...
- R1. La conservation, la valorisation et la commercialisation des produits halieutiques sont améliorées
- R2. La production halieutique (pêche/pisciculture) est développée par des pratiques durables
- R3. Les services techniques gouvernementaux et les organisations professionnelles sont impliqués dans le programme et leurs capacités sont renforcées.
120 campements de pêche et / ou villages de pêche ont été identifiés avec la DNP comme sites d’intervention du projet. Read More...
Improving Effective Coverage of Maternal, New-born and Child Health Interventions for Reducing Preventable Child Deaths in Tangail and Khulna
Bangladesh has achieved success in reducing U5 & maternal mortality in last decade. UNICEF is partnering with GoB to contribute to reduce maternal and newborn deaths. To this end, MoH&FW with partnering with UNICEF and technical support from KOIKA implemented a MNCH project (IECMNCH) in Tangail and Khulna in line with UNICEF’s efforts to pay attention to low performing upazilas and HTR areas, started in 2015. CARE is one of the partners on this project.
designed to address main causes of newborn deaths (birth asphyxia, infection, prematurity)
to increase availability, utilization of quality MNCH-&-Nutrition services by
- increasing, sustaining of effective coverage of selected interventions;
- strengthening health system with increased availability & access to quality MNCH services;
-positive behaviour & social norm change through community participation & ownership for effective demand creation for increased utilization of MNCH services.
A baseline study in 2015 and an endline evaluation study in 2018 were implemented by UNICEF. Here are the endline study findings with corresponding baseline findings where necessary.
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designed to address main causes of newborn deaths (birth asphyxia, infection, prematurity)
to increase availability, utilization of quality MNCH-&-Nutrition services by
- increasing, sustaining of effective coverage of selected interventions;
- strengthening health system with increased availability & access to quality MNCH services;
-positive behaviour & social norm change through community participation & ownership for effective demand creation for increased utilization of MNCH services.
A baseline study in 2015 and an endline evaluation study in 2018 were implemented by UNICEF. Here are the endline study findings with corresponding baseline findings where necessary.
Read More...