Nutrition
Takunda Resilience Food Security Activity (RFSA) Outcome Mapping Baseline report
The main objective of Progress Marker Monitoring/Outcome Mapping is to assess, the extent to which gender transformative changes are taking place in Takunda Program areas among men, women, and youth based on age, life stage, socio-cultural norms, and religious practices. Takunda acknowledges that gender inequality is both a cause and consequence of food insecurity; hence gender equality is at the heart of the Takunda Program. To challenge gender norms that fuel food insecurity, the Program implements Social Analysis and Action (SAA), a key gender transformative approach that triggers shifts in gender norms at the individual, household, community, and policy level. This progress marker assessment specifically measured behaviors and practices at play for the different study participants before Takunda’s Social Analysis and Action (SAA) interventions and it confirmed some of the findings of the Takunda gender Analysis study held in December 2021. The progress marker assessment measured gender outcomes/behaviors as defined by the communities, whereas the gender analysis assessed program-wide challenges experienced by different groups as defined by the program. Read More...
Titukulane Gender Progress Marker Monitoring Report
Titukulane is a five-year, US $75 million Resilience Food Security Activity funded by the Bureau for Humanitarian Assistance. The project is led by the Cooperative for Assistance and Relief Everywhere (CARE) in partnership with Emmanuel International (EI), the International Food Policy Research Institute (IFPRI), the National Smallholders Farmers’ Association of Malawi (NASFAM), Save the Children (SC), and WaterAid. Implemented in 19 Traditional Authorities (T/As) of two southern districts of Malawi (Zomba and Mangochi), Titukulane directly impacts 510,910 individuals – including adolescent girls and boys aged 10 to 19, and young women and men aged 20 to 29 – who face an uncertain future as farming becomes less viable. Titukulane offers an integrated and gender-responsive package of interventions across the following program elements: maternal and child health; nutrition and water, sanitation, and hygiene, (WASH); agriculture sector capacity; microenterprise productivity; civic participation; and capacity building, preparedness, and planning. The program works across three purpose areas:
Purpose 1: Increased, diversified, sustainable incomes for ultra-poor, chronically vulnerable households (HHs), women and youth.
Purpose 2: Nutritional status among children < 5, adolescent girls, and women of reproductive age improved; and
Purpose 3: Increased institutional and local capacities to reduce risk and increase resilience among very poor and chronically vulnerable households in alignment with the National Resilience Strategy.
Gender integration is a crosscutting component among all activities and project emphasizes the critical importance and benefits of increased voice, participation and leadership of women and youths, including young women. A Gender Analysis was initially conducted for Titukulane in 2020 to identify context specific gender barriers, inequalities, and potential risks that could negatively affect the achievement of the project’s expected outcomes, as well as to assess how these constraints could be addressed in Zomba and Mangochi. Read More...
Purpose 1: Increased, diversified, sustainable incomes for ultra-poor, chronically vulnerable households (HHs), women and youth.
Purpose 2: Nutritional status among children < 5, adolescent girls, and women of reproductive age improved; and
Purpose 3: Increased institutional and local capacities to reduce risk and increase resilience among very poor and chronically vulnerable households in alignment with the National Resilience Strategy.
Gender integration is a crosscutting component among all activities and project emphasizes the critical importance and benefits of increased voice, participation and leadership of women and youths, including young women. A Gender Analysis was initially conducted for Titukulane in 2020 to identify context specific gender barriers, inequalities, and potential risks that could negatively affect the achievement of the project’s expected outcomes, as well as to assess how these constraints could be addressed in Zomba and Mangochi. Read More...
Qualitative Monitoring Improvement Initiative Pilot for the SHOUHARDO III Program in Bangladesh
Strengthening Household Abilities to Respond to Development Opportunities (SHOUHARDO) III was a five-year multisectoral and integrated program implemented by CARE Bangladesh between 2015 and 2020 and funded by USAID and the Government of Bangladesh. The objective of the program was to improve the lives and livelihoods of 549,000 people living in poor and extreme poor communities in eight districts in the Deep Haor and Remote Char region of northern Bangladesh. The program focused on community-based asset development and women’s empowerment, building the capacity of local government and community-service organizations, increasing resilience to frequent shocks and stressors, and improving nutrition and health outcomes for mothers and children under two-years of age. SHOUHARDO III was extended for two years (2020 to 2022) and a second extension phase (SHOUHARDO III Plus) was funded for an additional two years (2022 to 2024). During this period the program will focus on engaging with and linking local service providers with the government and the private sector. Read More...
Ghana: Inequalities in Food Insecurity
Food insecurity is a global health challenge, especially among low- and middle-income countries. The Sustainable Development Goal (SDG) 2.1 targets to: “End hunger and ensure access by all people, in particular the poor and vulnerable people, including infants, to safe, nutritious and sufficient food all year round by 2030.” In Ghana, the situation worsened in 2022. The number of individuals in food crisis surged from 560,000 in 2021 to 823,000 in 2022, marking a 47% increase in individuals suffering from lack of food access, availability, and utilization. As per the Food and Agricultural Organization, in terms of the prevalence of moderate or severe food insecurity in Ghana, 12.9 million people, or 39.4% of the total population, were affected in 2022. Read More...
SHOUHARDO III Performance and Impact evaluation
This report evaluates the performance of the SHOUHARDO III project, which targets poor households in the char and haor (wetland) areas of Bangladesh and aims to address food and income insecurity, maternal and child health and nutrition, women’s and youth empowerment, as well as improve access to public services while building resilience capacities. This evaluation employs three methodologies: qualitative inquiry, pre-post comparison, and impact evaluation. The impact evaluation matches communities treated by SHOUHARDO III with untreated communities ex-post, using baseline stunting rates from the 2014 DHS dataset. The evaluation finds that the SHOUHARDO III project engaged more than 40% of households surveyed within target villages and successfully targeted poor and female-headed households. The analysis of baseline and endline statuses (pre-post analysis) of households in the SHOUHARDO III-targeted areas demonstrates that households from these areas improved across several indicators, including poverty levels, the nutritional status of women and children, women’s empowerment, and gender equity. From a qualitative standpoint, participants from areas where SHOUHARDO III appeared well-implemented offers insights into the potential of the interventions. The qualitative evaluation found mechanisms of change in several areas that can be built upon and enhanced. Qualitative findings show that the program succeeded in promoting multi-sectoral change at household and community levels. They also show that SHOUHARDO III effectively targeted services to the most food-insecure, Poor and Extremely Poor members of communities, and its multi-generational and gender-inclusive approach to its interventions facilitated community acceptance. From the impact evaluation, it is likely that we can credit SHOUHARDO III with improvements in women’s dietary diversity, women and children’s minimum acceptable diet, antenatal care access, and the increase in participation across several sectors. In addition, households in SHOUHARDO III villages experienced statistically significant differences in one resilience indicator, and households in program villages that experienced major shocks were better able to maintain their food consumption than similar households in comparison villages. However, the impact evaluation does not find meaningful differences between households in targeted communities and households in non-targeted communities in terms of women’s mobility and decision-making, children’s nutritional status (including child stunting and underweight status), children’s diarrhea, exclusive breastfeeding, household hunger, and improved use of health and nutrition services overall. Improvements in mostmeasured conditions in the SHOUHARDO III program areas appear to have been matched by similar improvements in non-program areas, suggesting broader forces may account for them. Ultimately understanding differences between program areas and non-program areas can help inform decisions about future chapters of the SHOUHARDO III program and other development food security programs to ensure the most effective programs for vulnerable populations. Understanding the dynamics and mechanisms of change and responses of participants to interventions can also inform future work. Salient findings are also important to highlight for action. The research team concludes this report with recommendations. Read More...
N utrition Knowledge Attitude and Practice (KAP) Survey for DINU Program in North and North-Eastern Uganda
Background: The Development Initiative for Northern Uganda (DINU) is a Government of Uganda integrated programme. It is implemented in districts that include the 11 of Kitgum (Acholi), Nakapiripirit, Amudat, Nabilatuk, Napak, Moroto, Kotido, Kaabong, Karenga and Abim (Karamoja), and Katakwi (Teso) sub-regions for three years from 2020 – 2022. The overall supervision is with the Office of the Prime Minister through local governments in partnership with a wide range of stakeholders. DINU supports interventions in three specific interlinked programs: (1) Food Security, Nutrition and Livelihoods (2) Transport Infrastructures and (3) Good Governance. The CARE consortium focusses on the sector of food security, nutrition and livelihoods with specific emphasis on community-based interventions. A survey was launched by the CARE Consortium partners with the overall objective of generating comprehensive gender sensitive Nutrition Knowledge, Attitude and Practices (KAP) information in the targeted 11 CARE consortium districts. It is intended to help inform the implementation of the nutrition component of the DINU project.
Methodology: The KAP survey was conducted from 17th November to 8th December 2020 in the 11 districts. The study populations were mothers and/or caregivers in household with children aged 0-23 months, adolescent girls aged 10 to 19 years with or without children 0-23months. Key district, subcounty and community leaders who played crucial role in programming for MIYCAN related interventions were reached. A cross-sectional survey utilising both quantitative and qualitative data collection methods was used. Sample size estimation was based on WHO Vaccination Coverage Cluster Survey guidance, July 2015. Household questionnaire comprising of 5 modules was adapted from the FAO manual for assessing nutrition related KAP. Semi-structured interview guides were used to facilitate the Key Informants Interviews and Focus Group Discussions. Quantitative data collection was done using mobile phones through Computer Assisted Personal Interviewing (CAPI) working on the Open Data Kit (ODK) platform and hosted on the ONA platform. Quantitative Data analysis was done using SPSS 26. Qualitative data analysis was done based on the interpretative approach that involved eliciting meanings from the collected information. A total of 164 clusters were reached, 1,139 households, 1,158 children aged 0 to 23months, 1,112 women and 452 adolescents from all the 11 districts. Meanwhile, 22 FGDs and 44 key informant interviews were conducted. Read More...
Methodology: The KAP survey was conducted from 17th November to 8th December 2020 in the 11 districts. The study populations were mothers and/or caregivers in household with children aged 0-23 months, adolescent girls aged 10 to 19 years with or without children 0-23months. Key district, subcounty and community leaders who played crucial role in programming for MIYCAN related interventions were reached. A cross-sectional survey utilising both quantitative and qualitative data collection methods was used. Sample size estimation was based on WHO Vaccination Coverage Cluster Survey guidance, July 2015. Household questionnaire comprising of 5 modules was adapted from the FAO manual for assessing nutrition related KAP. Semi-structured interview guides were used to facilitate the Key Informants Interviews and Focus Group Discussions. Quantitative data collection was done using mobile phones through Computer Assisted Personal Interviewing (CAPI) working on the Open Data Kit (ODK) platform and hosted on the ONA platform. Quantitative Data analysis was done using SPSS 26. Qualitative data analysis was done based on the interpretative approach that involved eliciting meanings from the collected information. A total of 164 clusters were reached, 1,139 households, 1,158 children aged 0 to 23months, 1,112 women and 452 adolescents from all the 11 districts. Meanwhile, 22 FGDs and 44 key informant interviews were conducted. Read More...
Multi-sectoral and integrated humanitarian assistance for the conflict displaced and most vulnerable populations Sudan
This baseline survey was conducted for the USAID/BHA funded project “Multi-sectoral and integrated humanitarian assistance for the conflict displaced and most vulnerable populations in South and East Darfur” implemented by CARE International in Sudan. The baseline was designed to collect data in selected communities in southern and eastern Darfur State to assess the situation before the start of the project and determine baseline values for project indicators. The baseline used multiple methods for data collection, including desk review of project documents, individual interviews with household leaders using a structured questionnaire, Focus Group Discussions (FGD) with representatives of different groups in the communities, Key Informant Interviews (KII) with the respective institutions.
When asked how much water they collect per day for all uses, it was discovered that households collect a mean of 5.6 Jeri Can per day (1 Jerrican=20 liters) which gives 17 litters/day/person from all sources including unsafe ones, keeping in mind that this water is collected from all sources including unsafe ones and for all types of uses.
Access to latrine: From the total surveyed families, 39% do not have access to latrines (48.3% M, 31.9% F). Lack of access to latrines is common in SD, with the majority of HH (55.9%) without access compared to ED (21.4%). And from the total families;23.3% of the HH surveyed acknowledged that their family members usually practice open defecation (26.4%M, 20.8%F), 23.5% use community latrines, and 3.8% share latrines with their neighbors. 51.8% of those who have latrines are inaccessible to people with disabilities (61.5%M, 44.2%F).
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When asked how much water they collect per day for all uses, it was discovered that households collect a mean of 5.6 Jeri Can per day (1 Jerrican=20 liters) which gives 17 litters/day/person from all sources including unsafe ones, keeping in mind that this water is collected from all sources including unsafe ones and for all types of uses.
Access to latrine: From the total surveyed families, 39% do not have access to latrines (48.3% M, 31.9% F). Lack of access to latrines is common in SD, with the majority of HH (55.9%) without access compared to ED (21.4%). And from the total families;23.3% of the HH surveyed acknowledged that their family members usually practice open defecation (26.4%M, 20.8%F), 23.5% use community latrines, and 3.8% share latrines with their neighbors. 51.8% of those who have latrines are inaccessible to people with disabilities (61.5%M, 44.2%F).
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LIVELIHOODS FOR RESILIENCE ACTIVITY
In October2019, CARE Ethiopia commissioned Care Plc. to conduct repeated annual intermediate result (IR) assessment of the Livelihoods for Resilience Activity over the coming three years, corresponding to the fiscal year of the project from 2019-2022. The study involves assessing project’s intermediate result that have been achieved based on the key performance indicators using information collected randomly selected project participating households as well as conducting multiyear trend analysis of changes in the well-being of project participants based on panel data are collected from 400 households . Read More...
Impact Evaluation of the Strengthen PSNP4 Institutions and Resilience (SPIR) Development Food Security Activity (DFSA)
The Strengthen PSNP4 Institutions and Resilience (SPIR) Development Food Security Activity (DFSA) in Ethiopia is a five-year project (2016-2021) supporting implementation of the fourth phase of the Productive Safety Net Programme (PSNP4) as well as providing complementary livelihood, nutrition, gender and climate resilience activities to strengthen the program and expand its impacts. The main objectives of SPIR are to enhance livelihoods, increase resilience to shocks, and improve food security and nutrition for rural households vulnerable to food insecurity. Activities under SPIR are organized into four Purposes: 1) livelihoods, 2) nutrition, 3) women’s and youth empowerment, and 4) climate resilience. Across these Purposes, SPIR provides community-level programming, training of government staff involved in public service delivery at the woreda (district) and kebele (subdistrict) level, and targeted livelihood transfers. Read More...