Stunting
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...
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...
Southern African Nutrition Initiative (SANI): Baseline Household Evaluation — Zambia
CARE is currently implementing the South Africa Nutrition Initiative (SANI) project in Malawi, Mozambique and Zambia. The goal of SANI is to improve the nutritional status of women of reproductive age and boys and girls under 5 years. This baseline study was conducted to obtain baseline values for the key SANI intervention areas in Mpika and Shiwang’andu Districts of Zambia. Eleven (11) key PMF indicators were able to be measured in order to set-up baseline values and establish achievable life of project targets for SANI in Zambia. (64 pages) Read More...
Southern African Nutrition Initiative (SANI): Baseline Household Evaluation — Malawi
CARE is currently implementing the South Africa Nutrition Initiative (SANI) project in Malawi, Mozambique and Zambia. The goal of SANI is to improve the nutritional status of women of reproductive age and boys and girls under 5 years. This baseline study was conducted to obtain baseline values for the key SANI intervention areas in Dowa and Ntchisi Districts of Malawi. Eleven (11) key PMF indicators were able to be measured in order to set-up baseline values and establish achievable life of project targets for SANI in Malawi. (78 pages) Read More...
Evaluation of Zambia’s First 1,000 Days Nutrition Programme
National Food and Nutrition Council (NFNC) and several donors—including the United Kingdom’s Department for International Development (DFID), Irish Aid, and the Swedish International Development Cooperation Agency (SIDA) —designed a bundled, multisector programme called the First 1,000 Most Critical Days Programme (MCDP). The MCDP will run for three years (from late 2014 through 2016) in 14 districts across Zambia, and it includes targeted interventions such as micronutrient supplementation; promotion of best practices in breastfeeding and complementary feeding; promotion of diverse diets for pregnant and lactating women; zinc treatment for diarrhoea; promotion of safe water, hygiene, and sanitation; growth monitoring; deworming; and management of acute malnutrition. The impact evaluation of the MCDP consists of four components, the first of which is the rapid qualitative assessment (RQA). The RQA is intended to facilitate formative research and is designed to provide tailored, programme-relevant information to MCDP implementers in order to guide refinements to the programme. It was developed around one central research question: “What is the nature and experience of poverty and undernutrition, including access to food, dietary and feeding practices, and behaviour for households with young children in rural Zambia?” To answer this question, the RQA employed three primary methods of data collection: focused ethnographic studies (FESs); focus group discussions (FGDs); and social mapping (SM). (84 pages) Read More...
Zambia’s First 1000 Most Critical Days Programme (MCDP)
This report presents the results of a mixed-methods, summative evaluation of Zambia’s First 1000 Most Critical Days Programme (MCDP). The MCDP is a bundled, multi-sectoral programme that aims to reduce stunting in Zambia by 50% by focusing on the most critical period for stunting: pregnant and lactating mothers, and children under 2 years of age. The programme focuses on bringing to scale a strategic subset of routine evidence-based interventions proven to reduce stunting: deworming and vitamin A supplementation; family planning; growth monitoring; iron and folic acid supplementation; iodised salt, micronutrients, and breastfeeding; fortified staples and specialised nutritional products; a mother- and baby-friendly hospital initiative; and management of severely malnourished children (National Food and Nutrition Commission of Zambia [NFNC], 2011). These interventions are supplemented by a range of trainings and behaviour change components designed to take advantage of potential complementarities between child health and improved maternal knowledge, WASH practices, and nutritional intake. The programme is led by the Zambia Food and Nutrition Commission (NFNC) and it involves the Ministry of Health (MoH), Ministry of Education (MoE), Ministry of Agriculture, Livestock and Fisheries (MoA), the Ministry of Community Development and Social Welfare (MCD), and the Ministry of Local Government and Housing (MLGH). CARE International is the main technical assistance and fund management partner and the MCDP is funded by the Scaling Up Nutrition network (SUN) in Zambia. (359 pages)
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SHOUHARDO III Midterm Methodology report
This Volume II of the report for the Mid-Term Evaluation (MTE) of the SHOUHARDO III Program implemented by CARE and local partners in Bangladesh summarizes the methodology that was used to conduct the MTE over the period from late October 2017 through mid-June 2018. This resource document is being provided as a separate document from the MTE Summary Report (Volume I) [also available on this site] which summarizes the priority recommendations that emerged from the MTE Process. (148 pages) Read More...
SHOUHARDO III Mid Term Summary
recommendations for the remaining life of the program to increase effectiveness in achieving sustainable impact and increase efficiency in use of resources. The MTE was planned and implemented over the period from late October 2017, through mid-June, 2018, with information gathering and preliminary analysis undertaken in Bangladesh from February 12 through March 12. The SHOUHARDO III Program is being implemented in 947 villages in 115 unions in 23 upazilas in 8 districts1 in northern Bangladesh. The goal of the program is to achieve improved gender equitable food and nutrition security and resilience for vulnerable people living in the flood-prone Char and Haor Regions of Bangladesh by 2020. The program is specifically targeting people defined by their communities as poor or extreme poor (PEP), expecting to have lasting impact by the end of its life on around 675,000 persons. The overall program value is USD 80 million3 from the United States Government with a complementary funding of USD 7,707,490 million from the Government of Bangladesh (GoB). A total of 126,810 Metric Tons (MTs) of commodities are planned for monetization over the life of the program, and 11,540 MT of commodities are planned for distribution under the maternal and child health and nutrition component (Purpose 2) of the program. (82 pages) Read More...