Nutrition
2023 Participant Based Survey: Titukulane Project – PaBS Outcome Report
Despite decades of robust government and donor investments in livelihoods, food security, nutrition, and resilience, over 50% of the population lives below the poverty line. Previous activities have not sufficiently reduced the number of chronically food and nutrition insecure households nor effectively enhanced the capacity of local and government structures to implement resilience focused policies and actions. To address these issues, the Government of Malawi developed a National Resilience Strategy 2018-2030 (NRS) to guide investments in agriculture, reduce impacts and improve recovery from shocks, promote household resilience, strengthen the management of Malawi’s natural resources, and facilitate effective coordination between government institutions, civil society organizations and development partners. CARE and consortium partners designed the Titukulane Resilience Food Security Activity (RFSA) which means “let us work together for development” in the local Chichewa language—to support pilot implementation of NRS in Zomba and mangochi districts. The Titukulane RFSA, implemented by CARE International in Malawi (CIM), aims to achieve sustainable, equitable, and resilient food and nutrition security for ultra-poor and chronically vulnerable households. Specifically, Titukulane is designed to increase households’ abilities to deal with shocks without experiencing food insecurity following a three-purpose approach:
1. Increased diversified, sustainable, and equitable incomes for ultra-poor, chronically vulnerable households, women, and youth.
2. Improved nutritional status among children under 5 years of age, adolescent girls, and women of reproductive age.
3. Increased institutional and local capacities to reduce risk and increase resilience among poor and very poor households in alignment with the Malawi NRS.
To meet these three purposes, the Titukulane RFSA provides households with a package of interventions, including: Care Groups with Nutritional Cash Transfers (NCT), Farmer Field Business Schools and crop marketing support, Village Savings and Loan Associations, Adolescent nutrition, Irrigation farming, Youth vocational training including start-up capital and Gender dialogues. Read More...
1. Increased diversified, sustainable, and equitable incomes for ultra-poor, chronically vulnerable households, women, and youth.
2. Improved nutritional status among children under 5 years of age, adolescent girls, and women of reproductive age.
3. Increased institutional and local capacities to reduce risk and increase resilience among poor and very poor households in alignment with the Malawi NRS.
To meet these three purposes, the Titukulane RFSA provides households with a package of interventions, including: Care Groups with Nutritional Cash Transfers (NCT), Farmer Field Business Schools and crop marketing support, Village Savings and Loan Associations, Adolescent nutrition, Irrigation farming, Youth vocational training including start-up capital and Gender dialogues. 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...
HATUTAN Endline Evaluation
In this report, we present findings from the endline evaluation of the HATUTAN (Hahán ne’ebé Atu fó Tulun ho Nutrisaun no Edukasaun or Food to Support Nutrition and Education) program. Running between 2018 and 2023, the program worked in partnership with the Government of Timor-Leste and development stakeholders to address two strategic objectives: improved literacy of school-aged children and increased use of health, nutrition, and dietary practices. The program operated in 443 schools and communities within four of Timor-Leste’s most deprived municipalities, Ainaro, Ermera, Liquica, and Manatuto, supporting an estimated 105,967 target beneficiaries including school-aged children, teacher, school administrators, and community members. Key activities included support for the government-run School Feeding Program (SFP) and trainings targeting teachers, school administrators, and community members. Read More...
Uganda: Food insecurity a pressing concern
The Development Initiative for Northern Uganda (DINU) was a 38-month long project (January 2020 to February 2023) with an aim to improve food security, maternal and child nutrition, and household incomes for smallholder farmers in 11 districts of Uganda. The project has three major outcomes: increased production of diversified food by both men and women smallholder farmers, enhanced market accessibility for these farmers, and improved nutrition and family planning services through gender responsive community-based approaches. As a result, here was a significant 16.3% increase in adoption and production of diverse food crops and animal products, as well as 23.8% increase in the adoption of climate-smart technologies among the project participants. Read More...
She Feeds the World Peru Final Evaluation
From April 2019 to December 2022, CARE PERU implements the project "She Feeds the World" - SFtW (SFtW - She Feeds the World), a program launched by the PepsiCo Foundation through CARE USA in several countries. The purpose of the project has been to reduce chronic malnutrition and anemia in children under 5 years old and increase the income of 4,000 poor families residing in 4 prioritized districts, corresponding to the provinces of Lima, Ica and Sullana with a gender approach. The target group are children under 5 years old and pregnant women.
The project considered as areas of change, to achieve its results, to work on the economic empowerment of women, improvement of nutrition and feeding practices, increase in access and control of productive resources, and increase in access to market opportunities. The project was organized into three components; Promotion of healthy practices and environments for maternal and child care in prioritized districts of the regions of Lima, Ica and Piura, Increased income of 4,000 households (16,000 beneficiaries) in poor communities in prioritized districts of the regions of Lima, Ica and Piura in a sustainable and inclusive manner, and Development of Strategic Alliances and Political Advocacy to improve maternal and child nutrition and local economic development with a gender approach. It should be noted that the project had a goal at the end of the action (December 2022) of directly reaching 54,000 women, men and children and indirectly benefiting 358,450 people, in this case through advocacy and scaling strategies, with a full scope estimated of 412,450 people.
At the end of the implementation, CARE PERÚ entrusts ESTRATEGIA, a consulting company, to conduct the final evaluation assessment of the project "She Feeds the World - Peru", to measure the level of achievement of the planned objectives and implemented strategies; as well as the status of the project indicators. Read More...
The project considered as areas of change, to achieve its results, to work on the economic empowerment of women, improvement of nutrition and feeding practices, increase in access and control of productive resources, and increase in access to market opportunities. The project was organized into three components; Promotion of healthy practices and environments for maternal and child care in prioritized districts of the regions of Lima, Ica and Piura, Increased income of 4,000 households (16,000 beneficiaries) in poor communities in prioritized districts of the regions of Lima, Ica and Piura in a sustainable and inclusive manner, and Development of Strategic Alliances and Political Advocacy to improve maternal and child nutrition and local economic development with a gender approach. It should be noted that the project had a goal at the end of the action (December 2022) of directly reaching 54,000 women, men and children and indirectly benefiting 358,450 people, in this case through advocacy and scaling strategies, with a full scope estimated of 412,450 people.
At the end of the implementation, CARE PERÚ entrusts ESTRATEGIA, a consulting company, to conduct the final evaluation assessment of the project "She Feeds the World - Peru", to measure the level of achievement of the planned objectives and implemented strategies; as well as the status of the project indicators. Read More...
Development Initiative for Northern Uganda (DINU) Mid Term Evaluation
This Assignment was commissioned by CARE DENMARK – the Lead Partner of the Consortium of five (5) Partner Institutions (namely, CARE; Catholic Relief Services (CRS); Gulu Agricultural Development Company (GADC); Dynamic Agro-Pastoral Development Organization (DADO); and SORUDA) – to carry out the Mid-term Evaluation (MTE) of the “Inclusive Market-based Development for Smallholder Farmers in Karamoja, Teso and Acholi Sub-regions” Project – implemented by the Consortium. The Project is supported by the European Union (EU) – under the Supervision of the Office of the Prime Minister (OPM), through the 11 Project Area District Local Governments of: Abim, Kotido, Karenga, Kaabong, Moroto, Amudat, Nakapiripirit, Nabilatuk, Napak; as well as Katakwi and Kitgum – in partnership with other stakeholders – on behalf of the Government of Uganda.
The Overall Objective of the Mid-term Evaluation (MTE), was to: “review the implementation of the project, since its inception – with the aim of generating evidence towards promoting project performance improvement, accountability, learning and evidence-based decision-making and management”. In particular, the Evaluation was intended to: “assess results achieved to date in comparison with the outcome indicators outlined in the Project Monitoring, Evaluation, Accountability and Learning framework”. Accordingly, the MTE report documents: the background to the Assignment; the general approach to work and methodology employed; Project design (including relevance and coherence); as well as Project management systems, processes and operational environments. It also documents: Project performance and effectiveness during the period under review – up to its mid-term point; as well as the identified major achievements; challenges; constraints; risks; weaknesses and threats that characterized the Project. Lastly, it, further, documents resource management and efficiency in Project implementation; project “impact”; sustainability of Project Interventions and outcomes; the major conclusions; recommendations for the way forward; as well as lessons learnt – over the period under review. Read More...
The Overall Objective of the Mid-term Evaluation (MTE), was to: “review the implementation of the project, since its inception – with the aim of generating evidence towards promoting project performance improvement, accountability, learning and evidence-based decision-making and management”. In particular, the Evaluation was intended to: “assess results achieved to date in comparison with the outcome indicators outlined in the Project Monitoring, Evaluation, Accountability and Learning framework”. Accordingly, the MTE report documents: the background to the Assignment; the general approach to work and methodology employed; Project design (including relevance and coherence); as well as Project management systems, processes and operational environments. It also documents: Project performance and effectiveness during the period under review – up to its mid-term point; as well as the identified major achievements; challenges; constraints; risks; weaknesses and threats that characterized the Project. Lastly, it, further, documents resource management and efficiency in Project implementation; project “impact”; sustainability of Project Interventions and outcomes; the major conclusions; recommendations for the way forward; as well as lessons learnt – over the period under review. 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...
Development Initiative for Northern Uganda (DINU) Value Chains and Market Assessment report
The CARE consortium comprising of partner organisations such as Catholic Relief Services (CRS), Gulu Agricultural Development Company (GADC), Dynamic Agro Pastoral Development Organization (DADO) and SORUDA are currently implementing a three-year project titled “Inclusive Market Based Development for Small Holder farmers in Northern Uganda. This project contributes to the Development Initiative for Northern Uganda (DINU) – A Government of Uganda program aimed at consolidating stability in Northern Uganda, eradicating poverty and under nutrition and strengthening the foundations for sustainable and inclusive socio-economic development. Specifically, the project under the CARE consortium contributes to DINU’s specific Objective one on: ‘Improving livelihoods through increased production of diversified food, enhanced market opportunities and better maternal and child nutrition.’ The CARE consortium currently targets 11 districts including: Abim, Kotido, Karenga, Kaabong, Moroto, Amudat, Nakapiripirit, Napak, Katakwi and Kitgum. Given this background, the study sought to:
• Map out existing and new Agricultural and non-Agricultural value chains and assess their potential to promote women and youth economic empowerment, and community-based nutrition and household incomes.
• Identify challenges, specific entry barriers for women and youth into the VC and opportunities along the Value chains of; 1) crops such as Soybean, groundnuts, nutritious potato, vegetable, etc.); 2) Honey; and 3) livestock (small ruminants, and other non-Agricultural value chain) and propose ways of addressing these challenges.
• Develop an individual VCs, including mapping of actors, actions, supporting functions, institutions, policy issues, along each chain and propose recommendations for specific gender sensitive value chain activities that promote women and Youth participation and economic empowerment (employment opportunities as well as increasing their incomes along the chain).
• Assess the market structure (players, channels, sourcing), demand and supply (product specifications, prices, volumes, preferences), trends, market opportunities and challenges for the different value enterprises above Read More...
• Map out existing and new Agricultural and non-Agricultural value chains and assess their potential to promote women and youth economic empowerment, and community-based nutrition and household incomes.
• Identify challenges, specific entry barriers for women and youth into the VC and opportunities along the Value chains of; 1) crops such as Soybean, groundnuts, nutritious potato, vegetable, etc.); 2) Honey; and 3) livestock (small ruminants, and other non-Agricultural value chain) and propose ways of addressing these challenges.
• Develop an individual VCs, including mapping of actors, actions, supporting functions, institutions, policy issues, along each chain and propose recommendations for specific gender sensitive value chain activities that promote women and Youth participation and economic empowerment (employment opportunities as well as increasing their incomes along the chain).
• Assess the market structure (players, channels, sourcing), demand and supply (product specifications, prices, volumes, preferences), trends, market opportunities and challenges for the different value enterprises above Read More...