Nutrition

PROJET PASANGA

À la suite du passage de l’ouragan Matthew, CARE, étant donné sa mission humanitaire, a apporté un ensemble de supports dans les zones touchées à travers plusieurs interventions parmi lesquelles le projet d’Appui à la Sécurité Alimentaire, au Renforcement Agricole et à l’Amélioration Nutritionnelle dans la Grand’Anse (ASARANGA). Implémenté de concert avec ActionAid et Konbit Payizan Grand’Anse (KPGA), le projet ASARANGA avait pour but de contribuer à l’augmentation de la sécurité alimentaire et nutritionnelle des groupes vulnérables affectés par le passage de l’ouragan Matthew dans les communes de Beaumont, Jérémie et Roseaux à travers
quatre axes d’interventions :agriculture, relance économique, nutrition, et gouvernance. Read More...

SANI (Southern Africa Nutrition Initiative)

The Southern Africa Nutrition Initiative (SANI) is a $29,487,135 CAD project to address undernutrition in women of reproductive age (15-49) and children under 5 years in Malawi, Mozambique and Zambia. A partnership between CARE, Cuso International, Interagency Coalition on AIDS and Development (ICAD) and McGill University and the Governments and communities of implementing countries, SANI aimed to improve the nutritional status of women of reproductive age (15-49 years) and children under-5 years old. SANI was designed to align with national health and nutrition strategic priorities of Malawi, Mozambique and Zambia, and has been implemented in close collaboration with the Ministries responsible for Health, Agriculture, and Gender in each country, as well as national and district-level nutrition coordination committees (NCC and DNCC). Between June 2016 and March 2021, SANI contributed directly to the improved health of 234,000 women, children and men directly and over 498,000 individuals indirectly.
This final report covers the implementation period of the original SANI contribution agreement and project implementation plan finalized in February 2017.
Key project achievements:
Outcome 1100 aimed to improve nutrition practices and services for women of reproductive age, boys, and girls under 5 by strengthening the delivery of community-based nutrition services at the intersection between community health and the health system. Growth Monitoring and Promotion (GMP) and Community Management of Acute Malnutrition (CMAM) programs built this link, working on the continuum of prevention of malnutrition and early detection and treatment of moderate and severe acute malnutrition. Training and support on Maternal, Infant, and Young Child Nutrition (MIYCN), CMAM, and GMP was provided to health service workers and community health workers, and Care groups were established to support families to learn about and apply gender-sensitive MIYCN practices. Interactive teaching was also done at scale through participatory education theatre and cooking demonstrations using local nutritious foods. Social Analysis and Action (SAA) dialogues encouraged families involved in the program to identify, discuss, and challenge traditional social norms and practices that affect women’s health, nutrition, and empowerment.
Endline data revealed the following increases in nutrition-specific indicators from baseline:
- All three countries had considerable increases in rates of exclusive breastfeeding of children up to 5 months, increasing by 15-percentage points in Zambia (from 70% to 85%), 25- percentage points in Malawi (from 61% to 86%) and 17-percentage points in Mozambique (from 65% to 82%)
- Minimum Acceptable Diet (MAD) for children 6 to 23 months increased by 24-percentage points for boys and girls in Malawi (from 7% to 31%) and in Zambia by 7-percentage points for boys (from 24% to 31%) and by 13-percentage points for girls (from 17% to 30%)
- Knowledge of men and women on MIYCN practices improved by 6-percentage points for men (from 79% to 85%) and 4 percentage points for women in Malawi (from 90% to 94%), by 12- percentage points among women (from 59% to 71%) in Mozambique, and by 11-percentage points for women (from 81% to 92%) and 14-percentage points for men (from 72% to 86%) in Zambia. Read More...

Collective Impact for Nutrition (CI4N)

The objective of the Collective Impact for Nutrition (CI4N) initiative has been to improve the nutritional status of women aged 15 to 49 and children under 2, through a multisectoral approach and initiatives based on two strategic axes: (1) Alliances for learning and advocacy and (2) community nutrition. [34 pages] Read More...

Cocoa Sustainability Initiative III

The Cocoa Sustainability Initiative phase 3 (CSI III) is a three-year partnership between General Mills Foundation and CARE International that will be implemented over the period December 2020 to November 2023. The project seeks to improve the food and nutrition security of over 3,500 cocoa farmers and their families in 20 communities in the Asikuma-Odoben-Brakwa District in the Central Region of Ghana by promoting sustainable agriculture, climate resilience, inclusive agriculture systems, women’s empowerment and improved nutrition practices. Building on the success of CSI phase I and II, CSI III addresses a range of interconnected issues, from low agricultural productivity and income to gender equality and voice to inclusive governance, child protection, nutrition and climate change resilience. The aim of the study was to provide baseline values for project indicators to help track the progress and impact of the project during and after implementation. Drawing on face-to-face interviews, a mixed method approach with critical gender lens was employed in data collection and analysis. Specifically, data were collected through a household survey (N=225) and Focus Group Discussions with men and women (N=10). A summary of key findings and recommendations are presented below. [71 pages] Read More...

Integrated Humanitarian Assistance Program (IHAP) South and East Darfur

WASH, Health and Nutrition project is supporting the most vulnerable populations in South and East Darfur States. The project aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 443,190 individuals 332,764 individuals in South (including 253,191 IDPs and 79,573 host community members) and 110,426 individuals in East Darfur (including 10,000 IDPs and 100,426 host community members). CARE target IDPs and host communities in both South and East Darfur states by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for affected children under 5 and pregnant and lactating women (PLW). Integrating WASH, Health, and Nutrition activities the project will contribute to saving lives by reducing wasting and stunting levels caused by Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM).

In October 2020, CARE International Vibes Consultancy Services to conduct an end-line evaluation of the project implemented during the period 2019 to 2020 in two States (South and East Darfur) The evaluation is expected to contribute to strengthening accountability of CARE International for its donors and key stakeholders (including beneficiaries), and to learn from this experience to inform future WASH, Health and Nutrition projects. Key evaluation questions have been special focus on project relevancy, efficiency, effectiveness and impact of the project. This report therefore documents key findings of the evaluation as well as lessons learnt and recommendations useful in guiding the implementation of future projects. [44 Pages] Read More...

Final Evaluation Report: Gender-sensitive WASH, Nutrition and Health Support to vulnerable communities in South and East Darfur

CARE has been implementing the WASH ,Health and Nutrition project from which aims to provide lifesaving and integrated WASH, Health and Nutrition Services to 174,504 individuals (87,077 males and 87,427 females) in East Darfur and South Darfur through the GAC-funded 2019-2021 project (“the GAC project”).The program aimed to benefit refugees in camp and out of camp settings, out of camp IDPs and host communities by increasing access to safe water supply, sanitation facilities and hygiene supplies, improving access to basic curative and preventive primary health care, and increased access to nutrition assistance for children under five and pregnant and lactating women (PLWs). End line evaluation was conducted for the ended project.

Water: from the survey result it shows that 85.8% responded that their primary source of water is safe throughout the year, compared to the baseline survey which shows that 66% of the respondents still use unsafe drinking water sources.

Sanitary practices: 73.9% of survey participants indicated that they use family toilets for defecation, where in the base line survey show that 34% of the respondents having access to adequate sanitation.

Practice Of Hand Washing: 60.9 % of interviewees (Female: 61.0%, Male: 60.8%) know three critical moments, where in base line survey 65% of the respondents being able to mention at least 3 critical times to perform hand washing.

WASH satisfaction: The end line survey for HHs reported that with WASH regarding relevance, timely and accountability, (75.3%)- (70.6% f,77.9%m) reported that it was relevant

Nutrition: 72.9%% of respondents were satisfied with the nutrition assistance provided.
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McGovern-Dole Food Fore Education Program HATUTAN – Midline Evaluation

The HATUTAN program (Hahán ne’ebé Atu fó Tulun ho Nutrisaun no Edukasaun or Food to Support Nutrition and Education) is a five-year initiative to build a partnership between schools and communities in order to improve literacy, learning, healthy, and nutrition for children and adults in Timor-Leste. The program works 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 HATUTAN program is funded by the U.S. government through the Foreign Agricultural Service of the United States Department of Agriculture under the McGovern-Dole International Food for Education and Child Nutrition Program. The program is implemented by a consortium led by CARE International with Mercy Corps and WaterAid. The lead Timorese government partner is the Ministry of Education, Youth, and Sports, in collaboration with the Ministry of Health, Ministry of State Administration, and Ministry of Agriculture and Fisheries.

To achieve these objectives, the program supports, among a variety of activities, the Government of Timor-Leste’s school feeding program (SFP) to fully operate in all basic education and preschools throughout the school year. Key project activities include strengthening and supplementing the government-sponsored SFP and building school capacity through trainings for teachers and administrators and provision of resource materials. Additionally, the HATUTAN program seeks to support farmers to boost the production of local produce to increase yields and help create sustainable sources of nutritious food for local schools. In addition to activities related to literacy and SFPs, HATUTAN seeks to conduct trainings related to nutrition, health, and other topics, and to promote gender equality and the reduction of gender-based violence.

This report presents the midline evaluation of the HATUTAN program, which began in early 2019. It is important to note that restrictions due to the COVID-19 pandemic have had a substantial impact on program activities and target outputs and outcomes. In March 2020, HATUTAN field activities were halted, field offices were temporarily closed, and staff began to work from home due to a State of Emergency issued by the Government of Timor-Leste. This State of Emergency remains in effect to date, with varying levels of restriction on school activities, movement, and group gatherings. As a result, the HATUTAN program is behind schedule in terms of some major deliverables due to COVID-19. Read More...

SUAAHARA II GOOD NUTRITION PROGRAM Annual Survey Year 3

Nepal’s reductions in maternal and child undernutrition since the mid-1990s have been remarkable, but the high burden persists. Among children under five years, 36% are stunted, 10% are wasted, and 27% are underweight. Additionally, 17% of women of reproductive age (WRA, 15-49 years) are underweight while 41% are anemic (Nepal DHS Survey, 2016). The Government of Nepal (GoN) is rolling out the second phase of their national Multi-Sector Nutrition Plan (MSNP), with support of external development partners (EDPs). Suaahara II (SII) is a USAID-funded multisectoral nutrition program, aligned with Nepal’s MSNP, and is being implemented in all communities of 42 of Nepal’s 77 districts from April 2016 to March 2021. SII’s overall aim is 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), agricultural/homestead food production (HFP), and governance, using a gender equality and social inclusion (GESI) approach for all interventions.
SII has a large, rigorous monitoring, evaluation, and research system. Annual monitoring surveys, a key component of SII’s monitoring system, primarily serve to monitor progress over time related to key SII inputs, outputs, and outcomes 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. At the household level, mothers were the primary survey respondents. A primary male (or female, if male unavailable) household decision maker, the youngest child’s grandmother, and an adolescent girl (10-19 years), if residing in the same household, were also interviewed. Data was also collected from Female Community Health Volunteers (FCHVs) and 1 key informant from each health facility in the sampled areas. The household surveys included questions related to exposure, knowledge and practices for each of the thematic areas mentioned above. Anthropometric status was assessed for all female respondents and children. FCHV and health facility surveys collected information on exposure to training, motivation, supervision, and work-related activities. In 2017, the final survey sample included 3,642 households. Read More...

Growing Nutrition for Mothers and Children (GROW) Project in Ethiopia – End Line Household Survey Report

CARE has implemented the Growing Nutrition for Mothers and Children (GROW) Project in Ethiopia between 2017 and 2019. The goal of GROW was to improve the nutritional status of women of reproductive age and boys and girls under 5 years. This endline study was conducted to establish values for outcome level indicators for the project and assess change and impact of the project by comparing data from baseline to end line values. This evaluation employed a cross-sectional study design. The study includes a household survey and anthropometric measurements of women and children to assess their nutritional status. The study covered 39 project intervention Kebeles in 14 Woredas of East and West Hararghe and Afar. A total of 1291 women, 974 men, and 1291 children were included in the study. Read More...

A Win-Win for Gender and Nutrition: Testing A Gender-Transformative Approach From Asia In Africa

Since 2016, CARE Burundi has partnered with Great Lakes Inkingi Development (GLID), RBU2000, and the University of Burundi/Agronomy department and the Africa Center for Gender, Social Research and Impact Assessment to implement and test the EKATA approach – Empowerment through Knowledge And Transformative Action – integrated into an agriculture program to test its effectiveness against a typical gender mainstreaming approach (Gender Light) and a Control (with agriculture interventions only) in a modified randomized control trial, funded by the Bill & Melinda Gates Foundation.

The Win-Win project randomly assigned collines to EKATA, Gender Light and Control groups. Baseline data was collected in 2016 – Midterm was conducted in 2018, and end-line data was collected in 2020 from a random sample of 1,315 households and 1,849 individuals (1,059 female heads of household, and 790 male heads of household). Additionally, the project conducted 36 individual in-depth interviews, disaggregated by sex and age – and male- or female-headed households – at baseline, midline and end-line. This data was complimented with focus group discussions (FGDs). The evaluation looked at the impact of EKATA compared with Gender
Light and Control on several areas, including rice production (which was the main focus crop), income and wealth, gender equality and women’s empowerment. The cost-effectiveness of these approaches also was analyzed. The evaluation used the project level Women’s Empowerment in Agriculture Index (Pro-WEAI) to measure changes in gender equality and women’s empowerment. Read More...

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