Project Factsheet
Tools for » Children, Food Security and Nutrition in Mozambique
Project ID:00067237Description:MDGF-1993-I-MOZ
Fund:
MDG Achievement Fund
Start Date *: 29 Sep 2009
Theme:
MDGF SP-ChildFoodSec&Nutri
End Date*: 30 Jun 2012
Country: Mozambique Project Status: Financially Closed
  Participating Organization:   Multiple
About

Overview:

At the time of the joint programme, the Demographic and Health Surveys (DHS) indicated a prevalence of stunting for children under five of 41%, higher the sub-Saharan average of 38%. Micronutrient deficiencies were also documented high, particularly for anemia and vitamin A (75% and 69% respectively). Under five mortality rate was 168 per 1,000 live births, with malnutrition a key underlying factor. The programme was conceived at the peak of the food and fuel crisis at a time of steep increase in food prices that further affected household food security. In order to address the challenges in food security and nutrition, the programme included short-term mitigating efforts (strengthening the treatment of acute malnutrition), preventative interventions (vitamin A supplementation and deworming), and longer-term impact interventions (improving the food security and nutritional knowledge and skills of vulnerable households in urban and peri-urban families as well families and health worker’s knowledge and skills on infant and young child feeding). Nutritional surveillance was also included. A single outcome was identified, supported by three components.

The JP reported that it was effective in contributing to diminishing the prevalence of underweight children, and had a very strong impact on Vitamin A consumption, as evidenced by a survey in Nampula and Maputo. No changes in the dietary habits were recorded in that same survey.

At the intervention level, a total of over 110,000 children with moderate and severe acute malnutrition were attended through the work of the Nutrition Rehabilitation Programme at the country level.

Another result was the diversification of food production and consumption, through the training and vegetable gardening and fruit trees, that were able to reach 11,558 households (nutrition education) and 11,340 households able to benefit at least one season from the vegetable gardens.  10,838 fruit trees were also planted in selected neighbourhoods in Nampula and Maputo.

Nutritional surveillance capacity was enhanced through the support to the MoH in terms of equipment (for sentinel sites) and capacity development (TOT).

The programme supported the campaign on the  promotion, protection and support of breastfeeding in all provinces.

 

Outcome 1:

Improved health, nutritional and food security status for children by mid 2012.

Outcome achievements:

  • Preliminary results of the 2011 DHS indicate the prevalence of underweight to be 15%, versus a target of 16%, one of the two outcome indicators for the joint programme. For the other outcome “percentage of households with improved dietary diversity” the end line survey undertaken by FAO in Maputo and Nampula cities intervention areas did not find a significant difference in dietary diversity in the studied households. It did find an increase of 100% of intake in plant sources of vitamin A in both cities.
  • It is reported that due to the decision not to undertake stand-alone activities, it is difficult to determine the programme’s attribution to the results, but it can be assumed that the activities have contributed to an improved weight by age situation in the country.
  • Intensive and extensive trainings were undertaken for the Nutrition Rehabilitation Programme at provincial and district level, in addition to health center staff. Frequent on-the-job trainings were carried out. Supervision and monitoring was done jointly with national and provincial government staff, something that further developed capacity.
  • Within stakeholders, capacities have been strengthened in the application of specific approaches (such as urban gardening) and for the development of comprehensive protocols (like for the Nutrition Rehabilitation Programme).
  • In quantitative terms, 46,379 children with Moderate Acute Malnutrition (MAM) were reached with interventions, and 66,021 children with Severe Acute Malnutrition (SAM). The interventions in MAM and SAM were carried out initially as two separate interventions that were merged in the JP.
  • Another achievement was the number of under five children reached with the package of preventative interventions during the Child Health Week. In each of the three rounds, 3.4 to 3.8 million children were reached (versus a 3.5 million target).
  • The other indicator of diversified diet did not find any significant change in the survey undertaken in Maputo and Nampula, but it did record an increase from 15 to 30% of intake of plant source of vitamin A in both cities (e.g. 100% increase).
  • Various interventions targeting the household level were undertaken. The nutrition and urban horticulture component was implement in the cascade-training model with three categories of capacity development: 1) Trainings of Trainers (TOT) to 62 extension staff and community based organizations in home gardening, nutrition and basic health and hygiene; 2) TOT trained 450 community activities who worked directly with the families; 3) by the end of the intervention 11,558 households benefited from nutrition education sessions and 11,340 had at least one season of implementation in their own home gardens. Trainings included practical sessions and cooking demonstrations as well as reparation and conservation of food.
  • In the ten neighborhoods of Maputo and Nampula 10,838 households have planted fruit trees in their yards.
  • The programme supported the implementation of the strategy for the promotion, protection and support of breastfeeding in all provinces. All provincial hospitals benefited from training and in nine provinces TOT on community based counseling for leaders of mother support groups took place. In addition television and radio spots on breastfeeding received national coverage.
  • For the support to nutritional surveillance, the MoH had 38 districts registered as having nutrition sentinel sites. To improve the quality of data collection the JP procured equipment to 11 sentinel sites and a national TOT on the software was conducted with seven technical staff from the MoH at central level.

 

Best practices:

  • The use of one protocol for the detection and treatment of acute malnutrition with a continuum of care ranging from detection in the community via inpatient treatment to those who need it and outpatient treatment for those eligible, and discharge upon cure. This protocol was finalized with the support of the JP.

 

Lessons learned:

  • It is important to ensure linkages between intervention areas so that the target population benefits optimally (the neighborhoods benefiting from urban and peri-urban horticulture and fruit trees could have been linked better with the respective health centers).

 

More details can be found in the final project report: http://mptf.undp.org/document/download/9867

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Contacts

If you have questions about this programme you may wish to contact the RC office in Mozambique or the lead agency for the programme. The MPTF Office Portfolio Manager (or Country Director with Delegation of Authority) for this programme:

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