Project Factsheet
Tools for » Integrated Nutrition and Food Security Strategies for Children and Vulnerable Groups in Vietnam
Project ID:00067241Description:MDGF-2007-I-VNM
Fund:
MDG Achievement Fund
Start Date *: 31 Mar 2009
Theme:
MDGF SP-ChildFoodSec&Nutri
End Date*: 30 Jun 2013
Country: Viet Nam Project Status: Financially Closed
  Participating Organization:   Multiple
About

Overview

The JP aimed to address the continuing high prevalence of malnutrition among the most vulnerable, with a focus on reducing stunting and preventing malnutrition. The target groups were under-five children, women of reproductive age and pregnant women in the provinces of Cao Bang, Dien Bien, DakLak, Kon Tum, Ninh Thuan and An Giang. These provinces were selected based on their high levels of stunting (prevalence rates and numbers) as well as the presence of related on-going activities and the capacity of agencies at the field level to implement programme activities. 

The JP had five outcomes, the first was implemented at national level, the second at national and at provincial levels and the other three were implemented at province level. 

Under outcome 1, the systems for monitoring food, health and nutrition status of mothers and children were improved to support the formulation of evidence-based policies, including the National Nutrition Strategy 2011-2020 and the three year National Action Plans for Nutrition and Infant and Young Child Feeding. In addition, a  Global Information and Early Warning System (GIEWS) on food and agriculture was set up together with the Standardized Monitoring and Assessment of Relief and Transition (SMART) methodology to facilitate planning, implantation, automatic quality assurance and timely reports. 

Under outcome 2, the JP achieved increased political commitment to support and promote recommendations for maternal nutrition and infant and young child feeding was strengthened and translated into policies and legislation. The information generated under outcome 1 was used for advocacy resulting in the extension of paid maternity leave from 4 to 6 months in the 2012 Labour Code, as well as the alignment of the 2012 Advertisement Law and revised Decree 21 with the International Code on marketing of breast-milk substitutes and subsequent World Health Assembly resolutions. WHO/UNICEF training courses on breastfeeding and young infant feeding were adapted and used to train 1,236 health workers and 783 village health volunteers in target provinces; six baby Friendly Hospitals were established leading to an increase in early initiation of breastfeeding from 70% to 97%. 

Under outcome 3 key internationally recommended interventions and implementation strategies were incorporated into the National Nutrition Strategy, the National Plan of Action for Nutrition  and the Action Plan for Infant and Young Child Feeding. Updated guidance on micronutrients was also integrated into the National plans and over 400 local health workers trained. Supplies for vitamin A, iron, folic tablets, zinc and de-worming drugs were made available to all targeted beneficiaries. 

As a result of training undertaken in Outcome 4 roll-out of the Integrated Management of Acute Malnutrition trainings and treatment services took place, and the model of treatment was incorporated into the National Nutrition Strategy 2011-2020 and 3 Year Action Plans.  National guidelines and training materials on Kangaroo Mother Care were developed and six Kangaroo-Mother care units were established.

Under outcome 5 the JP introduced Rice Integrated Crop Management (RICM), ICM technique and FFS approach for rice, sticky corn, vegetable, green bean in all six provinces, as well as international guidance on nutrition and farmer Field School (FFS). The JP provided support to the homestead food model to enhance nutritional sources and adequate daily consumption, with the distribution of thousand of fruit trees, nearly 5,000 chicks, fish, fertilizers accompanied by on the spot training courses.

The JP’s intervention led to an important foundation for adoption of international standards and recommendations for infant and young child feeding and maternity protection, as well as for replication of agricultural production best practices and models in each locality. 

The amount approved for the JP was $3,500.000, with an additional commitment of $50.000 and other resources such as human resources provided by the Government of Vietnam; a WHO core budget contribution of $143,000 and $2,269,530 from UNICEF. In addition, and as a result of the JP’s success, the government has assumed the responsibility for procuring 100 per cent of the Vitamin A required for the whole country.

 

Outcome 1:

Improved monitoring systems on food, health and nutrition status of mothers and children used to guide food, health and nutrition-related policies, strategies and actions.

 

Outcome Achievements:

  • The National Nutrition Surveillance System was redesigned with inclusion of globally recommended indicators for maternal, infant and young child nutrition
  • Support to the nationwide General Nutrition Survey and development of Provincial Nutrition Profiles.
  • Support to the data collection framework for disaggregation based on geographical location, ethnicity, gender and socio-economic status.
  • Monitoring and reporting of Iodine deficiency disorders and salt iodisation was supported for all 63 provinces and integrated into the Nutrition Surveillance System to complement monitoring of other micronutrient deficiencies.
  • A Global Information and Early Warning System (GIEWS)on food and agriculture was set up to monitor the food supply and demand and generate early warning of impending food insecurity in provinces and districts.
  • The Standardized Monitoring and Assessment of Relief and Transition (SMART) methodology was introduced to the National Nutrition Surveillance Network with further application of new Emergency Nutrition Assessment Delta software to facilitate planning, implantation, automatic quality assurance and timely reports.

 

Outcome 2:

Improved infant and young child feeding practices including increased compliance with the UNICEF/WHO guidelines on exclusive breastfeeding from 0-6 months and safe complementary feeding for children 6-24 months.

 

Outcome Achievements:

  • The National Communication Plan on infant and young child feeding (IYCF) was developed jointly with other partners and national counterparts. The results of this communication plan were assessed through the annual Nutrition Surveillance System.
  • Support was provided to 6 hospitals and 76 community health stations to become baby-friendly and establishing community-based clubs for breastfeeding mothers. A final evaluation mission reported an average increase in early initiation of breastfeeding from 70.5 to 97 per cent.
  • Village-based breastfeeding clubs established in areas known to have poor feeding practices reported an increase in mothers’ knowledge about breastfeeding resulting in an increase in breastfeeding rates from 80 to 92 per cent and so far an increase in exclusive breastfeeding for six month from 0 to 12 per cent.
  • Two training packages of the Baby Friendly Hospital Initiative were revised, updated and expanded for integrated care
  • The Infant and Child Feeding training course was translated, adapted and used for capacity building in target provinces.

 

Outcome 3:

Reduction of micronutrient deficiencies in targeted children and women.

 

Outcome Achievements:

  • Two international meetings were organized on anemia and on strategies to reduce micronutrient deficiencies. As a result key internationally recommended interventions and implementation strategies were included in the National Nutrition Strategy 2011-2020, the National Plan of Action for Nutrition 2012-2015, and the Action Plan for Infant and Young Child Feeding 2012-2015.
  • The 2nd draft of National Guidelines on Micronutrient Deficiencies Control is expected to be finalized by the end of 2013. Updated guidance on micronutrients was also integrated into the essential stunting reduction package in the National Plans of Action for Nutrition and Infant and Young Child Feeding 2012-2015.
  • The JP directly improved capacity of local health workers in implementing micronutrient deficiency control activities (vitamin A, iron anemia and Iodine Deficiency Disorders), with the training of a total of 438 responsible health workers.
  • Supplies of vitamin A capsules, iron folic tablets, zinc and de-worming drugs were made available to all targeted children and women, as well as 80% of the needed Vitamin A supplements, plus emergency stock to cover 1.8 million children.
  • Quality assurance inspections were also conducted to assess and provide technical assistance for local production of sprinkles and fortified ready to use foods.

 

Outcome 4:

Improved care and treatment for children with severe malnutrition and improved nutrition services for young children in emergency situations.

 

Outcome Achievements:

  • An estimated 40 senior pediatricians were trained as trainers for the treatment of children with severe acute malnutrition, with subsequent roll-out of the Integrated Management of Acute Malnutrition trainings and treatment services. This resulted in available services at 9 hospitals and 28 commune health centres with over 700 children treated as of June 2013. This model of treatment was incorporated into the National Nutrition Strategy 2011-2020 and 3 Year Action Plans.
  • Local production of Ready-to-Use-Therapeutic-Foods was established with a current production capacity of 140 metric tons covering the needs for 11,000 children.
  • Over 80 per cent of responsible government officials and international partners in the Nutrition Cluster & Partnership Group were trained in the Global Harmonized Training package for Nutrition in Emergencies, with 60% of participants scoring above 80 per cent in the post-test compared to only 5% in the pre-test.
  • National guidelines and training materials on Kangaroo Mother Care were developed and six Kangaroo-Mother care units were established in Cao Bang and DakLak provinces.

 

Outcome 5:

Improvements in availability, access and consumption of a more diverse food supply in selected highland and mountainous regions in Vietnam.

 

Outcome Achievements:

  • Rice Integrated Crop Management (RICM), ICM technique and FFS approach application for rice, sticky corn, vegetable, green bean were introduced in all six provinces.
  • International guidance on nutrition, food security and sustainable agriculture for food security at household levels were introduced through localized publications such as Family Nutrition Guide, Seasonal Food Calendar, Save and Growth.
  • Farmer Field School (FFS) on RICM were introduced for 350 farmers through technical and input materials support for demonstration sites in 6 provinces.
  • Introduction of rice seed production model was made to farmers in disadvantaged areas.
  • Technical guidance and a manual on ICM for rice, fruit and livestock production were developed and made available for technical staff and farmers.
  • Diverse livelihood opportunities for farmers to enhance the nutritional sources and adequate food for daily consumption were facilitated through support to the homestead food mode.
  • Homestead production to improve nutritional intake for daily meals of local people was supported by providing of different options like rice, green bean, fruit, chicken raising and aquaculture. More than 120 aquaculture farmers provided training on aquaculture production technique and 12 aquaculture households were selected for demonstration model with full support from the JP.
  • Trainings were provided for 160 staff from local NGOs and 686 farmers.
  • The JP distributed thousand of fruit trees for home garden, as well as 4,700 chicks, fish, fertilizers together with on the spot training courses introducing small livestock production techniques.

 

Best practices:

  • Establishment of a Food Security and Nutrition Early Warning System for both nutrition and food security interventions in a country where natural disasters and climate change are underlying causes of food and health insecurity.
  • Promotion of government ownership through meaningful participation in planning, implementation and monitoring. Piloted models and interventions in both health and agricultural components were integrated into the development and intervention of the government-owned national targeted programmes.The results of the JP were made sustainable through the mainstreaming of its activities into national programmes and action plans - this is a good example of how UN working together can influence different areas of policy and laws.
  • Piloted models and interventions in both health and agricultural components were integrated into the development and intervention of the government-owned national targeted programmes.
  • Government leadership in coordination of multiple sectors to improve the nutrition outcomes proved to be efficient when UN technical interventions were incorporated into the national strategies and policies for the whole sector.
  • Integration of agriculture and nutrition as a means to improve maternal and child nutrition status. This was incorporated into the National Strategy for Nutrition and action plan of the country.
  • Deliberate and strategically planned coordination of multi-sectoral advocacy efforts from the grassroots to national level to impact policy change. The JP helped convey ideas and voices from the grass root level and from CSOs, which might otherwise have not been heard, and made them available to Government decision makers.

 

Lessons learned:

  • It is most effective to align JP to the policy and advocacy agenda of the host government, as well as UN agencies’ existing mandates and commitments.
  • Government ownership, leadership and meaningful participation throughout the project cycle (from design to evaluation) is essential for the JP’s program success and sustainability.
  • Effective implementation and sustainability of interventions requires the participation of both national and local level stakeholders.
  • Strong coordination mechanism with clear roles and responsibilities for decision-making is essential for the success of the JP.
  • Through the JP participating UN agencies and government institutions were able to avoid overlaps and create synergy, working together also helped UN agencies to have a strengthened common voice and message. For example, the key message on promotion of nutrition, health and food security for disadvantaged groups, children under five years old and pregnant women were clearer and stronger since they were created and solidified following inputs from various UN agencies. Other good examples are the common communication messages prepared for the national week of breastfeeding or the joint UN inputs provided to the National Institute of Nutrition and MOH during the development of the national nutrition strategy and action plans.
  • Joint Programmes helped promote collaboration with UN and government agencies beyond traditional partners while ensuring a more comprehensive approach.
  • Recruitment of national and international consultants by different institutions can be a challenge. This creates challenges in coordination and in addition, as each consultant is accountable to different agencies (Government, or UN), decision-making can be time consuming.
  • Broad coverage of issues in one JP may reduce effectiveness and efficiency due to significant time required for coordination and increased amount of risks to management (e.g. delay of one activity causing delay of other activities, staff turnover, multiple reporting). Effectiveness of JP may benefit from having narrower focus.
  • The amount of work required to coordinate and manage a JP should not be underestimated and sufficient resources should be secured.
  • Seasonality aspect of agriculture related activities need to be taken into consideration in the planning cycle of the JP (fiscal year planning and management, approval process, activities planning, contract negations with NIPs, etc).
  • Transaction cost for implementation of activities at grass root levels, especially in Central Highland where the access to commune limited, was high and exceed the original plan of the JP.
  • Capacity building should not be limited to one-off but should go together with follow-up training or support to ensure the long-term influence or change. Follow-up support would enable higher chance of sustainability of these capacity building activities since it will allow for application of new knowledge and skills in practice after training. 

  

More details can be found in the documents below.

Recent Documents
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Contacts

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