Project Factsheet
Tools for » National Nutrition Programme / MDG-F Joint Programme
Project ID:00067252Description:MDGF-2034-I-ETH
Fund:
MDG Achievement Fund
Start Date *: 31 Mar 2009
Theme:
MDGF SP-ChildFoodSec&Nutri
End Date*: 31 May 2013
Country: Ethiopia Project Status: Financially Closed
  Participating Organization:   Multiple
About

Overview:

The objective of the JP was to enhance and scale up implementation of the National Nutritional Programme (NNP ) by filling existing gaps and giving priority to community-based nutrition (CBN) interventions in Amhara, Tigray, Oromia, and Southern Nations, Nationalities, and Peoples (SNNP) Region. 

This was done by contributing the following four outcome areas: i) Improved management of children with severe acute malnutrition (SAM); ii) Improved caring and feeding behaviors/practices for children and mothers; iii) Improved quality and utilization of locally available complementary foods; and iv) Improved nutritional information and monitoring system.

As a result of this strategy Community-based management of acute malnutrition was expanded to cover 430 health posts and over 37,000  children under five received treatment for Severe Acute Malnutrition (SAM). In addition, 418 Out patient treatment (OTP), significantly exceeding the 320 originally targeted.  In addition nearly 18,000 children discharged from OTP services were provided with discharge rations, while over 11,000 pregnant and lactating women received targeted supplementary feeding rations.

Over five hundred health Workers (HWs) and health extension workers (HEWs) were trained on the Integrated Refresher Training (IRT) package which is reported to have resulted in a significant reduction of underweight among children under-two years of age in the participating woredas. Mothers and caregivers received counseling to improve infant and young child feeding practices (IYCF), which led to a reduction in prevalence of underweight from 50 per cent in 2010 to 9 per cent in January 2013. More importantly, the community was empowered to act through community conversation sessions.

Two pilot models for local production of Complementary Food (CF) were developed. The first model is rural model implemented in eight villages, while  through the second model four sites were identified for the semi urban model. Processing units were procured with mills currently operating in Wadla, Chinakson, Kedida Gamilla and Laelay Maichew woredas. A systematic assessment of the pilot was completed and key recommendations are being considered in the scaling up which will include 20 woredas with resources not from the JP.

The JP supported capacity building of federal, regional, woreda and health centre staff on routine data management and reporting. As a result, data are collected and analyzed monthly, and feedback is provided by the woreda health office to strengthen the system as needed. 

Additional contributions to the Joint Programme included $107,171,964.92 from agency core contributions.

 

Outcome 1:

Community-based management of acute malnutrition expanded to 382 Health Posts (HP) in the targeted Woredas.

 

Outcome Achievements:

  • Community-based management of acute malnutrition expanded to 430 health posts (HPs) in the targeted woredas.  This exceeded the initial target of 382 HPs.
  • 37,552 (Target 14,640) children under five received treatment for Severe Acute Malnutrition (SAM).
  • The performance of the programme remained within national and international SPHERE standards, with a recovery rate of 85.3 per cent and mortality and defaulter rates of 0.3 per cent and 4.3 per cent, respectively.
  • Out patient treatment (OTP)services were established in 418 HPs (131 per cent of targeted 320 HPs, and 97.2 per cent of the total number of HPs (430) in the 16 woredas).
  • Quarterly Child Health Days were undertaken for nutritional screening. 17,994 children were provided with discharge rations.
  • 11,029 pregnant and lactating women received targeted supplementary feeding rations.

 

Outcome 2:

54% of children participated in growth monitoring and mothers received counseling on improved care behavior.

 

Outcome Achievements:

  • Some 44 per cent of the under-two children in the targeted woredas were weighed every month, and nutritional screening was done quarterly. In total, 512 health workers (HEWs) were trained on the Integrated Refresher Training (IRT) package. A reduction of underweight among children under-two years of age participating in the growth monitoring session in the 16 woredas was reported, and thought to be due to increased nutrition management capacity of the Health Workers (HWs) and HEWs.
  • Mothers/caregivers are counseled to improve infant and young child feeding practices (IYCF). A reduction in prevalence of underweight from 50 per cent in 2010 to 9 per cent in January 2013 was reported in the supported woredas.
  • In addition, issues that need communal action are brought to the community conversation sessions for deliberation and agreement on the way forward.

 

Outcome 3:

Two models for implementation of Complementary Food (CF) developed and two sites/kebeles selected in each of the four regions (production of CF started In eight kebeles in rural areas): in each region one site is selected for processing through urban model, processing and utilization is started.

 

Outcome Achievements:

  • Two pilot models for local production of Complementary Food (CF) were developed; those are the rural and urban models. Eight village through rural model and four semi urban towns through urban model were selected from Oromia, SNNP, Amahara, and Tigray regions.
  • Eight child grain banks in rural were established and Processing units for urban model were procured and mills installed. Mills are operating in Wadla, Chinakson, Kedida Gamilla and Laelay Maichew woredas.
  • A systematic review and evaluation of the complementary feeding pilot was completed and key recommendations were put forward, which are being considered in the scaling up that will be implemented in 20 woredas through other funding.

 

Outcome 4:

Baseline (2010) and mid-line (2011) assessments conducted (recommendation to achieve maximum impact).

 

Outcome Achievements:

  • Improved nutrition information and monitoring and evaluation of the project. Baseline (2010) and mid-line (2011) assessments were conducted to recommend adjustments to programme implementation and to achieve maximum impact.
  • The JP supported capacity building of federal, regional, woreda and health centre staff on routine data management and reporting. As a result, data is collected and analyze monthly, in addition, feedback is provided by the woreda health office to continue improving implementation of the system as needed.

 

Best practices:

  • A combination of strategies focusing on both curative as well as preventive measures were used to address malnutrition and food insecurity
  • The complementary food production initiative and dissemination of knowledge is considered as a good practice by ensuring that children aged between 6 and 24 months get access to improved complementary food made from local available resources.
  • The review of the pilot project identified key recommendations which are being considered in the scaling up which will include 20 woredas with resources outside the JP.

 

Lessons learned:

  • The experience of the MDG-F has proved that multi-sectoral interventions, when applied in a coordinated manner, are more efficient in achieving results. This inter-sectoral collaboration resulted in the launch of the revised NNP on 24 June 2013, which was signed by all sector ministries that contribute to the nutrition sensitive actions with full endorsement of the Deputy Prime Minister.
  • The joint programme was designed under the leadership of the Government and in partnership with UN agencies and other stakeholders, enabling ownership and sustainability. As a result, while multi- sector partnering may be complex, it has been a learning process in which the national counterpart showed high commitment.
  • For the participating UN Agencies this was the first experience in joint programming in Ethiopia. This provided lessons that will help make the necessary changes and adjustments for future joint programming.
  • Need to examine the comparative advantages of each organization, instead of assigning the role and activities based on budget allocations. Needs based on each agency’s mandate, capacity and ongoing programme in the country should be taken into consideration.

 

More details can be found in the documents below.

Recent Documents
Key Figures
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