Overview

The objective of the Joint Programme (JP), was to strengthen local capacity in 24 highly vulnerable districts for the implementation of the Multisectoral Zero Malnutrition Program (PMDC). The aim was for families, children, pregnant girls and women in these Municipalities to: (i) have increased availability and access to safe food of high nutritional value; (ii) have effective access and use of improved water and sanitation services, and (iii) acquire better knowledge, attitudes and practices on food, nutrition, hygiene and health through (iv) coordinated involvement of the different actors implementing the PMDC, supported by empowered community-based organizations.

The JP was able to increase availability and access to safe food of high nutritional value for over seven thousand families. It also supported the use of food rations based on local production, in this way promoting better nutrition as well as increased income generation. It was able to support other existing initiatives such as the production of Blood Syrup, an ongoing nutritional support initiative by FAO.

The JP helped improve access to safe water for nearly 90 communities, this was coupled with the promotion of safe and proper use of improved services for water and sanitation which was achieved through training in the better use of water services and more effective hygiene practices. 

In addition, and as a result of the JP’s actions over 72 thousand families are able to access varied, nutritious, and timely supply of hygienically prepared food, and they now have an increased knowledge of their sexual and reproductive rights.

To ensure sustainability, the JP strengthened management and legislative capacities of local municipal authorities and strategic actors in 24 districts, to promote more efficient implementation of the PMDC with a rights-based approach.

Outcome 1:

Greater availability and access to safe food of high nutritional value under the PMDC in the municipalities of Arque, Bolívar, Sicaya, Tapacari Tacopaya, until 2012.

Outcome Achievements:

• 7,147 families in the municipalities of Arque, Bolívar, Sicaya, Tapacari and Tacopaya have greater availability and access to high nutritional value and safe food.
• Supported the consolidation of five producer associations capable of producing nutritious food rations based on local products such as quinoa, cañahua, wheat, barley, peas and potatoes with the aim of inclusion in school meals and promoting local purchase of food and improved revenue for producers and their families.
• The programme provided technical assistance to the FRIMUP Slaughterhouse for cleaner production and helped adequate the facilities for the production food products (nutritional support funded by FAO).

Outcome 2:

72 communities in 8 municipalities have improved access and appropriate use of safe water and improved sanitation services between 2009 and 2012.

Outcome Achievements:

87 communities in 17 municipalities have improved their access to water via 84 water supply systems, together with the promotion of safe and proper use of improved services for water and sanitation and safe water through training in use of services and hygiene practices.

Outcome 3:

At least 74,220 families in the municipalities of poroma, Villa Azurduy, Tarvita, Villa Zudáñez, Presto, Mojocoya, Icla, Tomina, Sopachuy, tarabuco Yamparaez, San Lucas, Incahuasi, Culpina, Ayopaya, Morochata, Arque, Tacopaya, Sicaya, Tapacarí, Vila Vila and Bolivar have the necessary knowledge to achieve a  nutritious, hygienically prepared timely and varied diet, and are informed about their sexual and reproductive rights.

Outcome Achievements:

72,004 families in 24 districts of Cochabamba and Chuquisaca, are able to access a varied, nutritious, and timely supply of hygienically prepared food, and are informed about their sexual and reproductive rights.

Outcome 4:

At least 50% of the institutions, organizations and actors involved in the implementation of cross-sectoral activities of the PMDC in the municipalities of poroma, Villa Azurduy, Tarvita, Villa Zudáñez,Presto, Mojocoya, Icla, Tomina, Sopachuy, tarabuco Yamparaez, San Lucas, Incahuasi, Culpina, Ayopaya, Morochata, Arque, Tacopaya, Sicaya, Tapacarí, Vila Vila and Bolivar, work in a coordinated manner to ensure meeting their goals.

Outcome Achievements:

Strengthened management and legislative capacities of local municipal authorities and strategic actors in 24 districts to ensure sustainability and to combat malnutrition through the implementation of the PMDC with a rights-based approach.

Best Practices:

• Joint monitoring and evaluation missions strengthened the effectiveness of the programme´s intersectoral approach.
• Linking of the agricultural component with aspects of health and nutrition lead to more impact.
• Promotion of joint municipal planning with participation of all stakeholders (national, departmental and municipal level) lead to more impact
• Intercultural community dialogues were a key methodological tool to reach communities and for replication of activities.
• Community socialization spaces, such as educational fairs to disseminate key practices with active participation of school children was very successful, generating interest and expectation from both families and communities.
• The synergy between actions for environmental health, like surveillance and control of drinking water quality, with health activities and community nutrition was essential for increased the level of prevention of infectious diseases.
• The component of food and nutritional education with a community focus and the involvement of various stakeholders proved to be an appropriate strategy for the dissemination of key practices to improve the health and nutritional status of the population.

Lesson Learned:

• The existence of national policies and programs that address the nutritional problems and food security promote access to finance and program implementation. Policies and programs create an enabling environment that should be used for the development of intersectoral interventions.
• Parallel independent administrative management by each agency negatively affected the flow of activities, as well as the quality and availability of financial information.
• The large geographical coverage was a challenge to achieving the objectives, outcomes and goals. It would have been better to focus all activities in a few municipalities.
• Intersectoral and interagency coordination is a process that requires time, good will, tolerance and mechanisms for systematic progress  monitoring and in order to reach all levels (management and operational).
• Intersectoral coordination is feasible at the local level but becomes increasingly difficult as you get to the regional and national levels. 
• Centralized decision making weakens ownership at the regional and local levels.
• The process of obtaining positive results requires long periods of time, constant feedback and interaction between key sectors, mainly health, education, production and water.
• Change in habits, cultural practices and customs require  is an extended and time consuming process
• The involvement and awareness of all actors was key to getting support and partnerships at municipality level. It is important to plan and respect the specific processes for each of the actors to avoid bottlenecks. 

More details can be found in the documents below.