ubale dfap final performance evaluation presentation presentation... · ubale dfap final...

UBALE DFAP Final Performance Evaluation PresentationTANGO International

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Lori Du Trieuille, BHA Malawi Team Leader, USAID/ BHA

Emmanuel Ngulube, Humanitarian Assistance Officer,

USAID/ BHA

Luis Ramirez, Team Leader, UBALE DFAP Evaluation

Monica Mueller, Senior Technical Advisor, TANGO International (moderator)

Dr Stephanie Martin, Quantitative Analyst, TANGO International

Jeanne Downen, Livelihood Specialist and Chief of Party for IMPEL, TANGO International (alternate presenter)

Meet our Presenters

Context and Methods

Southern districts: Chikwawa, Nsanje, Rural Blantyre • Endline: 88% households experienced shocks

• High climate variability; droughts and floods

• Low crop productivityo Rain-fed agriculture, low soil fertility, small landholdings, pests,

limited use of agriculture inputs

• March 2019: Cyclone Idai destroyed crops

• Market variability

• High disease burden; poor sanitation

• Chronic malnutrition

• Inequitable gender roles

UBALE Context

Methods

Quantitative SurveyJuly 24 – Aug 4, 2019

• Population-based survey• 1,260 households

Qualitative StudyOct 23 – Nov 15, 2019

• Three targeted districts• Purposive sample• 50 FGDs w/ 548

participants (276 F, 272 M)

• 72 KIIs w/ project participants (17 F, 55 M)

• Desk review• Field observations

What worked?

Helped achieve outcomes• Working through government

and traditional structures: • Promoted and coordinated

project field activities

• Working w/ local and traditional authorities

• Resulted in innovative ideas for reinforcing mobilization, participation, compliance

• Integrated design and approach

• Provided opportunities to reinforce messages between purposes and to complement and integrate activities at community level

Challenges• External shocks:

• Floods, dry spells, uneven rainfall (El Niño 2015/16)

• Fall armyworm (2017)• Market changes (pigeon pea

price drop 2016) affected production and sales

• Project delays; misalignment of project cycle and agriculture calendar

• Reduced time available to train, transfer and implement agriculture activities

Purpose 1:Vulnerable households

increase income

Purpose 1: Vulnerable households increase income

• Successfully strengthened and built the capacity of government and traditional structures to monitor and implement agriculture extension activities

• Successful agriculture extension strategy, working through Agriculture Extension Development Officers (AEDOs) to support lead farmers to transfer skills

• Transfer of low-tech, low-cost technologies to increase sustainability and yield, increase knowledge in farm management and business planning

• AEDOs >> lead farmerso Successful but low AEDO : farmer ratio

• DiNer fairs o Successful to promote farm

diversification but not sustainable

• Seed multiplicationo Successful and sustainable to increase

local availability (sorghum, OFSP, fortified beans)

o Linking seed multipliers to larger structures is important for sustainability


Capacity Building

• Shift to crop diversificationo From local maize and sorghum to faster-maturing varieties + beans,

cowpeas, OFSP; mixed cropping

o Increased production of nutritional foods needed to achieve P2 objectives

o Farmers continued to practice Conservation Agriculture techniques because they could see the improvement in their soils and yields

• High acceptance of low-cost and simple technologieso Sasakawa technique, mulching, soil conservation, manure making, pit

farming (Conservation Agriculture)


Capacity Building

Improved storage: PICS bags

• Durable, low-cost protection against post-harvest losses and aflatoxin contamination

• Promoted in marketing clubs, lead farmers, DiNER fairs

• Increased demand after 2 ½ years but few purchases due to cost, availability, low harvest after cyclone

NRM via Food for Assets

• Tree nurseries, tree planting, erosion control, bylaws for forest use, beekeeping. Successful and sustainable.

• Happy with training and results but FFA payment delayed

• Threats: free-roaming livestock, termites (working w/ Forestry Dept; mixed success)


Capacity BuildingPopulation-level data show effect of shocks


Savings and Internal Lending Communities (SILCs)

• Successful mechanism for poor households to save money and access credit

o Followed PSP model from WALA (some WALA SILCs still active)

o 3,699 SILC groups with 86,224 participants (75.1% F) (Sep 2018)

o USD 1.4M in savings; return on savings 38.1%

o USD 1.2M in outstanding loans (FY19); defaults rare

• Formed male SILCs to avoid impression that SILCs only for women

• Allowed women to purchase livestock for first time

• PSPs still forming new SILCs after UBALE ended

SILCs contribute to resilience



Value Chain Activities

• Decrease at population level

• Pigeon pea production:

o did well FY16; sold 153 MT

o FY17: bumper crops in India and China, and India import ban, affected markets (increased local availability)

o Chikwawa KI: 250 MT harvested in 2018 but could not sell; stopped growing it

Marketing Clubs

• Successes/challenges in collective marketing• Marketing club and association members were selling a larger volume

of crops at higher prices as a result of the training from UBALE

NASFAM Training: NASFAM Support:

Club formation Collective sales

Business planning Sustainable market connections; liaison clubs – buyers

Marketing Supervision

Higher-level marketing assoc.



Value chain commodities: • green gram, sesame, red beans

Five associations with 1,172 farmer-members (528 F, 644 M) earned >MWK 83M on sales of value chain commodities in 2017-18 (registering with GoM)

Challenges: • Aggregated crop storage facilities• Uncertainty of marketing PSP fees• Standard approach to crops regardless

of agric-eco zone

The marketing group concept is understood by farmers but needs time to mature and become effective

Photo Credit: Jeanne Downen

• Population level: significant decrease in use of financial services; one third using services at endline

o Loss of crops, assets and income after flooding in 2018-19 season; used savings for emergency needs

o 22% keep savings in SILCs (most common)

o Very low use of credit

• UBALE data: o More loans from SILCs went to men (154 percent of target) than

to women (69 percent of target)


Financial Services

Overview

• Intent = diversify options for project participants

• Began offering services Oct 2018

• ~ 2,800 members (63% F)

• >USD 41,000 in assets

Blantyre, Nsanje, Chikwawa (BNC) SACCO

Challenges

• Not enough demand for its services• Needs external financing to be sustainable

(IFAD/MUSCCO)• Needed a feasibility study, earlier start,

more partner engagement, 3-4 years to mature

• Not sustainable without substantial ongoing financial, technical and managerial support from gov’t and external organizations

Youth participation (age 18-35)

• Some youth were PSPs

• Youth Clubs – Office of Social Welfare

• Messaging on health, nutrition, sanitation, teen pregnancy, early marriage, school dropout prevention, gender

Lack of clear agenda for youth;

missed opportunity

Community Animal Health Workers

• Trainings, vaccines and other services appreciated

• Certification as paravets was an issue

Sustainability questionable:

uncertainty of fee payment;

no storage place for vaccines



• Men became more inclusive in decision-making about their self-earned cash

• Women improved their decision-making power over their own cash

Purpose 2: Improved

nutritional status among PLW and

CU2

• Community mobilization efforts and integration of P1and P2 activities, intense agricultural support to access to nutrient-dense, diverse foods

• Despite deterioration of household food access and decreased dietary diversity due to multiple shocks, consumption of nutrient-rich value chain commodities (esp. OFSP), increased among women of reproductive age and CU2

Purpose 2: Improved nutritional status – PLW and CU2

Strengthening GoM MCHN system management

Major achievement: full-scale-up of National Care Group Model; Scaling Up Nutrition• Supported gov’t expansion of Care Group model in all project districts

• Strengthened supporting structures at district, TA, GVH and community levels

Established committees; developed 23 management plans:• District Nutrition Coordination Committees, District Coordination Teams for WASH

• 17 TA-level Area Nutrition Coordinating Committees

Focus on the first 1,000 days works


Community Structures

• UBALE IPs engaged with 276 HSAs and >3,700 government frontline workers to roll out and oversee the Care Groups and related structures according to the new national guidelines

• Support to Care Groups and Water Point Committees well appreciated

• 732 Care Groups at end of project (target: 633); 8,454 volunteers

• 630 WPCs at end of project, most (432) in Blantyre

• Through WPCs, UBALE and government trained 3,915 GVH Water Committee members (61% target)

Care Groups get the message out


Community Structures

• Community Leaders for Action on Nutrition (CLAN) groups important to implementation

• 26 ACLANs and 149 CLAN groups established and registered by end of FY16

• Increasingly active over LOA, but transfer of community-level activities to groups incomplete

• Active participation of women in CLAN and Water Point Committee groups


Activities

• Care Group delivery structure enabled wide coverage

o Implemented 4 Department of Nutrition, HIV and AIDS standard modules: hygiene and sanitation, maternal health and nutrition, breastfeeding, and complementary feeding

o UBALE modules on BabyWASH, health decision-making, C-IMCI<<introduced in final project year

o Care Group Volunteers felt they acquired valuable and practical knowledge and continued to help families with young children

• Promoted locally available foods and fuel-efficient stoves

o Nutrition fairs, cooking demonstrations, home visits

Working across sectors has a strong impact on nutrition


• Community Complementary Feeding and Learning Sessions o Scaled up from WALA to a

2x/year activity; changed CU5>CU2

o Shifted from recuperative Positive Deviance/Hearth model to more preventative approach, with community activities with active learning

o Fewer CCFLS sessions in Y4 and Y5 b/c fewer children faltering

• Nutrition fairs (started Y3)


Activities

• Mother and child rations – hungry season• Grandmother Groups (82)

• Important for addressing cultural barriers to targeted MCHN practices and to changing social norms; recommended to include at project start

• Further study merited on the impact of food rations during lean season

• Women and men continued to attend Care Groups after the ration was discontinued because they saw improvements in their children’s health and nutrition


Outcomes

• Significant reductions in CU5 stunting and underweight, both surpassing target

• No change in wasting

• Better than national trend


Outcomes

• Significant reductions in CU2 stunting

• Stunting in 24-59-month age group decreased from 41.8% to 29.0% (p<0.001)


Outcomes

PBS data: cannot attribute results to project but qualitative data suggest project contributed positively

– Drastic reduction in severe malnutrition cases admitted to hospitals

– Respondents saw improvements in understanding of caregivers, child feeding practices, access to nutritious food, and hygiene practices

– Respondents felt decrease in diarrhea cases was linked to improvements in WASH

– Respondents thought CCFLS and screening enabled early detection and referral of faltering growth and more use of MCHN services


Women’s Nutritional Status and ANC Visits

• No change in underweight (~7%); consistent with DHS

• FGDs saw project impact on women’s health: increased women’s dietary diversity, use of health services during pregnancy and delivery

o Antenatal care coverage viewed as a significant project impact

o Project data ’18, ’19: >95% women attend at least one ANC visit

o Four or more ANC visits a challenge (about 50% women, both years)

o More men attending ANC w/ wives, hearing health messages directly

• District Nutritionists: teenage mothers most at risk of being underweight and their children malnourished

otargeting specific to this group was lacking


Child Growth Monitoring

• High participation (63%) of CU2 in growth monitoring in project communities in previous month, exceeding target

• Lower in Blantyre (59%), where UBALE worked with Care Groups in only half the TAs

• Compare to other two districts (70%)

• Growth monitoring higher children under one year because vaccinations to be completed in first year

• More motivation to take CU5 to clinic regularly

• More involvement of fathers


Exclusive breastfeeding

• Sample too small to show difference in EBF in children 0-6 months

• Health authorities, participants report increase in EBF; attribute nutritional gains and decreased diarrhea to EBF

Minimum Acceptable Diet

• Population data: MAD for 6-23-month-olds decreased 10 percentage points to ~5%

• Continued breastfeeding of 6-23-month-olds remained high (~93%)


Purpose 3: Communities are

empowered to contribute to their

own sustainable development

Purpose 3: Communities are empowered to contribute to their own sustainable development

UBALE reinvigorated and used the government structures and the social scaffold of traditional authorities

• Provided trainings to village, area and district committees

• Improved their understanding of their roles and responsibilities and ability to organize themselves

• Trained committees to obtain funding for priority activities to improve their communities

Village Civil Protection Committees (VCPCs) and Village Natural Resource Management Committees continue working on:

• Risk reduction activities

• Monitoring the coming rainy season

• Setting flood contingency plans

• Supporting tree nurseries for reforestation and protecting riverbanks

Challenge for VCPCs:

• turnover and lack of training for new members>> limited committees’ performance


Photo Credit: Jeanne Downen


• Village committees and participants appreciated the creation or rehabilitation of community assets and the support to vulnerable individuals

• Engaging traditional leaders improves adaptation to context

• Youth should be involved in activities

Gender

Joint Decision-making

• Gender Champions trained at beginning of project

• Gender dialogues well integrated across UBALE activitieso Meetings of SILCs, marketing groups, VDCs

o Messages reinforced by Care Group Volunteers, health promoters and Health Surveillance Assistants

• High level of awareness of importance & benefits of gender equality

Purpose 1/ Gender

Purpose 1/ Gender

Joint Decision-making

• High participation by women in village, GVH and district committees

• More men sharing in household chores and accepting of women’s participation in committees, earning income, etc.

• Decrease in gender-based violence; more open/joint discussion of family planning

• Gender messages supported changes in men’s behavior to help women with household responsibilities

Gender

UBALE delivered a variety of gender messages that enabled greater participation by women in decision-making structures.

More women now serve on committees, hold higher-level decision-making positions, and voice their opinions at the community and family level

56% of marketing club members and 75% of SILC group members were women

Participants perceive that most community leaders (60.5 percent) encourage women to participate and take up leadership roles

Sustainability

Sustainability

Sustainability factors:

Strengthening the capacity of government and traditional governance structures to implement government policies and organize communities

Promoting low-cost technologies and locally available inputs

Building on government policies to implement community health approaches; supporting participants to acquire skills that yield clear and tangible benefits

Greater gender equality has given women more time and freedom to participate in community activities and committees, where the benefits of their conscientiousness and organizational skills are acknowledged by men

Recommendations

Recommendations

R1. Expand opportunities for market-based food security solutions Link smallholders to large buyers Local storage facilities

R2. Root community assets in an integrated watershed management strategy Strategy to involve government officials, communities, and local

experts in defining risks, action plans and support for watersheds

R3. Use small irrigation schemes to build food security Could also be an opportunity for youth entrepreneurship

Recommendations

R4. Support innovative income generation opportunities for youth Opportunities for groups (Youth Clubs) and individuals

Agriculture and non-agriculture

R5. Invest in livestock development where it is a major component of livelihood strategies Continue with paravets/ animal health

Expand to work with farmers’ organizations, markets, value-added activities, coping strategies to adapt to shocks that affect livestock

R6. Allow sufficient time to build new financial institutions Start from beginning of project; include in sustainability strategy

Recommendations

R7. Build upon established and successful community health models and support government policies Consistent with national policy, Scaling Up NutritionGrandmother groups, CCFLS good complements

R8. Ensure support and proper selection of volunteer health promoters Budget to cover health promoter stipends Joint training for volunteers and HSAs

R9. Complement capacity building in water management with infrastructure provision New or repaired water pointsHarness run-off for livestock

RecommendationsR10. Promotion of latrines should be coupled with consistent standards and implemented in phases Need minimum standards and training

Different tiers/models according to resources available

R11. Implement a results-based M&E system Document success and challenges. Adjust per results.

R12. Implement baselines with sample sizes and expanded indicators to capture nutrition changes in CU2 Sample size needs to be sufficient to see changes in CU2Measure Minimum Meal Frequency, Minimum Dietary Diversity,

changes in key food groups, Minimum Acceptable Diet

Q&A Session

This presentation is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of the Implementer-led Evaluation & Learning (IMPEL)

award and do not necessarily reflect the views of USAID or the United States Government.

Thank you!Please take a moment fill out our brief evaluation:

www.ideal.events/IMPEL

http://www.ideal.events/IMPEL

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