EVALUATION OF UNICEF NUTRITION INTERVENTIONS IN CAMEROON FROM 2013 to 2017 (RE-ADVERTISEMENT)
UNICEF
TERMS OF REFERENCE
TERMES DE REFERENCE
SHORT TITLE OF ASSIGNMENT / TITRE BREF DE L’ACTIVITE
Evaluation of UNICEF nutrition interventions in Cameroon from 2013 to 2017
1. Background
UNICEF Cameroun is commissioning a summative evaluation of its Country Programme’s Nutrition component implemented between 2013 and 2017. Though already planned in 2017, the evaluation couldn’t be completed because of some issues that did not permit the hiring of a sufficiently experienced evaluation firm. Nutrition interventions to be evaluated are to be understood as UNICEF’s contribution to the reduction in the country’s malnutrition prevalence (for more details see the Theory of Change in Annex 1). Though focused on curbing children and maternal malnutrition in the country’s four most vulnerable regions, the Programme to be evaluated was also geared towards the strengthening of key components of the national systems in areas related to combating malnutrition.
As spelled out in UNICEF Cameroon Theory of Change, the nutrition sub-component of the Programme was planned as UNICEF’s contribution to the national effort of curbing under-five and maternal mortalities. This sub-component was focused on the attainment of the following results:
(i) Children aged 0 – 6 months are exclusively breastfed and wined per norms;
(ii) Infants and mothers are adequately supplemented with micronutrients (Iron – Zinc – Iodine – Vitamin A) per norms;
(iii) Malnourished children aged 0 – 5 years are treated in approved centres and in communities in line with the national protocol;
(iv) Children aged 1 – 15 years are effectively dewormed every six months;
(v) Children and women in emergencies situations are provided with food and nutrition support.
These results were directly expected to improve the nutrition situation of children and mothers. In order to achieve these results, the following strategies were put in place (for more details, see Box 1):
(i) Promotion of exclusive breastfeeding of children from birth till six months of age;
(ii) Promotion of enriched complementary foods;
(iii) Micronutrient supplementation (Iron – Zinc – Iodine – Vitamin A) to children.
Box 1. UNICEF Cameroun Nutrition Programme Key Components
Overall, UNICEF-supported nutrition interventions included the following components:
1) Development and revision of policy, strategic, normative documents;
2) Community food fortification;
3) Strengthening of the supply and Logistic chain – increasing storage capacity and stock management;
4) Supply of Ready to Use Therapeutic Food;
5) Capacity development of malnutrition cases management;
6) SMART survey to reinforce surveillance of malnutrition trends in the most vulnerable regions;
7) Community based prevention of malnutrition including early cases detection;
8) High level advocacy to Government authorities to bring malnutrition at the helm of development priorities in Cameroon
9) Collaboration with both chambers of the parliament for more national engagement against malnutrition;
10) Micronutrients supplementation and deworming.
In line with the 2013 – 2017 UNICEF Cameroon Country Program’s geographical focus, the Nutrition Sub-component was implemented in four priority regions, namely East, Adamawa, North and Far-North. These regions, which host more than half of the children in the country, have the lowest level of indicators in almost all the domains pertaining to children rights. All the initiatives of this Programme, which are to be evaluated, were developed and implemented by the UNICEF Office in Yaoundé in collaboration with the two UNICEF zonal offices that are serving the most disadvantaged in the four vulnerable targeted regions.
Like the rest of the 2013 – 2017 Country Programme, nutrition interventions were implemented in a changing and progressively unstable context. Contrary to the time when the programme was designed, emergency situations requiring response occurred. For instance, the Programme needed to contribute to an unplanned strong Sahel nutrition crisis response action. Prolonged dry season and poor agriculture yields have exposed many families to severe starvation (this crisis has particularly stricken the northern regions of Cameroon). In areas where malnutrition was already endemic, children’s nutritional status situation was worsened by direct and indirect effects of draught. The response plan was successfully implemented under the stewardship of the Regional Office.
Lessons learned from this response plan enabled the entire Country Programme to adjust its strategies and increasing collaboration with communities to strengthen the prevention of malnutrition. Mothers and other community health workers were trained in early detection of malnutrition and management at community level. Capacity of cases management were also reinforced. Each of the health centres in four priority regions has at least on personnel qualified in case management of malnutrition. This has permitted to improve the quality of services and increase of utilization. The rate of mothers who leave health centres before formal discharge has significantly reduced.
UNICEF key Partners in the implementation of this programme included the following:
- Hellen Keller International;
- International NGOs: ALIMA – International Red Crescent
- Civil Society: Community-based organizations, including Women’s groups, as well as National and international NGOS;
· Governmental agencies: Ministry of Health, Ministry of Scientific Research, Ministry of Fisheries, Husbandry and Animal Industries, Prime Minister’s Services, Ministry of Agriculture and Rural Development, Ministry of Economy, Planning and Regional Development, Ministry of Communication, Health Department of the Defence.
2. Objectives
The evaluation has two main purposes: accountability and learning.
- With respect to accountability, this evaluation will yield evidence on whether UNICEF’s supported interventions have either succeeded or failed in their effort to contribute to the reduction of child and maternal malnutrition in Country Programme intervention zones. Evaluation findings will also tell to what extent UNICEF’s supported interventions have contributed to improve the quality of malnutrition cases management by health personnel and to malnutrition prevention at community and household levels.
- With respect to learning, this evaluation is expected to inform:
- UNICEF Cameroun Country Office Management Team’s strategic choices on how to increase the coverage, effectiveness, efficiency of the nutrition sector interventions envisaged in the ongoing Country Programme with focus on stunting;
- UNICEF Cameroun’s Country team’s ability to vet the strategies that are more relevant for programmatic context and appropriate to yield better results;
- Country Programme Managers to judge which of the strategies proposed by the Strategic Plan is more appropriate to the context and can better contribute to the activation of change(s) expected change in nutrition status of children.
The evaluation is expected to:
· provide robust evidences on the level of the Nutrition Programme’s achievement of planned results;
· provide insights into any unforeseen challenges and/or opportunities that occurred and how the delivery and/or strategic results was affected;
· identify lessons learned as well as potential good practices that can be taken to scale and support acceleration of stunting reduction.
· Provide programmatic and operational recommendations on how to strengthen the performance of UNICEF Programme’s nutrition interventions.
Specifically, the objective of this summative evaluation is to:
(a) Independently and rigorously assess:
· The quality of the conception of the nutrition program component (strategic positioning – implicit/explicit Theory of Change – relevancy to needs of beneficiaries and to system’s bottlenecks);
· Appropriateness of implementation approaches and strategies used with special focus on synergies with major stakeholders at inter-ministerial level;
· Program’s effects on system’s strengthening – communities – families – community health workers and on children and pregnant/breastfeeding mothers;
· Effects (if any) of mothers’ capacitation in malnutrition early awareness and community food fortification.
(b) Identify:
· Lessons learned and good practices that can be proposed for scale-up at both strategic and operational levels;
· Possible alternative approaches that would have permitted to achieve better results (malnourished children and mothers served) with the same amount of resources invested in the Program;
· Possible alternative supply management that would have permitted to better serve the most deprived children and mother in dwelling in the most vulnerable and underserved zones;
· innovative approaches to encourage families and communities to adopt better young children and infant nutrition practices.
3. Evaluation scope
Thematic scope
Since many partners are involved in the health sector, the evaluation will focus mainly on interventions supported at strategic level (revision of norms – policy formulation – evidence generation – policy/strategies formulation). Thematically, the evaluation will cover:
· UNICEF support to nutrition enabling environment (policy formulation – inter-ministerial committee);
· Improvement of the quality of services provided to malnourished children and mothers; community engagement/contribution to efforts aiming at reducing malnutrition;
· Quality of services provided to children and mothers by health personnel; progress made in improvement of Infants and Young Child feeding practices by parents and other care givers.
Geographical scope
The evaluation will be conducted at both central level and in the four vulnerable regions of Cameroon (Far North, North, Adamawa and East) where the Programme’s nutrition interventions have been implemented. All nutrition stakeholders including government institutions, UN agencies, civil society organizations and beneficiary groups will be involved in all phases. At all levels, evaluators will collect information from those who played a role at any stage of nutrition program cycle. Key lessons and recommendations will be shared with them.
Chronological scope
The period to be scrutinized goes from January 1st, 2013 through December 31, 2017.
Evaluation context
Important efforts have been made over the past years to put nutrition among the top government priorities in Cameroon. The country joined the Scaling Up Nutrition (SUN) movement in 2013. Since then, there has been increased political commitment to improve nutrition governance and accelerate progress for nutrition. Despite this, undernutrition continues to be one of the most important problems in Cameroon. Over the past 25 years, Cameroon has made little progress in reducing undernutrition. The prevalence of stunting increased from 24.4% in 1991 to 32% in 2014. Likewise, the prevalence of wasting in children under 5 increased from 3% in 1991 to 5.2% in 2014, while the proportion of underweight children increased from 13.6% to 14.8% during the same period. Micronutrient deficiencies are also of concern. The prevalence of vitamin A deficiency among children under 5 is 39%, whereas it is 18% among pregnant women. Anaemia is also common among pregnant women, affecting nearly 40% of them. Moreover, the prevalence of iron-deficiency anaemia ranges from 12% to 47.4% among children and from 9% to 19.4% among women. At the same time, the country is experiencing a nutrition transition fuelled by a rapid urbanization and changes in diet and lifestyle patterns, with an increase in overweight, obesity and non-communicable diseases (NCDs). Nearly 7% of children under 5 in Cameroon are overweight (MICS, 2014).
To help improve the situation of children and their mothers in Cameroon, UNICEF and the government of Cameroon have signed a program cooperation agreement with the ambition to address, among others, maternal and child undernutrition between 2013 and 2017. The nutrition component of the cooperation program aims at accelerating progress towards reducing stunting and other forms of malnutrition in Cameroon. More specifically, the program is geared towards scaling up the prevention of undernutrition and improving the nutritional status of children under five, pregnant and lactating women. The program is designed around the following components: i) promotion of adequate infant and young child feeding practices, ii) community-based management of severe acute malnutrition, iii) prevention and control of micronutrient deficiencies, and iv) creation of a more enabling environment for nutrition.
Evaluation questions and criteria
Mindful of the nature of malnutrition problem in Cameroon and the importance of addressing root-causes and not symptoms, this evaluation will be guided by the following criteria: relevance, efficiency, effectiveness, sustainability, and equity. Priority questions to be considered under each criteria are listed below. Questions listed are to be considered as indicative and will be refined in the inception report.
Evaluation criteria and questions
Criteria 1: Relevance
a. To what extent has targeted communities, families and children’s care givers been involved in the planning, implementation and management of nutrition interventions?
b. To what extent has the nutrition program component made use of resources and other assets available locally in its efforts to craft response to root causes of malnutrition?
Criteria 2: Efficiency
2.2.To what extent were the nutrition interventions delivered in a timely manner? Compared to similar interventions in the same regions, are UNICEF Cameroon supported interventions more cost-effective?
2.2.To what extent has the program contributed to leverage additional resources and partnerships to support response to malnutrition nationwide?
Criteria 3: Effectiveness
3.1.To what extent has the program responded to the needs of the targeted populations?
3.2.To what extent has the programme contributed to improve the quality of care provided to malnourished children through the health and community systems?
Criteria 4: Sustainability
4.1 To what extent is any change observed in malnutrition cases management (through health and community’s systems) likely to continue after the end of the program?
4.2.To what extent have the program interventions been fully integrated into existing national framework put in place to fight undernutrition?
4.3.What is the Government’s capacity (level of readiness and equipment) to maintain, strengthen and extend the nutrition supply chain?
Criteria 5: Equity
5.1.To what extent have the programme planning and implementation addresses geographic, gender and socioeconomic disparities among the target population?
5.2.To what extent has the program addressed the barriers preventing the most marginalized from accessing and benefiting from its services?
4. Methodology
This evaluation will be a mixed methods theory-based with a strong participatory component and a distinct focus on equity. Overall, the evaluation will include a programmatic documents’ review and will require primary data collection, too. Since the evaluation scope includes interventions at both strategic and operational level, evaluators will propose methodologies that better suites each segment of the evaluand.
While quantitative data (mainly form secondary sources) will inform about the magnitude of interventions (e.g. the number of malnourished children and women served), the use of qualitative methods will allow gathering data that will tell the story of approached and strategies used by UNICEF to (i) convince Government that malnutrition was present and had reached a public health concern; (ii) create the capacity to respond; (iii) ensure effective delivery in health centres and communities; (iv) address major bottlenecks that were hampering demand and utilization and explain improvement of nutrition conditions of children, notably the most vulnerable ones. Qualitative approaches will also give the floor to key stakeholders, by gauging their perceptions of the overall Programme approaches and strategies, including its effects and modalities of community engagement. Last but not the least, the methodology should be designed robustly enough to permit the evaluation process to tell if progress attributed to Program’s interventions are sufficiently grounded in health system and communities to guarantee a minimum sustainability of gains produced by UNICEF’s actions
The document review will include the following:
- A document review on all major interventions performed by the Country Programme in nutrition related sectors;
- Review of SMART surveys reports completed during the referred period;
- Review of consortium administrative sources and other data and information sources that can provide useful information on the program;
The use of the monitoring data, which has been gathered to date and undertake additional data collection, will be maximised as much as possible.
Primary data collection will include the conduct of a survey and semi-structured interviews aimed to provide further insight into how UNICEF-Nutrition is working with key stakeholders including:
· The intersectoral committee body coordinated by the Prime Minister’s office;
· Programme management staff (personnel working in the areas of Donor Partnerships, data, performance-based management, resources Administration, Financial management);
· Key informants in communities in selected Districts;
· Staff of other related funding and technical organizations that are contributing to malnutrition reduction in Cameroon as well as peer organizations in the health sector;
· Representatives of the government at central, decentralized, operational and grassroots levels
· Leaders of CBO’s, NGO’s, CBO’s that contributed to program implementation and management.
5. Evaluation process
Maintaining the spirit of partnership and participation that guides UNICEF’s approach to the work in middle income countries, the Ministry of Public Health (department of nutrition and feeding), UNICEF and other strategic programme partners agreed that:
- An Advisory Committee (composed of a representative from each of Ministry of Public Health, Prime Minister’s Office, Ministry of Agriculture and Rural Development, Ministry of Fisheries and Animal Husbandry and UNICEF) will be set up to manage the evaluation and to secure quality and independence throughout the process. The Advisory Committee will be responsible for approving any significant change in the evaluation TORs, providing all required information or documentation, facilitate access of evaluation team to key informants. The Advisory Committee will be responsible for approving the evaluator’s work plan and methodology, verifying preliminary findings, providing feedback on the draft evaluation report and approving the final version of the report;
- Technical stewardship will be ensured by the UNICEF Country Office PM&E UNICEF Country and the UNICEF RO Nutrition Section Staff;
- UNICEF will hire the evaluation team and take charge of all financial implications of the contract. As the evaluation manager, the UNICEF PM&E Chief will closely monitor the evaluation process in line with milestones articulated in these TORs, review data collection instruments, and liaise with and inform the Advisory Committee and UNICEF Regional Evaluation Advisor on progress;
- Quality assurance of evaluation deliverables will be performed by Regional Evaluation Advisor in the UNICEF Regional Office, including the TORs, inception report (methodology - evaluation design), evaluation report and recommendations;
The final report of the evaluation must be a publicly available document. Evaluation findings will be published in a the most suitable users’ friendly way. The Ministry of Public Health and UNICEF will prepare a dissemination plan for the evaluation report. A joint Government and UNICEF management response will be part of the final evaluation report. that includes, among others, a record of agreement/disagreement with the findings and recommendations from the evaluation that will be prepared for circulation within the consortium organizations.
6. Evaluation Outputs
The expected outputs of this outsourced evaluation are as follows:
- An inception report (“note de cadrage” in French) including an Evaluation framework, a work plan, the recommended methodology, approach and data collection instruments;
- Presentation of preliminary findings + Power Point Presentation and draft outline of the structure of the evaluation report;
- Draft evaluation report;
- Final evaluation report by the evaluators of no more than 45 pages (excluding annexes) that responds to the questions outlined in these TORs, and incorporates feedback obtained on the draft report. The report should be formatted as per the guide on formatting evaluation reports and its content should be consistent with both the UNEG/UNICEF Template for Evaluation Report and the UNICEF GEROS Meta-evaluation Template (to be distributed to the selected evaluation team upon signature of the contract).
- An user-friendly executive summary of no more than 2 pages.
· Annexes with details on the methodology, informants, and data collection instruments.
7. Timelines and milestones
Below are the timeline and milestones envisaged in the evaluation of UNICEF-supported interventions in the nutrition sector. The specific details will need to be confirmed in negotiation with the evaluation team and the Advisory Committee to ensure timely completion of the evaluation and delivery of the evaluation report.
Activity
Date
Milestone
Advertisement of the targeted call for evaluators
October 1, 2018
Selection of evaluators
By October 18, 2018
Contract start-up
By October 25, 2018
· Contract signature by both parties
Submission and presentation of evaluation work plan and methodology to Advisory Committee for feedback
By November 10, 2018
· Work plan
· Evaluation framework
Approval of work plan and evaluation design
By November 18, 2018
Document review and data collection (including in-country mission)
November 20- December 20, 2018
Presentation of preliminary findings and submission of detailed Evaluation Report Outline to Advisory Committee
December 20, 2018
· Progress report
· Power Point on preliminary findings
· Evaluation Report Table of Contents
Presentation of draft report and discussion in workshop with Advisory Committee
January 10, 2019
· Draft evaluation report
Submission of final evaluation report
January 30, 2019
· Final evaluation report
8. Evaluation team
The evaluation team will consist of three members with demonstrated expertise in the following domains (i) evaluation and team leadership; (ii) nutrition, preferably with qualification in case management and systems strengthening; (iii) supply chain management and reinforcement; (iv) qualitative approaches.
Academic backgrounds, technical skills and work experience required from team leader and members are detailed below leader and members are detailed below.
Qualification envisaged for the Evaluation Team Leader (international)
· Graduated in social sciences or any other recognized equivalent field;
· At least 10 years of relevant work experience in conducting evaluations and operational researches missions in developing countries;
· Ability to work in an iterative, collaborative team approach; ability to give and receive constructive feedback;
· Strong communication skills including negotiation skills;
· Knowledge of the field of innovation and research in the context of nutrition;
· Experience in the design and conduct of program-level evaluation of multi-partner initiatives, from a systems perspective;
· Strong report writing and presentation skills, ability to communicate complex technical ideas using non-technical language to diverse audiences (an electronic copy of the most recent evaluation report authored by the consultant will need to be included in the application);
· Ability to work in multi-organizational initiatives; a focus on innovation in health science and technology) research in the context of low and middle income countries;
· Knowledge of evaluating initiatives that fund innovation research for development, particularly aspects relating to innovation derived from research (dissemination, commercialization and knowledge translation);
· Fluency in written and spoken English; written and spoken French or a capacity to ensure that interview and other data collection can be undertaken in French
Competencies envisaged for the Expert in Supply Chain management and reinforcement (international)
· Qualified logistician with at least 10 years of experience in system’s management and reinforcement
· At least 7 years of relevant experience in health system logistic
· Proven skills in team work
Competencies for the Expert in nutrition (Cameroonian national)
· Graduated in nutrition or any other recognized related field;
· At least 7 years of relevant work experience in conducting evaluation, studies and operational researches missions in developing countries;
· At least 7 years in nutrition program covering interventions at strategic and operational levels;
· Strong experience in work with communities aiming at promoting best child feeding and nutrition approaches;
· Strong communication skills including negotiation skills with community stakeholders with decision making roles;
· Experience in being part of an evaluation team for at least two assignments over the past three years;
· Very good report-writing and presentation skills, ability to communicate complex technical ideas using non-technical language to diverse audiences (a copy of a recent evaluation report whose the consultant has been a primary author will need to be included in the application);
· Fluency in written and spoken English; written and spoken French or a capacity to ensure that interview and other data collection can be undertaken in French with francophone recipients of DIF-Health.
Competencies envisaged for the Expert in qualitative approach (Cameroonian national)
· Graduated in anthropology, health or medical sociology or in any other equivalent field
· Proven practical expertise in social development research activities;
· Involvement in at least three researches/evaluations or studies over the past five years;
· Good knowledge of social development issues on the East – Adamawa – North – Far-North.
· Proven experience in design – collection – analysis – report writing of qualitative data.
9. Contract arrangements
Each member of the team will be allotted a different number of days of work based on their respective tasks and responsibilities. The recommended number of days will be spread between October 2018 and January 2019.
- Evaluation team leader: 60 days
- Expert in nutrition with strong experience in cases management: 40 days
- Expert in supply chain management: 30 days
- Expert in qualitative approach: 35 days
The detailed planning proposed by the team leader will clearly demonstrate how each of the team members will contribute to the process and to the final evaluation report.
10. Team selection criteria
Applicants will be assessed in accordance with their ability to meet the following criteria:
· Experience in working in complex institutional settings and with high-level officials.
· Knowledge of consortium level and/or program level evaluation of research for development.
· Knowledge of the field of nutrition and the Grand Challenge niche areas.
· Knowledge and understanding of how nutrition research impacts the lives of people living in the developing world.
Interested groups of individuals or evaluation firms should forward their CV`s, a cover letter (along with a sample of a recent evaluation report both for the Evaluation Team Leader and each one of the evaluation team members) to the hiring team through the web portal within fifteen days after the publication of the bidding.
Only short-listed candidates will be contacted by UNICEF hiring personnel for contracting purposes. As part of the selection process, an interview with shortlisted candidates may be conducted.
11. Proposal submission
Applications shall be submitted to UNICEF Cameroon before the deadline containing the following required documentation:
- Technical Proposal: Consultant shall prepare a proposal in response to the ToR, ensuring that the purpose, objectives, scope, criteria and deliverables of the assessment are addressed. Draft work plan and timeline for the assessment should be included. The Technical Proposal shall also include updated CV and Personal History Forms (P11) of the consultant, and copies of 2 assessments performed previously by the consultant.
- Financial Proposal: Offer with cost breakdown: Consultancy fees, international (economy class) and internal travel costs, Daily Subsistence Allowance (DSA) and required translations and other costs. The Financial Proposal shall be submitted in a separate file, clearly named Financial Proposal. No financial information should be contained in the Technical Proposal.
12. Proposals Evaluation Criteria
A two-stage procedure shall be utilized in evaluating the applications received in accordance to the below criteria, with evaluation of the technical proposal being completed prior to any price proposal being compared. Submitted applications shall be assessed using Cumulative Analysis Method. Technical proposals should attain a minimum of 50 points to qualify and to be considered:
a) Technical proposal (70 points)
- Overall Response: (10 points)
- Understanding of the evaluation scope objectives along with the completeness and coherence of the technical proposal (5 points)
- Overall match between the others ToR requirements and proposal (5 points)
- Proposed Methodology and Approach: (20 points)
- Quality and innovation of the proposed evaluation approach and methodology (10 points)
- Quality of proposed Implementation Plan, i.e. how the consultant will undertake each task, and maintenance of project schedules (5 points)
- A clear division of tasks and responsibilities among the team members (5 points)
- Technical Capacity: (40 points)
- Range and depth of evaluation experience in the nutrition or other related domains (10 points)
- Knowledge of the latest developments in the field of evaluation within the context of UN supported technical assistance (5 points)
- Knowledge of nutrition and development (5 points)
- Knowledge of the cultural, socio-economic and political context in Cameroun (5 points)
- Strong analytical skills and qualitative and/or quantitative statistical data processing applications (5 points)
- Excellent communication, report writing and presentation skills (10 points)
b) Financial Proposal (30 points)
The maximum number of points shall be allotted to the lowest Financial Proposal that is opened /evaluated and compared among those technical qualified candidates who have attained a minimum of 50 points in the technical evaluation. Other Financial Proposals will receive points in inverse proportion to the lowest price.
Annex 1: theory of change
Intrants
Activites
Produits
Effets immediats
Effets a Moyen Terme
Impact
Ressources (finances, Humaines, Techniques, informationnelles)
Renforcement institutionnel
- Capacités
- Coordination
- Plaidoyer
- Politiques
- Facilitation
Renforcement Système
- Approvisionnem
- Informations sanitaires
Collecte données
- Enquêtes
- Evaluations
- Routine
Monitoring et participation communautaire
Développement nouveaux produits
Produit 4.1.1 D’ici 2017, les ministères des secteurs concernés ont integré et budgetisé des interventions en faveur de la nutrition dans leur politique, strategies et plans d'action
Effet 4.1.
D’ici à 2017, le development et l'operationalisation d'un cadre politique, legal et multisectoriel de nutrition pour la coordination/suivi et evaluation est assuré
Produit 4.1.2. D’ici 2017, l’augmentation du financement des interventions en faveur de la nutrition dans les différents secteurs conformément aux plans d’action est effective.
Mise en œuvre de de politiques et stratégiques favorables au développement durable et a une croissance inclusive
Produit 4.1.3. D’ici 2016, Les curricula des secteurs santé, agriculture, éducation et social intègrent la nutrition humaine et sont effectivement enseignés dans les différents cursus.
Reduction de la malnutrition chronique
Produit 4.2.1. D’ici 2017, la disponibilité et l'accès aux intrants, aux services, aux ressources humaines qualifiées et aux systèmes de prestation de nutrition au niveau national et décentralisé et particulièrement dans les zones d'intervention y compris en situation d'urgence, sont assurés
Effet 4.2.
Les systemes de santé integrent et assurent la prestation d'un paquet d'interventions de nutrition aupres des enfants et des femmes y compris en situation d'urgence
Populations, ont un accès accru et équitable et utilisent efficacement les services de soin de sante et de prévention et d’éducation de qualité
Produit 4.3.1. D’ici 2017, un modèle multisectoriel de prévention a base communautaire de la malnutrition chronique est développé et diffusé
Produit 4.3.2. D’ici 2017, les programmes/structures des diffrents secteurs (education, agriculture, protection sociale, promotion de la femme, WASH) et les collectivites territoriales decentralisees mettent en oeuvre des interventions specifiques et sensibles à la nutrition auprès des populations vulnerables
Effet 4.3.
D’ici 2017, la population accede et adhere a des interventions en faveur de la nutrition au niveau de la communauté a travers tous les secteurs
Produit 4.3.3 D’ici 2016, un modèle d’action communautaire sur les normes sociales en alimentation et nutrition intégrant les dimensions du changement est testé dans une zone d'intervention
Produit 4.3.4. D’ici 2017, des formulations d'aliments de complément à base de produits locaux sont disponibles, vulgarisés et utilisés