USAID Scaling Up Nutrition Technical Assistance

Quarterly Progress Report October 1 – December 31, 2019

Submission Date: January 30, 2020

Contract Number: 72061119C00002 Contract Period: February 18, 2019 – February 17, 2023 COR Name: Kayt Erdahl ACOR Name: Helen Chirwa

Submitted by: DAI Global LLC 7600 Wisconsin Avenue, Suite 200 Bethesda, Maryland 20814 USA Tel: 301-771-7600

This document was produced for review and approval by the United States Agency for International Development/.

USAID SUN TA 72061119C00002

TABLE OF CONTENT

TABLE OF CONTENT ...... 2

ACRONYMS AND ABBREVIATIONS ...... 3

1. PROGRAM OVERVIEW ...... 4 1.1 Project Scope & Introduction...... 5

2. ACTIVITY IMPLEMENTATION PROGRESS ...... 6 2.1 Progress Highlights ...... 6 2.2 Implementation Status ...... 6 2.3 Implementation Challenges ...... 9 2.4 MEL Plan Update ...... 9

3. STAKEHOLDER PARTICIPATION AND INVOLVEMENT ...... 11

4. MANAGEMENT AND ADMINISTRATION ...... 11 4.1 Human Resources ...... 11 4.2 Procurement ...... 11 4.3 Finance ...... 12 4.4 Information Technology ...... 12

5. PLANNED ACTIVITIES FOR NEXT QUARTER ...... 13

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USAID SUN TA 72061119C00002

ACRONYMS AND ABBREVIATIONS

APMs Area Pump Menders CBVs Community Based Volunteers CHVs Community Health Workers DNCC District Nutrition Coordination Committee EMMP Environmental Management and Monitoring Plan GRZ Government of the Republic of Zambia HIIs High Impact Interventions IYCF Infant and Young Child Feeding MCDP II Phase Two of 1,000 Most Critical Days Program MEL Monitoring, Evaluation and Learning MCCP Monitoring, Coordination and Communication Plan NFNC National Food and Nutrition Commission PNCC Provincial Nutrition Coordinating Committee QASP Quality Assurance Surveillance Plan SAGs Sanitation Action Groups SBC Social and Behavior Change SMSG SUN Mother Support Groups SUN TA Scaling Up Nutrition Technical Assistance USAID United States Agency for International Development VWASHE Village Water Sanitation, Hygiene, and Education WASH Water, Sanitation and Hygiene WNCC Ward Nutrition Coordinating Committee

Cover picture A community-based volunteer in District registering a household for the SUN program. October 2019. © SUN TA Quarterly Report October 1 – December 31, 2019 Page 3 of 13

USAID SUN TA 72061119C00002

1. PROGRAM OVERVIEW

Program Name: Scaling Up Nutrition Technical Assistance (SUN TA) Activity Start Date and End February 18, 2019 - February 17, 2023 Date: Name of Prime Implementing DAI Global LLC Partner: Contract Number: 72061119C00002 Name of Subcontractors /Sub TechnoServe, Viamo, EXP Zambia and Toilet Yanga awardees:

Major Counterpart National Food and Nutrition Commission (NFNC) Organizations

4 Provinces (Central, Copperbelt, , Northern) & 13 Geographic Coverage Districts of Zambia (Mumbwa, Chibombo, Kapiri-Mposhi, (cities and or countries) , , , Mansa, Samfya, , , Kasama, , Luwingu).

Reporting Period: October 1, 2019 – December 31, 2019

Maternal & Childe Health (13.423%), Family Planning Funding Source/Spigot: (8.95%), WASH (35.8%), Feed the Future (17.9%), Nutrition (23.94%)

Planned LOP ($): $50,535,620

Mortgage ($): $28,185,620

Obligations as of December 31, $22,350,000 2019: Does this activity have a costed Yes work plan?

Average monthly expenditures ($): $459,319

Accrued expenditures through $4,774,823 December 31, 2019 ($):

Pipeline ($): $17,575,177

Pipeline Months: 17

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USAID SUN TA 72061119C00002

1.1 Project Scope & Introduction

SUN TA is a project funded by the United States government to provide technical assistance to the Government of Zambia towards a national goal of reducing stunting among children under two. The project operates in 13 districts across four provinces.

In the quarter under review, the project focused on identification and selection of SUN households, Community Based Volunteers (CBVs) in the three key thematic areas i.e. Health and Nutrition, Agriculture and Livelihood, and WASH. The selection for both activities was done using a set of tools which will be shared. Other activities involved the formation of, and orientation on, the MCDP II for the Provincial Nutrition Coordinating Committee (PNCCs) for Central and Copperbelt provinces and District Nutrition Coordinating Committees (DNCCs) for the new seven districts (Nchelenge, Luwingu, , Kabwe, Chibombo, Kitwe and Ndola). The project provided technical support to the seven new DNCCs in the development of work plans and budgets.

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USAID SUN TA 72061119C00002

2. ACTIVITY IMPLEMENTATION PROGRESS

2.1 Progress Highlights The project in the quarter registered 102,468 SUN households based on defined criteria in all the initial six districts (see MEL section). SUN TA and NFNC oriented the 6 DNCCs in the household selection methodology who in turn oriented the WNCCs and the CBVs.

The SUN TA and NFNC team oriented the provincial and district heads of government departments on MCDP II and how SUN TA will support its implementation in the seven new districts. The ministries involved included Health, Agriculture, Fisheries and Livestock, Education, Local Government, Water Development and Sanitation, Community Development and Social Services, Chiefs and Traditional Affairs, and Lands and Natural Resources. The newly constituted DNCCs in the seven districts were oriented on the work planning process which focused on the High Impact Interventions (HII) across the three thematic areas.

To enhance delivery of the HII, the SUN TA did a gap analysis of government staff and CBVs and created a structured way of how all the interventions will reach the targeted households using the SUN Pyramid model for each thematic area. The findings of the gap analysis are presented under crosscutting issues below.

2.2 Implementation Status

2.2.1 Water, Sanitation and Hygiene

The WASH thematic area focuses on reducing exposure to causes of diseases, environmental pathological load and the risk of diarrheal diseases and intestinal infections. SUN TA’s aim is to increase access to safe water, sanitation and hygiene at household and community level through the following approaches:

i. District-wide roll out of CLTS by building capacity of DWASHE members, Environmental Health Technologists and Community Champions; and at community level by forming Sanitation Action Groups (SAGs) to spearhead implementation at village level. ii. Increasing access to safe water by construction of new boreholes and rehabilitation of non- functional boreholes. Training of Area Pump Menders (APMs) and equipping them to ensure there is capacity and skill at community level for timely repair and maintenance of hand pumps. SUN TA supports districts to form and train V-WASHE committees. Support will also be provided to strengthen routine water quality monitoring, chlorination and promote home-based water treatment and safe storage. iii. Improving private sector participation in sanitation marketing to ensure there is availability of sanitation and hygiene options at community level.

During the period under review the following activities were done:

• Adaptation of training materials: In preparation for the roll out of CLTS and APMs training, SUN TA engaged the Ministry of Water Development, Sanitation and Environmental Protection on the adaptation of the CLTS Training Manual, Operations and Maintenance Manual for APMs,

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USAID SUN TA 72061119C00002

Reporting Booklets for SAGs, community champions and EHTs. These materials have since been shared with the field staff in readiness for usage in Q1 of 2020.

• Training of Area Pump Menders: SUN TA working with ministries of Water Development; Local Government; and Health trained 46 APMs (26 in Mansa and 20 in Samfya) to repair and maintain boreholes using the government approved WASH training materials. The 46 trained APMs will contribute to increased community capacity to operate, maintain and repair broken down boreholes, thus increasing and sustaining access to safe water. These APMs will be expected to reach 46 and 83 health facility catchments, respectively.

2.2.2 Agriculture and Livelihoods

The agriculture and livelihood component aims to increase reliable access to safe and nutritious food through nutrition-sensitive agriculture and financial inclusion. Access to safe and nutritious food will be achieved through production of diverse (nutrient-dense) nutritious vegetables and crops at community and household levels using climate smart agricultural (CSA) practices to sustainably address household food security. Financial inclusion will be attained through community savings and loans groups (CSLGs). In rolling out these interventions, SUN TA works with the Ministry of Agriculture and Ministry of Community Development structures from the district to the community.

During the period under review the following activities were done:

• Capacity-needs assessment of CSLGs: The project conducted a capacity-needs assessment of CSLGs in the first six districts. The purpose of the assessment was to establish the status of CSLGs activities in the districts as well as to map functional CSLGs per ward/zone, existing trained community facilitators, active organizations overseeing CSLGs, and what CSLG models are being used in the district. The assessment will allow to leverage existing assets and partnerships in the districts for rapid scale-up.

• Adaptation of CSLG training materials: In preparation for the roll out of CSLGs, adaptation of training materials using the VSLA foundation model has been done. The training materials have been shared with the field staff in preparation for training and rollout in Q1 of 2020 and beyond.

• Procurement of savings kits: The project-initiated procurement of cash boxes and all necessary materials in the training kits: calculators, pens, pass books, and ledger books to be used by the Community Facilitators/Agents as they form saving groups. The items will be delivered in the first quarter of 2020 ahead of the selection and training of Community Facilitators/Agents.

• Assessment of value chains: The project, working with its consortium member Techno Serve carried out a rapid assessment for priority value chains in the targeted districts and prioritized soybean and local chicken farming for 2020 and identified small ruminants, fish and mangos as potential value chains to be explored in subsequent years. A draft high-level intervention plan was done, and implementation of soybean and local chicken farming activities will be initiated in the first quarter 2020. As requested, the findings of the assessment will be shared with USAID.

2.2.3 Nutrition and Health

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USAID SUN TA 72061119C00002

The Health and Nutrition component of SUN TA aims at improving Infant and Young Child Feeding (IYCF), caring practices, Maternal and Adolescents Nutrition. SUN TA will use nutrition-specific HIIs (antenatal care, early initiation of breastfeeding, exclusive breast feeding, complementary feeding, and systems strengthening for iron, folate and vitamin A supplementation including ORS/Zinc) targeting pregnant, breast feeding women, teenage pregnant adolescent and children under two years. This is to be achieved by working with the Ministry of Health through formation of SUN Mother Support Groups to reach beneficiaries at community and household level.

With the first round of household registration now complete in the first six districts, the formation of SUN Mother Support Groups (SMSG) is the next activity. The SMSG is the channel through which all the interventions itemized above will be delivered. In preparation for the formation of SMSGs, in the period under review, SUN TA worked with the Ministry of Health and NFNC to review and adapt IYCF training materials to the MCDP II.

2.2.4 Cross cutting activities

Recruitment of CBVs: Based on the number of registered households in each of the first six districts, SUN TA calculated the number of CBVs that are needed to support rollout of interventions in the three thematic areas. As at December 31, the following CBVs were identified:

• Health and Nutrition: Based on the current Ministry of Health volunteer gap analysis in the districts, 1,560 CHVs were identified and recruited to be trained as health promoters. Each of these will reach 4 SMSGs each comprising 15 mothers.

• Agriculture and Livelihoods: 629 lead farmers have been identified with 257 already trained (to reach 3,855 follower farmers). Based on the gap analysis and following the lead farmer - follower model, each lead farmer will reach 15 follower farmers.

• Water Sanitation and Hygiene: Based on the current district gap analysis, 332 and 204 CBVs have identified and recruited to be trained as Community Champions and APMs, respectively. The 332 community champions will reach the 166 health facility catchments across the six districts. Each APM will attend to hand pump repairs and maintenance at catchment level.

Orientation of Chiefs: The six initial districts have a combined 30 chiefdoms. All the chiefs need to be sensitized on the program’s objectives to obtain their buy-in. In the quarter under review, SUN TA worked with the NFNC District Coordinators and the Ministry of Chiefs and Traditional Affairs to meet 14 chiefs in Mansa (7), Samfya (3), Kasama (3) and Kaputa (1) to explain the MCDP II. The remaining 16 will be visited in the first quarter of 2020.

Formation and orientation of WNCCs: Formation and engagement of sub-district community structures is critical to delivering interventions. The Ward Nutrition Coordinating Committees are the structures overseeing implementation of activities and are responsible for reporting progress and outcomes to the DNCCs. In the quarter under review, the project formed 51 of the 73 WNCCs that currently exist in the six districts. The remaining 22 will be formed in the first quarter of 2020. Formation of CANCCs: SUN TA’s entry point for its community-based interventions are health facilities

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USAID SUN TA 72061119C00002 and their respective catchment areas. For interventions to be coordinated at the lowest delivery point, a Catchment Area Nutrition Coordinating Committee (CANCC) must be formed and engaged. The CANCC is chaired by the health facility in-charge and has representation from various volunteers within the catchment area to ensure full representation of health outreach posts, agricultural camps, sanitation action groups and women’s associations active in the area. During the period under review, three districts formed a combined 108 CANCCs as follows: Mansa (63), Samfya (20) and Kasama (25). Mbala, Kaputa and Mumbwa districts are scheduled to form CANCCs in the first quarter of 2020. Capacity building sessions for the formed CANCCs will be held in the first quarter of 2020.

2.3 Implementation Challenges

• The vastness of catchment areas and the long distances between villages required CBVs to cover long distances to visit households for the registration exercise requiring more time and resources to cover all catchment areas. Going forward, SUN TA will, in addition to using CBVs, also use health facilities to routinely capture new eligible households at first antenatal care visits.

• Competing priorities (other government programs) among district-based government departments also affected SUN TA activity implementation during the registration of households. Although this cannot be entirely avoided, the project will seek to establish closer contacts with, and build the capacity of, catchment area level staff and community-based change agents such as lead farmers and community development assistants and community health workers for conducting household registration.

• The SUN TA Finance team was overwhelmed with a large volume of transactions during the intense implementation of the household registration. This resulted in delays for payments of government staff allowances. In response, SUN TA is recruiting additional based accountants for the review and processing of district expense reports to increase capacity and efficiency.

• Some NFNC District Coordinators view SUN TA District Managers competitors rather than collaborators. SUN TA continues to engage NFNC’s senior management to nurture productive and collaborative working relationships at the district level.

2.4 MEL Plan Update

MEL is a critical component to the project, enabling design of the monitoring plan, tools, and tracking of results. SUN TA’s M&E system draws on and uses the existing government district and sub-district reporting structures and systems. Where there are capacity gaps and system weaknesses, SUN TA will build capacity and strengthen the existing systems. In the quarter under, the M&E unit undertook the following:

Registration of SUN Households: The project identified and registered 102,658 households. The criterion used to register households included a household with a pregnant or lactating woman and/or a child under the age of two. The ‘SUN Most Vulnerable Households’ were identified based on one or more of the following criteria: (a) household with a child with low birth weight (below 2.5kg) who is 6 months of age or younger at the time of registration; (b) household with a pregnant woman with a low MUAC (below

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USAID SUN TA 72061119C00002

21cm); (c) household with a teenage pregnancy; (d) household with a maternal death and a surviving infant below six months of age.

Below is the breakdown of the households registered as SUN households and as SUN Most Vulnerable households per district:

District Mumbwa Samfya Mansa Kasama Mbala Kaputa Total Number of SUN 102, 658 19,325 12,824 19,363 30,648 7,286 households 13,212 registered Number of SUN Most Vulnerable 1410 1,300 1796 1645 785 596 7,532 households registered

Project Database: The project set up a database where data of the registered households are being entered and stored. The system provides all the data collected data from the households which will be instrumental for the targeted delivery, monitoring and evaluation of interventions.

Data Digitalization of SUN Households: Following the registration of households in the six districts, 22 data entry clerks were hired to enter the data into the database system. The SUN TA IT Manager supported the M&E team to recruit the clerks and set up the workstations in readiness for data entry to start in the first week of 2020.

Communications and Advocacy: With support from SUN TA, the NFNC convened the first meeting of the Communications and Advocacy Technical Working Group under SUN 2.0. Participants included NFNC, SUN TA and its partners Viamo and EXP Zambia; other implementing partners including WFP, UNICEF, GIZ, the Ministry of Health and the Zambia Bloggers Network. The meeting reviewed the TWG’s Terms of Reference in line with the changes that have occurred since SUN 1.0 ended in 2017; re-affirmed the NFNC in its Secretariat function; and agreed on harmonizing approaches and strategies, messaging and materials to avoid duplication, create economies of scale and ultimately broaden the reach to targeted population. The next meeting will be held in January 2020 to adopt the revised TOR and elect the Chairperson. The TWG is expected to drive the forthcoming SUN National Social Behavior Change Campaign and serve as an avenue for the initiation of various communications activities under the SUN program.

Formative Assessment for Social Behavior Change (SBC): EXP Zambia, SUN TA’s partner, conducted a formative assessment in the 13 SUN TA districts to collect qualitative information about current knowledge, attitudes, behaviors, and practices related to SUN core interventions, namely, nutrition and health; agriculture and livelihoods; and water, sanitation, and hygiene. The findings will be shared in January 2020 and feed into the development of the SUN National SBC Campaign along with findings from a desk review conducted in the previous quarter and the results of the SUN 2019 Baseline Survey.

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USAID SUN TA 72061119C00002

3. STAKEHOLDER PARTICIPATION AND INVOLVEMENT

Participation at SUN Global Gathering: SUN TA participated at the SUN Global Gathering held in November in Kathmandu, Nepal. The biennial event brings together all SUN Government Focal Points, as well as representatives of cooperating and implementing partners, civil society, the private sector, academia, media, parliaments, and other actors. It is the flagship event of the Global SUN Movement, comprising of 61 countries and the participation of over 100 countries in total. The gathering is an important moment where members take stock of progress and challenges, and learn and share innovations, best practices and lessons learned that contribute the most to the reduction of malnutrition across all SUN countries. The SUN TA and NFNC delegates learned that the approaches the program has adopted, such as prioritizing a core set of interventions, strategically targeting households and integrating multi-sectoral activities, were growing and continued practices globally, a sign that the project is in tune with global trends under the SUN.

SUN TA at SUN National Conference: SUN TA was part of the organizing committee of and participated in the Scaling Up Nutrition (SUN) National Conference hosted by the NFNC in Lusaka in October. Themed “Improving nutrition through learning and adoption,” the conference assembled government line ministries, cooperating partners, and SUN implementing partners. The conference’s focus was the dissemination of baseline findings conducted in 30 SUN districts, including the 13 districts supported by SUN TA. The baseline findings are relevant to SUN TA’s programming as they cover the core interventions the project is focusing on, namely, nutrition and health; community savings and loans; agriculture and livelihoods; and water, sanitation, and hygiene. The conference‘s key deliverables were programmatic and policy recommendations that implementers and the government will use to build a stronger foundation for the scaling up of the MCDP II and SUN programs nationwide.

SUN National Steering Committee: SUN TA participated in the first MCDP II meeting of the SUN Steering Committee where it presented on its mandate and activities in its 13 districts.

4. MANAGEMENT AND ADMINISTRATION

The Human Resources, Administration, Procurement and Finance teams continued to provide support to the technical department and the districts to ensure smooth implementation of the project.

4.1 Human Resources

Recruitment: In this quarter under review, the project increased in staff size from 38 to 54 to meet the growing needs and geographic scope of the project. Of the 54 staff, 11 are female and 43 are male, representing a 20/80 gender ratio. More staff are expected to be recruited in the first quarter of 2020 to fill vacancies in the Lusaka office and in the seven new districts where staff will be added.

4.2 Procurement

In the quarter under review, the following undertaken:

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USAID SUN TA 72061119C00002

• 1,200 bicycles were ordered and 360 were delivered to date. The bicycles are for the various cadres of CBVs with supervisory roles (health supervisors, WASH community champions, WASH area pump menders, lead farmer supervisors, savings and loans groups community facilitators). The additional 840 bicycles are expected to be delivered in the first quarter of 2020. • USAID granted approval for purchase of a list of agriculture inputs such as Mbereshi beans and vegetable seeds. • Various spare parts for India Mark II and Afridev water pumps were procured. The spare parts will allow for the repair of non-functional boreholes after the approval of the SUN TA Water Quality Assurance Plan. • GPS tracking systems were procured and installed on all project vehicles. • The procurement of seven additional vehicles for the new districts was initiated. The vehicles are in transit with an expected delivery date of March 2020. • The project signed a Service Level Agreements with Toyota Zambia for the maintenance of vehicles, with two service stations to provide fuel for the Mbala, Kaputa and Nchelenge designated vehicles, along with two suppliers for tires.

4.3 Finance

Development of Financial Guidelines: The finance team further improved the District Financial Guidelines. This tool provides guidance to districts for fund requests and transfers, petty cash management, fuel procurement and management, advance requests and settlements, and travel advance requests and expense reports, as well as how to manage National, Provincial, and District level GRZ Staff and Community-Based Volunteer (CBVs) stipends. The updated guidelines will be launched in the first quarter of 2020 and all staff will be trained accordingly.

Financial Support from the Home Office: DAI’s Principal Field Operations Specialist, provided STTA to the project to help the finance team review the workflow and streamline reporting forms, procedures and approvals structure. As part of the assignment, she visited the office together with the Director of Finance and Administration and the Senior Finance and Compliance Manager to fully understand, assess and improve district operations and management. also reviewed with the Lusaka office finance team the processes and workflow of financial data and the flow of funds to the districts.

4.4 Information Technology IT Cyber Security Training 2019: In November 2019, 46 project staff attended the IT Cyber Security training. The objective of the training was to educate staff about the threats to information systems and equip them with the knowledge to protect project systems and information. At the end of the training, all staff took a short assessment to assess their understanding of IT Cyber Security. Throughout the quarter, IT continued to provide routine support to the project to ensure smooth work flow.

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USAID SUN TA 72061119C00002

5. PLANNED ACTIVITIES FOR NEXT QUARTER

2020 Planned Activities Jan Feb Mar Program Management Key staff meet with USAID for project implementation updates X X X SUN co-creation workshop X Prepare and submit quarterly progress report X Conduct introductory/consultative meetings with relevant GRZ structures X X X Recruitment of staff for the remaining positions (including M&E Expert) Procurement of project equipment, supplies, and materials Submission of key deliverables (EMMP, WQAP, AMELP, MCC plan, workplan) X Nutrition & Health Orientation of DNCC/ WNCCs on formation of SUN Mother Support Groups X X Orientation of CBVs and supervisors on formation of SUN Mother Support X X Groups and activation thereof CBVs training on the IYCF community charts X X Formation of SUN Mother Support Groups Conduct field visits to the initial six 6 districts to conduct supervisory visits to

support quality implementations of activities WASH CLTS Training of Trainers and rollout of training program for community X X champions Training of APMs X Formation and training of V-WASHE Committees X X X Rehabilitation of boreholes (pending approval of the WQAP) X Conduct field visits to the initial six 6 districts to conduct supervisory visits to

support quality implementations of activities Agriculture & Livelihoods Training of Trainers in Community Saving and Loans Groups in the initial six X districts Conduct field visits to the initial six 6 districts to conduct supervisory visits to X X support quality implementations of activities Conduct assessments on the potential anchor farmers for the local chicken X X value chain and auxiliary support services Hold meetings with seed companies in the soybean value chain to ascertain seed supply systems and start identification of agro-dealers, host lead X X farmers for demonstration plots. M&E Data entry of registered households of the initial six districts Registration of households in the seven new districts

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