AKSYON Kominotè Nan Sante pou Ogmante Nitrisyon (AKSYON) Quarterly Report PY1-Q3 April1– June 30, 2017 Submission Date: July 28, 2017 Contract/Agreement Number: AID-521-A-16-00002 Activity Start Date and End Date: August 24, 2016 – August 23, 2021 COR/AOR/Activity Manager Name: Dr Olbeg Desinor Submitted by: Dr Florence Jean-Louis, Chief of Party Fonkoze 119, Ave. Christophe, Port-au-Prince, Haïti Tel: (509) 3702-1105 Email: [email protected] This document was produced for review by the United States Agency for International Development Haiti (USAID/Haiti) Training on “Alimentation du Nourisson et du Jeune Enfant (ANJE) in Jacmel, June 2017 This report 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 Fonkoze and do not necessarily reflect the views of USAID or the United States Government Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 2 Table of Contents Acronyms .......................................................................................................................................................... 4 1. PROGRAM OVERVIEW / SUMMARY ......................................................................................................... 6 1.1 Program Description ................................................................................................................................... 7 1.2 Summary of Results to Date ....................................................................................................................... 8 2. ACTIVITY IMPLEMENTATION PROGRESS ................................................................................................ 10 2.1 Progress Narrative ................................................................................................................................ 10 2.2 Implementation status ......................................................................................................................... 18 2.3 Implementation Challenges ................................................................................................................ 22 3. MANAGEMENT AND ADMINISTRATIVE ISSUES ...................................................................................... 24 4. PLANNED ACTIVITIES FOR NEXT QUARTER ............................................................................................ 24 5. FINANCIAL MANAGEMENT .................................................................................................................... 24 ANNEX 1- List of localities covered by AKSYON .......................................................................................... 25 ANNEX 2: List of referral care and treatment centers ................................................................................ 37 Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 3 Acronyms AKSYON – AKSYON Kominotè Nan Sante pou Ogmante Nitrisyon ANJE – Alimentation du Nourisson et du Jeune Enfant CHE – Community Health Entrepreneur CTN – Comité Technique de Nutrition (Technical Committee for Nutrition) EMMP – Environmental Mitigation and Monitoring Plan HE – Healthy Entrepreneurs HR – Human Resources ITECA – Institut de Technologie et d’Animation M&E – Monitoring and Evaluation MAM – Moderate Acute Malnutrition MARNDR - Ministère de l’Agiculture, des Ressources Naturelles et du Développement Rural MMIS – Malnutrition Management Information System MOU – Memorandum of Understanding MSPP – Ministère de la Santé Publique et de la Population (Ministry of Public Health and Population) MUAC – Mid-Upper Arm Circumference NUPAS - Non US-Organizations Pre-Award Survey PNS – Programme de Nutrition Supplémentaire (Supplementary Nutrition Program) PTA – Programme Thérapeutique Ambulatoire (Outpatient Therapeutic Program) RUTF – Ready to Use Therapeutic Food SAM – Severe Acute Malnutrition SFF – Sèvis Finansye Fonkoze (Fonkoze Financial Services) SSQH – Services de Santé de Qualité pour Haïti (Quality Health Services for Haïti) UCPNANu – Unité de Coordination du Programme National d’Alimentation et Nutrition UNICEF – United Nations Children’s Fund USAID – United States Agency for International Development USG – United States Government Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 4 WASH – Water, Sanitation, and Hygiene ZABA – Zouti Anrejistreman Benefisyè AKSYON Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 5 1. PROGRAM OVERVIEW / SUMMARY Name of Prime Implementing Fonkoze Partner: Name of Subcontractors/ Subawardees (if Dimagi, Inc. applicable): Healthy Entrepreneurs Icahn School of Medicine at Mount Sinai Institut de Technologie t d’Animation (ITECA) Sèvis Finansye Fonkoze (SFF) Program Name: AKSYON Contract/Agreement Number: AID-521-A-16-00002 Activity Objective: To decrease the number of women and children under age five who suffer from malnutrition Geographic Coverage(cities Haiti And or countries): Activity Start Date and End Date: August 24, 2016 – August 23, 2021 Total Estimated Agreement Amount: $18,000,000.00 Current Obligation: $6,000,000.00 Cash Disbursements per $796,368.64 Standard Form425: Estimated Expenditure Next Quarter: $517,929.46 Report Submitted By: Florence Jean-Louis Submission Date: July 28, 2017 Reporting Period: April 1 – June 30, 2017 Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 6 1.1 Program Description AKSYON is a five-year program that will decrease the number of women and children under age five who suffer from malnutrition in rural Haiti—reinforcing the sustainability of these gains through knowledge and skill building around nutrition, hygiene, sanitation, and food security strategies. AKSYON addresses malnutrition in rural Haiti through Fonkoze’s existing infrastructure, network, and health program. Fonkoze is the largest microfinance institution in Haiti. The 60,000 clients in its core lending program constitute a network of unprecedented scale in the country. At its heart are “Solidarity Groups” of up to five women; six to ten of these groups meet twice a month in “Credit Centers” led by an elected “Center Chief.” Critically, they serve as a reliable mechanism for education and outreach to the entire Fonkoze client network. Information is transmitted from Fonkoze’s head office in Port-au-Prince through its 45 branch offices through its 2000 credit centers, and vice versa. Fonkoze Foundation is leveraging this network to address the lack of reliable and affordable health products and services in rural Haiti. Boutik Sante (Community Health Store) is an innovative, self-sustaining social franchising initiative. Fonkoze Foundation’s staff, including registered nurses, provides monthly trainings to representatives from each Center, many of whom are Center Chiefs, who become “Community Health Entrepreneurs” (CHEs). The registered nurses train them to administer basic health screenings; deliver monthly community health education sessions in their Center meetings; and to explain product specifications to their clients. CHEs purchase over-the-counter health products from Fonkoze to sell in their microenterprises, establishing a boutik sante. AKSYON enables Fonkoze Foundation, through its Boutik Sante Program, to deepen its malnutrition interventions. CHEs, with support from registered nurses, will conduct community screening campaigns to identify cases of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM). Each case will receive appropriate care, referral, and/or follow-up, as dictated by Ministry of Health protocol. These activities will be reinforced by community health and nutrition education and by improving livelihoods opportunities for families affected by food and nutritional insecurity, through sustainable home gardening, livestock rearing, and access to financial services. By 2021, AKSYON will reach full-scale, with 1,800 entrepreneurs serving over two million Haitians. One of the key aspects of the Boutik Sante social enterprise is that, after initial start-up costs, it will be fully sustainable and perpetuated by the market, itself. Upon attaining sustainability, the program will no longer need to rely on additional donor investment. Researchers from the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai are monitoring the program roll-out to assess sustainability and impacts on health outcomes. The program goal is to decrease the number of women and children under age 5 who suffer from malnutrition, as measured by the following indicators: decrease, by 20%, the number of children under age 5 who are stunted; and reduce and maintain childhood wasting to less than to 5%. Quarterly report FY1-Q3 (April 1-June30, 2017) P a g e | 7 1.2 Summary of Results to Date Table 1. Summary of results-AKSYON-PY1Q3 (cumulative) Indicators Annual Q1 Q2 Q3 Q4 Target PY1 PY1 PY1 PY1 Number of children under 5 screened 114,750 304 2,856 9,399 Number of children 0-23 months screened 45,000 118 1,025 3,337 Number of pregnant/lactating women 36,000 62 666 2,146 screened Number of MAM identified 3,440 13 125 324 Number of MAM treated* 3,440 9 27 Number of MAM recidivists TBC 3 Number of SAM identified 1,145 1 23 70 Number of SAM referred 1,145 1 23 70 Number of SAM treated* 1,145 1 8 Number of SAM who abandoned TBC 0 institutional treatment Number of SAM recidivists TBC 2 Number of home visits 13,755 0 105 441 Percentage of SAM/MAM households 100% with increased dietary diversity Percentage of SAM/MAM households 100%