2014 Report on the seasonal nutrition prevention programme in the Sahel
February 2015 Table of Contents
Introduction……………………………………………………………………………………………………………………………………..3
Overview of Blanket Supplementary Feeding activities in 2014
Timeline of BSFP activities in the Sahel region in 2014……………….……………………………………………..4
Geographic targeting criteria utilized for BSFP activities…………………………….……………………………..4
Beneficiary selection criteria…………………………………………….……………………….……………………………..4
Global results……………………………………….…………………………………………………………………………………..5
Performance Analysis……………………..………………………………………………………………………………………..6
Overview of Blanket Supplementary Feeding activities by Country in 2014
Burkina Faso…………………………………………………………………………………………………………………..………… 8
Chad…………………………………………………………………………………………………………………………….…………..10
Mali…………………………………………………………………………………………………………………………….….………..12
Mauritania……………………………………………………………………………………………………………………..………..14
Niger ………………………………………………………………………………………………………………………………..……..16
Senegal……………………………………………………………………………………………………………………………..……..18
The Gambia……………………………………………………………………………………………………………………….……..20
Conclusion..……………………………………………………………………………………………………………………………………..22
INTRODUCTION
The Sahel region spans several sub-Saharan countries and stretches from the Atlantic Ocean to the Red Sea. Extending through West and Central Africa, the Sahel includes Burkina Faso, Chad, the Gambia, Mali, Mauritania, Niger and Senegal.
In general, the climate in the Sahel alternates between a short wet summer season and a very long dry winter season which ends when the rains begin. The dry season is very intense in the Sahel because many communities do not receive any rainfall during several consecutive months. These two seasons strongly influence agricultural production and the livelihoods those in the Sahel and, in turn, directly impact food and nutrition security at the household level.
The nutritional status of children under five in the Sahel is characterized by a high prevalence of wasting with a peak in the prevalence of acute malnutrition observed during the agricultural lean season. At this time of year the peak in acute malnutrition is caused by different factors, such as reduced food consumption and increased incidence of childhood diseases. The populations most vulnerable to undernutrition during this time of the year are pregnant and lactating women (PLW) and children under the age of five, specifically those aged 6 to 23 months (because of the increased care and quality food required for their growth needs). The chronically high incidence of acute malnutrition among young children in the Sahel corresponds in the long term to levels of stunting and child mortality rates that are among the highest in the world.
To prevent this rise in acute malnutrition among children under two years of age and pregnant and lactating women, WFP implements blanket supplementary feeding programmes in the most vulnerable countries and regions to target the most vulnerable populations. These prevention activities include the distribution of foods rich in protein and micronutrients paired with the promotion of good infant and young child feeding practices.
These seasonal blanket supplementary feeding programme activities align with Strategic Objectives 1 and 2 of the WFP 2014-2017 Strategic Plan, and target more than one million women and children across seven countries in the Sahel this year.
This report presents an overview of BSFP activity achievements in each country in 2014, with regard to figures initially planned and challenges encountered in the process.
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Overview of Blanket Supplementary Feeding Activities in 2014
Timeline of BSFP activities in the Sahel region in 2014:
Blanket Supplementary Feeding activities have been ongoing in most Sahelian countries since May or June. In northern Mali, programmes targeting children aged 6-59 months and pregnant and lactating women commenced in January. In Senegal, BSFP activities continued until December due to the delay in the commencement of operations in some locations.
Table 1: Calendar of BSFP activities implemented in 2014
BSFP Implementation Period Country JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC
Burkina Faso Chad Mali Mauritania Niger Senegal Gambia
Geographic targeting criteria utilized for BSFP activities
Geographic targeting is primarily based on the prevalence of acute malnutrition among children under 5 years of age, although other underlying factors (i.e. food insecurity, poverty, access to care, etc.) are also considered.
Although there are specific factors to consider for each country, targeting criteria is generally based on: The prevalence of global acute malnutrition (GAM): greater than 15% (emergency threshold), or greater than 10% with aggravating factors (according to data collected from SMART surveys) The consideration of additional relevant factors like food insecurity, livelihoods, income levels, health conditions, the incidence of disease, etc. (according EFSA surveys, HEA, and analyses of the Harmonized Framework for the Analysis and Identification of Areas at Risk and Vulnerable Groups in the Sahel).
Beneficiary selection criteria
Beneficiary selection criteria may vary greatly depending on the context and the problems specific to a targeted region. Overall, though, the following populations are targeted by BSFP activities: Children aged 6 to 23 months Pregnant and lactating women
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Beneficiaries planned and registered
Planned caseload figures are based on assessments of needs, according to criteria described above. The numbers presented in this report are those identified in project documents.
Each distribution is preceded by a census of all children in the targeted age group that live in areas covered by BSFP activities. This is represented in the “registered” columns below.
Most countries use this as an opportunity to perform a screening of beneficiaries in order to determine their nutritional status, based on MUAC readings. Individuals that are determined to be malnourished are referred to health centers for treatment and (depending on the country) are enrolled in prevention programmes.
Global results
Overall, the coverage of BSF activities in the Sahel was negatively impacted by the level of resources available for programme implementation. In most countries, initial plans were not realized due to pipeline breaks in the specialized nutritious foods recommended for children under two for the prevention of acute malnutrition (Plumpy’Doz and Super Cereal Plus).
Several strategies have been adopted by various countries in order to deal with this problem. These include: - Changes in rations: this was the case in Niger, Mali, Chad and Senegal. - Reducing the number of beneficiaries: in five of the seven countries presented in this report, the lack of resources has forced a reduction in the number of beneficiaries reached. Reductions in numbers have been greater than 60% of planned figures in Niger, Chad and Senegal. In Mali, after a steady expansion of coverage in the first half of the year, the lack of resources and the simultaneous deteriorating security situation in the north of Tombouctou led to a drastic reduction of the coverage of the programme. - The suspension of activities: in Burkina Faso, Mauritania and the Gambia, prevention activities were suspended, while in Chad, pregnant and lactating women were not reached.
Table 2: Number of children aged 6-23 months assisted vs. planned, January-December 2014
Children aged 6-23 months – January to December 2014 Country Number of Number of beneficiaries beneficiaries January February March April May June July August September October November December planned registered Burkina Faso 65,000 65,015 4,524 6,335 Activities suspended
Chad 200,000 89,654 53,660 61,255 79,757 25,156
Mali 100,000 109,879 27,480 41,820 75,550 108,172 74,106 65,818 58,893 44,156 94,242 80,292
Mauritania 70,095 34,451 30,063 34,330 34,451 5,337
Niger 126,000 42,577 37,260 37,088 36,082 37,664
Senegal 82,000 31,211 31,132 34,441 33,330 30,284 44,275 51,436 51,436
Gambia 22,500 - 14,969 20,967 20,906 Activities suspended
TOTAL 665,595 - 41,820 75,550 108,172 78,630 148,110 240,645 239,379 230,180 247,284 149,723 51,436 51,436
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Table 3: Number of pregnant and lactating women assisted vs. planned, January-October 2014
Pregnant and Lactating Women : January-October 2014 Country Number of Number of beneficiaries beneficiaries January February March April May June July August September October planned registered Chad 60,000 Activities suspended Mali 50,000 75,404 8,943 21,707 38,262 51,464 48,967 49,978 33,972 28,721 44,625 58,340 Niger 145,000 76,166 25,384 27,061 26,344 27,283 Senegal 50,000 Information not available TOTAL 352,565 8,943 21,707 38,262 51,464 48,967 75,362 61,033 55,065 71,908 58,340
Performance analysis
The results show that for most countries, initial planning figures were greater than the actual number of beneficiaries assisted.
Beneficiary registration The registration of beneficiaries takes place at each distribution for some countries, and for other countries only once at the commencement of activities. Ideally, registration should take place before each distribution in order to better track cohorts, thus allowing programmes to reach children attaining 6 months of age and those children exiting MAM treatment programmes.
Pipeline management Various difficulties were experienced over the past year in managing the pipeline of specialized nutritious foods for prevention programmes. This was especially the case in Burkina Faso, the Gambia and Mauritania, where breaks in the supply chain of specialized nutritional foods have led to the suspension of activities.
Monitoring and Evaluation Under the 2014-2017 Strategic Plan, WFP introduced indicators to be included in the monitoring, evaluation and analysis of acute malnutrition prevention activities: programme participation and programme coverage. These are to be collected during Post Distribution Monitoring (PDM). The collection of data on these indicators, and subsequent analysis, requires new methods of monitoring and evaluating nutrition activities and the support of new operational capabilities; a delay was seen in 2014 in the collection and analysis of these new indicators. To date, only three countries have managed to establish information on programme coverage and programme participation during the past year.
Table 4: Programme Coverage and Participation rates in Mali, Niger and Senegal in 2014
Country Participation (%) Coverage (%) SRF target value 66 70 Mali 72 76 Niger 92 76 Senegal 89 -
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The participation indicator is the proportion of the targeted population participating in a sufficient number of distributions: the results are satisfactory in Niger (92%), Mali (72%) and Senegal (89%). Participation rates have significantly exceeded the recommended threshold (66%) set by the 2014-2017 WFP Strategic Plan, indicating a satisfactory participation in the programme by the population. The somewhat lower percentage observed in Mali could be explained by the prevailing insecurity in some of the areas of implementation.
The coverage indicator is the proportion of the eligible population participating in the programme: only Niger and Mali have integrated the collection of this indicator into Post Distribution Monitoring exercises that were carried out during the implementation period. The coverage of programmes in Niger (76%) and Mali (76%) were above the recommended threshold (70%) set by the 2014-2017 WFP Strategic Plan.
Efforts are still needed to systematize the integration of these indicators into PDM survey exercises.
Acute malnutrition screening activities Screening activities of acute malnutrition were held during each distribution in Mauritania and Niger, and at the beginning of operations in Chad and the Gambia. There were no screening activities of acute malnutrition during distribution in Senegal as the partner that is in charge of WFP distributions already carries out a quarterly screening of children aged 6-59 months across all zones targeted by the national nutrition programme.
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Overview of Blanket Supplementary Feeding activities by Country in 2014
Burkina Faso
Targeting criteria The following regions, covered by generalized supplementary feeding programmes, have a GAM prevalence above 10% and high levels of food insecurity: Sahel, Centre-Nord, Centre-Ouest, Nord, Est and Centre-Est. According to the Harmonized Framework for the Analysis and Identification of Areas at Risk and Vulnerable Groups in the Sahel, based of HEA surveys, households in the provinces where intervention is taking place would potentially require emergency food assistance between April and September.
Individual targeting criteria Ration All children aged 6 to 23 months in covered zones Super Cereal Plus (those children screened that have SAM or MAM are referred to treatment (200g/day) centers and are also enrolled in prevention programmes)
Results The distribution of rations to beneficiaries took place at the household level by community health workers and under the supervision of partner NGOs. The strategy in 2014 was based on the integration of "cash for asset" activities.
The activities originally planned for the period from May to September 2014 had to be suspended in July due to lack of resources. Financing problems have also affected the distributions of May and June, which took place in only one of the six regions initially planned (the Sahel), barely reaching 10 % of planned beneficiaries.
Graph 1: Number of children assisted vs. planned in Burkina Faso, 2014
Number of children aged 6-23 months assisted
65 000
4 224 6 335
Number of planned May June beneficiaries
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Of the 65,000 planned beneficiaries, only 4,224 and 6,335 actually received the Super Cereal plus ration in May and June, respectively.
Acute malnutrition screening results
Table 5: BSFP site screening results in June, 2014 in Burkina Faso
Number MUAC Green MUAC Yellow (MAM) MUAC Red (SAM) Odema (SAM) of Month children Number % Number % Number % Number % screened June 4,908 4,821 98.2 66 1.3 21 0.43 0 0
Challenges faced The gap in resources has greatly affected nutrition activities, both prevention and treatment. Coverage has been significantly reduced as a result.
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Chad
Targeting criteria Regions targeted are those where the prevalence of GAM is greater than 15% (based on SMART surveys conducted in 2013 during the lean season and post-harvest in early 2014). Levels of food insecurity are also used in some occasions to further refine targeting (information based on ENSA and HEA surveys). BSFP activities are planned to take place in five regions (Ouaddai, Wadi Fira, Batha, Guera, and Kanem) that are located in the Sahelian band between July and September 2014.
Individual targeting criteria Ration
All children aged 6 to 23 months (those children screened that have SAM or MAM are referred to treatment centers and are also enrolled in prevention Plumpy’Doz (46g/day) programmes)
Super Cereal (215g/day) All pregnant and lactating women + oil (15g/day)
Results Distributions were carried out in villages at centralized distribution points, joining beneficiaries of several villages with the support of partner NGOs.
Programme coverage was significantly impacted by a lack of resources. By October, only 89,654 children had been registered (out of the 200,000 planned beneficiaries) for the duration of the intervention.
Graph 2: Number of children assisted vs. planned in Chad, 2014
Number of children aged 6-23 months assisted
200 000
79 757 53 660 61 255 25 156
Number of July August September October planned beneficiaries
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BSFP activities for PLW did not take place this year due to a lack in necessary resources; to compensate for a lack of Pumpy’Sup and Plumpy’Doz, the Super Cereal that had been planned for prevention activities for PLW was utilized for prevention and treatment activities for children.
In October, activities were only carried out in sites with beneficiaries returning from CAR, in Kanem and Waddi Fira (Biltine).
Acute malnutrition screening results
Table 6: BSFP site screening results in July, 2014 in Chad
Number MUAC Green MUAC Yellow (MAM) MUAC Red (SAM) Odema (SAM) of Month children Number % Number % Number % screened July 88,251 80,054 91 6,945 8 1,228 1 24 0.03
Challenges Distributions could cover Wadi Fira (Dar Tama, Kobe and Biltine), l’Ouaddai (Oura and assoungha), Batha (Fitri and Batha Est) and Kanem In order to ensure for the continuity of BSFP activities and in order to manage with the disruption in the supply of Plumpy’Doz, rations for children had to be replaced by Super Cereal (200g/day) with oil (15 g/day) and sugar (15g/day) in some areas.
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Mali
Targeting criteria The northern regions of the country (Gao, Timbuktu, and Kidal) and 3 pockets north of Mopti (formerly under the control of armed forces) were targeted for BSFP activities on the basis of recent surveys indicating a prevalence of GAM above 10% with the presence of aggravating factors (high mortality rates, poor access to care, etc.). Furthermore, a prioritization exercise was carried out as a result of data generated from the Early Warning System. An analysis of the Harmonized Framework showed that food insecurity is affecting more that 75% of households in some areas, and the exercise has enabled the identification of priority municipalities with very high vulnerability levels.
BSFP activities were implemented in Mali between January and October 2014.
Individual targeting criteria Ration Children aged 6 to 23 months (those children screened that have SAM or Super Cereal Plus MAM are referred to treatment centers and are excluded from prevention (200g/day) programmes until recovery) Pregnant and lactating women (those screened that are malnourished are Super Cereal (250g/day) referred to treatment centers and are excluded from prevention + oil (25g/day) programmes until recovery)
Results The distribution of rations to beneficiaries was carried out at sites in the villages. It is the staff of NGO partners that were responsible for carrying out the distribution of rations.
Graph 3: Number of children and PLW assisted vs. planned in Mali, 2014
Number of children aged 6-23 months and PLW assisted
108 172 100 000 94 242
80 292 75 550 74 106 65 818 58 893 58 340 50 000 51 464 48 967 49 978 41 820 44 156 44 625 38 262 33 972 27 480 28 721 21 707
8 943
Number of January February March April May June July August September October planned beneficiaries
Children aged 6-23 months PNW
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Distributions have been taking place since January in those areas that have been accessible. In July, BSFP activities were suspended in Tombouctou due to the evolving security situation. In August, distributions were carried out in 83 of the 88 communes that had planned for distributions; five communes could not be reached due to various reasons (security issues, delays in deliveries, pipeline breaks). Together, these setbacks have reduced the number of beneficiaries assisted during the months of July and August as only 68% and 49% of planned beneficiaries have been reached during these two months, respectively.
During the months of September and October, distributions were carried out as planned due to the availability of inputs at the intervention areas. The pre-positioning of food has proved effective and allowed the implementing partners to reach the figures that had been planned. The programme sought to reach 100,000 children and a total of 109,879 children were registered.
Challenges Ensuring the availability of inputs to enable operational partners to implement distributions on time has been a challenge. Minimizing the security risk associated with reaching targeted areas has proven difficult. The security situation continues to be problematic, and limits access to distribution sites for beneficiaries and partners.
Monitoring and Evaluation BSF activities in Mali extended over a period of ten distributions. One PDM, which included measures of programme participation and coverage, was carried out after the tenth distribution. The PDM demonstrated that the programme coverage was 75.8% and the programme participation was 71.6%. Participation and coverage rates were higher than target values established in the 2014-2017 SRF. The PDM survey was carried out by a consultant, hired by the CO, with the support of the M&E team in processing and analyzing the data.
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Mauritania
Targeting criteria A total of eight regions have been targeted based on GAM prevalence, as indicated in the July 2013 SMART survey. WFP has been implementing operations in three of the targeted eight regions (Gorgol, Guidimakha, and Brakna), while UNICEF is supporting prevention activities in the five other regions (those not covered by WFP). BSFP activities took place in Mauritania between June and September 2014.
Individual targeting criteria Ration
All children aged 6 to 23 months in covered zones (those children screened that have SAM or MAM are referred to treatment centers and are excluded Plumpy’Doz (46g/day)
from prevention programmes until recovery)
Achievements to date Project document planning figures include 210,287 children and 142,695 PLW and represent those beneficiaries in the eight regions that WFP plans to reach in 2015. For this year, the number of planned beneficiaries to reach in the three regions currently covered by WFP is not reflected in these documents, as it is an operational figure.
For that which concerns children aged 6-23 months, distribution sites had been approved and were functioning well. Geographic programme coverage corresponds to initial planning. However, the number of children registered has been less than the number of children planned to reach due to the limited number of resources.
PLW could not be assisted because of the pipeline break in the supply chain, related to the lack of availability of financial resources. The activity was implemented at the community level, and the distributions were carried out in villages by the staff of local partner NGOs.
Graph 4: Number of children assisted vs. planned in Mauritania, 2014
Number of children aged 6-23 months assisted
73401
34 330 34 451 30 063
5 337
Number of June July August September planned beneficiaries
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It should be noted that planned values were not reach; 34,451 children were registered in the programme out of the 70,000 planned.
Acute malnutrition screening results
Table 7: BSFP site screening results in June, July, August and September, 2014 in Mauritania
Number MUAC Red MUAC Green MUAC Yellow (MAM) Odema (SAM) of (SAM) Month children Number % Number % Number % screened June 34,928 32,104 92 2,432 7 393 1 0 0 July 36,231 34,330 95 1,573 4 328 1 0 0 August 36,966 34,451 93 2,109 6 406 1 0 0 September 5,732 5,337 93 331 6 64 1 0 0
Screening results, carried out during distributions, indicate a stable prevalence of acute malnutrition among children aged 6 to 23 months targeted by this activity. These results tend to demonstrate the impact of this seasonal programme on the prevention of acute malnutrition among the most vulnerable populations in the most critical time of the year.
Challenges Financial constraints have limited the implementation of certain activities (i.e. active screenings carried out on a large level, regular trainings for implementing partners). Pipeline breaks in Super Cereal strongly impacted activities during the month of September.
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Niger
Targeting criteria Geographic targeting is based on established regional plans of support and HEA surveys that identify those households that are poorest. A total of seven regions are covered by BSFP activities: Agadez, Tahoua, Diffa, Zinder, Maradi, Dosso, and Tillabéry. BSFP activities took place in Niger between June and September 2014.
Individual targeting criteria Ration
Children aged 6 to 23 months from the poorest households in targeted Super Cereal Plus zones (those children screened that have SAM or MAM are referred to (200g/day) treatment centers and are also enrolled in prevention programmes)
Pregnant and lactating women from the poorest households (those Super Cereal screened that are malnourished are referred to treatment centers and are (250g/day) + oil excluded from prevention programmes until recovery) (25g/day)
Results Due to financial constraints, it was necessary to reduce the number of targeted communes from 119 to 69. Decisions were made in collaboration with implementing partners and based on vulnerability analyses. These changes explain the differences in the number of planned and assisted beneficiaries.
Distributions are organized by NGO partners in the villages targeted; NGO partners are supported by the health workers and community volunteers. The distribution site is usually chosen in coordination with the authorities and must be close to water and shaded.
Graph 5: Number of children and PLW assisted vs. planned in Niger, 2014 Number of children aged 6-23 months and PLW assisted
145 000 126 000
37 260 37 088 36 082 37 664 27 283 25 384 21 380 26 344
Number of June July August September planned beneficiaries Children aged 6-23 months PLW
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In September, 64,947 women and children (or 24% of planned beneficiaries) received supplementary food rations. In September, distribution levels reached their maximum levels; 30% and 19% of the number of children and PLW planned were assisted, respectively. Overall, the total number of children enrolled in the programme was 42,577, compared to the 126,000 that were planned.
Acute malnutrition screening results Table 8: BSFP site screening results in June, July, August and September, 2014 in Niger
Number of MUAC Yellow MUAC Green MUAC Red (SAM) Odema (SAM) Month children (MAM) screened Number % Number % Number % June 24,632 22, 467 91 1,846 7 312 1.3 8 0.0003 July 29,191 26,354 90 2,422 8 393 1.3 22 0.0008 August 33,298 30,795 92 2,160 6 341 1.0 2 0.0001 September 33,825 31,774 94 1,745 5 305 0.9 1 0.0000
Screening results, carried out during distributions, indicate improvements in prevalence of acute malnutrition among children aged 6 to 23 months targeted by this activity. The prevalence of severe acute malnutrition and the prevalence moderate acute malnutrition both decline during these months. These results tend to demonstrate the impact of this seasonal programme on the prevention of acute malnutrition among the most vulnerable populations in the most critical time of the year. It should be noted however that the number of children screened is less than the number of children reached by programmes, explained by the fact that all children are not present on the day of distribution (even if it was asked of the mothers to bring their children during this time).
Challenges • Difficulties in the timely collection of monthly monitoring reports. • During the months of June and July, rations for children included Super Cereal and oil due to the fact that the necessary stocks of Super Cereal Plus had not yet arrived. The situation had been resolved in August.
Monitoring and Evaluation In Niger, two Post Distribution Monitoring surveys were conducted during the implementation of the programme. The second survey had collected data for programme coverage and participation. The results revealed that the target value (66 %) for the participation indicator has been reached; programme participation was at 92%. The target programme coverage of 70%, set by the 2014-2017 SRF, was also met; programme coverage was at 76%. The PDM surveys were conducted by the National Institute of Statistics in collaboration with WFP for specific aspects related to the calculation of these indicators.
The following recommendations were made in the context of future interventions: • Reflect on proper actions to be taken in the context of improving the quality of screening at distribution sites. • Review the requirements for the registration of beneficiaries for future operations to achieve planned figured. • Keep the monitoring and evaluation system updated during programme implementation. • Continue to support the implementation of the activities through supervision in order to improve data quality.
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Senegal
Targeting criteria Six zones have been selected according to the following criteria: GAM prevalence greater than or equal to 15% GAM prevalence greater than or equal to 10% with the presence of aggravating factors (analysis indicating greater that 30% of households experiencing a food insecurity)
Four departments (Matam, Kanel, Ranérou and Podor) have a GAM prevalence above 15% and two departments (Médina Yoro Foulah and Bounkiling) have a GAM prevalence above 10% and food insecurity levels surpassing 30%. However, these two departments could not be reached due to the availability of resources this year. BSFP activities took place in Senegal between June and December 2014.
Individual targeting criteria Ration Super Cereal Plus All children aged 6 to 23 months in covered zones (no screening) (100g/day) Super Cereal (150g/day) Pregnant and nursing women (no screening) + oil (25g/day) Results The registration of beneficiaries took place only at the time of the first distribution; in total, 31,211 children had been registered. New beneficiaries are included in the programme each month either because their parents were absent during the first census (nomadic populations) or because they attained 6 months and thus became eligible for programme entry.
Distributions of rations took place both at health facilities and at the community level. The distribution of rations to PLW is carried out at health centers by health personnel. Regarding children aged 6-23 months, distributions take place both in health centers and in villages. At the community level, NGO partners of the Cellule de Lutte contre la Malnutrition are responsible for distributions; they are assisted by community volunteers.
Graph 6: Number of children assisted vs. planned in Senegal, 2014
Children aged 6-23 months assisted 82 000
51 436 51 436 44 275 31 132 34 441 33 330 30 284
Number of June July August September October November December planned beneficiaries
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In August, 41% of the children aged 6-23 months (planned to be reached under the programme) received rations Super Cereal Plus. The highest number of children aged 6-23 months reached (63% of planned figures) was recorded in November.
Due to the strike of health workers, data on the assistance to PLW has not been transmitted to the WFP. Negotiations are currently underway in order to retrieve the information that is being withheld.
Challenges It has been difficult to know the number of women assisted due to the movements of those working in health centers. Certain sites have been inaccessible in Kanel and Ranérou due to the existence of heavy rains.
Monitoring and Evaluation - The first Post Distribution Monitoring survey, conducted in August, found that about 75% of the beneficiaries are participating in educational sessions and that nearly 99% of the participants are women. Among those surveyed, about 78% of the women think that these tips have been useful for them and their children. However, there remains more than 10% of women that do not understand the advice given. - A second Post Distribution Monitoring survey was carried out in 600 households in 30 villages in three departments of Matam (Matam, Kanel and Ranérou). The results were used to calculate beneficiary participation in the programme. According to the results, 89% of beneficiaries participated in a sufficient number of distributions. This result is satisfactory when compared to the 66% standard set by 2014-2017 SRF. The PDM was conducted by the Country Office with the support of the M&E unit in the supervision of data collection. Data processing and analysis were carried out by a consultant from the CO.
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The Gambia
Targeting criteria The two regions targeted, Upper River and Central River, are those where the GAM prevalence is greater than or equal to 10 %. BSFP activities took place in the Gambia between June and October 2014. The programme was suspended in August 2014 due to the pipeline break in Super Cereal Plus.
Individual targeting criteria Ration
All children aged 6 to 23 months (those children screened that have SAM or Super Cereal Plus MAM are referred to treatment centers and those with MAM are also (200g/day) enrolled in prevention programmes; those with SAM are excluded until
recovery)
Results A workshop was held during the month of May to examine experiences in 2013 and take away lessons learned. It was decided that distributions would be carried out at the community level by the government agency in charge of disaster and risk management. The rations were distributed by members of food management committees under the supervision of NDMA (National Disaster Management Agency).
Graph 7: Number of children assisted vs. planned in the Gambia, 2014
Number of children aged 6-23 months assisted
22 500 20 967 20 906
14 969
Number of planned June July August beneficiaries
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The distributions were carried out according to plan up until August, with more than 90% of planned beneficiaries reached. Due to the pipeline break in Super Cereal Plus, the activities that were supposed to continue until October were halted after August.
Acute malnutrition screening results Table 9: BSFP site screening results in June and July, 2014 in the Gambia
Number MUAC Yellow MUAC Green MUAC Red (SAM) Odema (SAM) of (MAM) Month children Number % Number % Number % screened June 14,994 14,023 94 948 6 23 0,2 - - July 25,303 23,824 94 1,409 6 70 0,3 - -
Monitoring and Evaluation A PDM took place in August 2014 and the results are in the process of being finalized
Challenges A pipeline break in Super Cereal Plus caused the cessation of activities in September.
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CONCLUSION
Seasonal acute malnutrition prevention activities in the Sahel experienced mixed results in 2014, depending on the country. In seven countries, a lack of resources impacted BSFP activities and, according to the context and the country priorities, these affected countries adopted different strategies in order to try and continue to provide services to those populations most vulnerable. Ultimately, despite these efforts, programmes did not reach planned beneficiary figures; a total of 250,000 children under the age of two and 75,000 PLW were assisted during the lean season, accounting for 64% and 21% of planned targets, respectively.
BSFP activities to prevent acute malnutrition, and thus indirectly reduce stunting, are among the interventions that have been demonstrated to have an impact on the reduction of undernutrition and mortality, if and only if, they are implemented on a sufficient scale. In this sense, the results of the studies in Niger on programme coverage and programme participation are reassuring. In those areas targeted by seasonal prevention activities, coverage and participation rates are quite satisfactory, meeting and exceeding the thresholds established in the 2014-2017 WFP Strategic Plan. These results mean that, in the surveyed areas, the children under 2 years of age reached by prevention activities regularly received complementary foods rich in nutrients.
Acute malnutrition screening results, conducted systematically before distributions, are an insightful source of information and establish data on the evolution of acute malnutrition among cohorts of beneficiaries. Screening results obtained in Niger and Mauritania in particular demonstrate a trend in lower levels of moderate and severe acute malnutrition. Looking at these results in conjunction with coverage and participation indicators suggests that seasonal prevention activities helped to stabilize the nutrition situation for many children during the time of the year where the incidences of food insecurity and childhood diseases are the highest.
The offering of services integrating nutrition, health and social protection with support to food security is another essential condition in the sustainable reduction of undernutrition and infant mortality. The recent publication (Langendorf et al) focusing on the impact of specific nutritional supplementation, combined with support for household food security, on the reduction of undernutrition highlights the need for better coordination between partners from different sectors in providing essential services for the survival and healthy development of new generations.
In 2015, efforts will be needed to harmonize the collection of information required in order to better measure the impact of seasonal activities in preventing undernutrition. This entails including routine screening before each distribution and implementing evaluations of programme coverage and programme participation.
In a world of crisis, while resources are limited, the demonstration of the impact of these programme will further permit the mobilization of necessary resources for the scaling up of these essential activities aiming at reducing undernutrition and infant mortality.
Overall, WFP complementary food distribution channels can provide a solid platform for reaching the most vulnerable populations with a minimum package of health and nutrition services. In 2015, improved coordination with health partners and the WASH program is necessary in trying to integrate services with the same objective of reducing undernutrition and infant mortality.
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Photo: WFP/Rein Skullerud
CONTACT For more information, please contact the Nutrition Unit at WFP’s Regional Bureau for West and Central Africa: Kinday Samba, Senior Regional Nutrition Advisor ([email protected]) Nicolas Joannic, Regional Nutrition Advisor ([email protected]) 23