Reporting fiscal year FY2019

Awardee name International Rescue Committee, IRC

Host/implementation country Award number 72DFFP18GR00060

Activity name Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali Activity start date August 1, 2018 Activity end date November 30, 2019 Submission date (21/19/2019) List of ARR documents uploaded in  ARR Narrative FFP PRT  Indicator Table (included in the narrative)  Annex 1 : Post Distribution Monitoring Report 3  Annex 2: Distribution Report (4th e- vouchers distribution)  Annex 3: Focus Group Discussions Report

Awardee HQ contact person Name, International Rescue Committee Email, Phone, Office Address 122 East 42nd Street, New York, NY 10168, USA Telephone: + 1 (212) 551-3015 Fax: + 1 (212) 551-3185 Erika Pearl, Program Officer E-mail: [email protected] Awardee host country contact person Franck Vannetelle, IRC Mali Country Name, Email, Phone, Office Address Director Email: [email protected] Telephone: +223 71287791

Contents

Acronym List ...... ii Activity results ...... iii Award Summary ...... 1 Output reporting ...... 2 a. Identification of beneficiaries ...... 3 b. Cash distribution ...... 4 Voucher distribution ...... 4 Electronic voucher distribution ...... 6 c. Post-Distribution Monitoring Survey ...... 8 d. Complementary activities ...... 9 Training of beneficiary households MUAC measurement ...... 9 Training of nutrition focal points on referral of SAM/MAM children ...... 9 Screening and referral of SAM/MAM children ...... 10 Training of Community Development Officers on a new approach on IYCF (Infant and Young Child Feeding) listening and counseling ...... 11 Training and follow-up of IYCF groups on the counseling approach for sensitizations ...... 11 Promotion of good nutritional and hygiene practices ...... 12 Outcome and Process Reporting ...... 12 Market, Lrip, and Modality Actuals ...... 13 Cross-Cutting Elements ...... 15 Challenges, Successes, and Lessons Learned ...... 15

Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 21, 2019 i

Acronym List

FGD: Focus Group Discussion

CDA: Community Development Staffs

ComHC: Community Health Center

CSI: Coping Strategy Index rCSI: Reduced Coping Strategy Index

DTC: Technical Director of the Health Centers

EVISA: Methodology for Listening, Valuing, Informing, and Suggesting, with Authenticity

FCS: Food Consumption Score

HEA: Household Economic Approach

IRC: International Rescue Committee

IYCF: Infant and Young Child Feeding

MAM: Moderate Acute Malnutrition

MUAC: Mid-Upper Arm Circumference

PDM: Post-Distribution Monitoring

SAM: Severe Acute Malnutrition

SLDSES: Local Service for Social Development and the Solidarity Economy

Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 21, 2019 ii

Activity results

Cash Food Voucher Transfer Planned number of transfer/vouchers for the reporting period 170,813 73 USD (paper vouchers for 3- months of food assistance) Value of Individual Transfer (USD) 48,5 USD (e-vouchers for 2- months of food assistance) Total amount approved (USD) for cash/vouchers for reporting period 963,360 USD Actual number of Vouchers/cash distributed for reporting period 169,109 Actual number of Vouchers/cash Redeemed for reporting period 169,109 # of months of distribution 31 / 62 / 73 / 84 / 95 / 106 Average cost per participant 73 USD Cost per month 24 USD 1 distribution7 / 3 Frequency of transaction distributions8 Total actual cost USD for cash/vouchers for reporting period 962,292 USD Planned participants for the reporting period (male) 3,345 Planned participants for the reporting period (female) 1,591 Actual number of participants reached (male) 3,345 Actual number of participants reached (female) 1,591 Time from signed agreement to the first distribution to beneficiaries if 35 days applicable to this reporting period

1 For 4,736 beneficiaries of paper vouchers (distribution 1). 2 For 4,736 beneficiaries of paper vouchers (distribution 2). 3 For 200 beneficiaries of electronic vouchers (distribution 1). 4 For 4,736 beneficiaries of paper vouchers (distribution 3) and 200 beneficiaries of electronic vouchers (distribution 2). 5 For 200 beneficiaries of electronic vouchers (distribution 3). 6 For 200 beneficiaries of electronic vouchers (distribution 4). 7 For 4,736 households benefitting from paper vouchers distribution 8 For 200 households benefitting from electronic vouchers distribution

Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 21, 2019 iii

Award Summary The region of Nara in Southern Mali remains particularly vulnerable to food insecurity. This project in Nara covers the six communes of the district (Nara, Dilly, , Niamana, and ) corresponding to 131 villages and is aiming at contributing to the sustainable improvement of food security and nutritional status for vulnerable households in Nara district, targeting 4,936 households. To achieve this goal, the IRC directly contributes to increase their ability to purchase food on the local markets while reducing the use of negative coping mechanisms (reduction of the number of meals eaten per day, using seeds stock to fill up food needs, selling of livestock and agricultural assets, etc.) that affects long-term livelihoods recovery. The security context in Nara remained particularly volatile during the reporting period and has been marked by banditry, armed robberies and kidnapping, especially in the communes of Dilly and Niamana, along with an increase of Malian military patrols in Niamana commune. Moreover, because of radical armed group threats, schools have been closed during the 2018-2019 schoolyear in some villages of sub prefecture where jihadists groups are present, and teachers kidnapped. However, these security incidents did not directly impact the implementation of IRC project, except in September 2018 when one of IRC vehicle was stolen, delaying the implementation of activities as the IRC suspended all activities in the area from November 5 to 10, 20189. To mitigate the risks, the IRC decided to use motorbikes instead of cars for visits to the field. The lean season for the year 2018-2019 in Nara’s district has been robust with 20 inches of rain within 27 days against 17 inches for 29 days at the same period last year (from the months of April to August). Rain fell from May to September 2019. Thus, the total areas planted in Nara’s district for 2019 have been estimated by the Local Agricultural Service at 191,016 hectares of millet, sorghum, cowpea, groundnuts, sesame and okra, 95% of the 200,646 hectares targeted due to the early exhaustion of stocks at household level following the poor 2017-2018 season). However, despite these encouraging figures, the current agricultural season is seriously threatened by the presence of crop-destroying predators such as grasshoppers, rats and granivorous birds. In addition to that, the floods that occurred in the communes of Fallou, Dilly, Ouagadou, Nara and Guire at the end of August 2019 caused an early loss of more than 345 hectares of agricultural crops. These floods have also led to the interruption of basic social services and to the closure of roads which has made some areas and weekly markets inaccessible for the populations (Fallou, Sountiana, Kolomina and Ngai markets). Thanks to the abundant vegetation cover in the area of the project intervention the livestock had an abundance of grazing areas, however in some areas wells are not protected from livestock, and this raises health concerns for the populations because of the risk of water contamination by the animals.

9 This incident was reported in the first quarterly report (July-September 2018) submitted to FFP on October 31, 2018 as well as in the second quarterly report (October-December 2018) submitted on January 31, 2019. An official notification was sent to FFP on November 6, 2018. 1 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

Output reporting

Number of participants reached per month10 Annual total participants (unique) Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Female: Planned n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Female: Actual n/a n/a 1,429 n/a 1,429 n/a 59 1,591 59 59 n/a n/a 1,591 Male: Planned n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Male: Actual n/a n/a 3,307 n/a 3,307 n/a 141 3,345 141 141 n/a n/a 3,345

Overall objective: Contribute to the sustainable improvement of food security and nutritional status for vulnerable households in Nara district, Mali QR1 QR2 QR3 QR4 QR5 Indicator Baseline Target Comments value value value value value Specific objective 1: Strengthen the capacity of vulnerable households to meet their basic food and nutritional needs, avoid negative coping strategies, and prevent acute malnutrition in children under five and pregnant and lactating women Number of vulnerable households receive three N/A 4,936 N/A 4,925 4,936 4,936 4,936 - quarterly vouchers during the project period Number of households receiving food vouchers that have an 4,936 4,936 acceptable Food Consumption 444 3,105 N/A N/A N/A - PDM2 PDM3 Score by the end of the project period Percentage of improvement of the average reduced Coping 57% 49% 43% Strategy Index (rCSI) score of 91% 30% N/A N/A - PDMI PDM2 PDM3 households receiving food vouchers improves Specific objective 2: strengthen coverage of malnutrition prevention services for children under five in vulnerable food- insecure households Number cases of SAM detected by trained beneficiaries and N/A 257 0 0 19 126 191 N/A referred to health centers for treatment See Percentage of SAM cases paragraph referred by trained beneficiaries N/A 90% 0% 0% 100% 100% 89% in the to health centers that are narrative admitted for treatment for details

10 For this project the targets of participants were no determined monthly, but for each distribution. 2 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

a. Identification of beneficiaries The 4,936-beneficiary households were identified in collaboration with the local NGO CSPEDA and the national governmental program Jigisemjiri, both working in the area to avoid the duplication of aid. To prevent this from happening, the IRC, CSPEDA and the Jigisemjiri program have shared their beneficiary lists to ensure that beneficiaries were not already included in their program. The identification of beneficiaries was based on the Household Economy Approach (HEA) – that is looking at the vulnerability of households through the basic food security indicators (food consumption score, coping strategy index, etc.) – to select the most vulnerable households in the 131 villages of the six targeted communes. The identification of the beneficiaries took place during the June – September 2018 quarter. The process of beneficiaries’ selection followed three main phases:  Phase 1 – Establishment of beneficiary pre-targeting committees The IRC set up 273 pre-targeting committees (two per village) consisting of community leaders, members of women’s organizations, and youth community members, along with 131 management committees to oversight the pre-targeting committees and ensure impartiality and neutrality in the selection of beneficiary household. Selection criteria based on the HEA approach (FCS, CSI, rCSI, market analysis, etc.) were also presented to these committees to ensure the effective targeting of the most vulnerable households.  Phase 2 – Households survey A household survey was then conducted for the beneficiaries identified by the pre- targeting committees. The survey was aiming at confirming or not the vulnerability status of the pre-targeted beneficiary households through the application of HEA criteria and methodology.  Phase 3 – Community validation of the list of beneficiary households Following the household survey, the IRC presented the list of the final beneficiaries identified for this project during community assemblies and explained again at the same time the selection process to the communities to prevent any tension that might emerge following the communication of the beneficiaries selected. At the end of the process, 4,936 households were selected, including 200 households that will be supported through another methodology than the distribution of paper vouchers with electronic payment. However, during the first papers vouchers’ distribution which took place between November 24 and December 15, 2018, out of the 4,936 beneficiary households previously identified, 11 were found to be already included in the Jigisemijiri project or to be double counted on the IRC list. To replace these beneficiary households, the IRC organized a mission on January 29, 2019 to identify 11 new beneficiary households, still in collaboration with the targeting and complaints committees already established in the villages. On the 4,936 beneficiary households targeted for this project, 1,591 households are women headed households (32%).

3 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

Table 1: Number of beneficiary households per commune

Number of beneficiary Number of villages Men head of Women head Communes households / neighborhoods household of household 1,007 Nara 12 508 499 (incl. 159 for e-vouchers) Fallou 862 36 710 152 Dilly 1,335 42 845 490 557 Ouagadou 7 420 137 (incl. 41 for e-vouchers) Koronga 338 4 206 132 Niamana 837 30 656 181 Total 4,936 131 3,345 1,591

b. Cash distribution Voucher distribution Since the beginning of the project, a total of 4,736 households have benefitted from a cash transfer of 120,000 XOF ($219) split in three trimestral transfers of 40,000 XOF each ($73) – the first one in November and December 2018, the second one in February and March 2018 and the third and final one in May 2019. All the distributions were supervised by both the IRC team and the Local Service for Social Development and the Solidarity Economy (SLDSES) of Nara’s district and followed these steps: 1. Organization of distribution sites in the communes where the project is implemented (25 sites selected) Table 2: Number of distribution sites per commune

Number of beneficiary Number of villages / Number of Communes households neighborhoods distribution sites Nara 848 12 4 Fallou 862 36 6 Dilly 1,335 42 7 Ouagadou 516 7 2 Koronga 338 4 2 Niamana 837 30 4 Total 4,736 131 25

2. Sensitization of beneficiary households on the functioning of the voucher methodology, on how to use the vouchers on the local markets, and on the quantity and the quality of the food products available;

4 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

3. Identification of beneficiary households using national identity cards, NINAs national identity cards with biometric data and beneficiary cards; 4. Beneficiaries signed the distribution list to confirm they received their vouchers; 5. And distribution of 12 food vouchers per beneficiary household. For each distribution, each beneficiary household received 12 food vouchers for a total of 40,000 XOF ($73) per household to cover the food ration for three months. The values of the vouchers distributed are the following:  Three vouchers for cereals (corn, rice, etc.) which is approximately representing 20 kg of millet or 12 kg of rice for 18,000 XOF (30.50 USD)  Three vouchers for animal proteins (meat or fish), representing 1,5 kg of meat or 1 kg of fish for 12,000 XOF (20.50 USD)  Three vouchers for cooking oil representing two liters for 6,000 XOF (10 USD)  Three vouchers for condiments representing 4,000 XOF (7 USD) Table 3: Number of vouchers distributed by the IRC to the beneficiary households

Date of Number of vouchers Value in XOF Value in USD distribution distributed 57,832 192,106,600 November 24 to (12 vouchers per household 1st (40,000 XOF x 4,736 December 15, for 4,736 households 324,660 distribution ménages + 13,333 XOF x 2018 + 4 vouchers per household 200 ménages) for 200 households11) 56,832 189,440,000 2nd February 28 to (12 vouchers per household (40,000 XOF x 4,736 320,154 distribution March 15, 2019 for 4,736 households) ménages) 56,832 189,440,000 3rd May 7 to May (12 vouchers per household (40,000 XOF x 4,736 320,154 distribution 21, 2019 for 4,736 households) ménages) TOTAL - 171,296 570,986,600 964,968

Table 4: Number of vouchers and total amount exchanged between the IRC and the local traders

Number of vouchers Date Value in XOF Value in USD exchanged December 18 to 24, 2018; January 99,109 336,007,723 567,853 2 to 22 and February 18, 2019 April 23 to April 26 and 58,873 188,703,084 318,908 June 10 to June 14, 2019 July 1 to July 17, 2019 10,948 42,902,787 72,506 Total 168,929 567,613,594 959,267

11 Because the Master Card Aid system for the e-vouchers was not ready yet for the first distribution of vouchers, the IRC decided to support the 200 households with paper vouchers for an amount of 13,333 XOF each corresponding to one month of assistance. 5 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

In return of these vouchers by the local traders, the IRC has proceeded to the payment of the local traders by Orange Money, bank transfer or by check for a total amount 567,613,594 XOF ($ 959,267) since the beginning of the project. 64 local traders, including 18 women, trained on the voucher’s methodology between October and December 2018, have participated to the vouchers’ exchanges on the local markets of Nara, Dilly, Niamana, Koronga, Fallou and Ouagadou. For each round of the three distributions, the IRC has then organized meetings with the local traders and focusing on the reception, the counting and the verification of the food vouchers received. During these sessions, 168,929 vouchers were received for a total value of 567,613,594 XOF (representing $ 959,267). At the end of the reporting period, a total of 2,367 vouchers were still missing and has not been paid to the local traders representing a total amount of 3,373,006 XOF ($ 5,701) which can be explained by many reasons that might have occurred at two level. The first one, the beneficiary households might not have visited the local traders because one or more of its vouchers were lost, or because the beneficiary did not want to purchase some speculations. The other possibility concerned the local traders that also might have lost the vouchers received by the beneficiaries and in thus, cannot been paid without presenting the vouchers to the IRC, or will provide the vouchers to be paid later. More information will be provided during the final report. What is important to note is that no complaints have been received by the IRC. Electronic voucher distribution IRC, in collaboration with the SLDSES, has distributed 200 electronic vouchers to 200 households in the communes of Nara and Ouagadou (159 and 41 beneficiary households respectively) in the villages of Kabida, Bamabara, Kabida Soninke, Berguenare and .

Table 5: Number of beneficiaries per commune

Number of e-vouchers Number of local beneficiary households Number of Communes traders working Local markets through the system villages with e-vouchers MasterCard Aid

Nara 159 3 4 Nara Ouagadou 41 1 3 Goumbou Total 200 4 7

Three missions have been carried out to distribute the electronic vouchers in April, May and June 2019. For each round of electronic vouchers exchanged in the local markets, seven traders including two women participated.

6 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

Table 6: Organization of the electronic vouchers’ distribution

Distribution dates Amount distributed Number of beneficiaries 26,666 points of electronic payment 199 households April 4 to April 24, 2019 26,666 points of electronic payment + 1 household12 13,333 XOF of paper vouchers May 25 to May 27, 2019 26,666 points of electronic payment 200 households June 11 to June 17, 2019 26,666 points of electronic payment 200 households July 3 to July 10, 2019 26,666 points of electronic payment 200 households

For each distribution, each household has benefited from an e-voucher worth 26,666 points which corresponds to eight paper vouchers for two months of food assistance (26,000 XOF or 45 USD) and to ensure food diversity is composed by:  8,000 points for animal proteins (meat or fish), representing 8,000 XOF (13.5 USD)  4,000 points for cooking oil, representing 4,000 XOF (7 USD)  2,666 points for condiments, representing 2,666 XOF (4.5 USD)  12,000 points for cereals (corn, rice, etc.), representing 12,000 XOF (20.5 USD) In total, each beneficiary household has received 80,000 points of electronic vouchers point for six months of food assistance in three rounds of distribution, except one household that received an additional 13,333 XOF ($24) to cover one more month of food assistance as this household had not received vouchers in the previous distribution13). The electronic vouchers system was supposed to be ready in February-March 2019, however the process was delayed because of delays in the deployment of the electronic voucher system, and the system was finally operational only in April 2019. For this reason, the 200 beneficiary households have first been supported with paper vouchers during a first distribution in November and December 2018. The IRC, in partnership with the SLDSES, directly supervised the exchange of electronic vouchers between beneficiaries and traders in the market to monitor the activity, ensure strict compliance and respect of the electronic voucher exchange procedures, control the quality of the products exchanged and the quantities distributed to each household, and guarantee the proper use of the dedicated electronic devices used for this activity (tablets, beneficiaries’ electronic cards, and MasterCard Aid terminals). Before the distribution and exchange of electronic vouchers in the local markets, the IRC staff, the local traders and the beneficiary households benefitted from a day-long training on how to use the equipment for the exchanges, as well as the mechanism for operating the MasterCard Aid system. This training took place in Nara and Goumbou from April 4 to April 9, 2019. 218

12 During the identification of beneficiaries, one of the 200 households was already part of the Jigismejiri program, and was therefore replaced by another household. This later household received during the April distribution the due vouchers from the past distribution (December 2018). 13 During the identification of beneficiaries, one of the 200 households was already part of the Jigismejiri program, and was therefore replaced by another household. This later household received during the April distribution the due vouchers from the past distribution (December 2018). 7 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

individuals including 62 women and 156 men have been trained by the IRC who developed the training module. c. Post-Distribution Monitoring Survey For each distribution of paper vouchers, the IRC has conducted Post-Distribution Monitoring (PDM) surveys. The focus group discussions (FGD) collected quantitative and qualitative data to complement the surveys. Between the first and the second PDM from January 11 to January 22, and from April 11 to April 19, 2019, the proportion of beneficiary households with a poor food consumption score (FCS) decreased from 52% to 0% (with a FCS increasing from 28 points – “poor” – to 45 points – “acceptable”), while the proportion of non-beneficiary households with a poor FCS decreased from 27% to 17% due to the re-dynamization of the markets in the area with the increase in the numbers of people visiting the local markets and in the products available there. Among the beneficiary households, the PDM 3 results illustrate that 100% of the beneficiaries have now an acceptable FCS with an average of 71 points. Before this project, almost all the project interviewed (91%) were in a situation of food insecurity or at risk of food insecurity. Moreover, the average Coping Strategy Index (CSI) of beneficiary households was two against five for non-beneficiary households during PDM1 and PDM2. The most recent PDM 3 conducted from June 21 to June 28, 2019 illustrated that the CSI for households benefiting from the program decreased by 95% from the start of the project (from 20 to 1 points). In parallel, the CSI for non- beneficiary households decreased by 90% (from 20 to 2 points). The PDM 3 shows that 57% of beneficiary households declared not using coping strategies to cover their food needs in contrast to 46.5% of non-beneficiary households. Whether they are beneficiary or non-beneficiary households, it is however worth noting that the coping strategies used (reduction of the number of meals eaten per day, change in the preferred food products etc.) although negative are less damaging than other serious negative coping strategies that had been witnessed in the past, such as selling economic assets of the beneficiary households (livestock or property) and consuming of seed stock held for the next season; strategies which have long-term destructive impacts on the household. The coping strategies used by the beneficiary households are: 1) consume less appreciated food because it is cheaper, 2) borrow food or rely on the help of family or peers, 3) reduce the portion size of meals, 4) reduce the number of meals taken per day. In terms of qualitative data, beneficiary households have reported no cases of disputes, conflicts or confrontations during the distribution process; the same applies to the members of the targeting and management committees within the villages of intervention. Finally, the project has had a positive effect on the practice of income-generating activities (IGA) as 24% of the beneficiaries have declared practicing one compared to only 4% at the beginning of the project. More information can be found in the previously submitted PDM1 and PDM2 as well as Annex 1 – Post Distribution Monitoring Report 3.

8 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

d. Complementary activities

Training of beneficiary households MUAC measurement The IRC Community Development Staffs (CDAs) and the nutrition focal points regularly carried out capacity-building activities during weekly visits to the voucher distribution villages focusing on how to take a MUAC measurement. Between January and March 2019, all 4,936 beneficiary households were trained on the MUAC measurement and the detection of edema by the nutrition focal points, including 1,591 women head of household. Each household trained has received one Shakir band – used for measuring the MUAC – to be able to proceed to the malnutrition screening for children under five. Table 7: Number of households per village that have benefitted from capacity-building to screen malnutrition for children under 5.

Number of beneficiary Number of Number of households trained on Communes focal points per Total villages MUAC commune Male Female Nara 12 50 508 499 1,007 Ouagadou 42 67 845 490 1,335 Fallou 7 28 420 137 557 Dilly 4 17 206 132 338 Koronga 30 42 656 181 837 Niamana 36 43 710 152 862 Total 131 247 3,345 1,591 4,936

Training of nutrition focal points on referral of SAM/MAM children Between January and March 2019, 247 nutrition focal points (one focal point for 20 beneficiaries, including 207 men, 40 women) in the communities were selected during community general assemblies according to selection criteria (knows to read and write, demonstrates motivation, is a beneficiary of food voucher, has gained acceptance from the community). The 247 focal points were trained by the IRC between January 11 to 26 (223 focal points trained) and February 12 to 22, 2019 (24 focal points trained) on their roles and responsibilities, on filling in the tools for referencing children to the appropriate health centers, as well as on the measurement of the MUAC and the finding of edema. The IRC facilitated the training sessions in 17 health areas in the six communes of intervention targeted by the project, in which the Technical Director of the Health Centers (DTC) and the nutrition officers of the 17 areas also participated (one in each community health center).

9 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

Table 7: Number of nutritional focal points and nutrition officers per commune and disaggregated by sex

Number of nutrition focal points Number of nutrition officers disaggregated by sex disaggregated by sex Municipality Male Female Total Male Female Total Nara 25 25 50 0 1 1 Dilly 52 15 67 2 2 4 Ouagadou 16 12 28 1 1 2 Koronga 15 2 17 1 0 1 Niamana 38 4 42 2 2 4 Fallou 42 1 43 1 4 5 Total 188 59 247 7 10 17

Each focal point trained received Shakir bands to be distributed to each beneficiary households of the project (the 4,936 beneficiary households), as well as scorecards and identification books for malnourished children. Each focal point has then in turn trained 20 food voucher beneficiary households in their locality and distributed them a Shakir band as well. Screening and referral of SAM/MAM children The IRC CDAs held monthly meetings from April to June with the 247 nutrition focal points and 17 nutrition officers present at the Community Health Center (ComCH) level. During these monthly meetings, the CDAs checked the screening books of the nutrition focal points to confirm the number of children screened for malnutrition by the beneficiary households and strengthened the technical capacities of the focal points on the screening and referral of children under five. Table 8: Number of children between 6 and 59 months screened at community households, referred and admitted for MAM and SAM in the CSComs by month

Children screened for MAM children SAM children Data malnutrition at community- Number of children Number of children Number of children Number of children per level referred admitted referred admitted month M F T M F T M F T M F T M F T Mar. 309 155 464 27 28 55 27 28 55 8 11 19 8 11 19 April 2,720 2,876 5,596 55 54 109 55 54 109 21 28 49 21 28 49 May 3,864 4,601 8,465 53 76 129 53 76 129 15 24 39 15 24 39 June 4,495 5,291 9,786 20 22 42 11 22 33 13 30 43 11 27 38 July 2,437 2,711 5,148 68 60 128 23 23 46 22 24 46 17 19 36 Aug. 1,384 1,269 2,653 14 18 32 12 14 26 6 9 15 8 6 14 Sept. 2,500 2,738 5,238 30 33 63 25 26 51 28 27 55 25 25 50 Total 17,709 19,641 37,350 267 291 558 206 243 449 113 153 266 105 140 245

10 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

The percentage of admission of referred MAM children to CSComs for the FY2019 is 80.5% but for SAM children it is 92%, which is above the target of 90%. Training of Community Development Officers on a new approach on IYCF (Infant and Young Child Feeding) listening and counseling From June 29to July 1, 2019, two IRC CDAs, one IRC IYCF officer and the IRC Program Manager participated in the ECHO-funded training focusing on counseling mothers on breastfeeding and the EVISA methodology (Listening, Valuing, Informing, and Suggesting, with Authenticity). The modules developed by the IRC for this training were: (1) the production of maternal milk; (2) “how does breastfeeding works?” and (3) the difficulties linked to breastfeeding. The objective of the training was to strengthen the technical capacities of IRC staff on how to listen to and accompany breastfeeding mothers, and to ensure that they will be able to train IYCF groups on this new approach, which emphasizes counseling and provides opportunities for mothers to share their experiences with each other’s and identify solutions. Training and follow-up of IYCF groups on the counseling approach for sensitizations As the IYCF groups will have to use the same new counseling approach with the EVISA methodology during their community activities when conducting group or individual counseling sessions. Six IYCF groups were trained from July 9 to July 24, 2019 on the counseling methodology to better support mothers on breastfeeding. IYCF groups have been trained on (1) the production of maternal milk; (2) “how does breastfeeding works?”; and (3) the difficulties linked to breastfeeding. IYCF groups will then develop group discussions with mothers on general topics such as exclusive breastfeeding. The one on one sessions will also allow mothers to feel free to ask specific and sensitive questions that they do not want to discuss in a group. Trainings were conducted by three IRC staffs (two CDAs and one IYCF officer) in each CSComs (6). 57 individuals including 49 women have benefitted from this training. Table 9: Number of IYCF groups and members trained on counseling and maternal breastfeeding

Number of households Number of IYCF group’s members trained IYCF group’s Commune benefitting from village vouchers’ distribution Male Female Total Nara Kabida-Bambara 56 1 7 8 Fallou Sountiana 62 1 9 10 Niamana Banadjougou 32 2 7 9 Ouagadou Dembassala 37 1 7 8 Dilly Demba-Diawara 27 1 11 12 Koronga Bourass 25 2 8 10 Total 239 8 49 57

At the end of the training, each IYCF group received materials to be used during sensitizations including a box image and the participants practiced the methodology among themselves before starting the sensitizations within the communities. At the end of July 2019, the IRC had held a 11 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

follow-upvisit with the IYCF groups to ensure that the sensitizations will be made in accordance in the counseling approach and values. Since the training, the IYCF groups had held two group sessions on IYCF counseling, and the evaluation demonstrated that 30% of the members of the IYCF groups had not yet mastered the counseling approach, especially the ability to rephrase, being empathetic and suggest good IYCF practices. IYCF groups have been advised to continue this process of practicing sensitizations sessions between themselves to strengthen their abilities on this counseling methodology for two to three more sessions before starting the sensitizations within the communities in October 2019. Promotion of good nutritional and hygiene practices During the distribution of food vouchers, the IRC team carried out sensitizations on the promotion of good hygiene and food practices such as handwashing techniques with soap, food diversification, etc. However, the main sensitization theme was the referral of malnutrition cases to the ComHCs. All the 4,936 beneficiary households including 1,591 women headed households were sensitized on the above-mentioned themes. There were seven of the aforementioned sensitization sessions and each had 20-30 beneficiary participants.

Outcome and Process Reporting During this fiscal year 2019, the IRC has provided 4,936 beneficiary households with food vouchers to cover their urgent needs, including 1,591 women head of households considered as more vulnerable households. The direct impact of the project can be seen both on beneficiary and non-beneficiary households on the major food security indicators that are the Food Consumption Score (FCS) and the reducing Coping Strategy Index (rCSI). For the FCS, both beneficiary and non-beneficiary households have reached 99% of the population with an acceptable FCS (at 71 points for the beneficiary households and 65 points for the non- beneficiary), which can be explained by the effects of food assistance on the local markets with: an increase in the number of local traders present in the markets, an increase in the frequentation of the markets by the populations and an increase in the number of products available, in terms of quantity and diversity. Thus, the food assistance has created positive effects on the local markets and has generated endogenous effects on all the populations living in Nara’s district. Regarding the coping strategies, the project had two impacts: the first one on the decrease in the use of coping strategies and the second one, change of behaviors in terms of the coping strategies used. Indeed, same as for the FCS, the CSIr indicator shows effect not only for beneficiary households but also for non-beneficiary households living in Nara’s district. Since the baseline, the use of coping strategies was at 20 points against 1 for the beneficiary households and 2 for the non-beneficiary households today, thanks to the effect of the food assistance on the local markets as explained above. Moreover, the IRC has also observed a change of behaviors in terms of the coping strategies used by the populations favoring coping strategies that have not long- term effects on the households’ livelihoods such as damaging their economic assets with the sale of their livelihoods (livestock, agricultural tools, etc.) or the consumption of seed stock held for the next season. The coping strategies used by the beneficiary households are: 1) consume less food, 2) borrow food or rely on the help of family or peers, 3) reduce the portion size of meals, 4) reduce the number of meals taken per day.

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Regarding the nutrition component of the project, the community approach to prevent and screen malnutrition at the household level has been a great success with the training of the 4,936 beneficiary households on the MUAC measurement and the detection of edema. 37,350 children under five has been screened for malnutrition at community level and among them, 824 has been referred by the households to the CSCom with 694 admitted (84.2%). The percentage of admission of referred MAM children to CSCom for the FY2019 is 80.5% but for SAM children it is 92%, which is above the target of 90%. At the end of the project, the IRC also expects positive impact and change of behaviors thanks to the IYCF groups that are supporting the mothers on breastfeeding with the EVISA methodology. As the sensitizations at household level have not started yet, more information will be provided at the end of the project.

Market, Lrip, and Modality Actuals The food vouchers distribution activity had very positive impact on the local markets (Nara, Goumbou, Mourdiah, Fallou, Dilly and Koronga) as it has not only benefited to the 4,936 beneficiary households but also to the non-beneficiary households with an increase in the FCS and a decrease in the use of rCSI. During the PDM surveys, the IRC has interviewed the beneficiary and non-beneficiary about their feelings on how the project impacted the local markets. Table 10: Populations’ feelings on the impact of the project on the local markets

Impact of the project on the local markets Down Stable Up Change of prices 12% 87% 1% Availability of the products 0% 2% 98% Frequentation of the markets by non-beneficiaries 0% 16% 84% Number of traders 0% 49% 51%

What is important to note is that we observe an increase in the availability of the products on the local markets, both in terms of quality and diversity, along with an increase in the frequentation of the markets by the population of Nara’s district and an increase in the number of traders present at these markets. Indeed, the food assistance has dynamized the local markets with positive endogenous effects: first, the project has led to an increase of the local traders working at the local markets targeted because of the attractiveness of contracting with the IRC for this project; in return, this has led to an increase in the products available; and thus, in an increase in the frequentation of the markets by the local populations. In terms of prices variation, the households surveyed has mostly declared (87%) that the prices remained stable during the project. The following table shows the evolution of average prices of food items in the six communes of intervention and their six markets in Nara’s district.

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Table 11: Variations of prices on the local markets during the reporting period

Cowpea Millet (kg) Rice (kg) Oil (liter) Salt (kg) Meat (kg) (kg) Oct-18 209.5 383.3 525 825 179.3 2,000 Nov-18 203 390 462.4 828.3 217.4 1,950 Dec-18 206.7 390 491.6 823.4 211.7 1,950 Q1 206 388 493 826 203 1,967 Jan-19 188.6 391.7 484.8 858.4 197.3 2,097.3 Feb-19 176.7 391.7 483.4 862.6 184.1 2,083.3 Mar-19 178.7 388.8 491.6 804.1 182.2 2,125 Q2 181 391 487 842 188 2,102 Apr-19 177.3 386.2 500 802.8 183.4 2,097.3 May-19 179.2 389.9 495 797.2 189 2,111.2 Jun-19 182.8 386.2 520 801.4 179.3 2,088.9 Q3 180 387 505 800 184 2,099 Jul-19 177.5 388.8 501.7 788.8 179.2 2,097.3 Aug-19 182.6 390.5 503.4 791.2 180.7 2,937.5 Sep-19 173.8 390.5 500 790.3 174.3 2,118.1 Q4 178 390 502 790 178 2,304

After December 2018, the price of millet decreased due to the harvest period and the reinforcement of road safety between the communes where the project is implemented which led to a decrease in the price of transportation for farmers selling their production. Moreover, the IRC has noticed a change in the diet of some beneficiary households receiving cereal vouchers by changing their diet from millet to rice, which can have also contributed to the drop of price for millet. In September 2019, the prices of millet and cowpea dropped 14% and 25% each compared to the previous months. This can be explained by the clearance of millet and cowpea previous stocks by the traders to receive the new agricultural harvest in November 2019. For the price of rice, throughout the reporting period, no major variation has been observed in the project’s intervention markets due to the abundance of local rice on the local markets with the presence of the Office du Niger in Nara which is well appreciated by the population despite the price (the average price of one kilo of local rice is 390 FCFA/kg compared to 350 FCFA/kg for imported rice). The price of cowpea has also slightly increased in April 2019 with an increase of 5.26% between May and June, and has then remained stable after, due to the reduced availability (e.g. low stocks) of cowpea during the seed season. The average price of oil per liter has known many variations during the project due to the increase and then decrease in the transport costs between Nara which is the oil supply market and the other communes of the project, especially the commune of Fallou which has no direct transport line. The decrease of oil’s price is then directly linked to the transport costs which have decreased after February 2019 due to the reinforcement of road safety between the communes and the 14 Emergency Support to Vulnerable Households Affected by the Early Agropastoral Lean Season in Nara District, Mali 72DFFP18GR00060 – November 19, 2019

procurement sites (Nara but also in Mauritania). The market price of vegetable oil has also dropped due to the increased availability of vegetable oil in the markets during the Ramadan period. Before Ramadan, local traders overstock in order to compensate for possible stockouts during the month as this period is characterized by a high population dependence on the acquisition of staple foods. In January 2019, an increase in the prices of meat has been also observed, which is proportional to the increase in the price of a bag of cattle feed and the export of animals to neighboring countries such as Senegal, Mauritania, Burkina Faso, and Guinea.

Cross-Cutting Elements According to the results of the September 2018 National Survey on Food and Nutritional Security (ENSAN), the average monthly income of female-headed households ($168.8) is 22% lower than those headed by men ($215.3). In terms of employment, nearly 80% of men have access to paid employment, while this rate is around 60% for women. With the 2012 crisis and the deterioration of the security and economic context, more and more women are becoming heads of households in the absence of their husbands (economic migration), and their low level of income when they do have an economic activity coupled with lower food crop yields or reduced economic opportunities are greatly affecting the livelihoods of the most vulnerable households. For this reason, the IRC has prioritized during all the beneficiary’s identification women heads of households but also women with disabilities and women in charge of one or more malnourished children among the households’ members to emphasize the complementary aspect of the nutrition activities. Thus, on the 4,936 beneficiary households targeted for this project, 1,591 are led by women which represents 32% of the beneficiaries and which is above the national threshold of 30%. Moreover, in each pre-targeting committees (273) and management committees (131), there were at least two elected representants for women and one representant of youth to ensure that specificities and increased vulnerability of both groups were taken into account while the beneficiaries were identified, but also to give them the opportunity to raise their voice if needed by reaching out to the management committees where they were represented as a group. These committees, especially the management committees, have also prevent the emergence of tensions and potential conflicts between the beneficiaries and the non-beneficiaries.

Challenges, Successes, and Lessons Learned The main challenges met by the IRC for this project focused on the inaccessibility of some villages during the rainy season due to the degradation of roads and the floods in Fallou commune. To be able to ensure continuous implementation of the project, the IRC team used motorcycles to reach these areas until roads became more accessible by vehicle. However, it is important to note that in addition to the deterioration of access caused by floods, issues regarding access to some localities also deteriorated due to insecurity, in Dalibougou, Kolla and Madina Koita in Niamana’s commune. Despite these risks, the IRC teams continued to access the beneficiary communities through a constant monitoring of the context.

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Concerning the food security component, the project has revitalized the local economy in the Nara district and reinforced the capacities of the local traders, while ensuring beneficiaries access to local markets through the provision of vouchers without being vulnerable to the variations of prices. The IRC provided nine-months of food security through vouchers for to satisfy beneficiary’s food basic needs while promoting a diverse diet. The households that have benefitted from the vouchers or e-vouchers distribution have also decreased the use of negative coping strategies such as the selling of productive assets (livestock, agricultural tools, etc.), or selling of agricultural seeds or the use of seeds. More information can be found in the previously submitted PDM1 and PDM2 as well as Annex I – PDM reports distribution 1 and 2. However, a new administrative distribution of communes in the Nara district was put in place by the government, and this redistribution separated some villages into different communes. As a result, some beneficiaries were reluctant to travel to the new distribution sites located in another area as they do not consider themselves as part of these communes. This led the IRC to create a new distribution site in the village of Djegue to allow all the beneficiary households to receive their vouchers. Furthermore, some beneficiaries, particularly the nomadic Fulani people were not always available on the distribution date which led the IRC team to proactively search for them to ensure that everyone received the voucher while extending the duration of the voucher distribution. Regarding the payment of local traders via Orange Money, the IRC experimented some difficulties due to the transfer capacity of Orange which restricted transaction transfers to 1,500,000 XOF ($ 2,539 at most). This transaction restriction is a mechanism to control financial movements set up by the Central Bank of West African States (BCEAO). To overcome this difficulty, the IRC tries to pay the local traders by check or bank transfers where possible. For the nutrition component, the early screening of malnourished children at the household level is successful and screening is now done by mothers which makes early detection of malnutrition possible. However, for the IYCF group training on the counseling approach, the IYCF groups haven't yet taken ownership of the EVISA methodology and more practice is required. The IRC team will continue to closely follow-up with the IYCF groups to better coach them on this methodology and why it is important to use it to promote good IYCF practices at household level.

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