Emergency food assistance program in the Brakna and Gorgol regions of Mauritania
Save the Children
AWARD NO. 72DFFP20GR00018
Fiscal Year 2020 Annual Results Report
October 1, 2019 – September 30, 2020
Reporting Fiscal Year FY 2020 Awardee Name Save the Children Federation, Inc.
Host/Implementation Country Mauritania
Award Number Award # 72DFFP20GR00018 Emergency food assistance program in the Activity Name Brakna and Gorgol regions of Mauritania Activity Start Date April 26, 2020 Activity End Date December 31, 2020 Submission Date November 2, 2020 - Narrative report - Annex 1: Indicator Table List of ARR documents uploaded in FFP PRT - Annex 2: Data Source Description - Annex 3: FSG Guidelines - Annex 4: Baseline Emily Clifton [email protected] Awardee HQ contact person Name, Email, (202)-794-1570 Phone, Office Address 899 North Capitol St. NW, Suite 900 Washington, DC 20002 Siw Dörte Diallo (Country Director) Awardee host country contact person Name, (+222) 45 25 66 93 Email, Phone [email protected]
Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 1 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
A. Annual Food Assistance Project Activities and Results
I. Activity Interventions and Results: a. Award Summary In FY20, Save the Children (SC) implemented the emergency food assistance program "Emergency food assistance program in the Brakna and Gorgol regions of Mauritania", funded by USAID/Food for Peace (FFP) in Gorgol. Programming areas covered the Moughataa of Monguel and Maghama, focusing on the communes of Monguel and Bokkol in Monguel and the commune of Toulel in Maghama. Implementation began in May and is projected to run through December 31, 2020.
The overall project objective is to immediately improve the food security of 1,330 of the most vulnerable households (HHs) in Brakna and Gorgol, based off of information gathered from the social register (SR). The targeted communes are Bokkol (38 villages) and Monguel (20 villages) in the Moughataa of Monguel, and Toulel (14 villages) in the Moughtaa of Maghama. Assistance to these HHs comes in the form of unconditional cash transfers (UCTs) to eligible HHs on the SR, the distribution of enriched flour to children ages 6 to 23 months and to pregnant and lactating women (PLW), as well as mass nutrition education and health promotion sessions through behavior change communication and mass screening. This last activity involves all key actors (community leaders, health workers, humanitarian organizations) and ensures SC’s mission towards the protection of children.
This project used the “Cash+” approach with the aim of equipping HHs with resources for a better nutrition. This approach links cash distribution to communication for a change in the nutrition behavior of the PLW and for the infant and young child feeding (IYCF), and complements the promotion, protection, and support of IYCF to ensure the best chances of survival, growth, and full development for infants and young children. Combining cash with the flour distribution provided families with sufficient money to meet their basic food needs and to enable children and PLWs with high risk of malnutrition, due to their physiological condition, to have a sufficient daily energy intake and prevent micronutrient deficiencies.
This project was implemented using the Social Registry, which is a database set up by the Mauritanian government and created with World Bank funding; it collecting profiles of the country's poorest households, and serves as an essential tool for social programs in their support to the poor. The Registry aims to benefit all targeted social interventions - both pre-existing and new. The Mauritanian State recommends that it serve as a basis for all social interventions by the State and its partners, and the Food Security Group (FSG) adopted the use of social register for all partners.
In March 2020, restrictive measures were installed by the government of Mauritania, including the Ministry of Health, in response to COVID-19, including a ban on movement between the wilayas and a curfew from 8 p.m. to 6 a.m. Those measures were gradually lifted despite the continued prevalence of COVID-19, which has led to neglect of precautions at the community level. However, the humanitarian organizations working in Gorgol (CRF, ACF, SC, etc.) are currently increasing awareness of barrier measures. SC decided to raise awareness on barrier measures throughout the implementation of this project. For this purpose, the field teams, in addition to their awareness raising activities, broadcasted messages from the Ministry of Health of the Mauritanian government
Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 2 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
during their activities with sound equipment. They also provided the communities with masks and handwashing systems before, during and after the group activities. Other measures were taken to reduce the risks of propagation of Covid-19, in common agreement with the FSG at the national level, such as doubling distributions to reduce field visits to the communities. As such, the project has carried out 2 distributions instead of 4.
Borders with neighboring countries have been closed since the end of March 2020, which has led to a reduction in the quantities of products and limited the accessibility of certain imported products such as rice, pasta, powdered milk at the end of September. Mauritania is heavily dependent on food imports (70% in a good agricultural year and 85% in a bad year), and very poor HHs such as SC’s program beneficiaries rely heavily on markets to buy food. This border closings have increased the price of certain staple foods, meaning that beneficiary HHs do not have access to the quantities of food at the expected prices with the amount of cash distributed. Moreover, even before COVID-19, the trend in prices of imported food in 2019 is marked by an increase compared to the previous years, caused by a combination of local currency depreciation (higher prices of imported goods) and the reduced availability of local supply (hence the use of imported goods, with the logistical costs associated with shipping goods from the capital to secondary markets).
b. Output Reporting Participants Actual/Planned Per Month Annual Total (unique) Cash Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Transfers Female: 4,8091 0 4,812 4,812 Planned Female: 0 4,788 0 4,788 Actual No Male: Program not yet started distribution 3,517 0 3,517 3,517 Planned planned
Male: 0 3,495 0 3,495 Actual
c. Outcome and Process Reporting :
Goal Improving the immediate food security situation of the most vulnerable families in N/A Brakna and Gorgol, Mauritania Outcome 1 Increase households’ access to and consumption of diverse and nutritious food N/A items.
1 One HH was replaced between August and September because it was absent and definitively gone from the area – economic migration towards Nouakchott). Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 3 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
Output 1.1 Cash transfers paid monthly to targeted households for 6 months. N/A Outcome 2 Improve the nutrition of pregnant and lactating women and children under five years N/A old through awareness-raising campaigns and training on infant and young child feeding (IYCF).
Outcome 1: Increase household’s access to and consumption of diverse, nutritious food.
Output 1.1: Cash transfers paid monthly to targeted households for 6 months.
FY20 Q4 (Jul-Sept) Cumulative FY20 Indicator Results Results Planned # of vouchers/transfers for reporting 1,163 x 2 = 23262 2326 period
Value of individual voucher/transfer ($USD) Size: 1-3 Size: 1-3 $24.64 $24.64 people people Size: 4-6 Size: 4-6 $61.60 $61.60 people people Size: 7-9 Size: 7-9 $98.56 $98.56 people people
Size: 10+ Size: 10+ $295.68 $295.68 people people
Total amount approved ($USD) for $256,190.66 $256,190.66 cash/vouchers in reporting period Actual # of vouchers/transfers redeemed for 2352 2352 reporting period Total actual cost ($USD) for cash/vouchers for reporting period $205,353.04 $205,353.04
Actual # of beneficiaries per month 8,283 8,283 # of months of cash/voucher support within 2 2 reporting period Frequency of cash/voucher distribution within Monthly (double Monthly (double reporting period distribution, occurring distribution, occurring every two months) every two months) Planned number of recipients for the reporting 1163 1163 period (HHs) Actual number of recipients reached for the 3 1176 1176 reporting period (HHs) Time from signed agreement to first 4 months 4 months distribution to beneficiaries
2 Please see more on this change in the page on page 6 3 7 HH were absent during the distributions which took place between July and September. Because SC is only counting the first distribution in this report (as the second distribution did not finish until October), we are only counting 1176 as 7 HHs were absent from this first distribution. Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 4 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
The first unconditional cash distribution, initially planned for June, was carried out in late August 2020 (with the second distribution starting in late September, to be evaluated through the PDM in late October). These distributions were realized in the particular context of the COVID-19 pandemic, which required some adaptation to the context through the recommendations of the FSG. The delay in distributions was mainly due to adapting our intervention to restricted movements within the areas of operation, as well as the restriction of contact with the population in order to avoid the spread of COVID-19 (there was no possibility of proceeding with the selection of beneficiaries and completing the HEA surveys as planned). SC encountered difficulties getting approvals for movements in the field (which were controlled by local authorities), and restricted the program’s geographic targeting (please see below), which also contributed to the delay in transfers. Moreover, SC had to renew the LMMS licenses to be able to complete beneficiary registration. The renewal took 4 weeks instead of 2 due to an increase in the LMMS fees, which required negotiation for better prices. This did not allow for registration to start in early June as planned. For both cash and flour, all distribution were planned as double distributions, to avoid bringing together large numbers of HHs and SC staff (and thus increasing the possibilities of spread of COVID-19), in accordance with the guidance of the FSG (in annex C). Distributions under this program were carried out with the collaboration of the El Amana Bank in Gorgol, selected following a call for tenders in May 2020. Pre-requisites for these distributions were based around signing protocols with the SR, the verification of beneficiary lists at the community level with government services (CSA and MFI), and the registration of HHs, which took place in June and July 2020. HHs receiving UCT fell into eligible socio-economic categories defined in the SR, which is set up by the Mauritanian government. Geographic Targeting Initial plans involved SC implementing the program in three different Moughataas in two neighboring regions (M’bagne in Brakna and Monguel and Maghama in Gorgol) in Mauritania. As noted in the proposal, SC planned to target through the CODEP, and used the 2019 data to propose geographic areas at the proposal stage, noting that adjustments may be required following the 2020 classification. The 2019 Cadre Harmonisé prioritized Moughataas with at least 20% of people facing food and nutrition insecurity, and the 2020 CODEP classification, completed in April, classified the Moughataas of Monguel and Maghama respectively in first and second position of vulnerability in phase 3+ CH in Gorgol, therefore indicating they should be prioritized for lean season assistance. The Moughataa of M’Bagne in Brakna was classified less severely; among the four communes, only two were classified as being vulnerable to food insecurity. Additionally, this area was already supported with food assistance by Oxfam and SC through an ECHO-funded program; therefore, geographic targeting focused on the most affected areas not covered by partners in Monguel and Maghama. SC adjusted their implementation range accordingly, with retroactive approval from USAID. Beneficiary Reach In line with the change in geographic targets, SC requested concurrence for a change in targeted beneficiary numbers. In SC’s approved award, SC planned to support 1,330 HHs (an estimated 7,980 Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 5 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020 individuals) with food assistance through cash transfers. Once it became clear that the program areas would need to be readjusted, SC requested concurrence to reach 1,163 HHs (8,367 individuals), reflecting a reduction in supported households but an increase in supported individuals. It should be noted that SC received concurrence to switch to targeting 1,163 HHs/8,367 beneficiaries based off of numbers presented by the Social Register; in reality, SC has found that the SR was incorrect, and numbers in the areas of implementation are expected to reach a level more in line with 1,183 HHs (8,367 individuals). This is another consideration to take into effect for future programming that may involve the SR, given the way it has misrepresented beneficiary numbers.
Approved Revised Moughataa (Wilaya) Estimated Initial number of Revisement beneficiary HHs per Moughataa Households M’Bagne (Brakna) 279 0 Monguel (Gorgol) 492 196 Maghama (Gorgol) 559 967 TOTAL 1,330 1,163 Individuals TOTAL 7,980 8,367
The change in the number of beneficiaries was a result of actual beneficiary registration data and the associated cost implications. HH cash transfer amounts are set by the Food Security Group, calculated based upon HH size. For budget planning purposes, SC used an average HH size of 6 people to estimate the total cash transfer amount. Beneficiary registration data indicates the actual average HH size is over 7, reflecting an average increase in transfer cost per HH and necessitating a reduction in the number of HH in order to offset the increased average HH cost. Despite reaching fewer HHs, SC is reaching more individuals than planned.
The change in prices of staple foods this year led to the FSG reviewing and adjusting the food basket (from 400 to 450 MRUs), which in turn led to changes in the amount to be distributed to each HH, as summarized in the table below :
Category Monthly CASH allocation - Category 1 : HH from 1 to 3 people 450 URM * 2 = 900 URM - Category 2 : HH from 4 to 6 people 450 MRU * 5 = 2 250 MRU - Category 3 : HH from 7 to 9 people 450 URM x 8 = 3 600 URM - Category 4 : HH of 10+ people 450 URM x 12 = 5 400 URM
Thus, during the double distribution in August, the HHs received :
Category Double monthly CASH allocation received
Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 6 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
- Category 1 : HH from 1 to 3 people 900 URM * 2 = 1,800 URM ; - Category 2 : HH from 4 to 6 people 2 250 MRU * 2 = 4,500 MRU ; - Category 3 : HH from 7 to 9 people 3 600 URM * 2 = 7,200 URM ; - Category 4 : HH of 10+ people 5 400 URM * 2 = 10,800 URM
After properly adjusting for incorrect HH numbers caused by targeting using the SR, SC’s first distribution planned to distribute UCTs to 1,183 households, including 78 HHs comprised of 1 - 3 persons, 490 HHs comprised of 4 - 6 persons, 426 HHs comprised of 7 - 9 persons, and 189 HHs comprised of 10+ beneficiaries. For the distribution of August 2020, for all beneficiaries, it was planned to complete a double distribution for a total amount of 3,726,900*2 = 7,453,800 MRU. Of the 1,183 beneficiary HHs (8,326 individuals) scheduled to receive UCT, 1,176 HHs (8,283 individuals) successfully received their transfers for this first round of distributions, and 7 HHs (40 individuals) were absent, all of whom were located in the commune of Bokkol. The amount of the distribution was therefore 7,419,600 MRU ($193,934.69 USD). The investigation showed that the absent HHs moved temporarily for agricultural reasons; SC was able to contact all 7 HHs, 6 of which confirmed they had only travelled briefly and that they would participate in the next distribution. At this time of the year, before the rains arrive, some HHs move to live in their fields, thus avoiding multiple displacements for the preparatory work for rainfed crops practiced at the end of August and beginning of September. The remaining one HH confirmed they had permanently moved away; this HH was replaced with the support of the village targeting committee (set up by the SR) in the same village after it was confirmed that they also fell into the program eligibility criteria as defined by the SR. For HHs that were absent during the first two distributions, the composition of their respective HHs will be verified before any distribution, which means there may be slight variations in the number of individuals assisted by the project.
Table 1: Category of Heads of HHs receiving cash
Category Head of HH Toulel Monguel Bokkol Total Man head of HH 207 26 98 331 Woman head of HH 119 189 537 845 Child head of HH 0 1 0 1 With children aged under 5 years old 242 136 493 871 With pregnant women 80 39 174 293 With lactating women 41 26 73 140 Total 326 215 635 1176
Table 2: Recipients of cash distributions disaggregated by commune, gender, and age
Less than 5 Between 5 and Between 12 and Between 18 and More than 55 years old 11 years old 17 years old 55 years old years old All ages Commun e H+ H F H+F H F H+F H F H+F H F H+F H F H+F H F F
Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 7 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
47 16 26 42 BOKKOL 443 9 922 529 600 1129 268 433 701 38 935 1243 96 172 268 44 19 63
24 12 14 27 TOULEL 243 5 488 325 307 632 204 219 423 415 582 997 109 67 176 96 20 16
11 55 74 13 MONGUEL 118 7 235 176 160 336 117 106 223 118 293 411 26 73 99 5 9 04
Total beneficiair 80 84 164 103 106 209 34 47 82 es 4 1 5 0 7 7 585 758 1347 841 1810 2651 231 312 543 95 88 83
Table 4: HHs served through the first distribution of CASH, August 2020
1st Distribution of Cash – August 2020
Number of beneficiaries planned Number of beneficiaries paid Number of absent beneficiaries
Global Total Wilaya Moughataa Commune Amount left amount Amount Size: 1- Size: 4- Size: 7- Size : Size: 1- Size: 4- Size: 7- Size : Size: 1- Size: 4- Size: 7- Size : BEA 3 6 9 10 planned 3 6 9 10 paid 3 6 9 10 TOTAL TOTAL TOTAL (MRU) person person person person (MRU) person person person person (MRU) person person person person s s s s and + s s s s and + s s s s and +
Gorgol Monguel Monguel 22 113 70 11 216 1 170 900 22 113 70 11 216 1 170 900 0 0 0 0 0 0
Gorgol Maghama Toulel 18 90 111 107 326 2 392 200 18 90 111 107 326 2 392 200 0 0 0 0 0 0
Gorgol Monguel Bokkol 38 287 245 71 641 3 890 700 37 283 243 71 634 3 856 500 1 3 2 1 7 40 500
TOTAL 78 490 426 189 1 183 7 453 000 77 486 424 189 1 176 7 419 600 1 3 2 1 7 40 500
According to the results of the PDM1 survey (which surveyed 287 HHs), 72% of the cash amount distributed was used for the purchase of food products, 11% for the purchase of non-food products, and 20%4 of the amount distributed was used for debt repayment (almost all of which is for food products). According to the results of the same survey, 64% of the HHs surveyed said that the amount of cash could not cover their food needs for two months, for the following reasons: - 62% of HHs surveyed cited debt repayment as one of the main reasons; - 49% of HHs surveyed the current market prices do not allow them to have sufficient quantities of cereal; - 34% of HHs surveyed said that the amount does not really take into account the size of the household or the sizes given in the lists of beneficiaries provided by the social registry do not correspond to reality; - 17% of HHs surveyed emphasize sharing with neighbors (extended family); It should be noted that SC is following the methodology validated by the government via the Plan National de Réponse 2020 (PNR - National response plan 2020) and could not have adjusted the
4 The percentage of use of cash is the ratio of the amount used to the amount received by household category (defined by the size of the HH). Since households are not the same size, this creates this final lag on the overall amount and percentage. Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 8 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
amount, as distributions sizes are set by the PNR and cannot vary between organizations.. The PNR is based on the recommendations of the FSG of which SC participate and contribute. The amount distributed still manages to cover a significant part or all of the food expenses according to the HHs interviewed, as summarized in the table below:
Coverage rate Household proportion
0 to 25% 2%
26 to 50% 15%
51 to 75% 30%
76 to 100% 49%
More than 100% 4%
Total 100%
It is clear that the extension of the lean season the previous year has had an impact on the use of cash for the repayment of debts contracted during this period, and has therefore created a shortfall in the coverage of needs by SC’s cash transfer distributions. However, based on the mass repaying of debts with the first transfer, it is hoped that the second double distribution in late September/early October will result in more cash being used to cover food needs for October and November. SC is also counting on a good winter, with sufficient rains over a homogeneous period of time, that is expected to allow HHs to use their agricultural production to have more resources to cope with the rising market prices caused by COVID-19 (border closures have limited the availability of certain products on the markets) and to cover the needs of the beneficiary families.
The second UCT started at the end of September, and was completed in October. These activities will be fully reported on in SC’s next quarterly, as the implementing office will have completed a full analysis of distribution data and PDM data.
Outcome 2: Improve the nutrition of pregnant and lactating women and children under five years old through awareness-raising campaigns and training on infant and young child feeding (IYCF).
Distribution of enriched flour Beneficiaries of the enriched flour (VITAMIL) were selected based on the criteria that they are beneficiary HHs receiving UCT under the program who include children aged 6 - 23 months or PLW. The ration of enriched flour for children is 6 kg of enriched flour/VITAMIL per distribution and 3 kg for PLW, an amount that has been agreed upon and accepted by all food security and nutrition partners and the Government of Mauritania. The supplementary food distributed is intended to reduce peak malnutrition and to prevent, in the short term, the deterioration of the nutritional status of these children and PLW, who are among the most vulnerable groups to Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 9 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020 malnutrition. Supplementary feeding operations are recognized by SC through previous interventions as an effective strategy for preventing acute malnutrition among children aged 6 - 23 months and PLW during the lean season in vulnerable areas. As the distribution of enriched flour to PLW and children aged 6 - 23 months is an activity that is coupled with unconditional cash distribution operations, beneficiaries receiving flour did so on a timeline that closely followed UCT distributions, meaning that each enriched flour beneficiary received a double distribution of flour during the reporting period. Identified PLW received a quantity of 6 kg (12 x 500g sachets) of VITAMIL-enriched flour, while each child received a quantity of 12 kg (24 x 500g sachets) of VITAMIL flour. Following beneficiary registration, it was planned to distribute flour to 1,143 beneficiaries, including 674 children, 335 pregnant women and 134 lactating women, or 10,902 kg of enriched flour. The first distribution reached 1,118 beneficiaries, including 656 children (331 girls and 325 boys), 329 pregnant women and 133 nursing mothers, or 10,644 kg of flour distributed. The slight shortfall in expected vs actual reach is attributed to 25 absentees during SC’s first distribution in August, including 18 children, 6 pregnant women, and 1 nursing mother. Following the cash distribution, 7 HHs were absent in the commune of Bokkol, so their flour beneficiaries were not registered. After an identification mission, SC counted 17 children, 4 pregnant women and 4 breastfeeding women. In total, as absent we will have 35 children between 6 and 23 months, 10 pregnant women and 5 nursing women, for a total of 50 beneficiaries to be regularized for first distribution during the second distribution.
Table 6: Planned vs Actual Distribution Summary of Distribution I VITAMIL Flour by municipality (August 2020)5
Table 4
Commun Beneficiaries: Beneficiaries : Beneficiaries : es Children from Total Total quantity of Pregnant Lactating 6 to 23 months Beneficiaries enriched flour (Kg) Women (PW) Women (LW) old
Planned amount: Planned reach: Planned reach: Planned Reach: 3,606 kg 238 Planned reach: 85 40 363 Actual amount: 3,474 Toulel Actual reach: 229 Actual reach: 81 Actual reach: 40 Actual reach: 350 kg
Planned reach: Planned Amount: 357 Planned Reach: Planned reach: Planned Reach: 5,946 kg Actual Reach: 204 73 634 Actual Amount: 5,832 Bokkol 349 Actual reach: 202 Actual reach: 72 Actual reach: 623 kg
5 Please note this is planned after the review of the social register – not from the proposal Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 10 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
Planned amount: Planned Reach: Planned reach: 1,350 kg Planned reach: 79 Planned reach: 46 21 146 Actual Amount: 1,338 Monguel Actual Reach: 78 Actual reach: 46 Actual Reach: 21 Actual Reach: 145 kg
Planned: 674 Planned: 335 Planned: 134 Planned: 1,143 Planned: 10,902 kg TOTAL Actual: 656 Actual: 329 Actual: 133 Actual: 1,118 Actual: 10,644 kg
Each beneficiary received a double-ratio of enriched flour, which leads to a total of 10,644 kg.
Accountability and feedbacks response mechanism In past programming, SC had tried to develop anonymous suggestion boxes, which did not work well as oral culture is very present in villages; as such, a toll-free number was set up for this program instead. Beneficiaries were sensitized to the CFRM at the start of programming, and the toll-free number was given out orally, as well as printed on paper and handed out during the distributions. However, activity on the line has been very infrequent. Beneficiaries seem to prefer calling SC field agents for complaints, clarifications and other matters; when the response given is to call the number to express their complaint, people do not do so. SC field agents have answered questions asked by beneficiaries, but can not take the complaints, as the person registering complaints cannot be part of SC in order to stay impartial. In these cases beneficiaries prefer to turn to their political leaders or to the administration (Hakem, Mayor, etc.). Authorities give SC informal feedback on these systems and have reported that most of the complaints were requests for information., which were answered. The lack of calls through the toll-free line could be cultural, as explained during a meeting with the FSG; going to an area of the village where there is network to make calls in order to call to complain about not being on the list when other HHs are there is considered to be a community betrayal. Therefore, beneficiaries find it preferable to complain to a local authority who can be trusted and who can mitigate issues. Along with the toll-free number, a committee of elders within the village targeting committee was set up to deal with complaints and conflicts to work with community dynamics around reporting complaints.
Status of Method Departm Commu the ID Date Region Village Sex Type of Complaint Complaint ent ne complaina Receipt nt
Request for information 00001 21/08/2020 Gorgol Maghama Toulel Toulel Village Chief M Toll-free number regarding the non- selection of his village Request for information 00002 31/08/2020 Gorgol Monguel Monguel Hel Greich inhabitant M regarding beneficiary Toll-free number selection
Request for information 00003 30/09/2020 Gorgol Monguel Bokkol Moujama'a inhabitant M regarding beneficiary Toll-free number criteria for selection
Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 11 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
Request for information 00004 19/10/2020 Gorgol Monguel Bokkol Vediara Village chief M regarding beneficiary Toll-free number selection
CHV Trainings From September 7th to 12th, SC organized and completed three training sessions (of three days each) for 72 community health volunteers (CHV), one from each village covered under SC’s programming from all three communes mentioned above. One team did the 3 day-training in Toulel and Monguel, and a second team completed the training in Bokkom. This training aimed to build the CHV capacity, who will be responsible for carrying out screening activities, sensitization on good food and hygiene practices, and cooking demonstrations with the support of the SC field team. We recall here that these CHV come from the community (1 per village) and are chosen by the community itself, according to their availability, commitment, permanent residence, ability to speak the local languages and their ability to read and write. All CHV are women. All selected CHVs were trained on good food and hygiene practices, and cooking demonstrations at least once in previous years, either by SC or by other partners (CRF, CRM, Oxfam, etc); as CHV are chosen by communities themselves, no new CHV candidates were chosen this year. This year’s training consisted of an update of training previously received, with specific focus on the COVID-19 pandemic. As such, the main objectives of the training were to strengthen skills in the following areas:
• Knowledge of the roles and responsibilities of a CHV • Community mobilization and monitoring of the brachial perimeter (BP) mothers • Knowledge of screening techniques and sensitization on IYCF in the project intervention villages
The end goal is that each CHV, once they receive full training, can perform the following roles in his/her village: • Prepare and conduct awareness sessions on nutrition and hygiene • Organize screening and train the children's mothers how to take their child's BP and the conduct and advice to be given in case of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) • Refer cases of malnutrition to appropriate health facilities (CRENAMs recently began activities again in the area) • Follow up on screening for BP mothers using the monitoring form designed for this purpose • Master the technique of culinary demonstrations based on local products
As COVID-19 is still presenting a risk to beneficiaries, the CHV were oriented on the measures to be taken to avoid contaminating or being contaminated (barrier measures and community awareness). Evaluations were done systematically before and after each training, with feedback to improve the understanding and capacity of the CHVs who did not get good initial evaluation results. Later, corrections and accompaniment were conducted with the CHV during team visits to the villages. At the end of the training, each CHV received an incentive kit to motivate them in their efforts to work with their communities. This kit was composed of: Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 12 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
• 1 bag of 25 kg of rice • 1 can of 25 liter oil • 1 large 333 g hard soap bar
Awareness sessions on nutrition and hygiene During the distributions of cash and enriched flour, awareness sessions were conducted for the benefit of the communities on the following themes, with the support of CHV:
• Malnutrition and its consequences on children and their mothers • The causes of malnutrition • The link between nutrition and hygiene • The importance of drinking water in nutrition and the consequences of the use of non- drinking water on human health, especially for children. • The use of cash received through programs • Explain to beneficiaries the cash amount per HH, which is based on the size of each HH (as mentioned previously in the report) • Remind beneficiaries of the donor's name • The importance of washing hands, respecting social distancing and the wearing of masks when you will be interacting with others during COVID-19
During awareness sessions, which took place right before distributions, 3,629 people were able to attend SC awareness sessions. It should be noted that SC sets up awareness sessions differently for parents and children; for the 12 - 14 year old age group, the sensitization is specifically oriented on COVID-19, whereas adults were mostly sensitized on nutrition subjects that focused on IYCF.
Table 7: Summarization of People Sensitized for the First (Double) Distribution, August 2020
Number of women Number of men Children from sensitized sensitized 12 to 14 years Commune Number old of Villages 15-49 50-60 More 15-49 50-60 More Boys Girls Total years years than years years than old old 60 old old 60 years years old old
Bokkol 38 758 48 26 53 22 13 548 614 2 056
Monguel 21 248 145 63 78 61 25 173 234 971
Toulel 12 143 63 39 87 73 41 69 87 602
TOTAL 71 1,149 256 128 218 156 79 790 935 3,629
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Screening During this program, screenings were organized in Gorgol for both Maghama and Monguel: a) A screening which exclusively concerned children aged 2 to 23 months and PLW of HHs receiving cash and flour, which served as a nutritional follow-up. b) A national mass screening, covering all children aged 6 to 59 months and PLW (including those not receiving cash and flour) in all the villages benefiting from the program's activities done, realized by MASEF and CRF (in Gorgol) with the support of SC. c) Mass screening conducted in both moughataa by the SC team only, as national mass screenings are often delayed. Nutritional follow-up screening for beneficiaries of VITAMIL flour The enriched flour distribution was coupled with two types of screening: a nutritional follow-up screening for the beneficiaries receiving enriched flour (children from 6 - 23 months and PLW), and mass screening. The first type of screening aimed to monitor the nutritional status of beneficiaries receiving enriched flour during the distribution periods to prevent any cases of malnutrition. The choice of PLWs and children between 6 and 23 months as the target of flour beneficiaries (in addition to cash distribution to their HHs) is linked to their physiological condition, which makes them vulnerable to malnutrition. SC has growing evidence in many countries that cash transfer interventions implemented simultaneously with additional nutrition interventions during the first 1,000 days of a child's life have an impact in improving nutritional outcomes.6 For the nutritional follow-up screening in August 2020, SC screened a total of 656 children aged 6- 23 months; there were 3 cases of severe acute malnutrition (SAM), 0.45% of the total screened, of which 2 were girls (1 in the commune of Toulel and 1 in the commune of Bokkol) and 1 was a boy (in the commune of Bokkol). Those identified were referred to the competent CRENAS, which manage SAM cases and are housed in health infrastructures at the communal level. CRENAS are managed by the State through a Head nurse. All the SAM cases presented themselves at these centers, and their condition was confirmed by the analyses carried out there (weight/height ratio). They were all admitted to the health facilities in their respective communes. The evolution of their nutritional status has been regularly monitored during the visits of SC teams. The absence of cases of SAM in the commune of Monguel can be explained by the relatively smaller number of beneficiary children detected (78 children). 18 children were identified as MAM (2.75%) and referred to the proper care structures (CRENAM) for evaluation of their weight and height. Although the sample is not representative, it follows the trend of the harmonized framework, which indicated a greater vulnerability of malnutrition in the Monguel and Bokkol region compared to the Toulel region. SC identified 12 MAM cases in Bokkol and 3 MAM cases in Monguel, representing respectively 3.45% and 3.85% of
6 https://mauritania.savethechildren.net/wp-content/uploads/2018/10/Resourcing-Families-for-Better-Nutrition-2- pager-Print-Version-July2....pdf Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 14 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
MAM cases in the area (even though the sample is not representative), whereas in Toulel, there were 3 MAM cases identified (1.3% of MAM cases in the area), representing a lower vulnerability. SC screened a total of 462 PLW, 10 of whom were MAM cases (2.16%); the remaining 452 were healthy women (97.84%). 7 of the MAM cases were in Toulel (5.78 %) and the 3 others were identified in Monguel (4.29%). No cases of MAM were screened in Bokkol.
Table 8: Summary of nutritional follow-up screening for children aged 6 to 23 months who received enriched flour from August 27 to September 4 2020
1st PB screening 1st Total 1st 1st PB screenign 1st PB screening PB >115mm screening screenin <115mm >125mm <125mm Edema g
Girl Boy Girl Boy Girl Boy Communes 6- 24- 6- 24- 6- 24- 6- 24- 6- 24- 6- 24- 23 59 23 59 23 59 23 59 23 59 23 59
DI- Nutritional Monitoring Screening from August 27 to September 01, 2019
11 Toulel 1 0 0 0 1 0 2 0 116 0 0 0 230 0 Monguel 0 0 0 0 1 0 2 0 39 0 36 0 0 78 16 Bokkol 1 0 1 0 7 0 5 0 168 0 0 0 348 6 31 TOTAL 2 0 1 0 9 0 9 0 323 0 0 0 656 2 TOTAL 3 18 635
Percentage 0.45% 2.75% 96.8%
Table 9: Summary of nutritional follow-up screening for PLW beneficiaries of enriched flour from August 27 to September 4
1st campaign 1st campaign
Communes Number PLW Number PLW Total 1st screening
PB <210mm PB >210mm
Toulel 7 114 121
Monguel 3 67 70 Bokkol 0 271 271 TOTAL 10 452 462
Percentage 2.16% 97.84%
Mass screening of children and PLWs
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During mass screenings, SC was able to screen 2,759 children in all implementation villages of the 3 intervention communes covered by the program. During this mass screening, SC detected 6 cases of SAM (0.22% of total population screened), including 3 girls aged 6 to 23 months (2 cases in the commune of Bokkol and 1 case in the commune of Toulel), and 3 boys aged 6 to 23 months (2 cases in the commune of Bokkol and 1 case in the commune of Toulel).
SC has noted that, in areas of implementation, girls and boys are affected by malnutrition in the same way in general. The lower rates than in the SMART (SAM which was 2.2% in Maghama and 3.1% in July 2018) could be explained by the fact that interventions by FFP and other partners in previous years have caused significant decreases in mass rates in these areas. For example, the highest SAM rate during the implementation of the FFP 2018 Project in Maghama was 0.6% in September and 0.4% in November in Monguel. On the other hand, the effectiveness of the work that is being carried out by the health services and its partners in the management of malnutrition (CRF and CRM) in children since then, including regular monitoring of malnutrition in the area for nearly four years, may also explain the absence of SAM cases in Monguel.
SC detected 46 MAM cases during the mass screening, or 1.67% of the total children screened. 23 were girls (17 were ages 6 - 23 months and 6 were ages 24 - 59 months) and against 23 were boys (19 were ages 6 - 23 months and 4 were ages 24 - 59 months).
Some of these cases of malnutrition could be explained by the absence of harvests in recent years and by the absence for nearly two years of a functional CRENAM (structure for the management of MAM in Gorgol). Lack of follow-up and treatment of MAM cases can lead these cases to go into the red. However, some CRENAMs have just resumed their activities in the region with WFP, in collaboration with the Mauritanian Red Crescent, and SC believes that the operation will be effective soon.
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Table10: Children aged 6 to 59 months screened during mass screening in the 3 intervention communes from 27 to 01/08/2020
1st PB screening 1st 1st PB screenign 1st PB screening Total 1st PB >115mm screening <115mm >125mm screening <125mm Edema
Commune Girl Boy Girl Boy Girl Girl Boy Girl s 6- 24- 6- 24- 6- 24- 6- 24- 24- 24- 6-23 6-23 23 59 24 59 23 59 23 59 59 59
DI- Mass screening from 27th august to 1st September 2019
Toulel 1 0 1 0 8 1 7 0 87 236 81 172 0 594
Monguel 0 0 0 0 7 1 1 2 126 230 95 257 0 719 Bokkol 2 0 2 0 2 4 11 2 412 334 392 285 0 1446
TOTAL 3 0 3 0 17 6 19 4 625 800 568 714 0 2759
0.22% 1.67% 98.11%
Table11: Summary of the number of pregnant and breastfeeding women screened during mass screening in the 3 intervention communes
1º campaign 1º campaign Commune Number PLW PB Number PLW PB Total 1st screening <210mm >210mm
DI – Mass Screening from the August 27 to September 1 2020 Toulel 5 85 90 Monguel 0 102 102 Bokkol 1 510 511 TOTAL 6 697 703
d. Market, Local Regional, and International Procurement (LRIP), and Modality Actuals Market monitoring The monitoring of prices is done monthly at the market level: - d'Aleg and Kaédi (chief town of the Wilaya of the intervention zones). - of Mbagne and Monguel (capital of Moughtaa in the intervention zones) - Lixeiba and Boghé (control markets).
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In those markets, SC collected prices and information to analyze the availability of the goods, as well as the sources of basic foodstuffs7, meats8, live cattle9, livestock feed,10 and fruits and vegetables, for which the collect of prices only began in 2020. This list of products to be monitored was drawn up with SC’s Nutrition and Food Security technicians, with the aim of being able to understand the access of HHs to the staple foods in the intervention area.
Results : Regarding the availability for 2020 in general: - The availability of cereals is low to average on all the markets monitored. - The availability of imported foodstuffs is good. - The availability of meats is average. The average prices of cereals and legumes in the first quarter of 2020 compared to those of the second quarter of 2020 increased by 1% for small millet, by 6% for sorghum (taghalite), by 9% for local rice, and by 20% for local corn, while the average price of cowpeas fell by 4%. Comparing the prices of the first quarter of 2020 with those in the first quarter of 2019, only pearl millet increased by 29%, while other products declined in their average price (-31% for local maize, -25% for sorghum (taghalite), -9% for local rice and -3% for cowpea). Comparing the prices of these cereals and pulses in the second quarter of 2020 with those in the second quarter of 2019, we note an increase in average prices of 13% for local rice and 22% for small millet, while the others have fallen. The average prices of imported foodstuffs observed in the first quarter of 2020 compared to those of the second quarter of 2020 remained stable for wheat; oil fell 19% for oil and powdered milk fell 6% for powdered milk, while imported sugar and rice rose by 3% and 7% respectively. In addition, comparing the first quarter of 2019 and the one of 2020, the average prices of imported wheat and rice remained stable while other imported foodstuffs increased (milk powder by 9%, sugar by 15%, and oil by 24%). The prices of these imported foodstuffs observed in the second quarter of 2020 compared to those of the second quarter of 2019 show an increase in the average prices of all these commodities; milk powder increased by 6%, wheat and oil by 7%, sugar by 11% and imported rice by 20%. As for the types of meat monitored (meat of small ruminants, beef and camel meat), their average prices in the first quarter of 2020 compared to those of the second quarter of 2020 shows a decline of 3% in the price of meat of small ruminants and 1% in the price of camel meat while the average price of beef has increased by 5%. The average meat prices observed in the second quarter of 2020 compared to those of the second quarter of 2019 show a decrease of 4% for cattle meat, 1% for camel meat while the meat of small ruminants has increased by 17%. The average prices of the second quarter of 2020 compared to those of the 2019 also show a downward trend for staple foods, with a 24% decline for pulses, 13% for imported rice, 7% for oil and 3% for sugar. The global cost of the basket has decreased by 15% in the first quarter of 2020 and by 12% in the second quarter of 2020 compared to the cost of the food basket in the 2019 lean season. This decrease in the cost of the basket in the first and second quarters of 2020 is explained
7 Local cereals and legumes namely local rice, sorghum taghalite, local maize, pearl millet and cowpea and imported food products namely imported rice, wheat, sugar, oil and powdered milk. 8 Small ruminants, cattle and camels 9 2 year old sheep, 2 year old goats, 2 year old cattle and 2 year old camels 10 Rakkal, dry wild straw and wheat Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 18 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
by the decrease in prices of all the basic foodstuffs composing this food basket, namely imported rice (cereals), cowpeas (pulses), sugar and oil, which could be explained by the good availability of these foodstuffs on the markets. Almost all of the foodstuffs in this basket are imported, so their level of availability, depending on the supply system, has remained steady. Evolution during the last month (September 2020) At the end of September, in the markets of Kaedi (located in the Gorgol wilaya) which is the main supply market for the Moughataa of Monguel and Maghama, there was a slight increase in overall prices (about 10%). This could be explained by the deterioration of the road network, which hindered the supply of certain localities affected by the floods. During this period, imported rice in particular was up nearly 40% compared to last year. Local products remained stable compared to the previous quarter, which could be the result of food distributions organized by the State and certain organizations such as the WFP, FAO, etc. The improvement in animal weight is favoring a slight increase of about 10% in the price of small ruminants on the market, thanks the availability of good pasture during the period of abundant rains and the continuation of livestock exports to Senegal. Senegal's currency is stronger than the Mauritanian currency, which allows farmers to sell livestock at a higher cost, raising prices on the Mauritanian market. Regarding the procurement for Cash and enriched flour Procurement for enriched flour was local; preparation and constant communication with the suppliers allowed SC to avoid further delays in procurement and distribution of both cash and flour. Once the registration of beneficiaries was completed in August, the distribution of cash and enriched flour were planned and completed on time according to the last planning set up in August; as noted in the market surveys, distributions didn’t seem to impact the local markets in a negative way.
e. Cross-Cutting Elements Conflict sensitive needs and issues SC is aware of the risks of the programming creating conflict in the villages, between the beneficiary HHs and the HHs which were not selected. In order to prevent this, SC collaborated with the targeting committees set up by the SR for the proper implementation of all cash and flour activities by setting up a complaints committee and popularizing the green line to anticipate and resolve potential conflicts. For transparency in the distribution process and to prevent conflict between the beneficiaries receiving different amounts of cash the amounts intended for each category, according to the number of people making up the HH, were explained to all cash beneficiaries. Each committee has at least one village Elder who is able to help settle conflicts amicably or to decide between individuals if the conflict cannot be settle amicably. Gender During the distribution of cash or flour, priority was given to pregnant women, breastfeeding women and sick people, to ensure that these more vulnerable groups are not waiting for too long. Particular emphasis was placed on possible discrimination and segregation of the use of cash and flour within the communities during the sensitization sessions to anticipate these types of practices. As Emergency food assistance program in the Brakna and Gorgol regions of Mauritania 19 72DFFP20GR00018 FY20 Annual Results Report Resubmission: December 28, 2020
mentioned above, SC was also careful to arrange distribution points so that women were able to access them in familiar spaces, without needing to walk far or feel endangered by attending a distribution. Every point of distribution is located in a village, in a well know space (school, house of the head of village, etc), so that it is familiar and accessible to all HHs, especially women (who might otherwise be wary of attending distributions alone). Each distribution happens outside (to avoid enclosed spaces), where women can wait under a wood or plastic shelter. Protection According to the PDM, the distribution points for cash and flour are well laid out, enabling each beneficiary to collect money or flour in their village while avoiding the need to travel long distances (less than 1.5 km from outside the village) with money for their safety and avoid spending money on transportation. 100% of the beneficiaries asked during the PDM reported feeling safe during the process and after the process when returning home, with no reported incidents. Awareness sessions for the Head of HHs on child protection has been a topic emphasized during the implementation of any activity. There were no cases of protection issues detected during the distribution. Arrangements were made during distributions and community activities to protect communities and SC workers against COVID-19 (implementation of hand washing devices before and after collection of cash or flour, wearing of masks for all participants, and respecting social distancing guidelines).
II. Challenges, Successes, and Lessons Learned
a. Challenges • It was difficult to respect the distribution schedules with the partner for cash distribution (the BEA bank), as distributions coincided with the mobilization of communities for fieldwork, which could take up to 6 hours in some villages. This often led to working late in the evening for the field teams to respect the schedule set with the bank in charge of distributing the cash. It took some time for BEA Bank to confirm the distribution date, which then left little time for the teams to notify communities in time on the distribution schedule. It should be noted that during the PDM, the communities complained that they did not know the exact distribution dates. This was due to security reasons: to avoid the risk of robbery by disclosing the distribution date too far in advance, SC chose to indicate the dates only 48 hours in advance. Some teams were also confronted with muddy conditions, due to the exceptionally frequent rains, causing a day or so loss of time. • The seven HHs who were absent during the first distributions had moved out to their fields and could not attend the first distribution. SC was able to successfully contact all HHs to ensure they will be present in the villages for the next distribution. • Enforcing social distancing in certain distribution locations where there wasn’t enough shade to shelter all the beneficiaries proved very difficult. For this reason, SC provided all participants and distribution teams with masks and required regular handwashing before, during, and after distribution at the installed handwashing stations (either tippy-taps which were installed during COVID-19 prevention activities, or mobile facilities). The teams were also asked to speed up the process to reduce community wait times.
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b. Successes
• The communities have expressed themselves through the toll free number available for complaints and suggestions to let us know their satisfaction with the progress of the distributions during COVID-19. • The creation and use of cards for the beneficiaries of cash and enriched flour, made to identify and register the households, allowed for quick and efficient identification of beneficiaries. These cards were produced from the LMMS database, printed by SC, and given to beneficiaries prior to distributions (usually the day before the distribution). This made it possible to compensate for the fact that many people do not have identification documents, which is common in rural areas. The use of the card's bar code with the LMMS system reduced input and spelling errors as well as avoiding errors related to homonyms, which are otherwise very frequent. • PDM surveys and the production of reports are usually very time-consuming. As a result, the reports are often ready after the next distribution, even though the interest of these reports is to improve future distributions. The Program team, in collaboration with the MEAL team, were able to produce and exploit the elements to be improved in the distributions in a timely manner, following an improvement in the work procedures between the two departments.
c. Lessons learned
It could be helpful to devote more human and logistic resources to put towards updating HH information before launching distributions in the future; this information could be shared with the SR. In two years, HH data can change significantly, thus impacting the size of the HH and its composition, and ultimately the amount of cash expected to be distributed. This would also allow for more time and means for the program’s preparatory phase in order to sensitize communities that are largely illiterate and have difficulty understanding the eligibility criteria and the amount they will receiving to the size of their HH. • The use of the SR has shown limitations, which were perceived during the mass screening where SC observed some SAM and MAM cases who were not beneficiaries as they had not been registered as vulnerable under the SR. A capitalization workshop will be held on this subject at the end of 2020 with all members of the FSG who have encountered the same limitations. •
III. Listing of Attachments
- Annex A: Indicator Table - Annex B: data Source Description - Annex C: Guidance from the Food Security Group - Annex D: Baseline
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