ENDLINE REPORT OF NUTRITION AT CENTER PROJECT CARE INTERNATIONAL BENIN/TOGO Draft Second version July, 2018 TABLE OF CONTENTS LIST OF TABLES ......................................................................................................................................... 4 TABLE OF FIGURES.................................................................................................................................... 5 LIST OF ACRONYMS AND DEFINITIONS .................................................................................................... 6 Introduction.............................................................................................................................................. 8 1.1 Study area/location .................................................................................................................. 8 1.2 Summary of key findings .......................................................................................................... 9 1.2.1 Nutritional status among children 0-36 months of age ................................................... 9 1.2.2 Infant and young child feeding (IYCF) and maternal nutrition practices ....................... 11 1.2.3 Household food security status (scale hunger).............................................................. 12 1.2.4 Water, sanitation and hygiene (WASH) practices .......................................................... 13 1.2.5 Maternal health.............................................................................................................. 14 1.2.6 Effect of P4P on N@C outcomes .................................................................................... 15 2. Methodology .................................................................................................................................. 16 2.1 Survey design ......................................................................................................................... 16 2.2 Survey Area and Sample Size ................................................................................................. 16 2.3 Survey tool ............................................................................................................................. 19 2.4 Training of enumerators ........................................................................................................ 20 2.5 Baseline Schedule ................................................................................................................... 20 2.6 Data Collection ....................................................................................................................... 22 2.7 Data Management and Analysis ............................................................................................ 23 3. Findings and discussion .................................................................................................................. 24 3.1 Findings .................................................................................................................................. 24 3.1.1 Household Demographics .............................................................................................. 24 3.1.2 Agriculture and fisheries production ............................................................................. 26 3.1.3 Food preservation and storage ...................................................................................... 27 3.1.4 Agriculture Extension ..................................................................................................... 27 3.1.5 Food Security (Household Hunger Scale) and women Dietary Diversity ....................... 28 3.1.6 Maternal Health and services ........................................................................................ 29 3.1.7 Infant & Young Child Feeding Practices (IYCF) ............................................................... 31 3.1.8 Water, sanitation and hygiene ....................................................................................... 38 3.1.9 Women’s Empowerment ............................................................................................... 44 3.1.10 Effect of P4P on N@C outcomes .................................................................................... 48 3.1.11 Qualitative data based on the results of focus groups .................................................. 50 2 3.2 Discussion ............................................................................................................................... 52 3.2.1 Indicators that might been improved by N@C initiative ............................................... 52 3.2.2 Indicators that N@C initiative might not been impact .................................................. 54 3.2.3 Analysis of results and implications ............................................................................... 55 Conclusion and recommendations ........................................................................................................ 57 References .............................................................................................................................................. 58 Annexes .................................................................................................................................................. 59 3 LIST OF TABLES Table 2.1: Sample size by age ................................................................................................................ 17 Table 2.2: Actual sample from endline evaluation ................................................................................ 17 Table 2.3: Details of questionnaire ........................................................................................................ 19 Table 2.4: Planning of supervision ......................................................................................................... 22 Table 3. 1: Demographic characteristics of households and women .................................................... 24 Table 3. 2: Agriculture and Fisheries Production ................................................................................... 26 Table 3. 3: Food Preservation and Storage ............................................................................................ 27 Table 3. 4 : Agricultural extension.......................................................................................................... 27 Table 3. 5 : Food Security (hunger of Scale Classification)..................................................................... 28 Table 3. 6 : Women Dietary Diversity .................................................................................................... 28 Table 3. 7 : Mother’s anemia status- Baseline (BL) ................................................................................ 29 Table 3. 8 : Mother’s anemia status –Endline (EL) ................................................................................. 30 Table 3. 9 : Mother’s BMI Status *-Baseline (BL) ................................................................................... 30 Table 3. 10 : Mother’s BMI Status*-Endline (EL) ................................................................................... 30 Table 3. 11 : Maternal health services ................................................................................................... 30 Table 3. 12: Infant and young child feeding practices: initiation to breastfeeding .............................. 31 Table 3. 13: Infant and young child feeding practices (Early feeding practices of infants) .................. 32 Table 3. 14: WHO IYCF Indicators for intervention area ....................................................................... 34 Table 3. 15: WHO IYCF indicators for control area ................................................................................ 34 Table 3. 16: Child Anthropometrics for intervention area – Baseline ................................................... 36 Table 3. 17: Child Anthropometrics for intervention area -- Endline .................................................... 37 Table 3. 18 : Child Anthropometrics for control area -- Baseline ........................................................ 37 Table 3. 19 : Child Anthropometrics for control area -- Endline ........................................................... 37 Table 3. 20 : Anemia Status 1 (Cut off <105g/L or 10.5g/dl) Children 6-23 months ............................ 38 Table 3. 21 : Anemia Status 2 (Cut off <110g/L or 11.0g/dl) Children 6-23 months............................ 38 Table 3. 22 : Acces to Water .................................................................................................................. 39 Table 3. 23 : Handwashing practices at the key moments .................................................................... 41 Table 3. 24: Water and Presence of cleansing agent in the household................................................. 42 Table 3. 25 : Type of toilet facility .......................................................................................................... 43 Table 3. 26: Child Defecation ................................................................................................................. 44 Table 3. 27 : Women’s Empowerment .................................................................................................. 45 Table 3. 28 : Gender attitudes and beliefs: tolerance towards