Save the Children in partnership with SNV Projet USAID Nutrition et Hygiène à Sikasso Cooperative Agreement No. AID-688-A-13-00004 Quarterly Report October 1, 2015-December 31, 2015 Contact Information for this report: Maurice Gerald Zafimanjaka, MSc, MPH Project Director, Projet USAID Nutrition et Hygiène Email: [email protected] 1 Contents Acronyms ............................................................................................................................................................ 3 Introduction: ...................................................................................................................................................... 4 Context and Project Objectives: ........................................................................................................................ 4 Planned activities for the reporting period (Y3Q1): ......................................................................................... 4 Achievements during Y3 Q1: ............................................................................................................................. 6 Success Stories ................................................................................................................................................. 26 Challenges and Constraints ............................................................................................................................. 28 Lessons Learned ............................................................................................................................................... 29 Gender Integration Achievements .................................................................................................................. 29 Major Activities Planned for Year 3, Quarter 2 (Y3Q2) ................................................................................... 30 Indicator Reporting Table ................................................................................................................................ 33 Report in Progress ............................................................................................................................................ 33 Environmental compliance .............................................................................................................................. 37 Conclusions .................................................................................................................................................... 388 Annexes……………………………………………………………………………………………………………………………………………………..38 2 Acronyms ASC Agent de Santé Communautaire AEA Agriculture Extension Agents ASACO Associations de Santé Communautaire ASDAP L’Association pour le Soutien du Développement des Activités de Population ATPC Assainissement Total Piloté par la Communauté or CLTS BDS Business Development Services CAP Community Action Plans CLAN Community Leaders for Action on Nutrition CLTS Community Led Total Sanitation or ATPC CM Community Mobilization CMAM Community-Based Management of Acute Malnutrition CSCOM Centre de Santé Communautaire DRS Direction Régionale de la Santé DRACPN Direction Régionale de l’assainissement et du Contrôle des Pollutions et des Nuisances ENA Essential Nutrition Actions FARN Foyer d ’Apprentissage et de Réhabilitation Nutritionnelle FFMSy Family Farming Management Systems FFS Farm Field Schools FSL Food Security and Livelihoods FP Family Planning GOM Government of Mali HKI Helen Keller International ICRISAT International Crops Research Institute for the Semi-Arid Tropics IER Rural Economy Institute IPC Interpersonal Communication IYCF Infant and Young Child Feeding MAM Moderate Acute Malnutrition MLA Maman Leader Animatrice MUAC Mid-Upper Arm Circumference NG Neighborhood Groups ODF Open Defecation Free OHADA Organisation pour l’Harmonisation du Droit des Affaires en Afrique OTP Outpatient Therapeutic Feeding Program PLW Pregnant and Lactating Women RUTF Ready-to-Use Therapeutic Foods SACCN Senior Advisors for Client Counseling and Negotiation SAM Severe Acute Malnutrition SBC Social and Behavior Change SBCC Social and Behavior Change Communication SIS Système d'Information Sanitaire SFP Supplementary Feeding Program SOW Scope of Work TA Technical Assistance TOR Terms of Reference ToT Training of Trainers USG United States Government VCA Value Chain Analysis VSLA Village Savings and Loans Association WASH Water, Sanitation and Hygiene 3 Introduction: Projet USAID Nutrition et Hygiène (Project) is in its third year of implementation and the reporting period October 1 through December 31, 2015 signals the completion of its ninth quarter of implementation. The Project is active in six health districts, 86 health facilities and 236 villages. 1,960 village community coordination committee (CCC) members, 2, 568 mother leader animatrices (MLAs), 2,078 mother-in-laws, 2,058 husband leaders, 444 relais communautaires, and 200 farmers are conducting social behavior change communication (SBCC) in nutrition, WASH, and Agriculture in the full package communities. In addition, Ms. Meghan Pollak was recruited during the quarter to fill the international WASH and Nutrition Specialist position. She will support the Sikasso team in rolling out the SBCC strategy, which is under development. Context and Project Objectives: Save the Children leads the implementation of the Project, in partnership with SNV. The Project’s goal is to improve the nutritional status of pregnant and lactating women and children under two years of age in six health districts (Bougouni, Nièna, Sikasso, Koutiala, Kignan, and Kadiolo) of Sikasso Region. Sikasso Region is considered Mali’s breadbasket. It is agriculturally productive and a trade center. It is also one of the most densely populated regions of Mali and host to high rates of malnutrition, particularly chronic malnutrition. The Project’s three strategic objectives are: - SO1: To increase the adoption of optimal behaviors to supports nutrition, health, hygiene and sanitation - SO2: To increase the production and accessibility of nutrient-rich foods - SO3: To improve the delivery of nutrition services to address acute malnutrition The Project’s approach is grounded in community mobilization and social and behavior change. It works through community structures to facilitate change and promote specific behaviors, engaging community members in Community Led Total Sanitation (CLTS), Care Groups, Women Farmers, Farmer Field Schools (FFS), and Family Farmer Management Systems (FFMSy). The Project also supports the Malian Ministry of Health and ASACO in addressing acute malnutrition through Community-Based Management of Acute Malnutrition (CMAM) and encouraging interpersonal communication (IPC) through client-patient exchanges as a means of prompting the adoption of recommended behaviors. Over the course of five years, the Project will reach at least 13,000 pregnant and lactating women (PLW) and 53,000 children under 2 years of age in six health districts in the Sikasso Region with its complete package of interventions. Planned activities for the reporting period (Y3Q1): Crosscutting activities to Operationalize SBC Strategy • Operationalization of SBC strategy: • Capacity building for Village CCCs in community mobilization, coordination, supervision, M&E and negotiation Contributions to International and local events (International days for Latrines and Handwashing) SO1: To increase the adoption of optimal behaviors to support nutrition, health, sanitation and hygiene IR1.1: Households and caregivers have adopted recommended behaviors to support health and nutrition Thematic training of SBC Assistants on Lactational Amenorrhea Method as Family Planning (FP) method; 4 Training of Trainers (ToT) for Mother Leaders in communication techniques, Roles &Responsibilities and Monitoring by SBC Assistants at municipality level; Thematic ToT of MLA by SBC Assistants at village level; Organize meetings of Neighborhood Groups (households serviced by MLA); Conduct home visits (full package area). IR1.2: Households and communities undertake actions to support optimal hygiene and sanitation Community-Led Total Sanitation (CLTS) Pre-Trigger communities (CLTS village assessment); Conduct workshop with DRACPN to validate list of communities to be triggered; Trigger communities in CLTS; Monitor communities post-triggering; Evaluate and certify communities for open defecation free (ODF) status. Post-Certification Interventions Train SBC assistants, municipality representatives and technical services on post-ODF activities focused on sanitation marketing; Train SBC agents, municipality representatives, masons and technical services on Slabs Sanplat manufacturing and water points maintenance; Train SBC agents, municipalities representatives and technical services to promote sanicenters and sanitation shops (links between slabs, Sanplats production center, vendors of sanitation and water materials); Train SBC agents, municipality representatives, technical services, and sanicenter managers to develop business plans to promote sanplats slabs for households; Assessment of water points to be rehabilitated. SO2: To increase production and accessibility of nutrient -rich foods IR2.1: Producer groups are strengthened • Workshop to assess local implementing partners; • Organizational and financial capacity building activities; • Organizational and institutional capacity building of farmer groups. IR2.2: Improved farm management