USAID Kenya Nutrition and Health Program plus QUARTER FY Progress Report USAID KENYA Nutrition and Health Program plus QUARTER 1 FY 2015/2016 PROGRESS REPORT 01 October l – 31 December 2015 Award No: AID-615-H-15-00001 Prepared for Ruth Tiampati United States Agency for International Development/Kenya C/O American Embassy United Nations Avenue, Gigiri P.O. Box 629, Village Market 00621 Nairobi, Kenya Prepared by: Nutrition and Health Program plus 2nd Floor Chancery Building, Valley Road P.O Box 38835 00623 Nairobi, Kenya The authors’ views expressed in this report do not necessarily reflect the views of the United States Agency for International Development or the United States Government. i Table of Contents ACRONYMS AND ABBREVIATIONS .................................................................................. III I. EXECUTIVE SUMMARY ............................................................................................... 5 II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT) ......................................................... 8 1. IMPROVING ACCESS AND DEMAND FOR QUALITY NUTRITION INTERVENTIONS AT COMMUNITY AND FACILITY LEVELS ........................................................................... 8 1.1 Strengthening Leadership, Advocacy and Policy Planning ............................................... 8 1.2 Improving Nutrition Service Delivery Management, Coordination and Implementation .... 9 1.3 Improving Nutrition Related Behaviour ............................................................................. 9 1.4 Increasing opportunities for learning and sharing of best practices in nutrition .............. 10 1.5 Increasing knowledge and skills of Health Care Workers in nutrition ............................. 11 2. STRENGTHENING NUTRITION COMMODITY MANAGEMENT ................................ 12 2.1 Improving Production, Supply and Distribution of Nutrition Commodities ...................... 12 2.2 Improving Quality and Safety of Food Commodities and Agricultural Products ............. 14 2.3 Improving Quality and Safety of Food Commodities and Agricultural Products ............. 15 3. IMPROVING FOOD AND NUTRITION SECURITY ..................................................... 15 3.1 Increasing Market Access and Consumption of Diverse and Quality Foods .................. 15 3.2 Increasing Resilience of Vulnerable Households and Communities ............................... 17 4. MONITORING AND EVALUATION ............................................................................. 19 III. PROGRAM PROGRESS (QUANTITATIVE IMPACT) .................................................... 23 SERVICE UTILIZATION, COMMODITY PRODUCTION AND DELIVERY .......................................................... 23 Reported Consumption (Prescription) .......................................................................................... 24 V. PROGRESS ON LINKS TO OTHER USAID PROGRAMS ............................................. 35 VI. PROGRESS ON LINKS WITH GOK AGENCIES ........................................................... 35 VII. SUBSQUENT QUARTER’S WORK PLAN .................................................................... 36 XI. ACTIVITY ADMINISTRATION ....................................................................................... 43 PERSONNEL ........................................................................................................................................ 43 ANNEX 1: SCHEDULE OF FUTURE EVENTS ................................................................... 44 ANNEX 2: SUMMARY OF TRAININGS .............................................................................. 45 ANNEX 3: PERFORMANCE DATA TABLES ...................................................................... 48 ii Acronyms and Abbreviations AIDS Acquired Immune Deficiency Syndrome AMPATH Academic Model for Providing Access to Healthcare APHIAplus AIDS, Population and Health Integrated Project ART Antiretroviral Therapy CBO Community-Based Organization CCC Comprehensive Care Centers CDC Centers for Disease Control CHANIS Child Health and Nutrition Information System CHEW Community Health Extension Worker CHV Community Health Volunteer CLTS Community-Led Total Sanitation CNTF County Nutrition Technical Fora CO Country Office COP Chief of Party CRISP Central Regional Integrated Program CU Community Health Unit DCOP Deputy Chief of Party DHIS District Health Information System EDL Economic Development and Livelihoods EmOC Emergency Obstetric Care EMR Electronic Medical Records EMMP Environmental Mitigation and Monitoring Plan ENA Essential Nutrition Actions EPZ Export Processing Zone FAFSA Food Aid and Food Security Assessment FANTA Food and Nutrition Technical Assistance Project FAO Food and Agriculture Organization FBF Fortified Blended Food FBP Food by Prescription FFP Food for Peace FHI Family Health International FtF Feed the Future GAIN Global Alliance for Improved Nutrition GIS Geographic Information System GMP Good Manufacturing Practice GOK Government of Kenya HACCP Hazard Analysis and Critical Control Points HEA Household Economic Assessment HFP Household Food Production HiNi High impact Nutrition interventions HIV Human Immunodeficiency Virus HNDU Human Nutrition and Dietetics Unit HTC HIV Testing and Counseling IMAM Integrated Management of Acute Malnutrition IP Implementing Partner iii IR Intermediate Result IYCF Infant and Young Child Feeding IYCN Infant and Young Child Nutrition KARI Kenya Agriculture Research Institute KEBS Kenya Bureau of Standards KDHS Kenya Demographic and Health Survey KEMSA Kenya Medial Supplies Authority KFDA Kenya Food and Drug Administration KHCP Kenya Horticultural Competitiveness KNDI Kenya Nutritionists and Dieticians Institute KPPB Kenya Pharmacy and Poisons Board LMIS Logistics Management Information System M&E Monitoring and Evaluation MEDS Mission for Essential Drugs and Supplies MIYCN Maternal and Child Health Integrated Program MNCH Maternal Newborn and Child Health MOH Ministry of Health MT Metric Ton NACS Nutritional Assessment, Counseling and Support NASCOP National AIDS and STI Control Program NFSNSC National Food and Nutrition Security Secretariat NHP Nutrition and HIV Program NHPplus Nutrition and Health Program Plus NICC Nutrition Interagency Coordinating Committee NNAP National Nutrition Action Plan NSR Nutrition Service Register OR Operations Research ORT Oral Rehydration Therapy OVC Orphans and Vulnerable Children PEPFAR President’s Emergency Program for AIDS Relief PLHIV People Living with HIV PAC Project Advisory Committee PMEP Performance Monitoring and Evaluation Plan PMTCT Prevention of Mother-To-Child Transmission of HIV QA/QI Quality Assurance / Quality Improvement RUTF Ready-to-use Therapeutic Food SBC Social Behavior Change SCNTF Sub-County Nutrition Technical Fora SMT Senior Management Team SUN Scaling Up Nutrition TA Technical Assistance TWG Technical Working Group WASH Water, Sanitation and Hygiene WFP World Food Program iv I. EXECUTIVE SUMMARY The overall goal of the Kenya Nutrition and Health Program plus (NHPplus) is to improve the nutrition status of Kenyans through improving access and demand for quality nutrition interventions at facility and community levels; strengthening nutrition commodities management; and improving food and nutrition security. The five-year program which started in January 2015 is in its second year of implementation and the current report refers to its 5th quarter (January – March, 2016) of implementation. The program is addressing undernutrition through interventions that focus on both the immediate and basic contributors to malnutrition. Key among NHPplus activities include capacity strengthening, technical assistance and data management/M&E support to health managers and workers at National and County levels; support for efficiencies in nutrition commodity procurement, management, distribution, quality control and safety; partnering with stakeholders to impact good nutrition for mothers and children; and working with Feed the Future (FtF) and other agri-nutrition partners to devise innovative approaches to reduce stunting during the first 1,000 days “window of opportunity and increase resilience of vulnerable households in the five focus counties of Busia, Kitui, Marsabit, Samburu and Tharaka Nithi. During the quarter, the program provided Maternal Infant and Young Child Nutrition (MIYCN) Technical Working Group (TWG) with both technical and financial support to re-design and review the National Policy on MIYCN. NHPplus also supported the National Nutrition Technical Forum (NTF) secretariat to host a quarterly meeting and Samburu County Nutrition Technical Forum (CNTF) secretariat to host a meeting to develop its terms of reference. The program sensitized 227 health care workers from 80 health facilities, in the 6 counties of Nairobi, Narok, Nakuru, Kitui, Homabay and Migori, on Nutrition Assessment Counselling and Support (NACS). The program also conducted facility assessment in Kitui County using HiNi- OJT tool and identified 54 facilities for subsequent capacity building on management of acute malnutrition. In Kitui County, the program conducted a CME on “In-patient Management of Severe Acute Malnutrition” with a focus on triage and admission criteria for 27 health care workers in Katulani Health centre. To contribute towards improving nutrition related behaviours, the reference charts for Nutrition Diagnosis and Protocol for Food by Prescription was revised to integrate key messages on maternal nutrition,