ACF INTEGRATED MULTI-SECTOR APPROACH TO MALNUTRITION
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1 ACF INTEGRATED MULTI-SECTOR APPROACH TO MALNUTRITION
2 Overall program goal To contribute to the reduction of malnutrition-related morbidity and mortality
3 WATER SANITATION HYGIENE NUTRITION FOOD SECURITY LIVELIHOOD
4 CASE STUDY ACF INTERGRATED PROGRAMMING IN GARBATULLA DISTRICT
5
6 CASE STUDY OF GARBATULLA DISTRICT ACF programs are result oriented. This is based on assessment undertaken in it s operational areas. MAY 2011 surveillance system results unveiled above emergency malnutrition rates: WHO standards: GAM (21.6%) and SAM (4.3%).
7 GAM and SAM rates with 85% Probability Exceeding Thresholds (using CDC calculator) FEB 2010 MAY 2010 SEPT 2010 FEB 2011 MAY 2011 N=Sample size Global Acute malnutrition (<-2 z-score and/or Oedema) 14.6% 12.8% 13.2% 13.6% 19.0% Prevalence of SAM (<-3 z-score and/or Oedema) 2.6% 0.1% 1.1% 0.7% 3.2%
8 Situational analysis & Probable causes of malnutrition MALNUTRITION Disease burden with increase in diarrhea incidence amongst children 6 59 months Inadequate food intake due to illness, sharing of food clanism reduced purchasing power, inconsistent supply in GFD
9 FSL Highlights of other probable contributing factors Main source of food was purchase with very minimal own production Drought situation Massive decrease in livestock quantities in a pastoral set up with main cause of change being animal death due to drought (75.0%) Main shocks experienced; High food prices, reduced pasture/forage available, reduced water available and high livestock death WASH Increased queuing time at water points because of scarcity or malfunction water points like boreholes making it hard for mothers to have enough time to take care of their children Reduced per capita consumption affect prioritization of hygiene practices Lack of hand washing with soap at critical times increase risk to contacting water borne diseases such as diarrhoea
10 GARBATULLA DISTRICT PROGRAMMING EMERGENCY INTERVENTION May Dec 2011 EARLY RECOVERY INTERVENTIONS (Since 2010) BUILDING RESILIENCE (Since 2010) OUTREACH SCALE UP OF OUTREACH HINI BLANKET SFP REHABILITATION OF WATER POINTS CAPACITY BUILDING e.g. Health workers, water mgt committees DESTOCKING WATER POINT CONSTRUCTION DRIP/ CANAL IRRIGATION CASH TRANSFER FOR IMMEDIATE NEEDS IGA TARGETTING VULNERABLE HH HEALTH EDUCATION EMERGENCY WATER TRUCKING KITCHEN GARDENING LIVESTOCK MARKET DEVELOPMENT
11 Example of linkages/synergy among ACF sectors in Garbatulla Linkages: FSL and Nutrition program CASH TRANSFER to vulnerable households for immediate needs; HH with malnourished children form part of this criteria Mean Dietary diversity score of 6.8; but this is more so on other foods such as oil, cereal, condiments and sugar. Consumption of nutritious foods such as vegetables is low. The kitchen garden activities thus address provision of this in the diet
12 LINKAGES: FSL / WASH activities that eventually impact on NUTRITION Water for livestock Water for agriculture (drip irrigation with WASH structure: tanks, pumps) Training on natural resources management (led by WASH) with water management for agriculture (irrigation) and for livestock etc Some common beneficiaries
13 LINKAGES: WASH/NUTRITION activities Hygiene promotion integrated into Nutrition activities (e.g.) nutrition education, hand washing Provision of water treatment substances such as PUR sachets, and pot filters to aid in minimizing incidence of water related diseases Supporting in provision of clean water at targeted feeding program centres (collaborative)
14 Program Impact in Garbatulla Overall objective = reduction of acute malnutrition integrated surveys and coverage assessments to measure overall impact A SMART survey was undertaken in September GAM of 18.6% and SAM rates of 3.0% (WHO Standards). Numerically this shows a decline in malnutrition status compared to May 2011.(Statistical significance to be established) Mid and end term project evaluations to determine the impact of the various projects e.g. ARC final evaluation in November/December 2011
15 COORDINATION IN GARBATULLA DISTRICT A number of other actors in Garbatulla undertaking different programs in close liaison with focal ministries as highlighted below. AGENCY ACF Activity Nutrition, FSL and WASH Others Monthly coordination meetings held at district and national level. Forum also used to plan and share any issues arising amongst various sectors. Save the Children World Vision Kenya Monitoring and Evaluation of High Impact Nutrition Interventions / BSFP Livelihood support, community empowerment, sponsorship and programme management, and child support. Internal inter departmental meetings and planning meetings Integrated surveys and sharing of findings for action/advocacy amongst the various stakeholders Action Aid Food supply for GFD, SFP and BSFP Kenya Red Cross Health
16 Other factors that enhance ACF strategy Technical support from team advisors Survey and surveillance system Developing of action on lessons learnt
17 Kenya mission overview, 2011
18 RESPONSE TO THE DROUGHT A major scale up of activities based on population s needs Until May 2011: 7 projects, 3 bases (Garbatulla, Tana River, and Makueni) As of October 2011: 24 projects/grants, 5 bases (2 new bases in West Pokot and Dadaab)
19 THANK YOU!! Any questions/queries/ inputs?
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