Collaboration with UNICEF ESARO & WCARO Wednesday, September 27 th
Outline of Webinar 1. Background on the collaboration between UNICEF and SMART 2. Methodology and results of the analytical report landscaping national and small-scale surveys in West, Central, Eastern and Southern Africa regions using SMART 3. Methodology and results of the Case Studies carried out in Tanzania and Burkina Faso 4. Dissemination Plan of outputs and Questions
Objectives Be aware of the background of the outputs from the collaboration between SMART and UNICEF Regional Offices in West and Central Africa, Eastern and Southern Africa. Understand the process and main results of the 3 main outputs, including an overview of their dissemination
Background Meetings following Regional SMART Workshop in Nairobi How to leverage on Tanzania s National Nutrition Survey for advocacy No clear operational definition of a National Nutrition Survey using SMART methods Role of nutrition surveys using SMART in national nutrition programmes: a review of the process and utilization of results
Key Outputs 1. Analytical report landscaping national and small-scale surveys in West, Central Eastern and Southern Africa regions using SMART including lessons learnt and their role in Nutrition Information Systems 2. Case Study on Burkina Faso: Institutionalization process of SMART methods for national nutrition surveys 3. Case Study on Tanzania: Advocacy process of for 1st national nutrition survey in ESAR using the SMART methods
Analytical Report Sample of countries based on 3 categories:
9 Countries selected Selection of Countries Countries Density of SMART surveys Smallscale Regional Annual National SMART Surveys Presence of an Early Warning System Humanitarian Context Triggers of use Routine Development Context Primary stakeholders conducting SMART NGOs UNICEF Government Mali None Low Yes Yes X X X X XX Senegal None Low Yes Yes X X X XX Cameroon None Low No No X X X X XX D.R.C None High None Yes X X X XX Kenya Med High None Yes X X X XX South Sudan High Med None Yes X X X X XX Madagascar High Low None No X XX X X Malawi Low None None Yes X X X X XX Mozambique None None None No
Main Findings
Main Findings The implementation of nutrition surveys using the SMART Methodology has contributed to the harmonization of nutrition rapid assessment methods across the region. The use of National Nutrition Survey/SMART owned by governments has contributed to achieve consensus on the nutritional situation in a country. This review also illustrated the key role played by: UNICEF Offices with regard to SMART surveys in Sub-Saharan Africa: UNICEF provides significant technical support, supplies anthropometric equipment, and supports the implementation of SMART surveys financially. Action Against Hunger - Canada s support is also pivotal, providing SMART Methodology training, helping build the SMART capacities of the individuals responsible for conducting the surveys, and maintaining the technical stringency required to obtain quality data.
Coordination Mechanisms Coordination between the government (i.e. Ministry of Health, Statistics Institute) and the different technical and financial partners (other government institutions, UN agencies, non-governmental organizations) is generally good during the planning, implementation and results validation/dissemination phases. Valuable contribution to the decision-making of Nutrition Information Working Groups: IPC (cadre harmonisé) analyses, caseload estimations, nutrition information trends and analysis
Implementation of Surveys Implementation processes (i.e survey protocol development, training, inclusion of a standardization test) are similar across selected countries and comply with SMART technical recommendations. Governments are becoming increasingly independent from outside technical support. It is increasingly difficult to raise and secure funds to carry out SMART surveys: some thought will have to be given to the frequency and representation of regional and/or smallscale surveys in order to reduce their associated implementation costs and thereby facilitate the sustainability of the information systems currently in place.
Use of Survey Results Results are used for nutrition programming, as tools for advocacy and lobbying for the mobilization of resources, and included in early warning systems to enhance responses to crises and emergencies. Constant interest from development partners in SMART surveys, considering results (including malnutrition prevalence) as benchmark nutrition data. Data on women of childbearing age are collected in several countries, helping to highlight the nutritional transition underway in developing nations.
Case Studies 1. Interview guides developed, face-to-face meetings held 2. Analysis of key survey documents undertaken. 3. Tanzania: advocacy process vs. Burkina Faso: the institutionalization of SMART methods 4. Implementation process and key partners of a National Nutrition Surveys using SMART methods for each country 5. Lessons learned and recommendations identified for each
Tanzania: Objectives Prior to 2014, national nutrition information in Tanzania was primarily obtained from Demographic and Health Surveys (DHS), carried out every 5 years. The Tanzania Case Study highlights key steps and lessons learned from the first Tanzania National Nutrition Survey (TNNS) using SMART Methods. Prevalence of chronic malnutrition in children 0-59 months of age, by region (TNNS, 2014).
Tanzania: Process - objectives
Tanzania: Process - implementation
Tanzania: Use of Results Tanzania National Nutrition Survey results have been used to: Estimate and update the number of children who are stunted and the number with acute malnutrition per region in order to identify priority regions for scaling-up key nutrition interventions. Prepare the National Multisectoral Nutrition Action Plan for the period 2016-2021. In a parallel manner, the SUN focal point is using these results to prioritize regions and advocate focus areas for nutrition partners and donors (CIFF and DFID).
Tanzania: Key Lessons Learned Positive Buy-in/ownership from key nutrition leaders within government (PMO, TFNC, MoHSW, NBS, zmoh and OCGS). Good communication and weekly planning meetings of the Technical Committee Members. Low cost per region (less than US$ 15,000) helped development partners to fund the survey. Recruitment of regional and district nutrition officers as survey personnel. Use of NNS results to prepare the National Multisectoral Nutrition Action Plan for the period 2016-2021. Challenges Technical Committee only composed of government institutions and UNICEF. Meeting to present survey protocol occurred after finalization by SC (too late to incorporate input from other partners). Dropout of enumerators (additional training/budget required). Delayed dissemination of the survey results and final report (>3 months after end of data collection) due to delays in the validation process of the final report and the organization of the HLSCN meeting.
Tanzania: Key Recommendations Overall: The implementation of the first National Nutrition Survey with the SMART Methodology was a great success thanks to the important involvement of the government throughout the different phases of the survey. Efforts to continuously build the capacity of nutrition partners within the government, as well as their involvement in the training of the survey teams for future TDHS, should continue in order to continually strengthened capacities of relevant government structures to monitor nutrition situation of the population. The National Nutrition Surveys using SMART Methods should be one of the key elements of the future National Multi-sectoral Nutrition Information System in Tanzania.
Burkina Faso: Objectives Burkina Faso was particularly affected in the 2008 Sahel crisis and carried out a National Survey. The results were vastly different from the previously available results (MICS 2006) which lead to lack of consensus on the national nutrition status. The first SMART National nutrition survey was carried out in 2009 with the overall aim of better monitoring the prevalence of malnutrition and the status of IYCF indicators with their changes over time, and to develop a consensus on the country s nutrition status.
Burkina Faso: Process - planning
Burkina Faso: Process - implementation
Burkina Faso: Use of Results Planning of nutrition interventions and to evaluate humanitarian needs To evaluate impact of nutrition interventions For advocacy To monitor global nutrition indicators To contribute to Cadre Harmonise (IPC equivalent in West Africa)
Burkina Faso: Key Lessons Learned Positive Consensus on the country s nutritional status. Government leadership through the Department of Nutrition and involvement of other key Government partners. Regular technical support for SMART (from UNICEF and ACF) has resulted in increasing independence of Department of Nutrition. Inclusion of the SMART national survey in the National Statistics annual workplan has meant it is registered as a national activity and its results are used as benchmarks. Dissemination of results and use by all partners. Challenges Implementation remains timeconsuming and blocks other work of the Department of Nutrition for at least a 3-month period annually. No consideration given to timing / seasonality of data collection. Second-level representation is too costly even if desirable. Despite innovative approaches to reduce cost, budget remains higher than in other countries in the subregion, and funding is uncertain.
Burkina Faso: Key Recommendations Find ways to ensure the long-term continuation and sustainability of the National Nutrition Survey, including: Securing Government contribution Reducing the level of representativeness (from Provincial to Regional) to reduce the cost Continue to promote / ensure government autonomy for the National Nutrition Survey.
Dissemination of Results Webinars including the recordings and SMART Newsletters 3 articles for submission to peer reviewed journals 1 synthesis paper for ENN-Field Exchange Presentations at upcoming events: International Conference on Nutrition: mid-october in Buenos Aires Regional Assessment Working Group Meeting: November 22-23 rd in Nairobi
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