Endline Survey on the Infant and Young Child Feeding -- Child Grant in (IYCF-CG) Programme in the Karnali Zone of Nepal, 2016

 

The overall objective of this Endline Survey was to assess the impact of the Child Cash Grant program on the nutritional well-being of the under-five children in mountain districts of Karnali zone in Mid-western region of Nepal through cross sectional quantitative research in five selected districts on IYCF-CG and qualitative study in selected intervention sites. The specific objectives of this survey were to: undertake comparative analysis of nutrition data in selected intervention and control district; conduct trend analysis of core IYCF-CG indicators in program districts for examining implementation progress over this time period; and evaluate the program performance from the perspective of key selected stakeholders at the district, and VDC levels. The populations for this survey were children below five years of age including mothers/caretakers of under five children and community level key informants. A total of 3647 households with children below five years of age in endline and 3750 households in each of the baseline and midline were included in the study. Similarly, focus group discussions with grandmothers and fathers of under five children and  in-depth interviews with community level key informants (VDC secretaries, HP/SHP in-charges and FCHVs) was conducted from five study districts. This endline survey was conducted for UNICEF.

 

Policy and Science for Health, Agriculture and Nutrition (PoSHAN) Process Study – Round 3 and Frontline Workers Study, 2015

 

The key objective of this PoSHAN study was to expand the concept of process evaluation at various levels for effective implementation of multi-sectoral activities – to go beyond a singular program to integrated programs. The frontline workers (FLW) survey has the objective of measuring the extent to which frontline workers have retained knowledge from various integrated nutrition programs training like Suaahara, KISAN, Community Resilience Program (SABAL and PAHAL), whether and how they are using the SBCC tools and materials developed by these programs, to what extent and how they are reaching the 1000-day mothers, whether they are transferring the knowledge and skills to these mothers and other secondary audiences, what motivates and presents obstacles to frontline workers, how the interactions between frontline workers and beneficiary households happen and to assess FLW cross-sectoral collaboration.

 

The populations for this study were the key government and non-government officials at the district, Ilaka, village development committee (VDC) and ward level. The PoSHAN survey included 134 respondents and the FLW survey included 282 officials from the study districts. This study was conducted for the Tufts University, USA and Helen Keller International (HKI) Nepal.

 

An assessment of frontline workers and their delivery of Suaahara interventions, 2015

 

Suaahara works with front line workers from different relevant sectors such as FCHVs, agriculture/livestock extension workers, village WASH coordination committee members, social mobilizers and secondary audiences from schools and communities such as community leaders, teachers, and students . As a matter of fact, these audiences are the main workforce who enhances the process of implementation of Suaahara program. The overall objective of the study was to assess the status of process of implementation of Suaahara intervention on the basis of which it can have insight into the strengths and weaknesses of the program implementation and make mid-course corrections to the program in order to achieve high level outcomes. The specific objectives are to: a) find out the extent to which the frontline workers are using the knowledge, skills and materials provided by Suaahara to provide better services to 1000-day mothers, as expected; b) measure the extent to which the frontline workers have retained knowledge from the Suaahara training; c) find out whether and how the frontline workers are using the SBCC tools and materials developed by Suaahara; d) trace out how the frontline workers are reaching the 1000 day mothers; e) find out whether the frontline workers are transferring the knowledge and skills to the mothers and other secondary audiences; f) find out motivating and hindering factors among the frontline workers; and g) assess the ways interactions between frontline workers and beneficiary households occurring. A total of 734 frontline workers from eight study districts were included in the study. This study was conducted for Save the Children, Suaahara.

 

An assessment of the degree of exposure to Suaahara intervention platforms and adoption of key Suaahara-promoted practices, 2015

 

The overall objective of this study was to assess overall program exposure including various platforms across the Suaahara-related sectors. This assessment emphasized an examination of the reach of the mass media campaign; the extent and frequency with which households were exposed to frontline workers; and whether the Suaahara strategy to provide additional support (material and communications) to targeted disadvantaged households was happening as designed. This study covered a total of 472 women (currently married and those having under two years of child) from eight study districts representing both DAG and non-DAG groups. This study was conducted for Save the Children, Suaahara.

 

Suaahara DAG Reach Approach: Baseline Survey, 2014

 

The overall goal of the Suaahara is to improve the nutritional status of pregnant and lactating women and children under two years of age directly addressing the vulnerable points of development which result in stunting. Suaahara has a approach to target disadvantaged groups (DAGs) which entails mobilization of health mothers’ group members (peers) to facilitate change among other members of their group in support of the work carried out by Female Community Health Volunteers (FCHVs). The key intervention of the Suaahara program has been designed to facilitate change, address barriers, and reinforces key messages at caregiver and household level. The overall objective of the study was to assess the effectiveness of the DAG reach approach, and specifically the peer facilatator (PF) approach, on improving: a) maternal knowledge and practices regarding child health and nutrition, specifically optimal breastfeeding and complementary feeding of children under 2 years of age; and b) maternal knowledge and practices regarding maternal health and nutrition, specifically during pregnancy and lactation. This study was conducted in 4 out of 20 Suaahara program districts, namely Bhojpur, Sindhupalchowk, Rupandehi, and Bajhang. The population for this study constituted the 1000 days mothers (mothers of children between 6 months to 23 months) residing in DAG village development committees (VDCs). The sample size was 2520 mothers of children between 6-23 months old – 1260 from intervention and 1260 from comparison (control) areas. This study was conducted for Save the Children, Suaahara.

 

Policy and Science for Health, Agriculture and Nutrition (PoSHAN) Process Study – Round 2, 2014

 

The key objective of this study was to expand the concept of process evaluation at various levels for effective implementation of multi-sectoral activities – to go beyond a singular program to integrated programs. The populations for this study were the key government and non-government officials at the district, Ilaka, village development committee (VDC) and ward level. A total of 21 districts (7 from each of the three ecological zones) were included in the study. In each district one VDC was chosen for data collection at below the district level.  A total of 523 individuals from different institutions –215 from districts, 60 from Ilakas, 84 from VDCs and 164 from wards were included in the study. This study was conducted for the Tufts University, USA and Helen Keller International (HKI) Nepal.

 

Mid-line Survey on Child Grant in Karnali Districts, 2013

 

The main objective of the survey was to track progress of the child grant program and its impact on the nutritional well-being of the under-five children in five mountain districts namely Humla, Jumla, Mugu, Dolpa and Kalikot of Karnali zone. The specific objectives of the survey were to: assess the nutritional status of under-five children, measure the extent of household food security, estimate household income and expenditure pattern, identify KAP of key behaviors that impact infant and child health and nutrition practices, identify existing practices of IYCF and generate evidence on access to and utilization of the cash grant and other social protection schemes. The populations for this survey were children below five years of age including mothers/caretakers of under five children and community level key informants. A total of 3750 children below five years of age and their mothers/caretakers were included in the study. Similarly, 30 focus group discussions with grandmothers and fathers of under five children and 60 in-depth interviews with community level key informants (VDC secretaries, HP/SHP in-charges and FCHVs) was conducted from five study districts. This study was conducted for UNICEF.

 

An Approach for Conducting Multilevel Analysis for Effective Implementation of Multi-sectoral Nutrition Plan and Integrated Programs 2013

 

The key objective of this study was to expand the concept of process evaluation at various levels for effective implementation of multi-sectoral activities – to go beyond a singular program to integrated programs. The population for this study was the key government and non-government officials at the region, district, Ilaka, VDC and ward level. A total of 21 districts (7 from each of the three ecological zones) were included in the study. In each district one VDC was chosen for data collection at below the district level.  A total of 682 individuals from different institutions – 29 from regions, 278 from districts, 79 from Ilakas, 97 from VDCs and 199 from wards were included in the study. This study was conducted for the Tufts University, USA and Helen Keller International (HKI) Nepal.

 

Endline Survey on A Study on Action against Malnutrition through Agriculture (AAMA Plus) in Baitadi District of Nepal, 2012

 

Helen Keller International (HKI), the Ministry of Health and Population (MOHP), the Ministry of Agriculture and Cooperatives, and local NGO partners were implementing the USAID funded Action Against Malnutrition through Agriculture (AAMA) project in Baitadi District. This project integrated agriculture and health interventions for addressing malnutrition among children aged 0-24 months and women of reproductive age as well as addressing household food insecurity in the district. The project used a homestead food production (HFP) model that focuses on increasing households’ year round access to nutritious foods as a platform to deliver educational messages on a package of proven Essential Nutrition Actions (ENA) to households with children less than two years old.

 

The overall objective of the study was to provide endline information, which would be used to test whether providing micro-nutrient powders (MNPs) in a programmatic context along with HFP and an intensive community level IYCF-BCC intervention would have a greater impact on reducing anemia and improving growth in young children than only providing the HFP and IYCF-BCC intervention without MNPs or a control with no intervention. This study was conducted in 22 Village Development Committees (VDCs) in Baitadi district. A total of 312 mothers of 312 children aged 6-24 months were included in the endline survey (105 from MNP-intervention, 101 from non-intervention and 106 from control areas). This study was also conducted for Helen Keller International (HKI).

 

Endline Survey on Action against Malnutrition through Agriculture (AAMA) Project in Baitadi District, 2012

 

The overall objective of the survey was to assess change (measure impact) in HKI’s Homestead Food Production plus essential nutrition action model in Baitadi district to determine whether it could significantly improve child nutrition (anthropometry and anemia status) compared to control groups and measure the change of nutritional indicators after intervention of AAMA model. This study was conducted in 24 Village Development Committees (VDCs); of which 12 VDCs were from intervention and another 12 VDCs were from control areas. A total of 2614 children aged 12-47 months and their mothers (n=1307 from intervention and 1307 from control areas) were included in the study. The Endline Survey was conducted for the Helen Keller International (HKI).

 

Building Livelihood and Improving Nutrition of Women and Children in Udayapur District of Nepal, 2012

 

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The World Food Program (WFP) has been supporting food for assets activities in Udayapur district in partnership with local non-government organization. The overall goal of the project is to build an integrated food security, livelihood and nutrition model in food-insecure households to improve the nutrition status of children under five year old and women in Udayapur district. The project is implemented in seven village development committees which cover approximately 3500 food-insecure households.

 

The main objective of the study was to gather the endline information on current infant and young child feeding (IYCF) practices. In addition, the survey also generated endline information on household food insecurity and current agriculture practices, and explore changes in nutrition behavior and HFP practices. The respondents in the survey composed of mothers having children below five years of age at the time of survey. Three hundred and fifty mothers of under five children were interviewed to collect necessary information from the seven program VDCs. This study was conducted for Helen Keller International (HKI).

 

Community Theater Intervention to Improve Nutrition: A Randomized Controlled Trial in Three Districts of Nepal, 2013

 

The Nepal Community Theater project consisted of two components: (1) theater performance in the designated villages followed by a question-and-answer discussion session, and (2) data collection before and after the program to determine the effectiveness of the program. The primary objective of the study was to determine whether the Community Theater intervention affects individual’s short and long-term health and nutrition-related understanding, perceptions and behaviors. The study was conducted in the selected areas of Sindhupalchowk, Nawalparasi and Bajhang districts. 3000 men and women aged 18-59 years were included in the study. This study was conducted for the Johns Hopkins University.

 

Building Livelihood and Improving Nutrition of Women and Children in Udayapur District of Nepal, 2010

 

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The World Food Program (WFP) has been supporting food for assets activities in Udayapur district in partnership with local non-government organization. The overall goal of the project is to build an integrated food security, livelihood and nutrition model in food-insecure households to improve the nutrition status of children under five year old and women in Udayapur district. The project is implemented in seven village development committees which cover approximately 3500 food-insecure households.

 

The main objective of the study was to gather baseline information on current infant and young child feeding (IYCF) practices. In addition, the survey would also generate information on household food insecurity and current agriculture practices to include the key project indicators. The respondents in the survey composed of mothers having children below five years of age at the time of survey. Three hundred and fifty mothers of under five children were interviewed to collect necessary information from the seven program VDCs. This study was conducted for Helen Keller International (HKI).

 

A Study on Action against Malnutrition through Agriculture (AAMA Plus) in Baitadi District of Nepal, 2010

 

Helen Keller International (HKI), the Ministry of Health and Population (MOHP), the Ministry of Agriculture and Cooperatives, and local NGO partners are implementing the USAID funded Action against Malnutrition through Agriculture (AAMA) project in Baitadi District. This project integrates agriculture and health interventions for addressing malnutrition among children aged 0-24 months and women of reproductive age as well as addressing household food insecurity in the district. The project uses a homestead food production (HFP) model that focuses on increasing households’ year round access to nutritious foods as a platform to deliver educational messages on a package of proven Essential Nutrition Actions (ENA) to households with children less than two years old.

 

The overall objective of the study was to provide baseline information which would be used to test whether providing micro-nutrient powders (MNPs) in a programmatic context along with HFP and an intensive community level IYCF-BCC intervention would have a greater impact on reducing anemia and improving growth in young children than only providing the HFP and IYCF-BCC intervention without MNPs or a control with no intervention. This study was conducted in 20 Village Development Committees (VDCs) in Baitadi district. The populations for the present study were mothers having children between 6-9 months of age at the time of survey. A total of 355 mothers of 356 children aged 6-9 months were included in the study; of which 118 mothers were from MNP-intervention areas, 120 from non-MNP intervention areas and 117 were from control areas. This study was also conducted for Helen Keller International (HKI).

 

Follow up Survey in Makawanpur District for the Mother and Child Health Care Activity, 2005

 

The Mother and Child Health Care (MCHC) Activity is being implemented in the selected village development committees of Makawanpur district by the Government of Nepal with support from the World Food Program since 2002. The MCHC program aims to increase the use of existing services by using health centers for distribution of food. At the same time the program aims at bolstering of the quality of services rendered by providing training to health care workers and also the increased supplies of key antenatal items such as iron-folate tablets and de-worming medication in the working areas.

 

The main objective of the study was to collect and review information about the nutritional and health status of children and women particularly the expectant and nursing mothers so that the impact of the MCHC activities carried out in district could be assessed objectively. A total of 252 expectant and nursing mothers and 461 caretakers were included in the study. Likewise, in-depth interviews and one focus group discussions were organized to solicit necessary information. This study was conducted for World Food Program.

 

Follow up Survey in Doti District for the Mother and Child Health Care Activity, 2005

 

The Mother and Child Health Care (MCHC) Activity is being implemented in the selected village development committees of Doti district by the Government of Nepal with support from the World Food Program since 2002. The MCHC program aims to increase the use of existing services by using health centers in distribution of food. The program aims at bolstering of the quality of services rendered by providing training to health care workers as well as the increased supplies of key antenatal items such as iron-folate tablets and de-worming medication in the working areas.

 

The main objective of the study was to collect and review information about the nutritional and health status of children and women particularly the expectant and nursing mothers so that the impact of the MCHC activities carried out in district could be assessed objectively. One hundred and twenty nine pregnant and nursing mothers and 281 461 caretakers were included in the study. In addition, 73 in-depth interviews and four focus group discussions were conducted for obtaining necessary information. This study was also conducted for World Food Program.

 

Baseline Survey in Baitadi, Darchula and Salyan Districts for the Mother and Child Health Care Activity, 2004

 

The overall objective of the study was to collect baseline information and establish benchmark estimates of various indicators on health and nutritional status of mothers and children in order to be able to assess changes over time. The study was done in the selected Village Development Committees of Baitadi, Darchula and Salyan districts. This study was conducted for World Food Program.