strengthening nutrition surveillance accelerating nutrition improvements in sub-saharan africa

114 Pages·2017·7.92 MB·English

ACCELERATING
NUTRITION
IMPROVEMENTS IN
SUB-SAHARAN AFRICA
STRENGTHENING
NUTRITION
SURVEILLANCE
FINAL REPORT 2012-2016

ACCELERATING
NUTRITION
IMPROVEMENTS IN
SUB-SAHARAN AFRICA
STRENGTHENING
NUTRITION
SURVEILLANCE
FINAL REPORT 2012-2016
WHO/NMH/NHD/17.5
© World Health Organization 2017
Some rights reserved. This work is available under the Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO;
https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
Under the terms of this licence, you may copy, redistribute and adapt the work for
non-commercial purposes, provided the work is appropriately cited, as indicated
below. In any use of this work, there should be no suggestion that WHO endorses
any specific organization, products or services. The use of the WHO logo is not
permitted. If you adapt the work, then you must license your work under the same
or equivalent Creative Commons licence. If you create a translation of this work,
you should add the following disclaimer along with the suggested citation: “This
translation was not created by the World Health Organization (WHO). WHO is not
responsible for the content or accuracy of this translation. The original English
edition shall be the binding and authentic edition”.
Any mediation relating to disputes arising under the licence shall be conducted in
accordance with the mediation rules of the World Intellectual Property Organization..
Suggested citation. Accelerating nutrition improvements in Sub-Saharan Africa:
strengthening of nutrition surveillance. Final report 2012–2016. Geneva: World
Health Organization; 2017 (WHO/NMH/NHD/17.5). Licence: CC BY-NC-SA 3.0 IGO.
Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.
int/iris.
Sales, rights and licensing. To purchase WHO publications, see http://apps.who.
int/bookorders. To submit requests for commercial use and queries on rights and
licensing, see http://www.who.int/about/licensing.
Third-party materials. If you wish to reuse material from this work that is
attributed to a third party, such as tables, figures or images, it is your responsibility
to determine whether permission is needed for that reuse and to obtain permission
from the copyright holder. The risk of claims resulting from infringement of any
third-party-owned component in the work rests solely with the user.
General disclaimers. The designations employed and the presentation of the
material in this publication do not imply the expression of any opinion whatsoever
on the part of WHO concerning the legal status of any country, territory, city or area
or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Dotted and dashed lines on maps represent approximate border lines for which
there may not yet be full agreement.
The mention of specific companies or of certain manufacturers’ products does not
imply that they are endorsed or recommended by WHO in preference to others of a
similar nature that are not mentioned. Errors and omissions excepted, the names of
proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by WHO to verify the information
contained in this publication. However, the published material is being distributed
without warranty of any kind, either expressed or implied. The responsibility for the
interpretation and use of the material lies with the reader. In no event shall WHO be
liable for damages arising from its use.
Design and layout by Alberto March
Cover photo credit: Rachel Palmer/Save the Children
Printed in Switzerland
Contents
Aknowledgments v
Executive summary 1
Project description, rationale and context 1
Overall outcomes 4
Lessons learned 5
Part I : Overview 7
Project description, rationale and context 7
Objectives 10
Expected deliverables 10
Performance monitoring framework 10
Grant coordination and supervision 12
Risks and their mitigation 12
Gender equality 13
Part II: Global and regional outcomes 15
Part III: Country activities and outcomes 21
Part IV: Analysis of project performance 73
Relevance 73
Project design 73
Sustainability 73
Partnership 73
Part V: Lessons learned and next steps 75
Part VI: Financial management report 78
Annex A: Country activities and sub-activities 81
Annex B: Country-by-country outputs and outcomes 98
Annex C: Staff trained by country 104
Annex D: Partners by country, in addition to implementing partner 106

Acknowledgments
T
his report was prepared under the leadership of Francesco
Branca, Director of the WHO Department of Nutrition for
Health and Development (WHO/NHD), in close collaboration
with staff from WHO headquarters (Monika Blössner, Kaia
Engesveen, Chizuru Nishida and Katerina Ainali), the Regional Office
for Africa (Adelheid Onyango) and inter-country support teams
(Hana Bekele and Elisa Dominguez). We extend our appreciation
to the group at the Berman Institute of Bioethics and the School of
Advanced International Studies at Johns Hopkins University (Jessica
Fanzo, Rebecca McLaren and Haley Swartz) for their considerable
input. Thanks go to Cathy Wolfheim for editing and coordinating
the production of the document.
WHO/NHD is grateful to Global Affairs Canada for the financial
and technical support provided to the Accelerating Nutrition
Improvements project.
(WHO Award 59470; GAC PO 7058566)
Project Budget: CAN$ 7 800 000
Project duration: 29 March 2012 – 30 September 2016
Submitted by:
Dr Francesco Branca
Director of Nutrition for Health and Development
World Health Organization
V
ANI Project Map
Surveillance 2
1 Burkina Faso
4
2 Mali
1
3 Mozambique
2
4 Senegal
Surveillance + scale up
1 Ethiopia
2 Uganda
3 United Republic of Tanzania
Surveillance + surveys
1 Rwanda
2 Sierra Leone
3 Zambia
4 Zimbabwe
VI
Executive Summary
Project description, rationale and context
A
frica is home to one third of the world’s 156 million stunted
children. Similarly, out of the 50 million children in the world
who are wasted, 14.1 million live in Africa. Severely wasted
children also encounter common infectious diseases, and
they are on average 11 times more likely to die than their healthy
counterparts. In Africa, the prevalence of babies born small for
gestational age is the second highest in the world, at around 24%.
There are also important issues of micronutrient deficiency diseases.
The high burden of malnutrition in Africa results in huge losses
of human capital and economic productivity. Maternal, infant and
young child nutrition needs to be improved drastically, with a
focus on the critical 1000 days during pregnancy and the first
1
two years of life. Results must be monitored and evaluated to
track progress, thus the need for a robust nutrition surveillance
system integral to programme implementation.
Baseline measurements revealed at least three essential gaps
2
in nutrition surveillance, related to the relative absence of nutrition
indicators in national health management information systems
1
(HMIS), late submission of sub-national data to the national level,
and little evidence of use of the data to influence local action, or the
3
use was limited to a select few people.
Given these challenges, and considering the commitment
of countries to report on the nutrition indicators agreed upon
in World Health Assembly Resolution 65.6, the World Health
3 Organization (WHO) was requested to provide guidance on
3
how to strengthen routine HMIS systems to track key nutrition
indicators.
4
1
Global Targets 2015
Target Baseline 2012 Target for 2025
2