county nutrition action plan - Nutrition International

Figure 2 Sample of financial tracking tool from Busia The CNAPs have also proven to be an important advocacy tool, which, coupled with the financial tracking tool, have been pivotal in mobilizing domestic resources for nutrition. Underlining its confidence in, and commitment to the CNAPs, Nutrition International, with funding from the Government of Canada, signed performance-based agreements with four counties − Busia, Vihiga, Makueni and Nandi − committing to match new national investments in nutrition on a one-to-one basis. So far this combined commitment has mobilized CAD $3.6M of new funding for nutrition actions in those counties. Nutrition International is continuing to negotiate performance-based agreements with other counties. The Governor of Kajiado has recently committed KSH 51M (about CAD $588,000) more to their CNAP and is in the process of signing a memorandum of understanding (MoU) with Nutrition International to match the investment, which will bring the total raised by the CNAPs to approximately $4.8M CAD. This matched funding model, and NTEAM’s support in developing the CNAPs, have been recognized as important factors in Kenya’s success in mobilizing resources for nutrition. In addition to successfully mobilizing financial resources, NTEAM support sought to strengthen counties’ capacities for nutrition planning by working alongside county officials to develop the tools and carry out training on nutrition planning. An NTEAM assessment of officials’ capacity for developing nutrition action plans in five counties before and after the TA was delivered indicates results in this area as well. The assessment noted improvements in their knowledge about defining key result areas (up 6.7%), costing (up 9.8%) and gender (up 21%) in particular. NTEAM believes that all 48 counties in Kenya should be adequately equipped with the capacity to develop their own CNAPs independently. To this end, NTEAM is developing CNAP guidelines and templates with information about how to form a secretariat to oversee the CNAP process and approvals, as well as key steps, such as defining gender-sensitive key result areas. Nutrition International is also supporting select counties to develop County Nutrition Investment Cases which will demonstrate the high return on investment from nutrition interventions and will further support counties to advocate to central government and donors to achieve full funding of the CNAPs. Nutrition International’s country office in Kenya is also pursuing MoUs with the remaining counties which have launched CNAPs to match their investments in nutrition, and has applied TAN’s model for CNAP development to four additional counties in the last year. The development of the County Nutrition Investment Cases, the four additional CNAPs and the MOUs for matched funding are supported with funding from both the Government of Canada through Global Affairs Canada, and through NTEAM’s TAN project, which is funded with UK aid from the UK government. [post_title] => NTEAM’s support helps secure multi-million dollar investments for nutrition in Kenya [post_excerpt] => Between 2017 and 2019, Nutrition International’s Nutrition Technical Assistance Mechanism (NTEAM) supported the Government of Kenya in reviewing the previous National Nutrition Action Plan 2012-2017 (NNAP) and in developing the new action plan known as Kenya Nutrition Action Plan II (KNAP II). [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => nteams-support-helps-secure-multi-million-dollar-investments-nutrition-kenya [to_ping] => [pinged] => [post_modified] => 2024-05-02 14:04:36 [post_modified_gmt] => 2024-05-02 18:04:36 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 15421 [post_author] => 54 [post_date] => 2021-03-04 22:21:29 [post_date_gmt] => 2021-03-04 22:21:29 [post_content] => The COVID-19 pandemic has disrupted daily life, threatened livelihoods, and disproportionately impacted women and girls with the potential to undo decades of gender equality work. Maureen Wangari, a farmer in Nakuru County, Kenya, stepped forward to turn these obstacles into opportunities. Wangari is a community health volunteer (CHV) in Jewathu, Kenya, where she lives with her family. In September 2020, Wangari participated in a training from Nutrition International through the county government of Nakuru. She was one of 292 CHVs trained on adolescent nutrition and anaemia prevention in the COVID-19 context. “Since I got that training, I have been interacting a lot in the community and I’ve seen a lot of change,” Wangari said. Nutrition International and county officials developed the training for CHVs to address a critical problem. When the pandemic forced schools to close, it cut off access to iron and folic acid supplements distributed weekly through schools. The supplements are a proven and effective intervention to prevent anaemia. In Kenya, anaemia prevalence is 16% among adolescent girls aged 10-14 years and 14% among girls aged 15 to 19. Anaemia among pregnant women is 42% and the rate of teenage pregnancy and motherhood is 18%. In 2016, Nutrition International started an adolescent program to target girls aged 10-19 years with nutrition education and supplements to prevent anaemia, providing them with knowledge that will impact them long after their teen years. When the pandemic hit and in-classroom learning halted, the team pivoted to explore alternative methods to support girls during this crucial phase of development.

Woman raises both arms into the air confidently

Maureen Wangari is a community health volunteer in Kenya. She provided essential education to families on anemia prevention and adolescent health when schools were closed due to COVID-19. While observing social distancing, Wangari started going door-to-door spreading awareness about good nutrition to adolescent girls in her community and mobilizing them to access iron and folic acid supplements from the nearby health facility. She was responsible for reaching 95 girls in her area and mapped out a route to visit half of them on Thursdays and the other half on Saturdays. At first, reactions to her visits were mixed. Wangari came across several households where parents were not familiar with the benefits of supplements. Rumours had spread that they were for family planning or would make it impossible for their daughters to get pregnant later in life. Faced with misinformation, Wangari explained the purpose of the supplements − how they helped boost the production of red blood cells in the body to promote health overall. She talked about the fatigue and lack of concentration girls can experience because of anaemia, and that taking the supplement would help prevent this. Wangari could relate to the reluctant parents. Prior to the training with Nutrition International, she said she also had not fully accepted the program in her daughters’ school. One of her daughters would hide her supplements because she knew her mother would tell her not to take them. That shifted with Wangari’s newfound understanding − and by sharing her knowledge with her neighbours she changed community perceptions as well. “Through supplementation and good nutrition our children’s performance has improved,” Wangari said. “Their grades have improved too. They feel energetic, happy, healthy and they are hardly absent from school.”

Two girls in school uniforms do their homework in their living room

Wangari's daughters Maryanne (left) and Jemimah (right) received nutrition education directly from their mom when schools were closed. As Wangari spoke, two of her daughters sat quietly by, working on their science homework. Jemimah is in Grade 4 and Maryanne is in Grade 8. Jemimah said she plans on being a doctor when she grows up, wanting to help others like her mom. “Before I started getting the supplements I used to feel weak,” she shared. “Now, I am able to concentrate and understand what the teacher says in class better.” Maryanne said she felt the difference when supplements became available at the nearby health facility. “It has helped us to have good concentration and to have more energy.” Maryanne also said she’s eating more green vegetables now that her mother is a nutrition advocate. “She has been a good role model to us and to the community.” As a mom of girls, Wangari feels the importance of the program first-hand. “This project can bring equality between girls and boys,” she said. “Nowadays girls attend school because they are feeling strong and can put effort into their studies. This is something I have witnessed especially when their marks improved. When girls get educated, they will have well paying jobs and they will grow to become doctors, engineers or pilots. So, we cannot say that these professions are only for boys because girls are not good enough.” Agnes Mauko, a teacher at Ndege Secondary School in Njoro, Nakuru County, saw rates of female absenteeism drop once her school started implementing the adolescent nutrition program in 2018. “Before we had the supplementation of the iron and folic acid... girls weren’t concentrating in class. They were sleepy. They were drowsy,” Mauko said. "But after the supplementation I have noted a very great improvement.”

Three women standing in front of a school sign in Kenya

High school teacher Agnes Mauko (middle) with the sub-county nutritionist and Nutrition International staff. When the pandemic forced schools shut, Mauko didn’t want her students to be negatively affected. “At the beginning we were very worried. We didn’t know if the program could push through,” she shared. But parents started to call, demanding school closures do not disrupt supplement distribution. The school worked closely with county and sub-county health workers and CHVs, and was able to continue handing out supplements to students who lived close-by, reaching over 90% of the female students. In January 2021, schools reopened for in-classroom learning in Kenya and with it the adolescent nutrition program is back to business as usual. Wangari’s daughters are back in the classroom, but she’s not stopping her advocacy work. She’s continuing to visit the adolescent girls in her community to understand how they are doing, check that they are taking their supplements regularly, and share her nutrition knowledge. If it ever becomes challenging to distribute through the schools again, she said the program can be brought back to the community. She is ready. [post_title] => Community health volunteer goes door-to-door in support of adolescent girls’ nutrition [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => community-health-volunteer-supports-adolescent-girls-nutrition-kenya [to_ping] => [pinged] => [post_modified] => 2024-05-02 14:04:39 [post_modified_gmt] => 2024-05-02 18:04:39 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2919 [post_author] => 32 [post_date] => 2020-11-15 17:32:37 [post_date_gmt] => 2020-11-15 17:32:37 [post_content] => Technical Assistance for Nutrition (TAN) was a project within our Nutrition Technical Assistance Mechanism (NTEAM) through which we provided support and assistance to help SUN Movement countries improve the nutritional status of their populations, especially women and children. The Opportunity The Scaling Up Nutrition Movement

Created in 2010, the Scaling Up Nutrition (SUN) Movement is founded on the principle that all people have a right to food and good nutrition. SUN aims to unite people − from governments, civil society, the United Nations, donors, businesses and researchers − in a collective effort to improve nutrition.

SUN countries are putting the right policies in place, collaborating with partners to implement programs with shared nutrition goals, and mobilizing resources to effectively scale up nutrition. Through NTEAM’s TAN Project, funded with UK aid from the UK government, we support countries by responding to priority technical needs, addressing gaps, and building technical capacity and capability at national and sub-national levels.

Our Solution Improving the capacity of SUN countries through technical assistance

Through the TAN project, we seek to improve the capacity of SUN countries to design, plan, manage and monitor the delivery of multisectoral national nutrition plans, and to generate, learn from and adopt knowledge that works.

This happens through the direct provision of technical assistance to support needs identified through a consultative process, led by SUN country focal points and the in-country multi-stakeholder/sectoral platforms. Technical assistance is also provided to the SUN Movement Secretariat.

We provide support and assistance to countries that have joined the SUN Movement as part of their efforts to improve the nutritional status of their populations – especially women and children.

Through this technical assistance, we help national SUN focal points in select countries to overcome gaps in capacity for the design and delivery of multisectoral national nutrition plans, tapping into its global hub to source and deploy the expertise needed.

The project aims to accelerate the achievement of better health and nutrition status of populations by ensuring that governments are better equipped to act swiftly to scale up nutrition in their countries.

Our approach to the provision of technical assistance is country-driven and coordinated. This ensures all partners committed to improving nutrition outcomes, including donors, national governments, civil society or community groups, are connected and consulted, so that our contribution to the in-country support systems for scaling up nutrition provides clear added value for achieving maximum and sustainable impact.

Our technical assistance:

Supports development or operationalization of national nutrition plans in the Philippines, Bangladesh, Kenya and Tanzania
At the sub-national level, supports development, operationalization and implementation of County Nutrition Action Plans in 12 counties in Kenya that that promote local ownership and sustainability

We are gathering a list of experts from a variety of nutrition-specific and nutrition-sensitive fields interested in helping SUN countries translate their global targets into concrete action. Complete the NTEAM Technical Assistance Provider Recruitment Form

The Impact Helping countries scale up nutrition Through NTEAM's TAN project, we provide technical assistance to build the capacity of SUN countries to deliver national nutrition plans and ensure they are better equipped to act on them to improve the health of their populations. [post_title] => Technical Assistance for Nutrition (TAN) Project [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => technical-assistance-for-nutrition-tan-project [to_ping] => [pinged] => [post_modified] => 2023-01-23 21:08:30 [post_modified_gmt] => 2023-01-23 21:08:30 [post_content_filtered] => [post_parent] => 0 [guid] => https://development.nutritionintl.org/?post_type=project&p=2919 [menu_order] => 0 [post_type] => project [post_mime_type] => [comment_count] => 0 [filter] => raw ) [3] => WP_Post Object ( [ID] => 13735 [post_author] => 35 [post_date] => 2020-11-09 15:18:50 [post_date_gmt] => 2020-11-09 20:18:50 [post_content] =>

Kenya’s Kajiado County launched its County Nutrition Action Plan (CNAP) on October 14, committing Ksh51 million (US$500,000) to improve the nutrition status of its population. The five-year plan, developed with technical and financial support from Nutrition International, will help mainstream nutrition into Kajiado’s development plans and budgets to reduce the burden of malnutrition in the county. The CNAP provides practical guidance for implementing proven, cost-effective and high-impact nutrition interventions. It recognizes the role of nutrition as a fundamental human right and a driver to accelerating economic development as envisioned in the Government of Kenya’s Vision 2030. It also defines a coordination mechanism for various actions across sectors, including health, agriculture, education, water, gender and social protection. The plan is aligned with the Kajiado County Integrated Development Plan, the County Health Strategy and Investment Plan, County Medium-Term Expenditure Plans and the Kenya Nutrition Action Plan.

“The County Nutrition Action Plan builds into the county’s deliberate efforts to prioritize nutritional services in our food security and healthcare interventions,” said County Governor H.E. Joseph Ole Lenku while addressing participants at the CNAP launch. “Going forward, we shall match these interventions with necessary budget allocations, particularly to ensure sustainability of maternal, newborn and child health and nutrition interventions in the county.”

One in four children in Kajiado are affected by acute malnutrition, while 44% of women and girls are overweight, much higher than the national average. Nutrition International has been working in the county since 2017 to improve the health and nutrition of women and children.

“We have made tremendous progress in scaling up efforts to address malnutrition in Kajiado County,” said Martha Nyagaya, Country Director, Nutrition International Kenya. “This could not have been possible without the support and contribution of the county government and other nutrition partners. We call upon the governor and the county leadership to pursue a long-term approach to sustainable financing of nutrition in order to support the implementation of the CNAP.”

In total, the CNAP will cost Ksh 1.8 billion to implement. In addition to the county government’s allocation, other partners have committed resources and technical support, including Nutrition International, Welthungerhilfe, World Vision, FEED, UNICEF, Dupotu-e-maa and the Kenya Scaling Up Nutrition Civil Society Alliance. Nutrition International has provided technical and financial support to the development of 16 of the 23 CNAPs completed in Kenya. Kajiado County’s CNAP is the ninth to be launched. [post_title] => Kajiado County commits funds to nutrition [post_excerpt] => Kenya’s Kajiado County launched its County Nutrition Action Plan (CNAP) on October 14, committing Ksh51 million (US$500,000) to improve the nutrition status of its population. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => kajiado-county-commits-funds-to-nutrition [to_ping] => [pinged] => [post_modified] => 2024-05-02 14:04:55 [post_modified_gmt] => 2024-05-02 18:04:55 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [4] => WP_Post Object ( [ID] => 13292 [post_author] => 10 [post_date] => 2020-06-17 11:59:15 [post_date_gmt] => 2020-06-17 15:59:15 [post_content] =>

Building sub-national performance-based matched-funding arrangements in Kenya

In 2015, we began asking ourselves some uncomfortable questions about how we were investing our resources at Nutrition International: when development organizations like ours put a dollar on the table, was it ‘additional’ to what would have been spent anyway – or did governments then shift a dollar away from nutrition to something else? Did the availability of health and nutrition funding from donors and partners reduce or remove the pressure on some governments (national and sub-national) to put more of their own money on the table? How could we get the most for every donor dollar we spent – not just in terms of human impact but by encouraging local authorities to invest more too? To dig into these and other questions, we started in Kenya. Nutrition International initiated a series of financing roundtables, consultations, and team-to-team meetings with an array of county and national officials, including bilateral meetings with county governors. By 2019, we had co-created and developed a new investment model with counties: sub-national, performance-based matched-funding arrangements. This approach was specifically designed to leverage verifiable increases in domestic funding for high-impact nutrition interventions and system strengthening activities – and to tie our funding to performance.

The investment model

We developed this approach in Kenya due to its decentralized system of governance and the critically important role of the 47 county governments in the success of nutrition programs. County governments have considerable budgetary autonomy in determining how they plan, budget, allocate, and spend funding from national government transfers as well as locally raised revenue. The extent to which nutrition is a local priority determines the extent to which it is locally funded. The approach had several upstream elements. Firstly, with funding from the United Kingdom and Canada, Nutrition International supported Kenya in drafting a five-year multi-sectoral National Nutrition Action Plan (2018-2023) which identifies – and costs – priority actions for eliminating malnutrition in the country. We then worked with sub-national governments to translate the national priorities to the local county context. This was a truly multi-sectoral initiative which involved the departments of health, agriculture, finance, education, and other nutrition sensitive sectors. We also secured early buy-in by working directly with County Assembly members (those who approve the county’s budget and expenditure). In this way, we were able to bridge the technical, financial and political while remaining focused on the most important part of the equation: people. The resulting County Nutrition Action Plans (CNAPs) identify priority nutrition activities to be implemented by various sectors, their outputs and – again – their cost. From these costed action plans, Nutrition International worked with county governments to prioritize a subset of high-impact activities that focused on results as well as system building, with the goal of strengthening the counties’ capacity to plan, manage and sustain these programs. We also worked together to identify each county’s baseline funding, so additionality could be measured. The counties then committed to increasing funding beyond this baseline over the next three years without negatively impacting outcomes in other social sectors. They created dedicated budget lines for nutrition and established a special account within Kenya’s Financial Management Framework to manage the matched funds. Once the county funds have been transferred, Nutrition International matches the above baseline investments on a 1:1 basis, using funding provided by Global Affairs Canada.

The results

On February 4, 2020, following significant consultation and engagement, Nutrition International signed performance-based funding agreements with the County Governors of Busia, Makueni, Nandi, and Vihiga. Combined, these counties have committed nearly CAD $2M in domestic nutrition investment between 2020 and 2023 – CAD $1.6M of which is additional funding. This represents a five-fold increase in domestic funding for high-impact, low-cost nutrition actions that work. Combined with Nutrition International’s 1:1 match of the additional funding, CAD $3.6M in total will be invested in these four counties through 2023. Since the signing, and despite the impacts of COVID-19 on government budgets, all four counties have transferred their first quarter funds and triggered match funding from Nutrition International. Negotiations are currently underway with six additional counties who have committed to joining the model by July 2021, and we are supporting a further six to create CNAPs, which will form the basis of future performance-based matched-funding arrangements.

The road ahead

Despite evidence of success, Kenya still suffers from a huge burden of preventable malnutrition. More than many countries, it has the power, the people, and the means to put an end to this. Forward-thinking governors were rightly concerned not only about preventable maternal and child deaths, but also about rising obesity and deaths due to non-communicable diseases. Malnutrition is a great destroyer of immune systems, and the foundation of any health system is the immune system strength of the people in it. When a pandemic like COVID-19 preys upon the most vulnerable, the benefits of investing in nutrition become doubly clear and increasing the priority for nutrition investments at local level is more important than ever. As we proceed, we will keep the following six lessons in mind:

Upfront engagement is key. Nutrition actions must be tailored to the local context by counties themselves.
Local governance matters. National nutrition plans offer good guidance, but sub-national commitment drives action on the ground.
Nutrition must be made political or it will never be a priority. Governors and their teams who helped co-create the action plans are key nutrition ambassadors, within their counties and for other counties and other countries.
Evidence and impact must drive prioritization. Counties operate in resource-constrained environments and funds must be prioritized based on evidence for impact in vulnerable groups.
People must remain at the centre. Programs must bridge the technical, financial and political while remaining focused on the most important part of the equation: people.
Now is the time for greater ambition. COVID-19 has shown us that global health is a local matter and that strong immune systems are the foundation of strong health systems. Now is the time to scale up this model and ensure there is more money for nutrition as well as more nutrition for the money.

At Nutrition International, we will expand our work with sub-national governments across Kenya and beyond to increase domestic investments for nutrition and build stronger, more resilient communities. Communities that are better able to withstand future shocks, be they health, environmental or economic. We will also continue to partner with leading nutrition donors, such as Canada and the United Kingdom, to build sustainable programs that deliver measurable results for every dollar invested. [post_title] => Doing Development Differently: increasing domestic investments for nutrition [post_excerpt] => Nutrition International co-created and developed a new investment model with Kenyan counties: sub-national, performance-based matched-funding arrangements. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => doing-development-differently-increasing-domestic-investments-for-nutrition [to_ping] => [pinged] => [post_modified] => 2024-05-02 14:05:22 [post_modified_gmt] => 2024-05-02 18:05:22 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [5] => WP_Post Object ( [ID] => 13136 [post_author] => 35 [post_date] => 2020-05-13 15:33:38 [post_date_gmt] => 2020-05-13 19:33:38 [post_content] => In light of the COVID-19 pandemic, Nutrition International’s Nutrition Technical Assistance Mechanism (NTEAM) has conducted a thorough review across its portfolio of current or planned technical assistance to determine, and implement, the necessary modifications that could optimize their contribution to national COVID-19 impact mitigation responses. The review also included a readjustment of technical assistance workplans, in the event that the original deliverables no longer constitute a priority due to COVID-19, or where activities are no longer feasible, such as travel, workshops, in-person meetings with government, etc. For NTEAM’s Technical Assistance for Nutrition (TAN) project – funded with UK aid from the UK Government – the review was a collaborative effort with SUN Focal Points, Nutrition International Country Directors and technical assistance providers and, in some cases, heads of nutrition in government. Consultations with them have been led by NTEAM's technical assistance Regional Project Teams in Asia and Africa, and supported by Nutrition International staff based in Ottawa, Canada (at headquarters). To share information and ensure alignment with other efforts, Nutrition International is also holding coordination calls with the SUN Movement Secretariat to share what we've learned about the in-country context and resulting technical assistance adaptation. So far a total of 21 technical assistance projects that are either on-going or starting soon have been reviewed in four Asian countries (Bangladesh, Indonesia, Pakistan and the Philippines) and six African countries (Ethiopia, Kenya, Malawi, Mozambique, Nigeria and Senegal), as well as the technical assistance provided to the SUN Movement Secretariat in Geneva, and to the East, Central and Southern Africa Health Community. We are reassured by the reaffirmation by the ten countries of the continued relevance of the agreed technical assistance, and their agreement that it should continue. In some cases, SUN Focal Points felt that the technical assistance has gained even greater relevance in light of the COVID-19 pandemic, such as support for the development of Indonesia's National Food and Nutrition Action Plan 2020-2024. However, in several assignments, the approach taken to deliver technical assistance has had to adapt to the limitations imposed by COVID-19 response measures, for example:

To support technical assistance provision at the subnational level in Ethiopia and Kenya, where trips to the subnational level cannot be undertaken, funds earmarked in technical assistance budgets for travel are being re-allocated to internet and telephone credit, for improving communication with subnational teams, and to printing, which can be done at the subnational level to ensure access by the intended beneficiaries
Dissemination workshops in Pakistan are being replaced with virtual exchanges, and in Kenya the Guidance Manual being developed to help county officials develop Nutrition Action Plans (CNAPs) will include information to ensure that these CNAPs will also be responsive and adaptive to emergencies like the COVID-19 pandemic
In several countries routine face-to-face working meetings are being replaced with phone or video calls
In the Philippines, support to subnational entities with nutrition budgeting exercise for 2020 is being provided via virtual platforms such as Zoom
In some situations, selected activities such as training, have been postponed for two to three months, while the situation is regularly re-assessed

Furthermore, the consultation has identified several long-term technical assistance providers who, because of their expertise and seniority, have been invited to join national COVID-19 response planning teams, to lead COVID-19 related working groups, and to lead the development of nutrition-related COVID-19 response plans and guidance, such as in:

Bangladesh: Dr. Iqbal Kabir (Team Lead) and Dr. Mohsin Ali
Ethiopia: Dr. Sisay Sinamo
Kenya: Dr. Daniel Mwai

Finally, the technical assistance review has identified additional needs for support to national COVID-19 responses which have been incorporated into technical assistance workplans, as detailed in this article. As the COVID-19 situation evolves, the technical assistance review will continue with all the countries that have ongoing or upcoming technical assistance, to ensure each technical assistance workplan reflects up to date COVID-19 considerations. [post_title] => Nutrition International reviews its technical assistance portfolio in light of the COVID-19 pandemic [post_excerpt] => In light of the COVID-19 pandemic, Nutrition International’s TAN project has conducted a thorough review of its portfolio of current or planned Technical Assistance (TA) to determine, and implement, the necessary modifications. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => tan-reviews-its-technical-assistance-portfolio-in-light-of-the-covid-19-pandemic [to_ping] => [pinged] => [post_modified] => 2024-05-02 14:05:27 [post_modified_gmt] => 2024-05-02 18:05:27 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [6] => WP_Post Object ( [ID] => 2347 [post_author] => 41 [post_date] => 2020-03-27 00:00:00 [post_date_gmt] => 2020-03-27 00:00:00 [post_content] =>

Nairobi, KENYA - At a Nutrition Financing Workshop on February 4^th, four Kenyan county governments signed agreements with Nutrition International, committing to increase domestic resources for nutrition programs. Governors from Busia, Vihiga, Nandi and Makueni counties signed the agreements following the launch of their County Nutrition Action Plans (CNAPs) in November. Nutrition International worked closely with the national government to develop the Kenya Nutrition Action Plan (KNAP) 2018-2022, which identifies priority actions and associated costs for the country to address malnutrition. But, as programs are implemented at the county level, there was a clear need to work more directly with counties to ensure they could deliver these programs effectively to the community. In 2016 and 2017, Nutrition International engaged county leaders in discussions around requirements and necessary support to begin, or improve, planning, costing and budgeting for nutrition. The need for counties to mobilize their own resources to achieve these targets was central to these conversations. Nutrition International committed to support at least 16 counties to develop their own nutrition action plans: Kajiado, Nakuru, Bomet, Kiambu, Murang’a, Nandi, Elgeyo Marakwet, Vihiga, Busia, Nyeri, Narok, Nairobi, Tharaka Nithi, Makueni, Embu and Kwale. In November 2019, Busia, Vihiga, Nandi and Makueni counties launched their County Nutrition Action Plans 2019-2023. The CNAPs are designed to help implement local nutrition interventions in order to achieve the goal of the KNAP to “achieve optimal nutrition for a healthier and better quality of life and improved productivity for the country’s accelerated social and economic growth.” Following the launch of the CNAPs, Nutrition International engaged the leadership of the four counties in a discussion of how to mobilize resources to implement the plans. The counties made commitments to increase funding to nutrition above the baseline and to work through existing county financial systems.

“We listened to leaders from Busia, Vihiga, Nandi and Makueni counties, and began to build a new model that would address their needs,” said Joel Spicer, president and CEO of Nutrition International, at the nutrition financing workshop. “These efforts produced the CNAPs that translate the national nutrition plan to the county level, focusing on priority interventions and implementation. Together, we’re bridging the technical, financial and political while remaining focused on the most important part of the equation: people.”

The resource mobilization agreements support the implementation of the CNAPs, ensuring county ownership, financial sustainability and predictability. The agreements guarantee additional domestic resources for low-cost, high-impact interventions and increase donor confidence in the county’s system.

“I thank counties for working with us to develop this new performance-based model,” said Martha Nyagaya, Nutrition International’s country director for Kenya. “For the first time, we have established baseline levels for funding of key nutrition interventions.”

At the end of the workshop, leadership from six additional counties – Bomet, Embu, Kajiado, Kiambu, Murang’a and Nakuru – committed to work with Nutrition International to develop their own CNAPs and committed resources as they look to adopt the new nutrition financing model. Kajiado county's CNAP was completed in March. The Nutrition Financing Workshop was held in Nairobi and brought together various stakeholders, including representatives from Nutrition International, Global Affairs Canada, the UK’s Department for International Development, and national and county ministries. [post_title] => County governments in Kenya commit to increase resources for nutrition [post_excerpt] => At a Nutrition Financing Workshop on February 4th, four Kenyan county governments signed agreements with Nutrition International, committing to increase domestic resources for nutrition programs. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => county-governments-in-kenya-commit-to-increase-resources-for-nutrition [to_ping] => [pinged] => [post_modified] => 2022-02-05 19:00:20 [post_modified_gmt] => 2022-02-05 19:00:20 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [7] => WP_Post Object ( [ID] => 2341 [post_author] => 41 [post_date] => 2020-03-18 00:00:00 [post_date_gmt] => 2020-03-18 00:00:00 [post_content] => [caption id="attachment_12881" align="alignnone" width="1000"]

MPs from the United Kingdom visit a school in Murang'a County, Kenya.

MPs from the United Kingdom, Lord Ray Collins of Highbury and Baroness Zahida Manzoor, visit a school in Murang'a County, Kenya.[/caption] In February, members of parliament from the United Kingdom saw first-hand the impact of Nutrition International’s programming in Kenya. Two members of the All Party Parliamentary Group for Nutrition and Growth – Lord Ray Collins of Highbury, a member of the House of Lords and the shadow minister for International Development, and Baroness Zahida Manzoor, a conservative member of the House of Lords – traveled to the country to meet with organizations and people benefitting from nutrition programs there. The visit, organized by RESULTS UK, included meetings with stakeholders in Nairobi and field visits to see projects being implemented by Nutrition International and UNICEF. On the first day the MPs met with key nutrition partners, including UNICEF Kenya, Nutrition International, DFID Kenya, Scaling Up Nutrition and Christian Aid. In the meeting, Nutritional International Kenya’s Country Director Martha Nyagaya called for the prioritization of nutrition financing and advocacy in order to tackle malnutrition in the country.

“According to the 2019 Cost of Hunger in Africa study, undernutrition costs Kenya's economy Ksh373.9b, which is 6.9% of the Gross Domestic Product,” said Ms. Nyagaya. “Nutrition International is therefore focusing on multi-sectoral nutrition interventions especially at county level.”

The next day, the MPs traveled to Murang’a County where they met with Mr. Joseph Mbai, a member of the County Executive Committee.

“The county government is committed in terms of nutrition,” said Mr. Mbai. “We have worked closely with Nutrition International, especially in vitamin A supplementation and the development of the County Nutrition Action Plan.”

Kangaroo Mother Care The first site visit was to the maternal and child health clinic at the Maragua sub-county hospital. Nutrition International established the kangaroo mother care (KMC) mother support group there in August 2019, targeting 15 mothers. They meet monthly to discuss the benefits of KMC and share lessons learned with other mothers in the hospital’s newborn unit who have low birthweight children. Mercy Muiruri, a member of the support group who practiced KMC on her son Francis explained the benefits to the MPs.

“I have witnessed a good growth of my last-born child, Francis,” said Mercy. “I gave birth to him when my pregnancy was at 34 weeks. He was very tiny and weighed only 1400 grams. He was immediately put in the incubator. After 10 days, he was removed from the incubator with a weight of 1700 grams. Then a nurse introduced me to kangaroo mother care. After one week of practicing KMC in the hospital, we were discharged with Francis weighing 1950 grams. We were given weekly follow-up visits to the hospital where the nurses monitored his progress until he reached 3200 grams. Thereafter, we were given monthly follow-up visits. My husband and I practiced KMC for two months.”

Mother to Mother Support Group The MPs also met with members of the Gichengo Mother to Mother Support Group, comprised of 20 women between the ages of 19 and 30. They meet every Monday at a member’s home to discuss Anzilisha or Right Start, which focuses on healthy habits from pregnancy until a child’s second birthday. The lead mother guides the conversation, using messages from the Mama Anzilisha booklet. Members of the group explained to the MPs the benefits of their weekly meetings, including learning the importance of taking iron and folic acid supplements and eating iron-rich foods during pregnancy. They also noted that they had learned how to feed young children and the importance of proper hygiene. Kobil Father Support Group Later in the afternoon, the MPs met members of the Kobil Father Support Group that was established in January 2020. The group has 39 members and meets at the Mukereniu dispensary. Ever Thursday, the lead father leads the group through a discussion on healthy habits in the first 1,000 days, using the Baby Anzilisha booklet as a guide.

“After attending Anzilisha meetings, I realized that I have a role to play as a parent and I must assist my wife,” Peter, the team leader, told the visitors. “I now know that I need to accompany my wife to clinics.”

Another member of the group explained the importance of exclusive breastfeeding.

“I have learned that a child should not be given anything, including water, before six months. He or she feed on breast milk alone and eat food at six months.”

Vitamin A Supplementation in School The final visit was to Maragua Primary School, which is linked to the Maragua sub-county hospital. The MPs met with students and teachers to understand their roles in vitamin A supplementation (VAS). Through the Murang’a VAS Optimization Project, 413 Early Childhood Development Education (ECDE) teachers have been trained on the importance of vitamin A. They then pass this knowledge on to students and their parents. The teachers also work closely with health workers to ensure that all children registered in their ECDE centres get twice-yearly doses of vitamin A. The VAS optimization project began in March 2018 and is being implemented in the sub-counties of Kandara and Murang’a South. The pilot project provides technical support in planning and optimizing delivery of VAS through multiple channels, including health facilities, community health units and early childhood development centres. Since the project began, more than 2,000 caregivers have learned about the importance of vitamin A. VAS coverage for children 6 to 11 months improved from 27.7% in 2017 to 66.4% in 2018 and for children under five, coverage increased from 30% to 72%. Murang’a county has set a target of 80% coverage for all children under five. After completing their tour, Baroness Manzoor and Lord Collins met again with key stakeholders, including DFID Kenya, UNICEF Kenya, Nutrition International, Kenya’s Head of Nutrition and Dietetics Veronica Kirogo, Kenya’s Scaling Up Nutrition Focal Point Gladys Mguambi, and representatives from the National Treasury.

“You are doing wonderful work,” Baroness Manzoor told the group. “We have seen and heard the impact of nutrition interventions in the communities.”

Following the field visits and meetings, Lord Collins called for increased outreach activities and support for community health workers.

“We have seen the integration of nutrition from the national to county level,” said Lord Collins. “We need to see greater strategic priorities right at the start of programs and translation of the same from national to counties, with clear indicators.”

[post_title] => Members of parliament from the UK see impact of nutrition projects in Kenya [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => members-of-parliament-from-the-uk-see-impact-of-nutrition-projects-in-kenya [to_ping] => [pinged] => [post_modified] => 2021-08-25 14:49:42 [post_modified_gmt] => 2021-08-25 14:49:42 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [8] => WP_Post Object ( [ID] => 2314 [post_author] => 41 [post_date] => 2020-02-06 00:00:00 [post_date_gmt] => 2020-02-06 00:00:00 [post_content] =>

Islamabad, PAKISTAN – A two-day national conference to step up action on malnutrition brought together parliamentarians, government officials, donors, academics and civil society organizations in Islamabad today. With only 10 years left to reach global targets, including the Sustainable Development Goal of zero hunger, Nutrition International, the Scaling Up Nutrition (SUN) Secretariat and the SUN Civil Society Alliance, and the Ministry of Planning Development and Special Initiative brought together Pakistan leaders for “Improved Nutrition – Secure Future” to build strategies for the country to meet these targets. The learnings from this conference will be used to fast-track effective implementation of maternal, child and adolescent nutrition strategies and programs.

“This conference is an opportunity for stakeholders to take stock of the malnutrition situation at the national and provincial levels and identify opportunities for action,” said Dr. Shabina Raza, Country Director for Nutrition International, to open the proceedings. “The national nutrition conference will help us understand clear pathways for multisectoral integration and develop actionable plans, using existing coordination mechanisms for accelerating improvement in nutrition.”

The event was organized in response to the alarming results of the government’s most recent nutrition survey. According to National Nutrition Survey 2018, Pakistan is facing the triple burden of malnutrition, with high rates of undernutrition, micronutrient deficiencies and increasing prevalence of obesity. Women, adolescents and children are most affected. The survey found 40.2% of children under five years of age are stunted, while 17.7% suffer from wasting. The double burden of malnutrition is apparent, with 28.9% of children underweight and 9.5% overweight. Despite marginal improvement from 2011, when the prevalence of stunting was 43.7%, it remains at a critical level. Experts believe that this change can be attributed to population increase, and there has actually been very little improvement. Women aged 15-49 years of age are also facing the triple burden of malnutrition: 14% are undernourished, 28% are overweight and 38% are obese, a number that is reported to be increasing. Almost 42% of women and 57% of adolescent girls are anaemic. President of the Islamic Republic of Pakistan, Dr. Arif Alvi, was the Chief Guest of the conference. He expressed his concern about the alarming rates of malnutrition in the county and emphasized the need to move beyond just talk, take action and follow deadlines to tackle the crisis of malnutrition. President Alvi stressed the importance of breastfeeding and consuming locally available diverse and nutritious foods. He also highlighted the media’s role in raising awareness about health and diet. Also addressing the attendees, Dr. Allah Baksh, Secretary Ministry of National Health Services, Regulation and Coordination, outlined the actions the government has taken to address the situation, including the National Health Vision 2016-2025, which aims to achieve universal health coverage through a resilient and responsive health system, and realize the Sustainable Development Goals and other national and international commitments. To fulfill that vision, many crucial policy and guidance documents have been developed at the federal level, such as the Infant and Young Child Feeding Strategy 2016-2020, the adolescent nutrition strategy, the nationwide vitamin A supplementation program, and the national food fortification program. A multi-billion rupees nutrition program is also being finalized, which will be implemented at the provincial level. Ms. Wendy Gilmore, Canadian High Commissioner to Pakistan, shared Canada's support for the country's efforts to eliminate malnutrition.

“Canada is proud to support Pakistan’s efforts on addressing malnutrition issues through our partner Nutrition International," said Ms. Gilmore. "Nutrition requires a comprehensive approach, with the empowerment of women and girls at its core, as it impacts health, education, and economic development outcomes.”

During the first day’s technical session leading global and national experts, including Dr. Zulfiqar A. Bhutta and Dr. Rubina Sohail, shared feasible recommendations for improving maternal and child nutrition in Pakistan. The session was chaired by Professor Dr. Mehr Taj Roghani, a senior parliamentarian, and co-chaired by Dr. Nosheen Hamid, Parliamentary Secretary for the Ministry of National Health Services Regulations and Coordination. Messages from Mr. Joel Spicer, President and CEO of Nutrition International, and Ms. Gerda Verburg, Global Coordinator for the SUN Movement and Assistant Secretary General for the United Nations, were screened for participants, showing their support and congratulating the government on its leadership. The first day was concluded by Tehrik e Niswan, who gave a theatrical performance demonstrating the first 1,000 days of life. The second day of the conference will feature specialists from health, agriculture, social protection, education and other relevant sectors sharing their recommendations to leverage existing investments in development projects. [post_title] => Leaders urged to act quickly to improve nutrition in Pakistan [post_excerpt] => A two-day national conference to step up action on malnutrition brought together parliamentarians, government officials, donors, academics and civil society organizations in Islamabad. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => leaders-urged-to-act-quickly-to-improve-nutrition-in-pakistan [to_ping] => [pinged] => [post_modified] => 2022-02-05 19:19:06 [post_modified_gmt] => 2022-02-05 19:19:06 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) [9] => WP_Post Object ( [ID] => 2295 [post_author] => 1 [post_date] => 2019-12-13 00:00:00 [post_date_gmt] => 2019-12-13 00:00:00 [post_content] => [caption id="attachment_12691" align="alignnone" width="1000"]

Launch of CNAP in Kenya[/caption] Four county governments in Kenya have launched their County Nutrition Action Plans (CNAPs) 2019-2023. The governors of Busia, Vihiga, Nandi and Makueni counties unveiled the plans during colourful events that brought together various stakeholders, among them Nutrition International’s President and CEO Joel Spicer, representatives from national and county ministries and departments, and nutrition partners. The main aim of the CNAPs is to contribute to the Kenya National Nutrition Action Plan (KNAP) 2018-2022 goal of ‘achieving optimal nutrition for a healthier and better quality of life and improved productivity for the country’s accelerated social and economic growth'. With support from Nutrition International and partners, the KNAP was developed to provide strategic direction and accelerate scale-up efforts towards the elimination of malnutrition as a public health problem. Using the KNAP as a guide, the CNAPs were developed to address county-specific nutrition issues and propose interventions that are appropriate for the local context. The development of the CNAPs is in line with changes in Kenya’s political environment that resulted in the creation of 47 county governments. The role of county governments has become critical in ensuring the successful implementation of sustainable nutrition actions. With support from the Government of Canada and with UKaid from the UK Government, Nutrition International and partners are providing technical support to 16 counties, including an initial seven counties, to develop nutrition action plans. These plans were developed through a consultative process involving all stakeholders in health and nutrition, as well as other line county departments. This process included the county health leadership, county government line departments, county line ministries, development partners and implementing partners. The CNAPs identify priority multi-sectoral nutrition actions for each sector, define targets for each intervention, and provide a monitoring and accountability framework as well as costing of interventions which county governments can use for subsequent planning and budgeting. “For over 25 years Nutrition International has remained committed to its core vision: a world where everyone, everywhere, is free from malnutrition and able to reach their full potential. Nutrition International Kenya works closely with government (national and County), to support research, policy development and implementation of nutrition interventions in the country. The development of the County Nutrition Action Plans in Kenya is a key milestone in our continued quest to contribute to addressing the problem of malnutrition,” said Martha Nyagaya, Nutrition International Kenya Country Director, during the launch of the plans. County Governors commended Nutrition International and partners who supported the development of the CNAPs, which they termed a roadmap to improving nutrition in Kenya. “The CNAPs light the path for the implementation of low-cost, high-impact activities that will have the greatest impact on the largest number of people,” said Mr. Spicer. “It takes a multi-sectoral approach because nutrition is a multi-sectoral issue where health, education and agriculture come together. The plan also defines targets, coordination and accountability mechanisms needed to make sure this plan is not just a piece of paper but something that will save and improve people’s lives.” In Kenya, it is estimated that between 2010 and 2030, undernutrition will cost the economy approximately US$38.3 billion. “Imagine what we could do with that money if we invested it in prevention and creating health,” Mr. Spicer reflected. During the launch of the Makueni CNAP, the Head of Kenya’s Nutrition and Dietetics Division, Veronica Kirogo, presented an overview of the country’s malnutrition situation. Kenya is facing a triple burden of malnutrition, with the coexistence of undernutrition (stunting, wasting or underweight), overweight or obesity, and micronutrient deficiencies. Out of 7.22 million children under five, nearly 1.9 million are stunted (26%), 290,000 are wasted (4%) and 794,200 (11%) are underweight. Following the launch of CNAPs in four counties, Nutrition International held roundtable discussions with county government officials to mobilize resources for nutrition through a matched grant that seeks to increase domestic resource allocation to the costed nutrition plans. [post_title] => Kenyan counties launch Nutrition Action Plans [post_excerpt] => Four county governments in Kenya have launched their County Nutrition Action Plans (CNAPs) 2019-2023. The governors of Busia, Vihiga, Nandi and Makueni counties unveiled the plans during colourful events that brought together various stakeholders, among them Nutrition International’s President and CEO Joel Spicer, representatives from national and county ministries and departments, and nutrition partners. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => kenyan-counties-launch-nutrition-action-plans [to_ping] => [pinged] => [post_modified] => 2022-02-06 18:13:11 [post_modified_gmt] => 2022-02-06 18:13:11 [post_content_filtered] => [post_parent] => 0 [guid] => [menu_order] => 0 [post_type] => news [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 10 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 15691 [post_author] => 41 [post_date] => 2021-03-29 12:44:14 [post_date_gmt] => 2021-03-29 12:44:14 [post_content] => Between 2017 and 2019, Nutrition International’s Nutrition Technical Assistance Mechanism (NTEAM) supported the Government of Kenya in reviewing the previous National Nutrition Action Plan 2012-2017 (NNAP) and in developing the new action plan known as Kenya Nutrition Action Plan II (KNAP II). NTEAM’s work, via the Technical Assistance for Nutrition (TAN) project, focused on developing the costing framework for the KNAP II, which is considered by partners to be one of the most useful sections of the KNAP II. The framework was developed through a consultative and evidence-informed approach, and draws on lessons learned from the previous NNAP. The resulting user-friendly and practical costing framework served as a solid foundation for the first-ever County Nutrition Action Plans (CNAPs), which NTEAM helped to develop. The framework revealed a significant nutrition planning and financing gap in Kenya, which is unlikely to be met without increased domestic resource contributions at all levels. The investments of development partners were recognized as a lever that could serve to encourage increased discretionary budgetary allocations to nutrition at the subnational level, and the KNAP II costing framework also underscored the need for subnational governments to be supported with costed county nutrition implementation plans. The costed CNAPs have proven to be instrumental in mobilizing additional domestic resources in Kenya, and NTEAM hopes this experience can inspire and guide other countries in their bid to strengthen subnational level planning, resource mobilization and financial tracking. Importantly, county representatives had participated in the development of the KNAP II, which greatly facilitated buy-in for the CNAP process. Between July and December 2019, NTEAM’s technical assistance (TA) providers worked with County Nutrition Coordinators and multisectoral teams of nutrition stakeholders in Kajiado, Makueni, Nandi, Tharaka Nithi, Busia, Vihiga and Elgeyo Marakwet counties to develop their CNAPs. These seven CNAPs were produced through an inclusive and consultative process with nutrition-sensitive sectors (which varied by county, but could include health, education, water and sanitation, gender, social protection, and agriculture, livestock and fisheries), development partners, civil society organizations, NGOs and the private sector, and were launched by the Governors in each of the counties. From February to November 2020, through an adapted process given the constraints imposed by the COVID-19 pandemic, NTEAM successfully supported five more counties to develop and finalize their CNAPs: Nakuru, Bomet, Murang’a, Embu and Kiambu. The combined cost of implementing the 12 CNAPs over four to five years would be KSH 21.8B total (approximately $253M CAD), ranging between KSH 1.2B and 2.6B for each county ($14M to $30M CAD). One of the most valuable tools developed by NTEAM to help operationalize the CNAPs is the multistakeholder financial tracking tool. This allows counties to monitor nutrition expenditures by activity and outcome across government, NGOs and the private sector, thus identifying the funding available for each outcome and where resources fall short. See Figure 2 for a sample section of the financial tracking tool being used in one county.

Field Stories

March 4, 2021

Community health volunteer goes door-to-door in support of adolescent girls’ nutrition

During the pandemic, a mom and community health volunteer in Kenya became a nutrition education advocate. She didn’t want her daughters, and other girls in her community, to fall behind.