<div class="title-block" style="border-bottom-color: #d5992a"><h1><img class="title-image" src="http://www.heart-resources.org/wp-content/themes/heart/images/nutrition.svg">Nutrition</h1><div class="post-type-description"></div></div> – Health and Education Advice and Resource Team http://www.heart-resources.org Providing DFID staff and other development actors with health, education and nutrition knowledge and expertise from around the world Fri, 02 Mar 2018 13:10:49 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.4 What works to improve nutrition in northern Nigeria? http://www.heart-resources.org/blog/works-improve-nutrition-northern-nigeria/ http://www.heart-resources.org/blog/works-improve-nutrition-northern-nigeria/#comments Wed, 13 Dec 2017 11:18:53 +0000 http://www.heart-resources.org/?post_type=blog&p=30280 Read more]]> With a strong focus on learning and continuous engagement with Nigerian policy-makers, the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management, was successfully completed in August 2017. ORIE has contributed for the past five years to inform nutrition research and the policy debates in Nigeria and beyond.

ORIE provided operations research, impact evaluations, costing and cost effectiveness studies for the ambitious £52 million, six-year, Department for International Development (DFID)-funded Working to Improve Nutrition in Northern Nigeria (WINNN) programme, which supports the government to improve maternal, newborn and child nutrition in five northern states. ORIE worked closely with key federal and state government stakeholders to ensure that findings reached them and informed their policies.

ORIE findings contributed to changes in policy and practice by the WINNN programme and government. They included:

  • Revision of national guidelines on nutrition outreach services to improve access, by increasing the number of health facilities used and improving social mobilisation strategies;
  • Improved guidelines and practices for educating mothers, other family members and community leaders on best practices in breast-feeding and weaning children;
  • Supporting and recognising the volunteers who play a key role in delivering services in the community; and
  • Strengthened research capacity in nutrition in four northern Nigerian universities.

Since 2012 ORIE has produced more than 25 separate studies which were the result of five years of activities that included rigorous mixed methods impact evaluations, operational research, and research capacity building among Nigerian academics.

Key endline outputs, all available on the HEART website, include the Integrated Evaluation Report, a summary of key findings from all ORIE studies; a set of five thematic briefs which summarise learning from over the past six years of studies and implementation on governancemicro-nutrient supplementationinfant and young child feeding practicescommunity-based management of acute malnutrition (CMAM) and gender and that were co-produced in collaboration with WINNN implementing partners, and; a rigorous mixed methods impact evaluation (including quantitative and qualitative studies); and reports which analyse the cost and cost effectiveness of the programme.

Findings were appropriately packaged to make the messages more accessible to different audiences, making use of research summaries, policy briefs, blogs, infographics and other products. Overall, ORIE reports have been downloaded so far more than 60,000 times.

In August 2017, ORIE started the dissemination phase of its final findings. The ORIE-WINNN launch event was held in Abuja on 2- 3 August 2017 and brought together around 100 key stakeholders from many sectors and institutions in Nigeria across federal, state and local government, civil society organisations, non-governmental organisations, universities, and donors.

The official presentation of the findings was followed by lively learning workshops on key strategic themes. The five workshops encouraged stakeholders to discuss the key issues arising from ORIE findings and explore implications for future nutrition policy and practice. The workshops were well received and covered important topics around governance, gender, CMAM, micronutrient supplementation and IYCF.

The reports were highly rated by key stakeholders, as were our key engagement and dissemination meetings. At the dissemination event held in Abuja early in August 2017, 95% of participants rated their level of satisfaction with ORIE events and reports over the last five years as good or excellent.

We expect ORIE evidence to continue to have an impact on policy and practice in nutrition, in Nigeria and beyond, after the project closes.

Post written by Marta Moratti, who is a a monitoring & evaluation consultant at OPM.

This blog was posted on Medium on 6 October 2017. Reposted with permission. The Operations Research and Impact Evaluation (ORIE) project, is a Department for International Development (DFID)-funded consortium led and managed by Oxford Policy Management (OPM). The research outputs and studies were carried out in collaboration with London School of Hygiene and Tropical Medicine (LSHTM), Save the Children UK (SCUK), the Institute of Development Studies (IDS) and the Nigerian based institutions Ibadan University and the Food Basket Foundation International (FBFI).

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What can the United States Learn from the Scaling Up Nutrition (SUN) Movement? Examining Country Leadership in Zambia, Kenya and Bangladesh http://www.heart-resources.org/doc_lib/can-united-states-learn-scaling-nutrition-sun-movement-examining-country-leadership-zambia-kenya-bangladesh/ http://www.heart-resources.org/doc_lib/can-united-states-learn-scaling-nutrition-sun-movement-examining-country-leadership-zambia-kenya-bangladesh/#respond Mon, 18 Sep 2017 10:54:20 +0000 http://www.heart-resources.org/?post_type=doc_lib&p=30019 Read more]]> Country-led political and financial commitments to nutrition goals are widely recognized as critical to reducing malnutrition at scale. This report seeks to examine the relationship between country-level nutrition policy, implementation leadership, donor support and coordination, and nutrition outcomes at a national or subnational level. The analysis focuses on reducing the prevalence of stunting in countries targeted by the U.S. government global food and nutrition security initiative, Feed the Future. Drawing from progress of and lessons learned within the Scaling Up Nutrition (SUN) movement, it furnishes recommendations for Feed the Future to improve its engagement both with SUN and with broader country-level nutrition policies and aligned resources.

This report seeks to understand whether select countries that have more fully embraced and championed the SUN strategy have also witnessed greater progress in mounting a scalable and effective response to malnutrition. It explores whether multilateral coinvestments in nutrition policy and planning, in line with SUN aims and objectives, translate into change on the ground that sustains local ownership and leadership.

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Integrated Evaluation Report of the WINNN Programme: ORIE http://www.heart-resources.org/assignment/orie-nigeria-final-integrated-report/ http://www.heart-resources.org/assignment/orie-nigeria-final-integrated-report/#respond Wed, 02 Aug 2017 08:26:08 +0000 http://www.heart-resources.org/?post_type=assignment&p=29909 Read more]]> ORIE research on WINNN consisted of operations research, a mixed-methods impact evaluation, economic evaluation, and gender analysis which were conducted over a period of five years. This report integrates findings from this research to provide a high-level summary of WINNN’s achievements along with an overview of the key messages and recommendations that emerge from research findings.

The WINNN programme improved mother’s attendance at Maternal Neonatal and Child Health Week (MNCHW) events and mother’s IYCF knowledge and practices but had no impact on anthropometric indicators. The research finds that WINNN was well-aligned with government priorities and that government planning, coordination and forecasting improved during the course of the programme. In terms of efficiency, the CMAM and IYCF components of the programme are found to very cost-effective relative to international standards. While WINNN contributed to an increase in political commitment and funding for nutrition initiatives in Nigeria, funding levels are still not sufficient to meet necessary scale-up targets.

A summary of the report is available here.

Suggested citation: Hansford, F., Visram, A., Jones, E., Ward, P. (2017), ‘Integrated Evaluation Report of the WINNN Programme: Operations Research and Impact Evaluation’, Oxford Policy Management, Oxford, UK

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Strengthening nutrition sector governance: Lessons from the WINNN programme http://www.heart-resources.org/assignment/strengthening-nutrition-sector-governance-lessons-winnn-programme/ http://www.heart-resources.org/assignment/strengthening-nutrition-sector-governance-lessons-winnn-programme/#respond Tue, 01 Aug 2017 20:03:53 +0000 http://www.heart-resources.org/?post_type=assignment&p=29883 Read more]]> This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning about strengthening nutrition sector governance from the Working to Improve Nutrition in Northern Nigeria (WINNN) programme implemented in five states in northern Nigeria (Jigawa, Katsina, Kebbi, Zamfara and Yobe).

Key messages

  • Political commitment to the nutrition sector was strengthened by evidence-based advocacy, underpinned by collaboration among champions for nutrition in government, development partners and civil society.
  • Civil society engagement in the nutrition sector helped to strengthen political commitment and accountability.
  • Increased attention to malnutrition in the media has been influential in increasing awareness of the problem and political commitment to addressing it.
  • Close collaboration among numerous development partners on nutrition sector policy, planning and coordination strengthened both the coherence and the impact of WINNN’s work to strengthen governance.

While there has been progress in public financing for nutrition, public funding is still very low compared to the need. Nutrition work remains largely reliant on donor funding. State governments should be continuously encouraged to increase their funding for nutrition, and to access funding from federal and donor sources.

ORIE briefs are also available on the following themes:

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Gender barriers to nutrition services: Lessons from the WINNN programme http://www.heart-resources.org/assignment/gender-barriers-nutrition-services-lessons-winnn-programme/ http://www.heart-resources.org/assignment/gender-barriers-nutrition-services-lessons-winnn-programme/#respond Tue, 01 Aug 2017 20:00:56 +0000 http://www.heart-resources.org/?post_type=assignment&p=29880 Read more]]> This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning from the Working to Improve Nutrition in Northern Nigeria (WINNN) programme, a programme implemented in five states in northern Nigeria (Jigawa, Katsina, Kebbi, Zamfara and Yobe).

Gender roles and relations can have a powerful effect on development processes and outcomes. WINNN successfully influenced some of the gender-related barriers in northern Nigeria in order to increase service use and behaviour change.

key messages

  • Nutrition-specific interventions are more effective in improving nutritional outcomes if they take context-specific gender roles and relations into account.
  • Understanding relations among women and men in households and communities can unlock effective strategies for service uptake and behaviour change.
  • Messages targeted directly at fathers can help to reduce resistance to the use of nutrition services.
  • Finding ways to reach adolescent mothers is especially important, given the low level of autonomy of young mothers in relation to their husbands and older women in northern Nigeria.

ORIE briefs are also available on the following themes:

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Improving micronutrient supplementation among women and children: Lessons from the WINNN programme http://www.heart-resources.org/assignment/improving-micronutrient-supplementation-among-women-children-lessons-winnn-programme/ http://www.heart-resources.org/assignment/improving-micronutrient-supplementation-among-women-children-lessons-winnn-programme/#respond Tue, 01 Aug 2017 19:58:32 +0000 http://www.heart-resources.org/?post_type=assignment&p=29876 Read more]]> This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning from an intervention to improve micronutrient supplementation in five states in northern Nigeria (Jigawa, Katsina, Kebbi, Zamfara and Yobe) with the support of the Working to Improve Nutrition in Northern Nigeria (WINNN) programme.

Key messages

  • Increasing attendance at periodic, preventative health events like MNCHWs requires intensive community engagement and mobilisation to ensure that the target population receives the information and is convinced of the benefits of attending. Information should be targeted at both mothers and fathers.
  • Political commitment to such events, and adequate and timely public funding, are essential to ensure effective planning, delivery, and sustainability.
  • Technical capacity among local government officials and health workers is key to ensuring good planning and implementation and adequate supply of key commodities.
  • Additional efforts are needed to ensure that micronutrient supplementation reaches the poorest mothers, younger mothers, mothers with no formal education, and mothers living further away from health facilities.

ORIE briefs are also available on the following themes:

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Improved infant and young child feeding (IYCF): Lessons from the WINNN programme http://www.heart-resources.org/assignment/improved-infant-young-child-feeding-iycf-lessons-winnn-programme/ http://www.heart-resources.org/assignment/improved-infant-young-child-feeding-iycf-lessons-winnn-programme/#respond Tue, 01 Aug 2017 19:54:56 +0000 http://www.heart-resources.org/?post_type=assignment&p=29873 Read more]]> This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning from an Improved infant and young child feeding (IYCF) intervention implemented in five states in northern Nigeria (Jigawa, Katsina, Kebbi, Zamfara and Yobe) with the support of the Working to Improve Nutrition in Northern Nigeria (WINNN) programme.

Key messages

  • While political support for IYCF services has increased since baseline, more needs to be done to sustain and scale up the services at health facilities and in communities.
  • Effective implementation of facility-based IYCF counselling requires considerable health worker time. This is a challenge in the Nigerian context, given the inadequacy of human resources for health.
  • Engaging community leaders in IYCF counselling is critical for both community acceptance of CVs’ work and uptake of the IYCF recommendations.
  • A family-centred approach to IYCF, including targeted messaging toward fathers and grandmothers, is important for achieving behavioural change.
  • Finding ways to reach adolescent mothers is especially important, since they have particularly limited autonomy in infant feeding decisions in northern Nigeria.
  • Community members’ fears about not giving water to infants is a key challenge for exclusive breastfeeding. Further work is required to develop effective messages that address this concern.

ORIE briefs are also available on the following themes:

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Community management of acute malnutrition (CMAM): Lessons from the WINNN programme http://www.heart-resources.org/assignment/community-management-acute-malnutrition-cmam-lessons-winnn-programme/ http://www.heart-resources.org/assignment/community-management-acute-malnutrition-cmam-lessons-winnn-programme/#respond Tue, 01 Aug 2017 19:52:27 +0000 http://www.heart-resources.org/?post_type=assignment&p=29870 Read more]]> This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning from a Community management of acute malnutrition (CMAM) intervention implemented in northern Nigeria, with the support of the Working to Improve Nutrition in Northern Nigeria (WINNN) programme.

Key messages

  • Political support for CMAM services is critical for public financing and sustainability, and can be developed through evidence-based advocacy to highlight the severity of the problem of malnutrition in northern Nigeria.
  • Engaging community leaders and local organisations in CMAM oversight promoted strong local ownership and community support.
  • The resources required to treat the current burden of SAM in northern Nigeria are many times higher than the amounts currently spent. Continued advocacy is needed to increase awareness among senior political leaders of the health and economic benefits of effective treatment of SAM.
  • Alternative ways of treating SAM may be needed in severely under-resourced health systems, like those in northern Nigeria. These could include integration of RUTF provision with existing primary health care services, or less frequent visits to health facilities by caregivers to collect RUTF (which will be trialled in Sokoto).
  • Inadequate human resources for health were a key challenge for the provision of CMAM services. CMAM services require adequate planning and allocation of human resources. The government will need to consider hiring more health workers if it is to sustain and scale up the CMAM service.

ORIE briefs are also available on the following themes:

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Integrated Evaluation Report of the WINNN Programme – summary report: ORIE http://www.heart-resources.org/assignment/orie-nigeria-final-integrated-report-summary/ http://www.heart-resources.org/assignment/orie-nigeria-final-integrated-report-summary/#respond Tue, 01 Aug 2017 19:44:39 +0000 http://www.heart-resources.org/?post_type=assignment&p=29866 Read more]]> ORIE research on WINNN consisted of operations research, a mixed-methods impact evaluation, economic evaluation, and gender analysis which were conducted over a period of five years. This report integrates findings from this research to provide a high-level summary of WINNN’s achievements along with an overview of the key messages and recommendations that emerge from research findings.

The WINNN programme improved mother’s attendance at Maternal Neonatal and Child Health Week (MNCHW) events and mother’s IYCF knowledge and practices but had no impact on anthropometric indicators. The research finds that WINNN was well-aligned with government priorities and that government planning, coordination and forecasting improved during the course of the programme. In terms of efficiency, the CMAM and IYCF components of the programme are found to very cost-effective relative to international standards. While WINNN contributed to an increase in political commitment and funding for nutrition initiatives in Nigeria, funding levels are still not sufficient to meet necessary scale-up targets.

The full version of the report is available here.

Suggested citation: Hansford, F., Visram, A., Jones, E., Ward, P. (2017), ‘Integrated Evaluation Report of the WINNN Programme – summary report: Operations Research and Impact Evaluation’, Oxford Policy Management, Oxford, UK

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Quantitative Impact Evaluation of the WINNN Programme – summary report: ORIE http://www.heart-resources.org/assignment/orie-quantitative-impact-evaluation-summary/ http://www.heart-resources.org/assignment/orie-quantitative-impact-evaluation-summary/#respond Tue, 01 Aug 2017 19:23:55 +0000 http://www.heart-resources.org/?post_type=assignment&p=29851 Read more]]> This report presents the results of the quantitative impact evaluation of the WINNN programme, three years since the baseline study. Using a quasi-experimental approach combined with community-level qualitative research, the study evaluates the impact of the WINNN programme as a whole on nutritional behaviours, nutritional status and provision of nutrition services. Data was collected from a panel of 3,229 households in 2013 and then again in 2016 in three treatment and three control Local Government Areas in each of the five states. To factor out pre-existing differences between the treatment and control groups, a difference-in-difference approach is utilised.

While no impact of the programme is found on anthropometric indicators, the evaluation finds positive impact on a number of intermediate outcomes such as IYCF knowledge and practice, awareness of and attendance at Maternal Neonatal and Child Health Weeks events as well as coverage of Vitamin A supplementation. However, there are significant differences in impact across states as roll-out was not uniform in terms of timelines and modalities. Using evaluation findings, a number of important lessons and recommendations are outlined for the WINNN programme and for the design of nutrition programmes in Nigeria and in similar contexts.

This is a summary of the report. Volume 1 presents the main findings of the evaluation followed by lessons learnt from the evaluation. Detailed methodology, additional background information and results, and quality assessment reports can be found in Volume 2 which serves as a technical and methodological companion to the main report.

Suggested citation: Visram, A., Jasper, P., Vargas, P., Hug, J., Jones, E., Adegoke, F., Khaled, A., Ward, P. (2017), ‘Quantitative Impact Evaluation of the WINNN Programme – summary report: Operations Research and Impact Evaluation’, Oxford Policy Management, Oxford, UK

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