|Reaching Mothers and Children at Critical Times of their Lives (WFP)|
|POLICY ISSUES AND OPERATIONAL CHALLENGES|
19. Almost all WFP projects that provide supplementary feeding to expectant and nursing mothers are designed to provide an incentive for more regular utilization of MCH services, namely prenatal and postnatal health care. Supplementary feeding for moderately malnourished or at-risk small children is provided to improve their nutritional status and/or promote their regular growth monitoring. Fewer of the supplementary feeding projects are aimed at the nutritional rehabilitation of severely malnourished children. The immediate objectives of WFP-assisted projects are usually well linked with government policies and goals on the health and nutritional status of mothers and children.
20. Food rations used in health and nutrition education programmes can be an effective means of achieving mutually reinforcing objectives. Provided in this way, food rations:
21. As food assistance can contribute to tackling several of the causes of early malnutrition, it may often be advisable to aim for a combination of objectives (i.e., improved dietary intake, better utilization of MCH services, and increased household food security and mothers caring capacity). When this is done, however, decisions regarding the size, composition and timing of food rations as well as the range of complementary inputs become more complicated. For example, women can be effectively encouraged to attend a clinic through the provision of a single high-value food commodity, such as vegetable oil. On the other hand, when intervening to meet a nutritional deficit, a larger, more complete food ration may often be required. Therefore, in designing a food intervention a hierarchy among individual objectives needs to be established to reflect the relative importance of the causes of nutrition and health problems faced by expectant and nursing mothers and infants in the specific situation.
22. Progress towards the attainment of programme objectives must be monitored. Budgets for monitoring and evaluation of the performance of WFP-assisted supplementary feeding projects range between 0.1 and 1.1 percent of the total WFP cost. It would not be appropriate or beneficial to spend the substantially larger amounts which would be needed to measure the long-term effects of WFP-assisted supplementary feeding on growth, cognition and/or work performance, as such benefits have been demonstrated through longitudinal studies. The plausible inference from the achievement of intermediate targets such as weight gain of malnourished children or fewer cases of low birth weight to the greater realization of the genetic potential should suffice. Effective monitoring of child growth and birth weight should therefore have priority. And, of course, input and activity indicators such as timely food distribution and the provision of health and education services need to be monitored in order to verify the link between these project activities and the weight gains. To the extent possible, generation and analysis of project data should be linked with national health and nutrition statistics.