|Managing Successful Nutrition Programmes - Nutrition policy discussion paper No. 8 (UNSSCN, 1991, 152 p.)|
|PART II: PROGRAMME SUMMARIES|
Mrs J. Tagwireyi
· On a national scale, to encourage communities to work together in order to meet the demand for nutritious foods, particularly for young children.
· To promote the use of foods such as groundnuts, beans and vegetables in the diet.
· To promote community awareness of nutritional problems of children under-five years and to encourage community action to address these problems through self-reliance instead of depending on food handouts. To facilitate the inclusion of nutrition in the community's development plans.
· To assist in the identification of ways in which problems of malnutrition can be tackled through intersectoral action.
Duration: The programme was initiated on a pilot scale in 1981, and was evaluated in 1984 when recommendations for strengthening the programme were made. The programme has since expanded to cover most districts in the country with over 6,000 ongoing projects nationwide. These comprise programmes aimed at improving rainfed crops, vegetable gardens and small animal production.
Implemented by: The projects are implemented by intersectoral committees under the chairmanship of the Ministry of Agriculture with the Nutrition Unit performing secretariat functions. External support has been received from the Swedish International Development Agency (SIDA) through the Nutrition Unit in the Ministry of Health.
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The external funds cover such costs as inputs, training, material production, evaluations and transport. The internal budget covers salaries for programme implementors, transport, and subsistence allowances.
· Management - Intersectoral management committees were set at all levels to ensure effective programme implementation. Training is a major element for the extension workers who are members of the management teams.
· Community Mobilization - This aims to increase awareness of nutrition and facilitates active participation in the programme.
· Nutrition Education - The programme emphasizes nutrition messages on appropriate food production and consumption habits, particularly for young children, through community participation in the food production project.
· Food Production - The SFPP was initiated to increase community self-reliance in production of nutritious foods for consumption by children and other family and community members. This is aimed at weaning the communities from dependency on food handouts, such as the Child Supplementary Feeding Programme. The SFPP promotes communal production of groundnuts, beans, vegetables and small livestock, i.e. rabbits and chickens. Communities also pool their resources, making the project affordable for interested communities.
· Appropriate Technologies - Technologies for food production, processing, preservation and preparation are developed to improve food and nutrition security at the community level.
· Child Supplementary Feeding - The programme ensures communal feeding of children under-five at a community based feeding point or preschool with a daily supplementary meal 5 days/week. The children's weight is also regularly monitored.
· Monitoring and Evaluation - The programme is monitored continuously and evaluated periodically to facilitate the design and implementation of future nutrition programmes. Operational research is a component of the programme which is still to be developed further. However, data collection has been augmented under the programme.
Most Successful Aspects
· The SFPP helped in the establishment of an intersectoral collaboration towards meeting nutrition goals. There is an active participation of keys sectors, such as Agriculture, Community Development, Local Government, and Education, in Nutrition projects. The SFPP is now integrated into the Agriculture Sector plans, indicating a level of involvement and support from agricultural extension work.
This intersectoral approach has strengthened the service offered to communities by extension workers with regard to food and nutrition and other PHC components.
· Community participation and awareness of nutrition issues has increased. An evaluation conducted in May 1989 indicated a high level of community participation in the project which augers well for the sustainability of the project. A number of projects have been sustained through community efforts, such as labour, implements and even cash contributions.
· Nutrition issues have been brought into the development arena at various levels. The recent evaluation indicated that this project had been discussed in development committee meetings at village, ward, district and provincial levels. The members were aware of the project and its objectives and supported it.
· This programme has created the appropriate climate to introduce a National Food and Nutrition Policy. The National Intersectoral Committee has already been mandated to initiate activities towards the development of a Food and Nutrition Policy. A cabinet paper will be tabled on the Food and Nutrition issue, in order to obtain cabinet mandate to proceed more vigorously with policy development.
Programme information on specific Workshop themes
Evaluation: In 1984, the SFPP pilot project was evaluated by a joint SIDA/Zimbabwe team to assess organizational aspects of the programme and the feasibility and effectiveness of the strategies adopted to implement the pilot project. Two thousand projects had been established under the pilot programme. The evaluation noted that the SFPP was beginning to integrate nutrition into the broader development process. It also noted the potential for the programme to address the problem of childhood malnutrition through intersectoral collaboration. A number of weaknesses in the planning and implementation of the programme were identified, chiefly:
· Limited planning with a lack of a detailed plan of operation with clearly defined goals.
· Lack of clear objectives and guidelines for programme implementation.
· Lack of clear definitions of roles of sectors in the programme.
· Inadequate organization and management skills on the part of programme implementors.
· Lack of a clear agricultural management structure to support the food production component of the programme.
· No clearly defined mechanism for monitoring the programme.
· Lack of coordinating structures at all levels to ensure the adequate input of the various sectors which needed to be involved in the programme.
· Criteria for each section of the target area and group was not often well understood. The target group was not clearly defined and this led to variation in targeting. In some cases the target group was the families of malnourished children and in other cases the whole community in an at-risk area.
This evaluation facilitated the National Nutrition Unit in restructuring the programme, paying particular attention to strengthening organizational and management structures and clarifying roles and responsibilities of the various sectors. A management handbook was developed along with a training strategy to ensure that all members of the intersectoral committees were fully appraised regarding the objectives of the programme and their roles within it.
In May 1989, the National Nutrition Unit undertook a process evaluation of the programme, with the general objective to improve and strengthen the SFPP programme to better identify and address the problem of malnutrition in Zimbabwe. Specific objectives were:
· To assess the extent to which targeting of vulnerable communities and malnourished children is occurring.
· To assess the extent of participation in SFPP at all levels.
· To examine the management of SFPP at all levels.
· To assess progress in integrating SFPP into ongoing planning activities of all sectors.
· To examine the extent to which SFPP projects actually focus on malnutrition as a problem in operational terms, including raising community awareness in nutrition.
· To examine ways in which SFPP projects could be self-sustaining.
· To determine ways in which SFPP could be monitored regularly.
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