WFP Regional Bureau for Asia and the Pacific - 2016 SPRs RBB 2016 SPRs by country | Page 541

Standard Project Report 2016
Results/Outcomes
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Strategic Objective
: Support or restore food security and nutrition and establish or rebuild livelihoods in fragile settings and
following emergencies (SO2)
Outcome
: Stabilized or reduced undernutrition, including micronutrient deficiencies among children aged 6–59 months,
pregnant and lactating women, and school-aged children
Activity
: Treatment of moderate acute malnutrition (MAM) through targeted supplementary feeding modality (TSFP) in
Gorkha, Sindhupalchowk and Dolakha districts
In preparation for the distribution of supplementary food, WFP with the support of partner Save the
Children established 51 distribution sites in the government health posts in the three districts. Save the Children
deployed their trained nutrition assistants in the selected communities and in the treatment programme sites to
support the government-recruited female community health volunteers (FCHV) during the monthly screening of
children using the mid-upper arm circumference (MUAC) measurement. Forty-seven government health staff were
also trained in screening, monitoring and reporting. This helped to speed up the identification of acutely
malnourished children and refer them to the TSFP centres according to their nutritional status. The malnourished
children were treated with the Plumpy'Sup (a take-home ration of 92 grams per child per day for three months)
under careful monitoring of their progress.
All the children who underwent the screening process received the regular nutrition services provided by the
Government at the health posts. These services included counselling and behaviour change communication on the
promotion of breastfeeding and complementary feeding to mothers and caregivers through infant and young child
feeding (IYCF) activities, iron and vitamin A supplementation, and de-worming treatment. The nutrition assistants
helped maintain the MAM registers at the health posts supported the FCHVs and health staff in giving nutrition
counselling to 4,000 parents, caregivers and other community members who received nutrition counselling. At these
sessions, participants learned at least three key messages related to maintaining balanced nutrition and preventing
malnutrition. Since WFP did not undertake outcome monitoring as a result of insufficient funds received in 2016, it
was not possible to report the number of people who could recall three key messages that they had learned.
Reporting on monthly achievements, Save the Children produced three SMART Nutrition Survey reports during the
programme's implementation with WFP's guidance and support.
Community outreach was a key element of the Government’s nutrition services and was improved through the
FCHVs and the nutrition assistants. The improved outreach helped remote communities to better access the
nutrition services made available from the health posts. This was the primary method of community level screening
for acute malnutrition and referral to treatment for MAM or severe acute malnutrition (SAM), for tracing defaulters
and to convince caregivers to resume treatment. These outreach activities provided parents and caregivers of
children aged 6-59 months as well as their communities with information on the importance of balanced nutrition
that could help them recognise the early signs of malnutrition and seek timely assistance.
Although no outcome monitoring was done, WFP relied on Save the Children's regular monitoring and reporting of
the key MAM performance indicators to understand the progress of the project, any challenges and remedial
measures required to overcome them. The performance records maintained by Save the Children indicated that the
overall default rate was 11 percent, which was lower than the benchmark of 15 percent, while the recovery rate for
all districts was 82 percent, well over the 75 percent target. According to Save the Children's records, all the treated
children responded to the treatment (0 percent non-respondent rate). Furthermore, there were no deaths (0 percent
mortality rate) during the period of assistance. In terms of the coverage of the MAM treatment programme, WFP
and Save the Children achieved excellent results (94 percent), which was well over the set target of the programme
(50 percent).
However, it was noted that in Gorkha district, a high number of children (74.5 percent) had defaulted on their clinic
attendance. This was likely because of the significant time taken to cover the long distances between the treatment
sites and villages situated high in the mountains, which made it difficult for families to comply with the requirement
of follow-up vis