WFP Regional Bureau for Asia and the Pacific - 2016 SPRs RBB 2016 SPRs by country | Page 834

Standard Project Report 2016
Implementation of Evaluation Recommendations and Lessons
Learned
During 2016, the programme implemented a number of recommendations from the European Union's (EU) mid-term
evaluation of the United Nations Children's Fund (UNICEF) and WFP's mother and child health and nutrition
programmes. These recommendations included increased coordination with UNICEF's treatment programme for
severe acute malnutrition (SAM) through cost-sharing and the co-facilitation of national training on the
implementation of nutrition programmes, as well as closer coordination of the development and sharing of behaviour
change communication materials, including the joint development of a recipe book for communities. WFP integrated
the mSupply system with the Ministry of Health's system, through support to the Medical and Pharmaceutical
Supply Agency (SAMES). WFP also increased coordination and support to the Ministry of Health's monitoring and
evaluation department. For example, nutrition data collected in health facilities in Dili through the WFP and Ministry
of Health treatment programme for moderate acute malnutrition (MAM) were incorporated into the government-led
health information systems.
Addressing Capacity Development
The evaluation also recommended to increase capacity development for health staff, and provide institutional
capacity development to address the low number of adequately trained technical staff. In response, WFP placed an
internationally trained nutritionist in Oecusse, while supporting the rollout of technical training of health staff on
nutrition interventions and programming. WFP's staff also worked with the nutrition department of the Ministry of
Health, providing input into various nutrition guidelines and documents on contingency planning, dietetics for
hospital menu planning, and assessment formats for monitoring nutrition-related programmes.
One of the major challenges to the implementation of WFP's nutrition programme has been the low capacity and
frequent turnover of health staff, both at the national and municipal or local health facility levels. These challenges
affect programme implementation as new staff need additional support and on-the-job training on programme
activities and the national guidelines for MAM treatment. As a result, and following a request from the Ministry's
nutrition department, WFP changed the scheduled nutrition training from shorter two-day refresher sessions that
focused on the treatment of MAM using the national treatment protocols, to a more comprehensive six-day training
course covering ten nutrition-specific interventions developed by the Ministry of Health and the National Institute of
Health (INS). These training courses were conducted in partnership with the nutrition department, UNICEF and the
INS, with co-funding from UNICEF. Given the need for ongoing skills development, WFP also conducted refresher
sessions on monitoring and evaluation recording and reporting tools, as well as on community mobilisation and
behaviour change for nutrition.
Potential Commercialisation of Specialised Nutritious Foods
In order to address problems with the production of Timor Vita, the EU review recommended analysing whether
Timor Global could produce a fortified cereal blend, similar to Timor Vita. WFP hired a value chain consultant to
analyse the commercial potential and distribution possibilities for nutritious cereals for school feeding with the
Ministry of Education, and retail options for these food items. The resulting recommendations were provided to
Timor Global, and the preliminary products were promoted at an EU exhibition. Although the company had not yet
begun commercial production by the end of 2016, a small pilot programme is being run in conjunction with the
Ministry of Education, to test the use of a fortified blended cereal in one municipality.
Knowledge Sharing
Following requests made by the Ministry of Health and the EU to improve coordination and information sharing with
the Government, WFP initiated in-person presentations of programme results and recommendations (rather than
written reports alone) to the Ministry of Health, including to higher level Ministry of Health staff such as the Minister,
Vice-Minister, and Council of Directors. WFP also hosted a nutrition working group meeting in September, and
advocated for co-location/shared office space at the Ministry of Health for WFP, UNICEF and the nutrition
department staff to facilitate coordination and technical assistance.
Poor Community Understanding Around Nutrition
Findings from WFP's qualitative baseline study conducted in April 2016, and an evaluation of the household surveys
conducted by WFP staff from 2015-2016, identified a low level of knowledge amongst community members about
the signs of malnutrition, the importance of good nutrition in the first 1,000 days of a child's life and maternal
nutrition, as well as significant barriers to visiting health clinics. These qualitative findings confirmed the results of a
desk review which was conducted in 2015 by WFP, and the collection of anecdotal evidence from health staff, in
response to the low uptake of nutrition treatment services in the first year of the programme in 2015.
Based on these findings, WFP together with the Ministry of Health developed a comprehensive social and
behaviour change communications (SBCC) strategy, which included the development of SBCC activities and
Timor-Leste, Democratic Republic of (TL)
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