Standard Project Report 2016
• Regular monitoring by WFP field staff, along with continuous support to municipal health staff on recording and reporting.
• Household visits and qualitative checklists for post-distribution monitoring conducted by WFP field staff, who also encouraged regular visits to health facilities and continuation of treatment to reduce the default rate.
• Active coordination between WFP, the municipal health services, the district public health officer, and municipal-level nutrition focal points.
The special autonomous zone of Oecusse had the lowest rates of service uptake in the first quarter of 2016( 24 percent), along with high defaulter rates. In addition, a mass screening pointed to very high rates of MAM in this region, with 18 percent of households found to have children or PLW with MAM. Despite the mass screening, few community members used their referrals to visit health facilities, which prompted WFP to hold outreach events on health promotion in the villages with the highest rates of MAM. In response to these high MAM rates, WFP and the Ministry of Health implemented a joint pilot project for the prevention of acute malnutrition, providing specialised nutritious foods to all children aged 6-23 months. Pregnant and lactating women were not included in the temporary MAM prevention programme, since monitoring data from the MAM treatment programme indicated a high enrolment rate among PLW, as well as an above planned number of PLW beneficiaries. The pilot project, combined with the outreach and health promotion, led to increases in the uptake of nutrition services.
Household interviews with beneficiaries’ showed that on average, 68 percent of PLW reported sharing Timor Vita with their family, while 24 percent of children shared the ready-to-use supplementary food they received with other siblings. These findings may have contributed to the lower-than-expected recovery rates, particularly for PLW. In addition, the high default rate was linked to the fact that health staff lacked basic communication tools such as mobile phones and means of transportation necessary to contact beneficiaries that were absent or defaulted from the programme.
The high number of people not returning for treatment( defaulters and absentees) was a concern for WFP as it had a significant impact on programme performance. In response, WFP increased nutrition education for the targeted communities, highlighting the importance of following treatment for malnourished PLW and children, as well as changing their nutritional and caregiving practices. WFP did this through:
• Health promotion events, counselling, and learning sessions for mother and caregiver support groups in three municipalities.
• Training on active case-finding and follow-up as an important component of the nutrition treatment programme.
• Support for health staff to conduct cooking demonstrations and spread key messages on good nutrition, MAM treatment, and the proper use of SNF; for instance, not sharing food within a household.
• Using mass media, such as a radio spot and locally developed videos, and providing all caregivers who received treatment with take-home information, to reinforce these messages.
As a result of these activities, messaging around infant and young child feeding practices reached more people( 112 percent) than were targeted, many of whom did not receive nutrition treatment. This was a positive outcome for the nutrition behaviour change campaign, as theories of social change show people need to receive messages multiple times and in a culturally appropriate manner in order to adopt and maintain new behaviours.
The above-target number of children aged 6-23 months reached, and the lower than expected number of children aged 24-59 months reached through the MAM treatment programme in 2016 correlated to findings from the 2013 Timor-Leste Food and Nutrition Survey, which found very low rates of minimum acceptable diet among children aged 6-23 months as a result of poor infant and young child feeding practices.
Progress Towards Gender Equality
During 2016, WFP developed interactive tools and posters, as well as a video explaining the importance of good nutrition for pregnant and lactating women and the import role women play in ensuring their baby’ s nutrition status and physical and mental development. These tools were critical developments, as there was a low level of community awareness of the importance of good nutrition during pregnancy, particularly amongst male community leaders and male caregivers. Prior to the development of these tools, there were limited health promotion tools or posters on nutrition available, and those available were designed for passive, non-interactive use. Developing interactive health promotion tools has proved to be an important part of adult learning in order to promote behaviours for women to consume more nutritious foods.
Materials and messaging which WFP developed with the Ministry of Health, targeting fathers, male community leaders and women, were distributed down to the municipality level by the Ministry of Health, and were shared with Alola Foundation and World Vision for use in their 215 community support groups, therefore ensuring that messaging on nutrition was consistent and easily understood by rural caregivers.
Timor-Leste, Democratic Republic of( TL) 19 Development Project- 200770