Scaling up interventions Expected Result 4:

National comprehensive nutrition programmes implemented in coherent, coordinated and synergic manner with other sectors such as food security; health, WASH and social protection.

WCARO Activities:

 Assessment of opportunities for minimum package of cost-effective and safe interventions;

 Development of a model for conducting formative results for IYCF and community-based nutrition developed.

With regard to the relevance of the WCARO component to contribute to the achievement of ANSP expected result 4, the following:

1. The role of WCARO in the implementation of the scaling-up of national comprehensive nutrition programmes should be in the first place supportive to the national country programmes; however, the way the regional activities have been formulated does not clarify at all the supportive role;

2. No strategy has been developed on how national programmes can learn from each other good practices to scale-up interventions in an effective and efficient way; a clear framework how to analyse and document good practices to enhance joint learning is missing;

3. As the expected result under this pillar aims at a coherent, coordinated and synergic implementation together with other sectors, support to the development of multi-sectoral approaches applicable at national and sub-national levels has not been defined and is clearly lacking in the design of the WCARO component;

4. Given the fact that a substantial part of the WCARO budget is dedicated to this pillar 4, the logframe, nor the workplan or the budget provide a clear picture of what approach and activities are being undertaken to contribute to the ANSP expected result. The only defined activity is ‘formative research on IYCF’ which is expected to help improve IYCF programs in the region.

2.6.2 Effectiveness

23. The support role of UNICEF-WCARO to the Scaling-Up of interventions has remained rather limited.

According to the UNICEF WCARO nutrition team they have helped country teams to improve the package of interventions offered in the context of the prevention of acute malnutrition (e.g. develop the

‘WASH in Nutrition’ strategy). On another occasion the team has assisted to guide the revision and validation of the Mali national IYCF strategy. However, beyond providing technical support, WCARO

has been less well positioned to work on scaling-up interventions, as pillar 4 applies more to country-level work (See further Mali and Burkina Faso reports). The role of WCARO should be complementary to the work done in the country programmes, by focusing on learning, documenting, analysing and evaluating lessons learned and good practices.

However, as already indicated earlier, Pillar 4 constitutes 21% of the total ANSP-WCARO budget which would justify well-defined and effective support to Scaling-Up interventions, at least through the documentation of good practices as they emerge in the two target countries or other countries in the region.

Study on determinants of Child Feeding practices

24. The study on Infant and Young Child Feeding practices is relevant in order to improve understanding but lacks a detailed review of already existing knowledge

The only other implemented activity so far is the implementation of the formative research on the determinants of Infant and Young Child Feeding practices in Benin and Mali. UNICEF has hired a consultant to undertake this formative research on complementary feeding. Field work has been finalized in Benin whereas due to the unrest in Mali, its implementation could only start in November 2013.

The work is expected to help to improve IYCF programs in the region and therefore appears to be relevant. A comprehensive research proposal has been approved by the Ethical committee in Mali. It will be implemented in the two ANSP target districts of Yorosso and Bankass. The methodology is mainly qualitative by nature making use of different methodologies. One informant in Mali indicated that substantial information on IYCF practices is already known. The MTE team being of the same opinion questions the absence of an extensive literature review and key informant interviews before undertaking the exercise.

2.7 Efficiency

2.7.1 Operational Efficiency

25. Programme implementation at regional level appears to be appropriate as the technical support by the WCARO team are often solicited by the individual countries

The provision of technical support by the WCARO team is in principle demand-led based upon requests by individual countries. Requests for support often come from the need to develop or adjust policies in the context of the SUN movement or the REACH initiative. The same applies for UNICEF support and/ or collaboration to regional institutions and initiatives (ECOWAS-WAHO, CILLS, AGIR, etc).

Also the activities coordinated under the umbrella of RNWG are making use of the complementarities of the different organisations represented including the expertise of UNICEF. Moreover, UNICEF is playing a prominent role in the RNWG as it hosts its facilitator who at the same time is the regional REACH facilitator. This combination provides a good outlook for appropriate and coordinated technical support on nutrition security mainstreaming in the region.

26. The ANSP WCARO component is insufficiently linked to the two ANSP WA target countries.

Being part of the same ANSP programme, the link with the two target ANSP countries is rather weak.

With ANSP providing technical and financial opportunities to promote and experiment with the scaling-up of nutrition security interventions in the two countries, a close follow-scaling-up in terms of exchange and learning is not yet present.

Moreover, the trainings and/ or studies (C4D, Cornell, Determinants of IYCF) which are implemented in Mali and Burkina Faso, appear to be carried out without appropriate needs assessments and ownership by the individual countries. In particular the Cornell support gives the impression of being a project in a project with little embedding in the actual structures.

27. ANSP WCARO does not fully make use of experiences at regional level with regard to multi-stakeholder action relevant for the scaling-up of nutrition security interventions

As indicated earlier, there are substantial experiences in the promotion of multi-stakeholder action for the sake of reduction of chronic malnutrition which includes relevant sectors for enhancing improved feeding and nutrition practices. International NGOs like ACF, GRET or HKI provide some examples⁹; other attempts have been made to document for instance the evidence of the role of agriculture for improved food and nutrition security (e.g. vegetable growing during the dry season in the Sahel region;

production of enriched complementary foods, complementary feeding of animals for off-season milk production, etc) or the role of social protection (e.g conditional cash transfers).¹⁰

2.7.2 Financial efficiency

28. The allocation of ANSP budget to the WCARO component is substantial, almost as large as the two ANSP WA country budgets together. More than half of the ANSP WCARO budget consists of staff costs.

The ANSP WCARO budget represents about 21.4% of total ANSP budget: € 4,2M. The two ANSP country budgets of Mali and Burkina Faso together have a projected budget of € 4,5M representing about 22.7% of the ANSP budget.

Source: own calculations based ANSP Financial reports Yr 1 and Yr 2

The ANSP WCARO budget includes a significant contribution for staff costs which represents about 53% of the € 4,2M budget. UNICEF has budgeted for 7 staff + 1 administrative support in the ANSP programme. However, it should be noted that their ‘own contribution’ to staff costs is 41% for the first two years of ANSP operation. There is the risk that the share of UNICEF own contribution might diminish during the remainder of the ANSP programme as other sources of funding from which UNICEF nutrition staff are being paid, might dry. The budget for Cornell activities are catered for by the WCARO ANSP budget. The same applies for the one year salary of a WCARO C4D Specialist, The other budget expenditure categories are presented in the next figure:

9 Re: ACF Reconciler …2013; ACF Aid for Nutrition 2013, GRET–BF (personal communication);

10 World Neighbours in Burkina Faso, CRESA in Niger, Oxfam in several countries -

500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 4,500,000

WCARO Burkina Faso Mali

Total budget Staff budget

ANSP WCARO budget items as a % of the total ANSP WCARO budget

Source: based on ANSP Financial reports Yr 1 and Yr 2

By Pillar the WCARO projected budget looks as follows: Result 1 33%; R2 25%; R3 21% and R4 21%.

To some extent it is remarkable that Pillar 4 (Scaling-up interventions) is projected to be more than one-fifth of the total budget whereas the comparative advantage of the WCARO is with the other pillars (See 2.6.2). Again, this mainly relates to staff costs which represents 75% of the Pillar 4 budget.

However, in reality the contribution from WCARO to the scaling-up has been less visible up to date.

(source: Financial report year II)

29. ANSP-WCARO expenditure rate is slightly under the ANSP overall expenditure rate in the first two years

Overall expenditure rate is 37.3% of total budget after Year II (ending September 2013). The overall figure for the ANSP programme is 42%. During both years of implementation the WCARO expenditure has remained below the projected ones for that particular year: respectively 82% for year 1 and 70%

for year two. When analysing the expenditure rate per pillar it clearly shows that the delay in expenditure mainly originates from the slow start of Pillar 2 (Capacity Development) activities: R1 49%

R2 18% R3 40% R4 35%. The WANCDI activities only started early 2013.

2.7.3 Leverage of resources

30. WCARO nutrition activities benefit from other sources than ANSP

In terms of leverage from other sources WCARO has been able to secure other sources of funding which directly or indirectly contribute to the ANSP goals. Leverage is mainly from UNICEF’s other sources of funding. To some extent also other regional partners are contributing in the context of RNWG activities (MI, ACF, FAO, ECHO etc.) or WANCDI (e.g. HKI and MI), or MI for the ECOWAS Nutrition Forum.

2.8 Impact

In the context of the ANSP WCARO component it is difficult to address the issue of Impact at this stage. In the first place, WCARO is operating in 24 countries in the region, each one with its own dynamics and different contributing factors and programmes. WCARO has more of a supportive role to various initiatives and actions. Secondly, WCARO impact should be based on the achievements of stunting reduction on the long run.

53%

10%

8%

6%

7%

10%

4%

1%

Staff Consultants Contracts

Workshop/ Conferences Training

Travel equipment other

2.9 Sustainability

31. ANSP funds clearly complement other UNICEF-WCARO funding in order to maintain its supportive and promotional role for nutrition security in the region.

Though the ANSP contribution is relatively modest, the cumulative funds enable UNICEF to maintain a good number of staff with an appropriate range of competences such that the regional office can play the role that it is expected from. The ASNP contribution to UNICEF WCARO can be better described as core-funding to continue its advocacy work in the field of nutrition security and provide support to the 24 countries in the region. This type of financial support clearly enhances sustainability of the UNICEF WCARO nutrition activities as it builds upon their existing activities and staff competencies.

Although ANSP is formulated as a project with its own objectives and set of pillars (result areas), these largely coincide with the routine tasks of WCARO’s nutrition unit. Being so, the ANSP has enabled UNICEF WCARO to go further and take up activities which go beyond the routine, and especially to take up long term plans, which have been difficult to fund through other channels. Good examples are activities under the RNWG described under pillar 1 and the WANCDI programme under pillar 2. In terms of sustainability both are special cases as they represent a long term vision.

3 Conclusions

General conclusions

1. For UNICEF WCARO the RNWG clearly is the main mechanism for regional work on ANSP’s pillar 1 and 2 and to a very limited extent on pillar 4. (Pillar 3 work is by nature in UNICEF’s realm and is not placed in the RNWG workplan.) ANSP is for UNICEF the funding mechanism that makes it possible to continue the RNWG work. The ANSP funding contributes to making the RNWG more professional (workplan, facilitator) and provides finances for joint activities. The RNWG has an independent identity which does not come from ANSP or ANSP pillars. In terms of inputs and efforts UNICEF has been (one of) the most prominent member.

2. ANSP in terms of a model programme is meant to remain at the forefront of new developments with respect to nutrition security. This implies that it should continuously ask, ‘what next?’ when milestones have been reached. Given the highly dynamic context in which ANSP is operating in the WCA region, with new initiatives having emerged over the past few years (SUN, REACH, AGIR, etc.) and nutrition policies now being in place in many of the regional countries, UNICEF has not yet clearly positioned itself; but it has all means to do so!!

3. In general the question “Why” has been taken care of. Many countries in the region have become convinced that they should do something to reduce chronic malnutrition in their respective countries. UNICEF has played an important role to develop that conviction. But “How” to implement these policies on the ground, together with other stakeholders, is the current challenge; with the questions “At what cost?”, “With which (predictable) results?” and “How to maintain this?” looming.

This is where ANSP’s added value should lie.

4. The current nutrition discourse is vested on the positive attitude of the international donor community and technical partners at present. This is reflected in the wide number of initiatives (as mentioned SUN; REACH; AGIR; ARISE, etc.) that have recently emerged. There is always a risk that this attention may subside once donor attention is attracted to another development priority. In the context of ANSP, UNICEF has not always been sufficiently alert that its ANSP activities remain at the forefront of nutrition security mainstreaming and to avoid the notion of ‘business as usual’. In its annual planning UNICEF has not subsequently reflected upon and strategized in this rapidly changing context. For instance the question “Has stunting prevention come out as an integrative element for UNICEF nutrition activities?” has not sufficiently been answered by UNICEF.

5. Despite the fact that the current discourse of nutrition creates an overload of documents, meetings and conferences on the topic, some concepts do have the power to both engage and apply at different levels and to bring actors together. Resilience is such a concept; this could be further exploited in the context of UNICEF ANSP activities as has been shown by the RNWG Resilience Guide.

6. Most interesting of ANSP is the integration of the four pillars linking different elements of “Nutrition Institutional Strengthening”. This link is a strength of the programme which should be maintained and strengthened as much as possible during the implementation phase; however, the link to the Pillar 4 activities in particular those in the two ANSP target countries remains relatively weak.

4 Lessons Learned and Good Practices

Potential lessons learned could be:

Pillar 1: Compile lessons learned across WA countries and align write-up with lessons required by SUN

Pillar 2: The WANCDI programme to support Capacity development at a regional level.

Pillar 3: Smart use of SMART – see pillar 3

Pillar 4: Concept of resilience lends itself to innovative approach.

But these lessons learned are still to be developed and well-documented.

ANNEX F. COUNTRY BURKINA FASO