2013 Cambodia: Final Evaluation of the Joint Programme for Children, Food Security and Nutrition in Cambodia
Author: Frank Noij
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The Global Millennium Development Goal (MDG) Fund was established in 2006 through a partnership agreement between UNDP and the Government of Spain, for an amount of €528 million. The Fund’s aim was to contribute to the achievement of the MDGs and other development goals in selected countries, through the United Nations (UN) System. In September 2008 Spain pledged €90 million towards the launch of the thematic window on Childhood and Nutrition, one of the eight components of the MDG Fund.
The Joint Programme for Children, Food Security and Nutrition in Cambodia, supported by the MDG Fund, aimed to accelerate achievement of three of Cambodia’s Millennium Development Goals related to hunger and poverty (Goal 1), and child and maternal health (Goals 4 and 5). The implementation of the programme ran from January 2010 to June 2013.
Cambodia’s progress in terms of social development is undeniable. Infant mortality rates have declined from 96 deaths per 1,000 live births in 2000 to 36 deaths per 1,000 in 2011; and mortality rates among children under five declined from 124 deaths per 1,000 in 2000 to 43 deaths per 1,000 in 2011. Despite these developments, important challenges persist. Maternal mortality rate is amongst the highest in the region; and nutrition and food security are prevailing areas of concern notably at the sub-national level.
The Joint Programme design was aligned with the National Strategic Development Plan (NSDP) 2009-2013 and the United Nations Development Assistance Framework (UNDAF).
The Joint Programme was governed by joint arrangements between the government and six UN agencies namely the United Nations Children’s Fund (UNICEF), World Health Organization (WHO), Food and Agricultural Organization (FAO), World Food Programme (WFP), International Labour Organization (ILO) and United Nations Educational, Scientific and Cultural Organization (UNESCO).
This report presents the results of the final evaluation of the Programme. Recommendations and lessons have been formulated with a view to informing future initiatives on food security and nutrition in Cambodia, Southeast Asia and beyond. The evaluation is underpinned by the United Nations Evaluation Group Norms and Standards for Evaluation in the UN System as well as by the OECD DAC evaluation criteria.
The evaluation, which is summative in character, was aimed at demonstrating accountability as well as at distilling good practices and lessons learned that could be useful to other development interventions at national and international level. The evaluation is also intended to feed into the learning of the global food security and nutrition window of the MDG Fund. The evaluation focused, particularly, in Kampong Speu and Svay Rieng, the two provinces where the sub-national activities were implemented. It covered the period 2010 to mid-2013.
Users of the evaluation include Government stakeholders such as the Council for Agricultural and Rural Development (CARD), Ministry of Health (MOH), Ministry of Labour and Vocational Training, Ministry of Agriculture, Forestry and Fisheries, and the Ministry of Planning; as well as the Joint Programme participating UN agencies: UNICEF, WHO, FAO, WFP, ILO and UNESCO. The MDG Fund Secretariat intends to use the evaluation as an input to a meta-evaluation of the Children, Food Security and Nutrition thematic window. The evaluation is to be disseminated in order to advocate for sustainability and replication, as well as scaling-up.
The methodology combined quantitative and qualitative approaches to allow for triangulation of data and sources. A participatory approach was implemented throughout the evaluation process. A desk review of relevant materials was followed by semi-structured interviews, at the national and decentralized levels, with stakeholders from UN Agencies, the Government and civil society organizations. Focus groups discussions with programme beneficiaries were conducted at district and commune levels.
The baseline and end line surveys managed by the Joint Programme were meant to be an important source of quantitative data at the outcome and impact level changes. However, the delivery of the end line report was delayed; the report became available only at the end of the field work period of the evaluation. As the quantitative database was not made available to the evaluator, no further analysis was possible. The evaluation was informed only by the results as presented in the end line report.
The timing of the evaluation, overlapped with the period of National Elections and with the holiday period of international staff. This situation posed difficulties to access to key informants both from the Government as well as from the UN. Staff specifically recruited for the implementation of the programme, had moved on at the time of the evaluation, although several of these could be tracked and interviewed.
Findings and Conclusions:
The relevance of the Joint Programme was relatively high, and it was clearly aligned with RGC policies and strategies and with the UNDAF. The quality of the programme design presents limitations in various respects. The multi-sector programme approach proved to be relevant in practice, though the rationale for such an approach was not sufficiently made explicit in the programme document.
In terms of efficiency, the governance and management mechanisms of the Joint Programme, demonstrated that it worked well. So did the coordination system at the national and sub-national levels, which benefitted from the placement of coordinators at the national and the provincial levels. The main limitation in terms of efficiency was the focus of the Programme in implementing and monitoring the activity and output levels. This approach undermined the attention to outcome level changes and therefore limited the assessment of those changes that were intended to be shared amongst participating UN and RGC agencies.
The programme has been relatively effective as it has been able to achieve some important impact and outcome level changes. At the level of impact, the decrease in moderate as well as severe anaemia levels; and the decrease of underweight among children under 5 years of age in the intervention provinces stand out.
The levels of sustainability achieved by the Joined Programme varied. Ownership of the FSN agenda has been further enhanced throughout the Programme. Capacities have been developed at the enabling environment, organizational and individual levels. The Joint Programme made use of existing Government systems for implementation purposes as well as for supporting the development of additional capacities at enabling environment and individual levels. Financial sustainability for FSN has been slightly improved.
Recommendations (Abridged, see full recommendations under section 7)
For Royal Government of Cambodia at National Level
a. To lead the process on the development of a Theory Of Change of the new National FSN Strategy;
b. Build on the TOC for the development of a monitoring and evaluation framework and plan for the assessment of medium and longer term changes in food security and nutrition;
At Sub-National Level
c. Continue to further strengthen the provincial level coordination on FSN among parties concerned;
d. Make use of the NFSNS and the TOC to develop a provincial level results framework tailored to the context of the province and the priority objectives and actions identified;
e. Develop a provincial level plan to monitor and evaluate FSN related changes;
f. Establish a cross sector Food Security and Nutrition Data Analysis Team at the provincial level;
g. Continue the trainings to commune/district/provincial level officials on the concepts and practice of FSN.
For UN Agencies
h. Continue supporting FSN making use of a programme based approach, supporting RGC in the development of a TOC adapted to the Cambodian context in line with the NFSNS;
i. Enhance attention to aspects of the quality of the design of future Joint Programmes;
j. Support the monitoring of FSN indicators at the outcome level within the area of expertise of each of the UN agencies and related RGC counterpart agencies at national and sub-national levels;
k. Enhance support at the demand side of FSN focusing on local perceptions of malnutrition and on the reasons explaining why malnutrition is often not recognized or addressed.
For MDG Fund
l. Keep the number of UN agencies participating in a joint Programme, at a manageable level; and avoid adding agencies if they do not have enough resources to operate in relatively equal terms.
m. Align and relate the division of the budget among agencies with the scale of each of the programme components.
1. The Joint Programme needs to be seen as a project within a wider programme-based approach to FSN in Cambodia;
2. Allocation of resources among participating UN agencies, should consider the scale required for each of the programme components with the aim to ensure synergy of results at the local level;
3. The need for comparable targeting of programme components to enhance convergence at the local level
4. In a Joint Programme that works at both national and sub-national levels, sub-national level representatives need to be included from the start in national level coordination mechanisms;
5. The use of take home rations in the out-patient treatment approach to SAM at the health centre is a viable and efficient approach but does require some incentives for the system to operate in practice
6. Risks to the early scaling up the distribution of Micro-Nutrient powders
7. The methodology of baseline and end line studies needs to be adapted to the expected levels of change in a Joint Programme
Full report in PDF
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