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Evaluation report

2017 India: Reducing Stunting in Children Under Five Years of Age: a comprehensive evaluation of UNICEF’s strategies and programme performance – India Country Case Study



Executive summary

With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System (GEROS)". Within this system, an external independent company reviews and rates all evaluation reports. The quality rating scale for evaluation reports is as follows: “Highly Satisfactory”, “Satisfactory”, “Fair” or “Unsatisfactory”. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report, and the executive feedback summary labelled as ‘Part 3’.

Background:

Approximately 156 million of the world’s children under the age of 5 are stunted, with an estimated 80% of these children concentrated in only 14 countries. Stunting jeopardizes child survival and development by contributing to child mortality, morbidity, and disability, including impaired or non-optimal physical growth and cognitive development. In recent years, the global nutrition community has increased its focus on stunting. Developments in science have supported the causal relationship between stunting and short-term childhood development, as well as with long-term intergenerational effects on families. These relationships highlight the critical importance of nutrition during the first 1,000 days between a woman’s pregnancy and her child’s 2nd birthday, a period associated with risks of irreversible effects. In addition, research has provided evidence identifying effective, cost-efficient, and scalable interventions to address stunting. Concurrently, the international community working to reduce stunting has recognized lessons learned and models to support multi-sectoral approaches to improvements in nutrition.

Purpose/Objective:

The case study addresses three UNICEF objectives:

  1. Assess the relevance, appropriateness, and coherence of UNICEF’s country strategies and plans to address stunting in young children.
  2. Assess the effectiveness, efficiency, and sustainability of UNICEF’s country programmes in addressing stunting in young children, with particular attention to less reached, disadvantaged, and vulnerable groups, and draw lessons on equitable progress in reducing stunting in various programme contexts.
  3. Assess UNICEF’s leadership, guidance, and technical support, as well as the adequacy of UNICEF staffing and institutional capacity to respond to the lead role the organisation is expected to play at the field level in contributing to the sustainable and equitable reduction of stunting

The India country report was developed to provide evidence of UNICEF India’s accountability, effectiveness, and organisational learning and to advance its work to reduce stunting among young children in India. The report includes six major chapters that discuss the results of the India case study component of the Comprehensive Evaluation of UNICEF’s Strategies and Programme Performance.

Methodology:

  • Document review of UNICEF-provided documents
  • Secondary quantitative data - (RSOC 2013-2014)
  • Key informant interviews (KIIs) with UNICEF India staff and relevant external stakeholders CO and external stakeholder survey data

Document Review
Country documents for the evaluation of India included key UNICEF documents – Country Programme Documents (CPD), annual reports, national County Programme Action Plans (CPAP), and Mid-Term Reviews (MTRs) for the years 2010-2015 – as well as key research reports and journal articles related to nutrition in India.  In addition, the evaluation team reviewed Regional Office Operations and Management Plans (ROMPs) and Regional Analysis Reports (RARs), and global strategic documents related to stunting reduction. Publicly available documents for review have been extracted from UNICEF web-sites. The evaluation team worked with the EO, Regional Offices (RO), and Cos to collect additional documents for review. A complete list of documents reviewed is included in Annex 2.

Key Informant Interviews
Forty-five KIIs were conducted primarily during a two-week period in April 2016. Respondents included UNICEF India local level personnel involved in managing and supporting UNICEF programmes, representatives and/or deputies, programme managers and advisors at various levels, national policy makers and programme coordinators (including subnational staff), external experts and stakeholders, and staff of other UN agencies and organizations that contribute to and partner in relevant sectors at the global and national levels.
To supplement data collected through document review, KIIs, and secondary data, ICF developed two Web-based survey instruments. Survey questions included a mix of predetermined and open-ended responses across the evaluation subjects. The first Web-based survey was sent to the UNICEF COs in all evaluation countries. A second survey was administered to external stakeholders identified by CO staff.

Findings and Conclusions:

Key conclusions, see the full set in the Case Study report.

Conclusion 1: The Country Programme demonstrated strong progress towards adopting a more integrated, intentional, and effective approach to stunting, but some gaps in country planning remain.
Conclusion 2: UNICEF India has made considerable progress towards achieving stated outputs related to stunting.
Conclusion 3: Multi-sectoral approaches need further strengthening. 
Conclusion 4: UNICEF India plays a pivotal role in generating and disseminating knowledge and data related to stunting, however, gaps in data and knowledge remain.

Recommendations:

Country Programme Strategy and Approaches:

  • Build on the 2015 Stunting Priority Plan of Action to develop a clearly formulated theory of change that guides the UNICEF programme for addressing stunting. Further align results matrix with related global outcome indicators with focus on vulnerable groups
  • Clarify pathways for incorporating nutrition sensitive approaches. Increase focus on scalable innovations rather than interventions in designing and implementing future pilot initiatives.
  • Advocate for and support consistent inclusion of specific targets for improvements in nutrition status indicators for the State Nutrition Missions and regular monitoring of progress.

Resources and Coordination:

  • Continue to build staff capacity to strengthen programming for integrated approaches to addressing stunting, selective data analysis, policy advocacy / influence, public finance, and knowledge management. Further mobilize the expertise of regional and global staff and gain from cross-country learning.
  • Strengthen planning and coordination structures specifically designed to facilitate multi-sectoral work within UNICEF India CO.
  • Engage more regularly with external stakeholders with a focus on mapping stakeholder mandates and priorities, and improving financial and technical resource allocations to country programme needs.

Data and Knowledge Generation:

  • Improve evidence generation by engaging in formative research and effectiveness studies, to better understand success factors and challenges of specific approaches and interventions supported by the country office, and for ensuring their viable replication in varying state contexts.
  • Explore better use of information technology to provide real time data for decision making
  • Explore additional analysis on determinants of nutrition outcomes for tribal and non-tribal children, as well as analysis of district-level data to facilitate evidence-based advocacy and to better target disadvantaged groups


Full report in PDF

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Report information

Year:
2017

Country/Office:
India

Region:
ROSA

Type:
Evaluation

Theme:
Nutrition

Language:
English

Sequence #:
2017/001

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