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Evaluation report

2017 Niger: Reducing stunting in children under five years of age: a comprehensive evaluation of UNICEF’s strategies and programme performance - Niger 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 jeopardises child survival and development by contributing to child mortality, morbidity, and disability, including impaired or multisectoral 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 second 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 recognised lessons learnt and models to support multisectoral approaches to improvements in nutrition.

Country selection took into account the range of country contexts where stunting is widely prevalent, giving attention to development settings and to contexts affected by fragility and humanitarian emergencies. Niger has a high stunting prevalence with no change over the last 20 years —the most recent figures show a stunting prevalence of 45%. The country was selected for a case study to explore the situation of a high stunting burden coupled with high severe acute malnutrition rates and emergency context.

Purpose/Objective:

This country report was developed to provide evidence of UNICEF Niger’s accountability, effectiveness, and organisational learning and to advance its work to reduce stunting among young children in Niger. 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.

Methodology:

  1. DATA RESOURCES:
    1. Document Review: The qualitative assessment was informed by documents gathered by the UNICEF EO, Regional Office, and Niger CO, as well as publicly available documents extracted from UNICEF Web sites.
    2. Secondary Quantitative Data: The Niger DHS conducted in 2006 and 2012 serve as the primary source of secondary quantitative data. As a proxy for resources, UNICEF shared funding information related to overall and nutrition-related programming for Niger’s CO.
    3. Key Informant Interviews: Twenty-five KIIs were conducted during a five-day period in July 2016 by one ICF evaluation team member. The evaluator worked with the Niger CO to identify key informants, who included UNICEF Niger technical staff and leaders, national and subnational policymakers and programme coordinators, donors, other UN agencies, and NGO partners.
    4. Country Office and External Stakeholder Survey: To supplement data collected through document review, KIIs, and secondary data, the evaluation team developed two Web-based survey instruments.
  2. DATA ANALYSIS: The evaluation used thematic analysis to systematically review and sort data according to a framework informed by the programme logic and research questions. As issues, patterns, and themes were identified during the review, the evaluation team expanded the framework to incorporate them into the analysis. Interpretation of the data proceeded along with development of the thematic framework and included the identification of associations among, and explanations for, observed phenomena.
  3. CASE STUDY LIMITATIONS: The evaluation has made best efforts to triangulate information to follow the agreed-upon evaluation framework and respond to evaluation questions. However, in some cases, information was not available to assess some questions. Therefore, the depth of information collected in the KIIs varies across evaluation subjects and respondents.

Findings and Conclusions:

Conclusion 1: UNICEF Niger has invested in identifying key bottlenecks and understanding the context of stunting in Niger, which has resulted in formulating a relevant and coherent approach to stunting reduction. UNICEF Niger invested in and in-depth review and bottleneck analysis, and they adapted their nutrition programme based on the results of these activities. These processes were a key driver of their success in developing a robust approach to improving child nutrition that is reflective of national contextual factors, the global evidence base and global guidance from UNICEF.

Conclusion 2: UNICEF Niger has been effective in generating political commitment for stunting reduction, but commitment needs to be translated into programme actions. UNICEF Niger led the development of Niger’s first multi-sectoral nutrition security strategy, the National Multisectoral Policy for Nutrition Security, a key indicator of progress towards reducing stunting.

Conclusion 3: UNICEF Niger is internally planning and implementing mutlisectoral actions that should reduce stunting but are struggling to achieve effective coordination. UNICEF’s nutrition programme is primarily focused on nutrition-specific interventions, and the country programme and Strategic Note for Nutrition reflects this. There is a number of interventions in the health and WASH programmes relevant to stunting that are being implemented, but their specific contributions to stunting are not strongly reflected. Stakeholders feel that joint planning and implementation for truly mutlisectoral stunting interventions has been a struggle.

Conclusion 4:
Niger has been plagued by humanitarian emergencies that have necessitated attention of UNICEF. Wasting has been highly prevalent in Niger over the last decade, and much nutrition funding and attention has understandably been given to treating severe acute malnutrition rather than holistically preventing stunting.

Recommendations:

  1. Promote and support concrete processes that help clarify roles and responsibilities of strategic partners within and outside the United Nations, especially in the areas of nutrition-sensitive programming and multisectoral approaches to reduce stunting.
  2. Leverage UNICEF Niger role as facilitator of the 3N coordination body to advocate for input and buy-in from key ministries on the investment case and action plan, which are underway. Once developed, the investment case will be a key tool for identifying resources for implementing stunting interventions.
  3. Assess capacity gaps and needs. Mobilse partners and leverage UNICEF’s niche in the area of upstream work to further expand/diversify capacity building activities. In particular focus on the concept of stunting as a multi-sectoral issue and how to operationalise interventions to prevent stunting, especially at the subnational level.
  4. Internally, continue to build staff capacity around integrated approaches. Incorporate accountability across sections to improve collaboration and cooperation toward better results-orientation to reducing stunting and use them as the basis in assessing the achievement of country programme targets.
  5. A focus on behaviour change may help address some of the challenges that UNICEF Niger has faced. Consider borrowing lessons learnt from other countries around nutrition-related campaigns.
  6. Funding needs for both prevention and treatment are substantial. Continue advocacy for scaling up prevention through use of improved data, including data on cost effectiveness analyses.


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Report information

Year:
2017

Country/Office:
Niger

Region:
WCAR

Type:
Evaluation

Theme:
Nutrition

Language:
English

Sequence #:
2017/044

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