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Evaluation database

Evaluation report

2017 Rep. of Turkmenistan: EVALUATION OF TURKMENISTAN’S NATIONAL NUTRITION PROGRAMME



Author: Tamar Gotsadze

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:

Some key nutrition programmes and policies have been initiated in Turkmenistan over the past decades. In 2013, the Government of Turkmenistan endorsed the National Nutrition Programme for 2013- 2017 (NNP). The Government has already started developing the next generation of a nutrition programme that will cover the period of 2018-2025. Therefore, this evaluation is timely as its findings and recommendations informs and provides valuable insights into the development of the next programme as well as to the process of integration of nationalized SDG2 targets and indicators, concerning children and women. The evaluation was planned to cover the period 2010-2016 as per the original Terms of Reference (ToR), however, the absence of baseline data for some key indicators required the evaluation to extend the period of analysis to 2006 -2017 in order to be able to examine the changes in outcome and impact indicators using the 2006 MICS data. As requested by the ToR, the evaluation is targeted at the national level only. It examined both the Government’s role and responsibilities to develop and implement the NNP, including governance, management, resource allocations and capacity development, service delivery, quality assurance, surveillance and monitoring over the interventions under the NNP framework; and UNICEF’s role in supporting the scale up of direct nutrition interventions, as well as mainstreaming nutrition in non-nutrition sectors.

Purpose/Objective:

The evaluation had three objectives: i) to generate lessons learned, evidence and learning to guide effective action towards the achievement of SDG2 in Turkmenistan and development of the next generation of the nutrition programme of the country, ii) to help define UNICEF’s role in supporting the country’s efforts in the nutrition-related SDG implementation process in the country during the next five years, and iii) to promote results-based management and evidence-based policy development and iv) assess UNICEF’s role and contribution to NNP implementation.
The evaluation covers the period 2010-2016 and is targeted at national level. It examined both, Government’s role and responsibilities to develop and implement the NNP including governance, management, resource allocations and capacity development, service delivery, quality assurance, surveillance and monitoring over the interventions under the NNP framework; and UNICEF’s role in supporting the scale up of direct nutrition interventions as well as mainstreaming nutrition in non-nutrition sectors.

Methodology:

The evaluation used mixed method of evaluation according to OECD DAC evaluation approach  and examined the relevance, effectiveness, efficiency, impact, and sustainability of the NNP and UNICEF’s contribution towards main objectives of NNP. These criteria were selected as a) the standard international criteria for development evaluation, as reflected in OECD/DAC Manual, b) appropriately geared to the purpose and objectives of the evaluation, as set out above, and c) appropriate for the learning emphasis of the study. In accordance with UN policies, gender mainstreaming was assessed as a crosscutting issue. The evaluation was carried out in three phases by an international consultant between June – November 2017 and applied a mixed-method approach to maximize validity and reliability. The data collection methodology  included site visits and observations, face-to-face in-depth interviews, Focus Group Discussions, desk-based research and review of existing reports, documents and available secondary data.

Findings and Conclusions:

The NNP demonstrates high relevance to expanding access to adequate child nutrition and quality food and health services and is aligned to global nutrition priorities. The Program is consistent with the needs and interests of the vulnerable and most at risk groups and population in general, but is silent on the strategies for reaching out of and targeting these groups with nutrition related services. UNICEF’s contributions were relevant to existing delivery structures and exhibits its relevance to Government’s priorities and are relevant to UNICEF’s mandate and program principles.
Effectiveness: The government approved version of NNP lacks clear formulation of underlying theory of change and measurable results targets that limited evaluation to draw conclusions. For evaluation purpose, the TOC was retroactively constructed and selected result indicators that allowed to make the following conclusions:
RA1: Improved collaboration at all levels for the implementation of the NNP
ReRA2: Increased accessibility and affordability of the nutrition services and appropriate nutrition for children and their mothers.
RA3: Strict control of food quality and safety, support for food production in line with the   healthy nutrition requirements, environmental and physiological standards.
RA4: Scientific research of vital aspects of healthy nutrition in the country’s natural   climatic   environment   and   implementation   the   findings   in practices; training of specialists.
UNICEF played a primary role in promotion of nutrition related issues on the government’s top policy agenda and supported implementation.  Nutrition related issues were given a priority in UNICEF’s previous and present Country Program of Cooperation Document. Support provided in nutrition were relevant and largely contributed to the effectiveness of the NNP.

Recommendations:

The Government is advised to formulate clear theory of change, support development of multi-sectoral, preferably a whole of government approach; include a wide range of universal and targeted actions based on most recent evidence; incorporate specific goals, objectives and expected outcomes; provide a detailed implementation plan, including the allocation of financial resources and funding sources, roles and responsibilities of all involved public and non-public structures and timelines; The accountability and results matrix of the new NNP should show how each of the results can be realized and how each NNP implementing sector should contribute for better nutritional outcomes over the course of the lifecycle. UNICEF is recommended to advocate the government to consider recommendations provided by the evaluation and allow technical support for its implementation when needed.
Elaborate adaptive response for food security challenges from climate change
Prioritize nutrition specific interventions in the new NNP.
Continue inclusion of nutrition sensitive interventions in related national programs of other sectors.
Strengthen consumer protection by improving the quality and safety of food products.
Implement comprehensive programmes that promote the intake of healthy foods and reduce the intake of unhealthy foods and sugar-sweetened beverages by the population and children and adolescents.
Implement comprehensive programmes, directed towards reduction of obesity rates, that promote physical activity and reduce sedentary behaviours in children and adolescents.
Plan for the development and implementation of the effective communication strategy and for periodic evaluation of its impact on the behavior change of population.
Introduce coordinated, integrated system for monitoring and surveillance of food, nutrition status and nutrition determinants with the regular collection, analysis and presentation of data to inform decision-making and improving the quality.

Lessons Learned:

Based on evaluation findings three key lessons can be drown: i) Maintaining strong and stable leadership is the essential element to ensure integrated and well-coordinated comprehensive service delivery by NNP; ii) Complementary nutrition related activities between sectoral programmes maximizes effectiveness; and iii) Strong Monitoring and evaluation system along with well documentation of results is essential to track NNP performance.



Full report in PDF

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Report information

Year:
2017

Country:
Rep. of Turkmenistan

Region:
CEE/CIS

Type:
Evaluation

Theme:
Nutrition

Partners:
Ministry of Health and Medical Industry of Turkmenistan

Language:
English

Sequence:
2017/001

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