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Evaluation database

Evaluation report

2018 United Republic of Tanzania: Evaluation of the Bringing Nutrition to Scale Project in Iringa, Mbeya and Njombe regions (2013-2017)



Author: Stephen Turner, Bjorn Ljungqvist, Joyce Kinabo, Jim Grabham

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: 

UNICEF has commissioned an evaluation of the Bringing Nutrition to Scale in Iringa, Mbeya and Njombe Regions (BNTS) project, covering the period from its launch in 2013 to the time of the evaluation mission in November 2017. The project is funded by Irish Aid (IA). The BNTS project has, for operational purposes, been merged with the Accelerated
Stunting Reduction Project (ASRP), funded by the United Kingdom Department for International Development (DFID) through the Addressing Stunting in Tanzania Early (ASTUTE) project.
This exercise has served as a mid-term evaluation of the ASRP, which recently completed its second year of operations. Following approval of a matrix of 16 evaluation questions submitted in an inception report, it has reviewed progress across all four Regions in which ASRP is being implemented: Mbeya, Iringa, Njombe and Songwe (MINS). In
answering the 16 questions, the evaluation is intended to be formative, with a view to generating evidence and lessons to strengthen programme design and accelerate the achievement of results. It reports on the ASRP as a whole, with specific reference to the BNTS where appropriate. It is based on detailed assessment of available documentation and
a two-week evaluation mission in November 2017, which included visits to communities and Local Government Authorities (LGAs).

Purpose/Objective:

The ASRP has a broad scope of ambition ranging from national policy and systems to support at household level. It has made equally broad contributions, which are mainstreamed in overall national efforts to combat stunting – and has the potential, subject to available resources, for further creative support across the spectrum of those national
efforts. The evaluation therefore offers equally broad observations on the progress that those national efforts are making, although its focus is on the performance of the ASRP, and its recommendations specifically concern the project itself.
Levels of malnutrition have declined significantly in Tanzania since the 1960s, but not far enough. In MINS, some child nutrition indicators remain poor, despite the progress in commercial agriculture that is being achieved in some areas. Stunting is a particular concern, with MINS among the Regions that are furthest above the national average.
Tanzania’s National Multisectoral Nutrition Action Plan (NMNAP) has continued the emphasis of the Government of Tanzania (GOT) on enhancing the nutrition of young children and their mothers, aiming at rapid scaling up and a strong impact on reducing the high burden of stunting and acute malnutrition in children under five and the high levels of anaemia in women of reproductive age.

Methodology:

This is a formative evaluation at the mid-term of the currently planned and funded ASRP, focusing on but not
restricted to the BNTS that is funded, as part of the ASRP, by IA. It does not attempt to assess results in terms of reducing stunting, but it does aim to assess the ways in which the project has operated to date, the likelihood of achieving the intended outcomes and impact, and the possible ways in which its design, implementation and performance could be enhanced – within the framework of the GOT’s overall NMNAP and related structures and
system.

The report also committed the evaluation team to high standards and principles of confidentiality and ethics in its work with informants, in accordance with the requirements of the United Nations Evaluation Group10. The evaluation team has striven to comply with those requirements, and to conform to its own standards of collegial, constructive engagement with UNICEF and its partners in learning together about the project’s experience to date and identifying the best ways forward.

Findings and conclusions:

The ASRP’s alignment with international thinking on nutrition priorities is strong.

The project has made significant progress in helping to build strong foundations for enhanced monitoring of nutrition. Now that the systems and procedures are ready, continuing to support LGAs in effectively adopting and using them to achieve well-designed plans and effective implementation mechanisms will be a major and central task for the
remainder of the ASRP.

Agriculture. This component has made modest progress, and achieved useful benefits, on a very small scale.

Nutrition services provided through the health sector. The ASRP has worked to increase the proportion of health facilities implementing integrated management of acute malnutrition (IMAM).

Evidence and learning. Among the most significant results of the first two years of BNTS were the five baseline studies, which were valuable. BNTS also contributed to the important National Nutrition Survey.

The evaluation has been unable to undertake detailed analysis of the efficiency of project operations. The organisational complexity of the project, across multiple levels of government through three sets of IPs, might be thought to reduce its cost efficiency.


The project has helped to put the required nutrition governance structures in place (notably Regional and Council Multisectoral Steering Committees on Nutrition). But these bodies do not yet function in the way they will need to if intensive action against stunting is to continue beyond the project period. Supporting the necessary development of
understanding, attitudes, leadership and procedures in these bodies will be one of the most critical tasks for the project during its remaining life.

Many questions remain to be answered about the continuation of health-based nutrition-specific interventions.Overall, the sustainability of the project’s likely achievements is not yet assured.

Recommendations:

UNICEF should seek funding to extend the coverage of the ASRP’s SBCC and evidence and learning components to 100% of villages in MINS and 75% of the target group within them, strengthening the working links with TASAF for the identification and monitoring of beneficiaries.

UNICEF
and the GOT should negotiate with funding partners to ensure a further five-year funding schedule for the ASRP in MINS, with commitment to, and a strategy for, full handover to ongoing GOT implementation in these Regions from 2022.

SBCC
The ASRP should strengthen the character and content of its ‘counselling groups’ so that they fully perform the intended longer-term roles within the community of counselling and peer support, in addition to simple training, and that – under the auspices of village governments – they become permanent local institutions through which successive cohorts of parents pass, facilitated by a permanent CHW cadre.

Agriculture
The BNTS agriculture component should be reformulated, and its budget revised, so that while its current level of pilot field activities is continued and refined.

Coordination and budget
The project and its IPs should intensify their emphasis, at all levels, on the multisectoral character of the effort to combat stunting – which means combating the perception that nutrition is only a health issue and only a responsibility for the health services. This also means combating the perception that the ASRP is only a nutrition-specific project.

Through its links with PO-RALG, the ASRP should negotiate increased GOT recurrent funding for nutrition-sensitive support activities in the agriculture sector. 

Lessons Learned:

Captured in the recommendations.



Full report in PDF

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Report information

Year: 2018

Office/Country: United Republic of Tanzania

Region: ESAR

Type: Evaluation

Theme: Nutrition

Language: English

Sequence #: 2018/005

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