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Evaluation database

Evaluation report

2013 Kenya: Nutrition Support Officer Operational approach evaluation



Author: Gabrielle Appleford

Executive summary

"With the aim to continuously improve transparency and use of evaluation, UNICEF Evaluation Office manages the "Global Evaluation Reports Oversight System". Within this system, an external independent company reviews and rates all evaluation reports. Please ensure that you check the quality of this evaluation report, whether it is “Outstanding, Best Practice”, “Highly Satisfactory”, “Mostly Satisfactory” or “Unsatisfactory” before using it. You will find the link to the quality rating below, labelled as ‘Part 2’ of the report."

Background:

UNICEF Kenya, a key actor in the nutrition sector, has taken a lead role in supporting the scale up of high impact nutrition interventions (HiNi) in the country. One strategy has been to increase UNICEF’s field presence in order to provide sub national technical support to partners and Ministry of Health teams. To facilitate this, UNICEF recruited NSOs, through the United Nations Office for Project Services (UNOPS). NSOs are based in selected ASAL and other priority counties of Kenya to support the provision and scale up of nutrition services.

Purpose/Objective:

The ‘NSO project’ commenced in May 2010 and has been in operation for three years. As three years is adequate time for some of the change processes supported by NSOs to have taken place, an evaluation was proposed by the Ministry of Health and UNICEF to assess the project’s effectiveness and efficiency and formulate recommendations for the next phase of the project. The evaluation is also timely as there have been policy changes at national level that should be reflected in the next phase of the project. Additionally, the process of decentralisation has commenced creating new sub national governance structures and management arrangements which NSOs will need to engage with going forward.

Methodology:

The evaluation was conducted over the month of April 2013 and involved stakeholder consultation at national and sub national level.

Findings and Conclusions:

Evaluation findings suggest that the project has been successful against a number of Development Assistance Committee (DAC) criteria.
Relevance: The NSO project has enabled UNICEF to expand its sub national presence and technical support beyond its existing four field offices. The NSO role serves as a bridge function between the central and county levels by ensuring that national policies and guidelines are effectively understood and implemented.
Effectiveness: While the expected outputs and outcomes of the NSO project are not well known by stakeholders or articulated by UNICEF, there is evidence that progress has been made at county level on the prioritisation, coverage, quality and capture of HiNi and that the NSOs have played an instrumental role in this.
Efficiency: The project is an efficient means of providing technical support and facilitating nutrition service coverage and quality. NSOs have become more efficient in executing their roles over time as change processes have taken root. Efficiency has improved through greater coordination of partners, the use of common tools and government systems. As government capacity has been built at management and facility level, the need for hands on inputs has reduced allowing the NSO to work on more ‘upstream’ issues.
Impact: NSOs have contributed to improvements in the quality of services however in some settings these remain fragile due to a range of contextual factors. There is evidence of greater sub national engagement, ownership and ‘visibility’ of nutrition however this is uneven across counties.
Sustainability: The benefits of the project should continue after donor funding ceases and rest with how effectively roles have been internalised, capacity has been embedded and systems have been strengthened at sub national level. The presence of effective leadership and committed County and District Health Management Teams, more than anything else, creates uneven progress between and within counties.

Recommendations:

Devolution presents both opportunities and risks for nutrition. With transition to county governments, NSOs and UNICEF will need to move with this process, which is likely to be uneven across counties.

The following recommendations have been formulated:
Improve the documentation of the NSO project in order to clearly articulate expected outputs and achievements to internal and external stakeholders.

The NSO terms of reference (TOR) should be reviewed for the next phase of the project together with key stakeholders. It is further recommended that two TORs be developed, one for single county NSOs and one for ‘roving’ NSOs. The TOR should outline NSO accountability at sub national level as well as to UNOPS and UNICEF.

Develop NSO key performance indicators (KPIs) aligned with county annual nutrition workplans so that individual NSO performance is benchmarked to the county in which they operate. KPIs should be agreed with county stakeholders, aligned with UNICEF base plans (where NSOs are co-located) and tracked on a periodic basis. NSO reports to UNICEF could be aligned with KPIs and the reporting frequency reduced.

Improve the overall support to NSOs so that their presence at sub national level is optimised and greater consistency in implementation and learning is generated across NSO sites. Identify and support the development of NSO skills and engagement strategies so that these are fit-for-purpose for the next phase of the project and aligned with revised NSO TORs.

Develop an exit strategy for the project with defined criteria and milestones for exit. An exit strategy may include phased exit, from a more static model of NSO support to a roving model of support.
NSO cost effectiveness: Review the cost effectiveness of the NSO model and some of the functions performed by NSOs. This could be compared to alternative nutrition support models, such as those provided through partners.

Lessons Learned:

The consultant highly recommends that the NSO project continue. In the main, there is overwhelming support for the project from stakeholders at national and sub national levels. Effective relationships, systems and processes have been established in many instances at sub national levels. These are bearing results for nutrition.



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Report information

Year:
2013

Country:
Kenya

Region:
ESARO

Theme:
Nutrition

Type:
Evaluation

Language:
English

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