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Base de datos de evaluación

Evaluation report

SRI 1999/003: Mid-Term Evaluation of the Participatory Nutrition Improvement Project



Author: Indra Tudawe, I.; Gamage, D.; De Mel, S.; Wikramanayake, T. W.; Bandara, R.; Somaratne, W. G.; Hector Kobbekaduwa Agrarian Research and Training Institute

Executive summary

Background

The PNIP was designed to support the National Nutrition goals of the government, which are to reduce child malnutrition, reduce incidence of low birth weight of and improve maternal nutrition. The nutritional goals are to be attained by the PNIP through promoting requisite behavioural changes and increasing community demand for state provided services conducive to nutritional welfare. PNIP strategy comprised of three activities, namely making institutional arrangements for implementing PNIP, training and advocacy of PNIP personnel, and mobilizing of community to adopt behavioural changes for nutritional welfare. The importance attached to PNIP is indicated by the allocation of funds to the project which, is about 30% of the total funds assigned to Nutrition programmes in Sri Lanka by UNICEF for 1997-2001.

Purpose / Objective

The Participatory Nutrition Improvement Project (PNIP) was designed to support the National Nutrition goals of the government, which are to reduce child malnutrition, reduce the incidence of low birth weight and improve maternal nutrition. PNIP strategy comprised of three activities: making institutional arrangements for implementing PNIP, training and advocacy of PNIP personnel, and mobilizing the community to adopt behavioral changes for nutritional welfare.

Methodology

The methodology utilized to assess the outcome was a comparison of baseline information with that of mid-term. The changes from the baseline period of the project was assessed by the change in nutritional status and behavioral changes in selected project areas through a household survey, interviews with target population, discussions with project managers and review of project documents.

Key Findings and Conclusions

A number of targeted behaviors did indicate a positive change from the baseline period. The positive changes were mainly in relation to maternal care, breast feeding practices, and water and sanitation practices. Improved maternal care is indicated by the 13% reduction in low birth weight babies.

Behavioral changes were inadequate with regard to growth monitoring, frequency of feeding of children and feeding of children during illness. The evidence that there was no significant difference in their nutritional status over the two periods of study indicates the inadequacy of adoption of recommended practices in relation to child nutrition.

Assessment of nutrition and mobilization knowledge though a learning-testing questionnaire indicated that the knowledge of nearly half of the sample of facilitators was not adequate. Inadequate knowledge of the facilitators emanates from different sources such as differences in educational backgrounds, problems relating to training, and shortage of master teachers to train the facilitators.

The degree of mobilization of the community was examined by the extent to which community members participate in project-related activities. Although 48% were aware of PNIP activities, the percentage of villagers who participated was as low as 26%. It appears that there is a drop in the number of small groups formed from the initial stage of the project. Only very few communities so far have set up a central organization to complete the institutional development process. In many places, the services of the facilitators appear to be withdrawn from the village before the development of institutional capacity was completed.

It is worthwhile to note that the strategies adopted by the PNIP to institute changes in the structural behavior of the community with regard to child and maternal nutrition is promising. The PNIP strategy and master plan document have clear guidance and logic for the mobilization process to be followed up to the point of becoming sustainable. The project has just not progressed beyond the initial stage. With the necessary adjustments to the present project, the potential to increase nutritional welfare of the community through PNIP rates high.

Main constraints affecting the implementation of PNIP include the high dropout rates of facilitators; incomplete 'Triple A' process of community mobilization hindering the implementation of PNIP activities at the community level; delays in financial disbursements that interfere in meeting targets; and poor coordination with other nutritional and health delivery programs, which reduces expected outcome from the project. The present monitoring system emphasizes only the achievement of physical targets. The monitoring system at Divisional Secretaries Division and Ministry of Plan Implementation, in particular, needs improvement to ensure the availability and ready access to information that will facilitate project management.

Recommendations

Establishing selection criteria for facilitators, completing and implementing community action plans to ensure community participation and better financial management can reduce some of these constraints. Furthermore, establishing a management-oriented monitoring system that captures both physical progress as well as progress of nutritional welfare, will greatly assist better implementation of the project.



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Report information

Date:
1999

Region:
ROSA

Country:
Sri Lanka

Type:
Evaluation

Theme:
Health - Nutrition

Partners:

PIDB:

Follow Up:

Language:
English

Sequence Number:
1999/003

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