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Framework Contract Beneficiaries2013 Lot 1
European Union Delegation to Malawi
END-TERM REVIEW “SUPPORT TO IMPROVED NUTRITION STATUS
OF VULNERABLE GROUPS IN MALAWI” - SINSM”
Contract N°2015/366502
DRAFT FINAL REPORT
December 2015
This project is funded by the European Union Project implemented by
The contents of this publication is the
sole responsibility of AESA Consortium and
can in no way be taken to reflect the views
of the European Union
AESA Consortium
Lot1@aesagroup.eu
2
EUROPEAN UNION DELEGATION TO MALAWI
End-Term Review “Support to Improved Nutrition Status
of Vulnerable Groups in Malawi” - SINSM”
Contract N°2015/366502
Framework Contract Beneficiaries2013– LOT 1
DRAFT FINAL REPORT
December 2015
Team Composition:
Team Leader: Aart VAN DER HEIDE
KE 2: Cyridion AHIMANA
This report was prepared with financial assistance from the Commission of the European Communities. The
views expressed are those of the consultant and do not necessarily represent any official view of the
Commission or the Government of this country
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TABLE OF CONTENTS
ACRONYMES..............................................................................................................................................................................4
1. EXECUTIVE SUMMARY ..................................................................................................................................................7
2. INTRODUCTION............................................................................................................................................................10
3. ANSWERED QUESTIONS/ FINDINGS ........................................................................................................................13
3.1 PROBLEMS AND NEEDS (RELEVANCE) ................................................................................................................................13
3.2 ACHIEVEMENTOF PURPOSE(EFFECTIVENESS)....................................................................................................................14
3.3 SOUND MANAGEMENT AND VALUEFOR MONEY (EFFICIENCY) ............................................................................................16
3.4 ACHIEVEMENTOF WIDER EFFECTS (IMPACT)......................................................................................................................16
3.5 LIKELY CONTINUATION OF ACHIEVED RESULTS (SUSTAINABILITY).........................................................................................18
3.6 MUTUAL REINFORCEMENT (COHERENCE) ..........................................................................................................................19
3.7 EU VALUEADDED.............................................................................................................................................................19
4. VISIBILITY. .....................................................................................................................................................................19
5. OVERALL ASSESSMENT...............................................................................................................................................21
6. CONCLUSIONS AND RECOMMENDATIONS............................................................................................................22
6.1 CONCLUSIONS..................................................................................................................................................................22
6.2 RECOMMENDATIONS ...............................................................................................................................................24
4
ACRONYMES
AAH-UK Action Against Hunger or Action Contre la Faim (ACF)
AIDS acquired immune deficiency syndrome
CADECOM Catholic Development Commission
CSB Corn Soya Blend
CMAM Community Management of Acute Malnutrition
DAC Development Assistance Committee
DADO District Agriculture Development Officer
DCO District Council Office
DDO District Development Officer
DEO District Education Officer
DHO District Health Officer
DEM District Education Manager
DNHA Department of Nutrition, HIV and AIDS
DP Development Partner(s)
DPO District Planning Officer
ECDC Early Childhood Development Centre
EDF European Development Fund
ETR End of Term Review
EU European Union
EUD European Union Delegation
FAO Food and Agriculture Organisation
FIS Food Security Index
FISD Foundation for Irrigation and Sustainable Development
FSP Food Security Programme
GAM Global Acute Malnutrition
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GIZ Gesellschaftfür Internationale Zusammenarbeit of Germany
GoM Government of Malawi
INFSSS Integrated Nutrition and Food Security Surveillance System
INGO International Non-Governmental Organisation
M&E Monitoring & Evaluation
MKz Malawian Kwacha
MoAIWD Ministry of Agriculture, Irrigation and Water Development
MoE Ministry of Education
MoG Ministry of Gender
MoH Ministry of Health
MoU Memorandum of Understanding
MUAC Mid Upper Arm Circumference
MVAC Malawi Vulnerability Analysis Committee
MwK Malawian Kwacha
NAO National Authorising Officer
NGO Non-Governmental Organisation
OECD Organisation for Economic Cooperation and Development
OPC Office of the President and Cabinet
PE Programme Estimate
PLHIA people living with HIV and AIDS
PMU Programme Management Unit
RA Result Area
ROM Results Oriented Monitoring
SAM Severe Acute Malnutrition
SINSM Support to Improved Nutrition Status of Vulnerable Groups in Malawi
SNIC Support for Nutrition Improvement Component
SUN Scaling Up Nutrition
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TL Team Leader
TM Team Member
ToR Terms of References
UN United Nations
UNICEF United Nations Children Fund
VAM Vulnerability Analysis and Mapping
WASH Water Sanitation and Hygiene
WFP World Food Programme
WHH Welhungerhilfe or German Agro-Action
WVI World Vision International
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1. EXECUTIVE SUMMARY
Key purpose of the end term review.
In accordance to the Term of Reference (TOR ) , The purpose of this End Term Review
(ETR) was to carry out a comprehensive assessment of each of the four contracts
(Programme Estimate 1 and 2 and two grants)in order to establish progress made towards the
achievement of the objectives and also the expected results. It was also requested to assess
the relevance of the design, the efficiency and effectiveness of the project implementation
and the sustainability of their impact and last but not least to draw the lessons learnt. Based
on the findings recommendations will be made that will guide the Government of Malawi
(GoM) and the European Union (EU) on how to sustain the interventions introduced by the
SINSM1. This was detailed again in 2.2 of the Terms of Reference (ToR). It is also requested
to award the project and each component (PEs and Grants) a grade between A-Dsimilar to the
EU Results Oriented Monitoring (ROM) methodology.
The SINSM programme.
The EU Food Security Programme (FSP) for Malawi 2004 – 2006 was launched among
others to support the nutritional status of the most vulnerable groups. The SINSM or the
“Support to Improved Nutritional Status of Vulnerable Groups in Malawi” was financed by
the FSP budget line for a total amount of € 7,650,000. During 3 years – 2008 until 2011 - the
Department of Nutrition and HIV/AIDS (DNHA), the National Authorizing Office (NAO)
and the European Union Delegation (EUD) negotiated a new PE. Agreement resulted in a
new programme with the name “Support to Improved Nutrition Status of Vulnerable Groups
in Malawi” that was coordinated by the Department of Nutrition and HIV and AIDS.
The SINSM was implemented through 2 Programme Estimates (PEs) (PE1 and PE2) and 2
Grants to the Foundation for Irrigation and Sustainable Development (FISD) and
Welthungerhilfe (WHH). PE1 was implemented from the 1st of February 2011 – the 30th of
September 2012 and PE2 from the 1st of November 2012 – the 31st of October 2014. The 2
Grants for school feeding through the NGO’s were implemented during the year 2014.
The programme’s total allocated amount through two (2) MoU was € 7,650,000. Under PE1
+ 48% of the total budget was absorbed and under PE2 + 77%. The DNHA used € 4,840,000
and the Grants for school feeding €1,500,000 and an extra Grant for CSB of € 172,000 was
allocated. Therefore the expenditure for the whole SINSM (2011-2014) was € 4,840,000 + €
1,500,000 +€ 172,000 = € 6,510,000. This is 85% of the total allocated amount.
The SINSM was implemented in ten (10) Districts in Malawi. In each district the SINSM had
a food and nutrition focal point, one in the District’s Health Office and one in the District’s
Agriculture Development Office. The school feeding programme was implemented by the
District’s Education Management (DEM) Office through the School Health and Nutrition
Officers.
Each PE had five (5) Result Areas (RA): 1) Support to nutritional products distribution to
vulnerable groups (PE1) and Support to school meals programme (PE2); 2) Strengthen
capacity in nutrition for the communities and other stakeholders; 3) Nutrition Surveillance
System strengthened to enable tracking of malnutrition for timely and rational response; 4)
Capacity of health facilities to manage nutritional rehabilitation improved and 5) Project
coordination and management activities improved.
1The final auditoftheSINSMPEs 1 and 2 were already undertaken in order to establish, among other things, the exact eligibl e and
ineligible expenditures. The recovery ofall ineligible costs has also been done.
8
The main analytical points.
 Relevance: Great relevance given the current food and nutrition situation in Malawi
where stunting is still high (<40%), wasting low (<5%), the food situation is still insecure
and rural communities still vulnerable to food and nutrition insecurity, WASH insecurity
and poverty.
 Effectiveness:
1. RA1: The support to nutritional products distribution to vulnerable groups programmed for
PE1 was not carried out. The school feeding programme proposed to carry out in the PE2
under the RA1 was carried out in 2014 – only one year – through WHH and FISD with
rather positive results.
2. RA2: All pilot Districts had nutrition officers in the Ministry of Agriculture District Service
(DADO), the Ministry of Health (DHO), the Ministry of Education (MED) and the District
Council (DC) etc. They were permanently involved in the strengthening of the capacity in
nutrition for communities and other stakeholders. The SINSM programme carried out a
number of capacity building programmes for District’s nutrition officers but how these
capacity building activities impacted the capacity was not measurable. No professional
monitoring system was set up.
3. RA3: Under PE1 and PE2 a total amount of € 113,000 or MwK 37,383,179 was spent on
the INFSSS. Only 3 bulletins were published with incomplete information. The DNHA was
supposed to develop a Geographical Information System (GIS) database and website for
nutritional data. The INFSSS stopped activities in 2013 according to the final report due to
“interruption of funding” but according to the NAO and the EUD funding was not
interrupted. The project’s expected results - to enable tracking of malnutrition for timely
and rational response - were not attained.
4. RA4: Under PE1 an amount of + € 63,800 (Mk 14,659,008) was spent and under PE2 + €
89,000 (Mk 35,482,025). The expected result was improvement of capacity of health
facilities to manage nutritional rehabilitation. However the DNHA and the MOH realised
various capacities building improvement trainings under various programmes (SUN
movement, SNIC, MOH etc.) The specific impact of SINSM was neither monitored nor
measured. The low wasting figure – in 2014 only 3.8% - for Malawi is objective evidence
that the specific attention for nutrition worked. To what extend SINSM contributed is not
demonstrable because it was not monitored in a quantitative way.
5. Under PE2 + € 89,000 (Mk 35,482,025) had been spent. The result area aimed at
improvement of project coordination and management activities. The SINSM suffered of
various external political developments among others the change of a new president
belonging to a different political orientation, the move of the DNHA from the OPC to the
MOH. Internally the SINSM had 4 different liaison officers. The budgetary amounts for
each RA were objectively too limited to guarantee optimal impact. The DNHA mentioned
also the strict rules of EU funding inhibited flexible management. The quality of the
coordination role of the DNHA was questionable.
 Efficiency: The efficiency of the SINSM was very poor except from the school meals
grants to WHH and FISD. It must be recognized that the DNHA as coordinating agency
was subject to political changes, the shift from the OPC to the MoH, the frequent change
of imprest2 officers (for the PE1 and PE2) four (4) imprest officers but also due to the low
budgets for the various components. The example of the INFSSS that was budgeted for
2The imprest system is a form offinancial accounting system. Thebase characteristicofan imprest system is that a fixedamount is
reserved, which aftera certainperiodoftime or when circumstances require, becausemoneywas spent, it will bereplenished.
9
only € 113,000 for a pilot programme for 4 years was unrealistic. The needed
decentralisation proposed in the PE1 was not carried out.
 Impact: except from the school meals component, the overall impact of this
programme is not measurable in an objective way since no professional monitoring
system was set up. The two final reports of PE1 and PE2 mention that the programme
was a “success” but the success could not be validated by concrete and quantitative
results. No progress reports were found by the evaluation team in order to measure the
expected impact.
 Sustainability: The school meals component through the two Grants for WHH and FISD
jointly with the MoE had a positive impact not only it supplied school meals to more than
47,000 learners during the year 2014 but also produced new strategies on how to involve
the communities in an optimal way. It also worked in a positive way to stimulate school
enrolment in general and of girls in particular and the improvement of the nutritional
situation of leaners in schools targeted by the two grants.
 Coherence: The coherence with other programmes, donor’s strategies and GoM policies
was not questionable.
 EU added value: The EU member states operate in Malawi mainly through the UN
agencies UNICEF and WFP, the support to the SUN movement and international NGO’s
active in poverty reduction, education, health, WASH etc.
 Grades3 awarded to the project and each component (PE’s and Grants)
Capacity building nutrition C (=problems)
INFSSS D (serious deficiencies)
School feeding: B (= good)
General coordination and communication: C (= problems)
Decentralisation C (= problems)
District’s involvement and participation: C (= problems)
Monitoring and evaluation: D (= serious deficiencies)
Data collection: D (= serious deficiencies)
SINSM general C/D (=problems and serious
deficiencies)
Main conclusions.
The ETR was carried out one (1) year after termination of the SINSM. The Relevance of the
SINSM was generally recognized given a vulnerable food and nutrition security situation in
Malawi. The two final reports - Nutrition PE1 and PE2 Report – came to the conclusion that
the SINSM was a success but the ETR does not agree with it (see “grades awarder to the
project and each component). The review team is of the opinionthat political changes and
shift from Office of the President and Cabinet (OPC) to the Ministry of Health (MoH)
affected the results of the programme in a negative way. Another reason was that too many
different activities or Result Areas were brought together in one programme. The INFSSS
was interrupted in 2013 and did not perform any results. The available budget of € 113,000
for such a pilot programme was also far too low. The food security element was weakened
after the shift from the OPC towards the MoH excluding in this way the MoAIWD. Weak
management by the coordinating institution (DNHA) affected the programme also negatively
(4 imprest officers in 4 years). A weak and non-professional monitoring system resulted in
the impossibility to measure impact. The PE1 intended a strong decentralisation towards the
Districts but that was not achieved. The only activity that performed positively were the two
Grants for WHH and FISD for the school meal programme jointly with the MoE on national
3Grades are as follows: A=very good, B =good; C =problems and D =serious deficiencies.
10
level and strong involvement of the DEM on District level. The role of the steering
committee was not possible to assess. Minutes of the three (3) meetings of this committee
were not fund. In general terms the SINSM was not very successfully.
Main lessons learnt.
The main lesson learnt is that despite the relevance of the different components of the SINSM
a combined programme must not be carried out by a coordinating institution that is part of
only one (1) ministry. The capacity building component for the community and for the
Districts health facilities can be carried out by the MoH jointly with the DNHA. The INFSSS
– its relevance is generally recognized - must be implemented by a semi-public institution
controlled by the GoM, preferably the OPC or the cabinet of the prime minister, by
independent academic institutions and by donors. It must have at its disposal sufficient
funding and highly qualified and competent staff. The school meals programme was
implemented in a rather successful way despite its short implementation period – only in
2014 – and the symbiosis between the MoE, the DEM and the NGO’s was successful.
Specific recommendations.
1. Decentralisation of programmes is necessary for fully involvement of the District
Counsels.
2. Capacity building in nutrition under the responsibility of the MoH.
3. INFSSS implemented by an independent institution controlled by the GoM, independent
academic institutions and donors with enough funding and competent and professional
staff receiving acceptable salaries.
4. School meal programmes under the MoE with help of NGO’s.
5. Systematize first findings of community involvement in order to diminish the costs.
2. INTRODUCTION.
This report contains the outcome and conclusions of the end-term review (ETR) of the
Support to Improved Nutrition Statusof Vulnerable Groupsin Malawi (SINSM) carried out
from the 26thof October till the 20thof November 2015. The SINSM programme was a pilot
programme implemented by the Department of Nutrition and HIV and AIDS (DNHA) in
conjunction with the line Ministry of Health (MOH), Ministry of Agriculture, Irrigation and
Water Development (MAIWD), Ministry of Gender (MOG) and Ministry of Education
(MOE) and two NGO’s - “Welthungerhilfe” (WHH) and the Foundation for Irrigation and
Sustainable Development (FISD).
The SINSM programme aims to contribute towards the improvement of the nutritional status
of all Malawians with special emphasis on vulnerable groups such as pregnant and lactating
women, children below the age of 5 years, both school aged and school going children,
orphans and people living with HIV and AIDS through improved service delivery systems in
10 selected Districts in Malawi. In each district the SINSM had a food and nutrition focal
point: one in the District’s Health Office and one in the District’s Agriculture Development
Office. The school feeding programme was implemented by the District’s Education
Management (DEM) Office through the DEM education health and nutrition officer.
The SINSM programme consisted of two Programme Estimates (PE): PE1 from 01/02/2011 -
30/09/2012 and PE2 from 01/11/2012 - 31/10/2014, each having five Result Areas (RA):
Support to nutritional products distribution to vulnerable groups (PE1) and to the school
meals programme (PE2);
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1. Strengthen the capacity in nutrition for the communities and other stakeholders;
2. Nutrition Surveillance System strengthened to enable tracking of malnutrition for
timely and rational response;
3. Capacity of health facilities to manage nutritional rehabilitation improved and
4. Project coordination and management activities improved.
In PE21 two (2) Grants of each € 750,000 (+ € 172,000) were allocated to WHH4 and FISD5
to implement the school meals programme.
The programme’s total allocated budget through two (2) MOU was € 7,650,000. Under PE1
about 48% of the total budget was absorbed and under PE2 about 77%. The DNHA used €
4,840,000 and the Grants for school feeding € 1,500,000 and an extra Grant for CSB of €
172,000 was allocated6. Therefore the expenditure for the whole SINMS (2011-2014) was €
4,840,000 + € 1,500,000 + € 172,000 = € 6,510,000. This is 85% of the total allocated
amount.
The two main purposes of the SINSM according to the Terms of Reference (TOR in annex 1)
were:
1. To make an overall independent assessment of the performance of the SINSM
programme with special attention to the analysis of relevance, efficiency,
effectiveness, impact, sustainability, coherence and the EU added value of the
programme.
2. To analyse the feasibility of the programme design and the implementation for
reaching the stated objectives.
Introductory phase.
The ETR was carried out in two main phases including the inception phase, the field work
and the validation workshop during which key findings were presented. The first week of the
ETR was an inception period (26-30 October 2015). An inception meeting took place on the
2nd of November with the EUD, NAO, DNHA, MOH, MOAFS etc. An official inception
report with a more detailed work plan and methodology was presented and sent to the EUD.
Field work
During the second and third week of the assignment, i.e. from Monday 2nd of November till
Friday 13thof November, nine (9) out of the ten (10) SINSM Districts7 were visited. During
the field visits all the implementing partners8were extensively interviewed. Based on the
results of the implementation phase, visits to health facilities, schools and involved
communities were scheduled as far as feasible given time constraints, distances and
availability of the beneficiaries themselves etc. All questions related to the SINSM service
implementation, its Surveillance system and backstopping from the DNHA were intensively
assessed. Based on the results of the assessment complementary field visits to health facilities
and involved schools were planned. Each visit to a District started with a visit to the District’s
4Supporting improved nutritionandhealthand building institutional capacity for sustainable homegrown school mealprogrammes in
Malawi'(01/01-31/12/14).
5
Sustainable School Meals Initiative (SSMI) (01/01-31/12/14).
6
TheexpenditureforthetwoGrants€1,500,000wereunderSpecialCommitmentandnotincludedinthePE2expendituresummary.TheSchoolMealsProgramme
alsobenefitedonaSupply Contractfor CornSoya Blend(CSB) –value€172,000(source:NAO).
7khatabay,Rhumpi, Dowa, Salima, Mangochi, Phalombe, Chikhwawa,Chiradzulo, Neno, Dedza.
8
District Agriculture Development Office(DADO), DistrictNutritionSINSMfocal point,District Education orDEMSINSMfocalpoint, District
M&Eofficer.
12
Council office to officially inform the District Commissioner and the District Planning
Director on the objective of the visit. The ETR-team made a final District’s Assessment Fiche
for each District in which main findings and results were capitulated. The ETR-team used the
District Assessment Fiches as a basis to write up the general impressions in a concessive way.
The overall findings of the field work can be found in Annex 7.5.
Final Validation Workshop
The fourth week, the 16-20thof November, was used for writing of the aide memoire,
debriefing and a final validation workshop in which all partners on Central and District’s
level participated. The workshop aimed at presenting the findings of the ETR to the main
stakeholders, to check the factual basis of the evaluation and to discuss the draft findings,
conclusions and recommendations made by the ETR-team.
The Terms of Reference (TOR) for this ETR detail in part 2.3 the requested services in five
different (5) points the so called DAC evaluation criteria (see chapter 3 “answered questions).
Each point has a bulleted number of “guidelines” to concentrate on and to be answered based
on available information.
This ETR faced the following constraints in conducting the ETR:
 According to the TOR, ten (10) of the implicated Districts were to be visited while
only nine (9) effective days were only available for conducting the field visits.
Therefore, workdays of more than 8 hours were mainly used for long distance travels
and interviews. However, most District’s services have an official working hours
from 7.30 AM – 4.00 PM. This was also the case for the schools and the health
facilities.
 In a number of Districts involved staff members of Government services were new
and had never been involved in the implementation of the SINSM programme, which
ended in October 2014. Given that there had never been a central coordination entity
on Districts level no district’s institutional memory was in place either.
 According to the TOR, the ETR is to provide the reader with sufficient explanation on
the methodology used during the review in order to enable the reader to gauge the
credibility of the conclusions and to acknowledge limitations or weaknesses, where
relevant. This can only be done once we have analysed the optimal implementation of
the programme and on condition that the DNHA supplied optimal support to the
Districts. It also means that if the Districts were in a position to support the sentinel
sites in an optimal way and a good working surveillance system, the nutritional status
of the vulnerable groups in these sites would have been improved substantially. The
ETR-team can only assess this during the visits to the Districts. Only if the Districts
and also the DNHA were in a position to provide clear data on the nutritional and the
food security status in the concerned Districts, the assessment could point out whether
the programme was able to meet its objectives. If this was not or only partially
implemented by the Districts and DNHA, the ETR has to find out why it was not
implemented as planned. The programme was, however, to piloting or testing how the
proposed activities were able to improve the food and nutrition security status of the
proposed vulnerable groups. If these data are not readily available, it will be difficult
for the ETR-team to assess the relevance, the efficiency, the effectiveness, the impact
and certainly the sustainability and the coherence in an objective way. In summary it
must be pointed out that the lack of produced reports was a real constraint.
13
 The ERT-team would like to point out the results and recommendations made during
the 2008 final evaluation of ACF-UK as listed in annex 7.6. It is important to know
how the first emergency food and nutrition security surveillance system performed
and what the recommendations were on how to implement the surveillance system by
the GOM.
 Important background documentation for this review included the PE1 and PE2
official documents and the two (2) final progress reports. A number of documents
were not available or difficult to find. This was felt by the ETR team as a really
constraint in order to make conclusions based on some written evidences. For
example the written minutes of the steering committee were not available. The PE1
provided the ETR-team with information on the Human Resources that were made
available for this programme and the “ORGANOGRAM” or organisational chart, the
role of the steering committee as well as its implementation structure at the District
level (see annex 7.7).
3. ANSWERED QUESTIONS/ FINDINGS
The methodology used to answer the evaluation questions and to formulate the main findings
is described in annex 3 – detailed assessment method – and also the documents mentioned in
annex 5. In annex 6.2 the Implementation Progress Templates of PE1 and PE2 show the
results according to the DNHA final reports.
3.1 Problems and needs (Relevance)
To what extent were the objectives of the development intervention of the SINSM programme
consistent with the beneficiaries' requirements, the country needs, the global priorities and also
the GOM and the EU's policies?
The overall objective of the SINSM was to contribute to the improvement of the nutritional
status of all Malawians, with special emphasis on vulnerable groups such as pregnant and
lactating women, children below the age of 5 years (under-five children), both school aged and
school going children, orphans and people living with HIV and AIDS (PLHA) through
improved delivery systems. The purpose was to strengthen the institutional and stakeholders
capacity at national, district and community levels in the delivery of the nutrition service
management, coordination, implementation and monitoring and evaluation (M&E) of the
nutrition programmes, projects and services.
The general food and nutrition security situation in Malawi is according to many sources
alarming as official stunting – in 2014 >40% - whereas wasting – 3.8%9 - figures for the whole
country give partly the lie this concern. The rather high stunting levels urge systematically
interventions according to standards. The acceptable and rather low wasting levels (< 5%)
indicate the impact of the intensive GOM emphasize on nutrition and especially the
introduction and strengthening of Community Based Management of Acute Malnutrition
program (CMAM). The vulnerability to poverty but also the poor WASH situation explains
partly the high stunting rates. The Food Security Index (FSI) developed by the Action Against
Hunger-UK managed INFSS was a useful indicator to predict food insecure situations on
district level. The SINSM planned according to the PE1 to use and eventually to improve this
indicator.
9 which is acceptable according to theinternationalWHO standards
14
The school meals initiative component was a pilot programme managed by the MoE on
national level and the DEM on District’s level with help of NGO’s WHH and FISD. It aimed at
promoting better school enrolment, promoting school attendance especially for girls, promoting
better nutrition awareness through learners, their parents and although the whole community
using school feeding
The DNHA was a department directly under the Office of the President and Cabinet (OPC). It
came in 2012 under the MOH. Its mandate is to provide visionary guidance and strategic
direction for the implementation of the national response to nutrition disorders, HIV and
AIDS in the country.
The SINSM proposed a necessary form of decentralisation to the Districts aiming at
promoting ownership to nutrition and food security interventions on District’s level for
development planning with the help of a professional monitoring system through the
INFSSS.
The general conclusion is that the SINSM was a good programme consistent with the
requirements of the beneficiaries, the needs of the country, the global priorities and the
policies of the GOM and the EU.
3.2 Achievement of purpose (Effectiveness)
To what extent were the project’s results attained, the project’s specific objectives achieved or
expected to be achieved?
The SINSM Programme Estimate 1 and 2 expected to yield each five (5) results:
Result Area 1: Support to nutritional products distribution to vulnerable groups (PE1) and
support to school meals programme improved (PE2).
Result Area 2: Strengthen capacity in nutrition for communities and other stakeholders (PE 1 &
2).
Result Area 3: Nutrition surveillance system (PE1) and INFSSS (PE2) strengthened to enable
tracking of malnutrition for timely and rational response.
Result Area 4: Capacity of health facilities to manage nutritional rehabilitation improved (PE 1
& 2).
Result Area 5: Project coordination and management activities improved (PE 1 & 2).
The Result Area 1 for the PE2School Meal Grant Contract for “Welthungerhilfe” or WHH
(in 2014 for an amount of € 750,000) aimed to support improved nutrition and health and
building institutional capacity for sustainable home grown school meal programmes in
Malawi. The school meal grant contract for the FISD (in 2014 an amount of € 750,000)
aimed at improving the nutritional status of 80, 000 pre-schoolers and school going children,
Increasing enrolment, attendance and retention in primary schools as well as ECD centres by
40% and building the capacity of community structures to sustainably run school meals
program. N.B An extra grant of € 172,000 was allocated for CBS purchase.
The question is whether the project’s results were attaint and the specific objectives achieved?
The answer to this question is as follows:
Result area 1 for PE1 and PE2: The support to nutritional products distribution to vulnerable
groups programmed for PE1 was not carried out. The school feeding programme proposed to
15
carry out in the PE2 under the RA1 was carried out in 2014 – only one year – through WHH
and FISD with rather positive results.
Result area 2 for PE1 and PE2:All pilot Districts had nutrition officers in the Ministry of
Agriculture District Service (DADO), the Ministry of Health (DHO), the Ministry of Education
(MED) and the District Council (DC) etc. They were permanently involved in the
strengthening of the capacity in nutrition for communities and other stakeholders. The SINSM
programme carried out a number of capacity building programmes for District’s nutrition
officers but how these capacity building activities impacted the capacity was not measurable.
The DNHA and the MoH carried out other capacity building activities with help of the SUN
movement and now with help of the SNIC programme.
Result area 3 for PE1 and PE2:Under PE1 an amount of +€ 35.000 (Mk 14,018,467) was
spent on the INFSSS and under PE2 €58,000 (Mk 23,363,712). Only 3 bulletins were published
with incomplete information. The DNHA was supposed to develop a Geographical Information
System (GIS) database and website for nutritional data. The INFSSS stopped activities in 2013
according to the final report due to “interruption of funding” but according to the NAO and the
EUD funding was not interrupted. The project expected results - to enable tracking of
malnutrition for timely and rational response - were not attained.
Result area 4 for PE1 and PE2:Under PE1 an amount of + € 63,800 (Mk 14,659,008) was
spent and under PE2 + € 89,000 (Mk 35,482,025). The expected result was improvement of
capacity of health facilities to manage nutritional rehabilitation. However the DNHA and the
MOH realised various capacities building improvement trainings under various programmes
(SUN movement, SNIC, MOH etc.) the specific impact of SINSM was neither monitored nor
measured. The low wasting figure – in 2014 only 3.8% for Malawi is objective evidence that
the specific attention for nutrition worked. To what extend SINSM contributed is not
demonstrable because it was not monitored in a quantitative way.
Result area 5 for PE1 and PE2:Under PE2 + € 89,000 (Mk 35,482,025) had been spent. The
result area aimed at improvement of project coordination and management activities. The
SINSM suffered of various external political developments among others the change of a new
president belonging to a different political orientation, the move of the DNHA from the OPC to
the MOH. Internally the SINSM had 4 different liaison officers and although continuity and
sustainability was not guaranteed. The budgetary amounts for each RA were objectively too
limited to guarantee optimal impact. The DNHA mentioned also the strict rules of EU funding
inhibited flexible management. The coordination role of the DNHA was questionable.
Results for the school meal contract: This activity under RA1 was only carried out under PE2
in 2014 by two NGO’s – WHH and FISD. The collaboration at district level with the DEM was
good. The DEM was fully involved and did all the coordination and planning activities. Both
NGO’s analysed jointly with the DEM how school feeding activities could be integrated in a
new policy aiming at optimal community involvement. And also ownership for school feeding,
the two NGO’s produced each a good final evaluation report in which activities were clearly
explained but also the way forwards indicated how community involvement can be stimulated
and realized. Both NGO’s also produced a detailed baseline study in which more background
information and data were collected. A total number of 47,000 learners got one (1) meal per
day during one year. This makes an average cost of € 35 per beneficiary child10. The general
impact of school feeding has improved school enrolment in general and particularly of girls. It
also improved learner’s performance. The good joint cooperation between the DEM and the
10 Total funds used for this activity was € 1,672,000 for 47,000 learners (schools +ECDC pre-schoolers). WHHwas operationalin 4 Districts
in 20 primary schools and 9 pre-schools. FISDwas operationalin 5 Districts in 25primaryschools and 25pre-schools.
16
two NGO’s also made clear that the maximum community involvement only can cover 30% of
the annual food needs. External support will always be necessary.
The expected results were attained. The costs for school feeding are now known. The optimal
community involvement has been found out but external support will always be necessary.
3.3 Sound management and value for money (Efficiency)
The question is how well did the various activities transformed the available resources into the
intended results that sometimes referred to as outputs, in terms of quantity, quality and
timeliness but also compared against what was planned.
The PE1 describes in its management structure of the SINSM the distribution of tasks between
the national and the District’s level a sound structure. However, the management structure on
DNHA level is from merely project management view poor: one (1) imprest officer, one (1)
accountant, one (1) liaison officer. The GOM should assign two (2) staff to coordinate the
implementation (deputy directors for nutrition and for planning) plus every time members of
staff of various categories when required. At the District level there was very limited staff
except from the focal points from the MOH and the MOA. The District Council is officially not
involved according to this organogram except from the two focal points of the MOH and the
MOAIWD. Involvement of at least the District Planning and Development officer and the
M&E officer had been highly necessary in order to guarantee the planned use of data for the
District’s development strategy. This was mentioned in the PE1 and not realized. For the school
feeding programme in 2014 the DEM had also a nutrition officer. These two focal points work
together with the District Assembly and the District Council. In the organogram of annex 7 the
staff management does not mention the district DNHA coordination presence and the
involvement of the District Council and the District Planning Director or the M&E officer.
The poor management on national level was also mentioned in the final PE report as “frequent
shift in management11” while the PE proposal mentioned a strong coordination unit on central
level. In footnote the names of the imprest officers are mentioned and also the period in charge.
The lack of a professional data manager and also a staff especially in charge of training etc. was
also a reason that caused the weakness of the programme. The final progress report of PE2
mentions on page 3 that “lack of cooperation by implementing partners and frequent changes in
management affected the implementation of some activities due to absence of political will”.
This means that the DNHA recognizes the findings of this ETR.
However, the DNHA mentioned also the rigidity of EUD procedures to timely release of
money for implementation activities and procurement of materials and equipment which were
given almost at the end of the project in 2014. However, the release of funds was delayed due
to noncompliance with EU procurement procedures leading to delays in contracting supplies
contract. This affected implementation of the programmes.
3.4 Achievement of wider effects (Impact)
The question is what the relationship was between the project’s specific and overall objectives
referring to what the SINSM effects or what influence it had.
The overall objective of the SINSM Programme was to contribute to the improvement in the
nutritional status of all Malawians, with special emphasis on vulnerable groups such as
pregnant and lactating women, children below the age of 5 years, both school aged and
school going children, orphans and people living with HIV and AIDS through improved
11 During the operational period 2011 –2014ofPE1 and PE2 theSINSMhadfour (4) different imprestofficers: Mary Shawa, Felix
PensuloPhiri(3 months), Janet Cuita (4 months) andJeanChilemba (6 months).
17
service delivery systems. The purpose of the project was to strengthen the capacity of
households and communities to recognise, manage and prevent malnutrition through
strengthening institutional and stakeholders’ capacity at national, district and community
levels in the delivery of the nutrition service management, coordination, implementation,
monitoring and evaluation of the nutrition programmes, projects and services.
Impact of a programme that ran for 18 months like PE1 – officially from 1st of April 2011 till
September 2012, cannot produce direct impact. PE2 ran 24 months from the 1st of November
2012 till 31st of October 2014 therefore “outcomes” should be a better word for PE1. Impact
for the PE1 and 2 including the school feeding programme is however not measurable due to
various reasons: absence of systematic monitoring system specifically for the SINSM, lack of
a professional food and nutrition surveillance system at the district level. There is not a
monitoring system and surveillance system that compares impact of the involved districts
with not involved districts.
However, it must be mentioned that the general wasting figure for 2014 was 3.8%. That is a
very low figure and considered by WHO-standards
The surveillance system INFSSS was stopped in 2013. According to the final PE2 report
because of “lack of funding” but this was not the real reason. Since funds were already made
available through the NAO “lack” cannot be the official reason. According to our findings
there was a lack of coordination in the DNHA. The “absence of political will” was mentioned
in the final PE2 report confirms our findings but this conclusion needs more analysis in order
to make it objectively verifiable. The global reason was lack of real leadership and the
presence of an independent professional Programme Management Unit. The various District
officers involved were not able to do their work properly. This was mainly due to the fact that
the programme had no coordinator in the District and the District Council was not officially
involved. In general lack of leadership, lack of coordination and communication were the
main reasons that achievements of wider effects (impact) were not measurable and
assessable.
However, in some visited communities, we have met only healthy children who were part of
the project area. We also can confirm that most mothers with young children use the services
provided by the health facilities. The low figure of 3.8% for wasting was confirmed by
evidence based observations during the visits. Some of the households were taught how to
produce their own seeds like pumpkin seeds, okra. Some of the few fruit trees were told to be
given by the project.
It is hardly to say that the many positive impressions are due to the SINSM activities. It is not
possible to do a counterfactual analysis because the programme didn’t develop a professional
monitoring system. The Districts where SINSM was not implemented should be compared
with the Districts where the SINSM was implemented. This needs the existence of a
professional data bank. Since the creation of the INFSSS pilot by the DNHA failed and the
DNHA does not dispose of a professional experienced data analyst the question cannot be
answered. The capacity building support activities mentioned in RA 2 and 4 were part of
many other core activities such as the DNHA managed SUN movement programme and now
the World Bank funded SNIC programme. The school feeding activity produced however
clear impact: learners received 1 meal a day, kitchens were built, ways of improvement of
better community involvement were analysed and last but not least the school feeding
programme built up a good M&E system.
18
3.5 Likely continuation of achieved results (Sustainability)
The question is to what extent the positive outcomes of the project and the flow of benefits were
likely to continue after external funding ends or non-funding support interventions such as
policy dialogue, coordination?
This question will be answered per Result Area and also generally.
RA1 Support to nutritional products distribution to vulnerable groups and to the school
feeding programme:
The support to nutritional product distribution has never been carried out. The school feeding
has implemented a good programme for only one year. The MOE and the DEM have now
clear ideas how to implement a feasible school feeding programme. WHH will continue this
activity jointly and under the responsibility of the MOE with funds from the German
Government. FISD negotiates new funding.
RA2 Strengthening capacity in nutrition for communities and other stakeholders:
With support of UNICEF, the SUN movement and now the SNIC programme the MOH
jointly with its DNHA continue through the District’s Council this activity. To indicate
whether SINSM contributed to it and in what extend cannot not be evaluated because all
these programmes were support programmes and no professional monitoring system to
answer these questions was ever setup.
RA3 Strengthening the INFSSS to enable tracking of malnutrition for timely and rational
response:
No surveillance system was set up. The pilot failed. Therefore the DNHA did not develop an
instrument that aimed at tracking malnutrition for timely and rational response. The need for
such a system is still high. The fact the DNHA shifted from the OPC to the MOH caused less
attention for the food security component.
RA4 Strengthening capacity of health facilities to manage nutritional rehabilitation:
The health facilities monitor the nutritional status of under-five children in an acceptable
way. The low wasting rate of 3.8% on national level is the evidence of it. How far the MOH
and the DNHA can guarantee permanent training was not the mandate of this ETR.
RA5 Improvement of project coordination and management of activities:
However the DNHA recognized frankly the need for improvement of coordination and
management of activities this activity could not be realized due to external most political
problems but also due to the proper identity of the DNHA. Change of government, shift from
OPC to MOH, internal organisation of the DNHA, emphasize on efforts how to decentralise
activities to the Districts but also incompatibility between the DNHA organisation and the
way EDF could support it all contributed to the non-compliance of the SINSM.
School meals programme (RA1): The school feeding despite its one year implementation
produced not only positive results but also produced models how to implement simple school
feeding programme with full community involvement and external support. The way public
and private cooperation – NGO’s worked and produced effective ways to improve nutrition
to vulnerable groups.
19
General: The SINSM must be considered as a complementary programme to support on-
going DNHA activities. The pilot INFSSS failed not only because of low funding but in the
first place due to the fact food and nutrition security surveillance systems only can be
implemented by semi-independent professional entities with enough funding and professional
and well paid staff. The needed capacity improvement services both on national, district and
community level exist already with tangible results. SINSM was supposed to support this
activity. It did it but lack of a professional internal M&E system and specialist to analyse this
could although not justify any evidence based impact.
3.6 Mutual reinforcement (coherence)
The undertaken activities allow certainly the main stakeholders (proposed action for EU) to
achieve its development policy objectives without internal contradiction or without
contradiction with other EU policies. Since the achieved activities were implemented by the
GOM and elaborated in accordance with GOM policies and other Development Partners'
(DPs) interventions full coherence exist. Since wasting is low now and stunting still high but
lowering the work DNHA does will certainly produce positive results. However, since the
direct official link with the MOAIWD was interrupted – due to the shift from OPC to MOH –
the food security component was eliminated. This programme despite its not direct tangible
results demonstrated the need for an organisational assessment of the DNHA in order to make
it more productive and efficient in policy development but also service providing towards the
Districts.
3.7 EU value added
In order to answer the question what the connection was to the interventions of Member
States and other Key Development Partners (DPs) it must be clear what EU member states
do. A number of member states work in programmes aiming at improving food and nutrition
security at household level. Others are involved through support to health delivery systems or
general programmes that aim at improvising family incomes or poverty reduction. It must be
recognized that member states prefer to work directly with non-profit development
organisations both faith or non- faith based. Also UN organisations such as UNICEF and
WFP benefit of funds from EU member states. The reason that EU member states prefer to
work through nongovernmental or UN channels is based on experiences in the past. The
conditions linked to the EDF use of funds influenced in a certain way the member states
justification.
4. VISIBILITY.
Visibility is the assessment of the proposed project’s strategy and activities in the field of
“visibility, information and communication” and also the results that were meant to be obtained
and the impact to be achieved with these actions in both Malawi and the European Union
countries.
Normally the visibility limits to some posters, T-shirts or stickers with the name of the project.
Concerning this the visibility was quite poor. Except from the WHH school feeding sticker and
the shirts distributed where the programme had the name “Programme Estimate” no other
“visible” testimonies were left. In all the 9 districts visited the name “SINSM” was not known.
However, the DNHA was well known through other activities and programmes such as the
World Bank funded SNIC programme or the SUN movement that both intend to improve
nutritional status of the population.
20
It must be recognized that the overall activities carried out by the DNHA since its creation in
the districts was very “visible”. In all governmental districts governmental services a “nutrition
officer” was employed to promote good nutrition. This is of great importance because it shows
the intention of the GOM to take nutrition seriously into consideration. Main performances of
these nutrition officers in the MOH, MOAWAI, MOG, MOE etc. at district’s level is to
promote nutrition and nutrition related activities. The impact of the work of this strategy has
never been assessed in a systematic was. However, general wasting or GAM figures are now
3.8% in Malawi and that is a clear indicator that the nutrition policy of the government works.
On the other hand wasting is still very high - >40% - and that indicates that promoting good
nutrition, good WASH and poverty alignment has a high priority.
It must be recognized that the SINSM programme was a complex programme because it was
composed out capacity building in nutrition components, the INFSSS component and also the
school feeding component. The capacity building in nutrition component was mainly carried
out by the DNHA and the MOH and was in a certain way complementary to the SUN
movement activities and the SNIC activities. The SUN movement activities and the SNIC
activities were well known in all districts while the SINSM’s activities not. The INFSSS did
not achieve what it pretended to become – creating a strong national and professional
nutrition and food security surveillance system – and also as a pilot programme did not
produce the impact it intended. The school feeding component despite its short
implementation period – only operational in 2014 – was in all districts were it was
operational very well known. The involved schools still had their kitchens and stores. The
MED’s were optimally involved. New plans were designed. In general terms the school
feeding component was very “visible” and the cooperation between the MOE and two NGO’s
– WHH and FISD – in general good.
It must be mentioned that in the EU the efforts achieved by the Malawian government in
reducing wasting figures till under 5% - in fact now 3.8% - with support of donors among
which the EU but also UNICEF and the SUN movement is not generally known. The
information circulating in the media in the various member states of the EU is still the high
rates of under-nutrition and the high rates of starving people in the rural areas. The ETR field
mission to the 9 districts didn’t provide any evidence. The interviewed nutrition officers in
the districts also couldn’t confirm this.
The so called “visibility” to be obtained and to be achieved by the actions of the SINSM in
particular and the other programmes is therefore in general quite absent. This should be and
become a core activity of the DNHA.
21
5. OVERALL ASSESSMENT
In this chapter all answers to assessment questions are synthesised aiming at articulating all
the findings, conclusions and lessons learnt in a way that reflects their importance and
articulates the key issues of concern to stakeholders, thus optimising the focus and utility of
the assessment. It must be repeated again that this assessment is also done to provide the
GOM and the EU ideas on more effective ways to realize stated objectives.
Synthesis of the answers to the evaluation questions.
The findings of this ETR in terms of DAC criteria show us in general the great relevance of
the SINSM for Malawi but it was a multi-activity programme of which the different result
areas where not always congruent with each other. The logic of the programme is mainly that
such a programme should be coordinated by only one entity or stakeholder necessarily on
governmental level. In thiscase the DNHA under the OPC was a logic choice. The
implementation of the different result areas should not necessarily be achieved by one entity
or stakeholder. In the case of the SINSM programme the five (5) RA were all implemented
by the DNHA and the school feeding programme was implemented by the MOE jointly with
two NGO’s. The grading scores according to the DAC criteria indicate for the general
coordination and communication, the decentralisation, the District’s involvement and
participation, the monitoring and evaluation and also the highly needed data collection were
all “weak to poor” (chapter 6 conclusion 2). However, the school feeding scored “good”.
The reasons for this low scoring have also been clear: political changes in the country shift
from the OPC to the MOH, no continuity in management due to the high number of imprest
officers etc. and according to the DNHA and other involved line ministries also the “rigorous
rules” of EU funding conditions12. The expected effectiveness, efficiency and also the impact
within the proposed way of implementation in the PE1 and PE2 and also the not compliance
of the needed decentralisation were all reason that the programme did not achieve expected
results.
In fact the SINSM had apart from RA5 – project coordination and management activities
improved – three (3) main activities: 1) capacity strengthening in nutrition for communities,
other stakeholders and health facilities (RA 2 and 4), 2) INFSSS and 3) school feeding. It
needed effective to bring them all together in one programme. The DNHA main role should
have been coordination and the needed organisation. The school feeding activity was in fact
“outsourced” to the MOE and two NGO’s with full implementation of the DEM. This should
also have been done with the INFSSS. National INFSSS only work effective and efficient if
implemented by a professional and independent structure that is controlled by the
government, academic institutions and donors. Experiences in other countries show also that
funding should not be a constraint. A good example is the Somalia Food and Nutrition
Analysis Unit FSNAU managed by the FAO that receives multi-donor funding13. Another
example is the Mozambican SETSAN – a governmental institution comparable with the
DNHA – that monitors the food and nutrition security situation nationwide and also was
responsible for the 2013 national food security baseline study. The FSNAU and also the
SETSAN show us that food security monitoring systems must be carried out not by
governmental institutions because of lack of flexible structures and the need of highly
12 One important stakeholderofa line-ministry participating in the data collection oftheINFSSS mentioned the procedures necessaryto
fulfil the duties; in order toget thedata from the fieldit takea 5 days mission and toget themoney needed for thatmission it takes 2
months etc.
13 The Somali FSNAU managed by the FAO has a budgetof24 million €for four years while theINFSSS disposed only of€ 250,000 for PE1
and PE2 (2011-2014).
22
qualified professionals. The school feeding programme was successful mainly due to a good
cooperation between public and non-governmental structures.
6. CONCLUSIONS AND RECOMMENDATIONS.
6.1 Conclusions
The programme used + 85% of the allocated funding. The final reports of PE1 and PE2
mentioned that the two programmes were a success without any justification. These reports
also mention that the programme suffered from “lack of cooperation by implementing partners
and frequent changes in management affecting the implementation of some activities due to
absence of political will”. However, it does not detail what lack of political will means and how
far EU procedures or regulations are concerned.
The conclusions of the ETR are the following:
General
1) The general conclusion regarding the SINSM is that despite its good objectives it resulted
in poor impact. The reasons are multiple: 1) too many result areas; 2) too limited budget
for five result areas including two grants for a school feeding programme; 3) chances in
the political situation in Malawi; 4) shift of the DNHA from the OPC to the MOH; 5)
incompatibility of a multi-purpose programme as SINSM with the organisational
structure of the DNHA; 6) lack of a professional unit with high skilled staff and budget to
implement such a programme;
2) The overall grading of the PE1 and PE2 is as follows14:
General coordination and communication: C (= weak)
Decentralisation C (= weak)
District’s involvement and participation: C (= weak)
Monitoring and evaluation: D (= poor)
Data collection: D (= poor)
School feeding: B(= good)
Problems and needs (Relevance).
3. Highly appreciated and relevant programme.
4. Very coherent with ongoing nutritional situation in Malawi – high stunting >40% and low
wasting <5%.
5. Still food insecure situation nationwide.
6. Uses existing governmental structures both nationally but also on district level.
7. Good cooperation model between governmental structures – MOH, DNHA, MOAIWD,
MOG etc. - on national and district level jointly with NGO’s.
Achievement of purpose (Effectiveness)
8. Too many result areas (for PE1 4 and for PE2 5) in one programme.
9. Rather small budget for 5 Result Areas during an implementation period of 4 years.
14Grading basedon OECD DACcriteria.
23
10. Improvement capacity building both for communities and for District services of
agriculture and health has been carried out by the DNHA, the MOH and the MOAIWD
but impact not known due to absence of professional monitoring system.
11. IFNSSS pilot implementation was not achieved mainly due to underestimation of needed
institution and also needed budget.
12. DNHA does not have the organisational capacity or the technically qualified staff to build
up a professional and independent IFNSSS.
13. The effectiveness of the SINSM due to the lack and therefore the weak decentralisation
was poor.
14. The school feeding activity despite its short implementation period – only one year in
2014 – was effective. It cost an average of € 35 or MWK 21,000 per year. It fed + 47,000
learners. It was a good example how public and private non-governmental organisations
can cooperate in a effective way. It generated also information how to improve
community participation and ownership.
Sound management and value for money (Efficiency).
15. The management for the result areas 1 – 5 was questionable. The frequent shift of imprest
officers – during the PE1 and PE2 a number of 4 imprest officers were in function - and
the short period for them to be in charge - for 3 imprest officers from 3 – 6 months –
made the SINSM a poorly managed programme.
16. The school feeding programme was implemented under two separate grants. It was a
good managed programme. The cohabitation between the MOE and the DEM one side
and the two implementing NGO’s the other side was fruitful and efficiently carried out.
This has been a good decentralized programme.
Achievement of wider effects (Impact).
17. Impact of the SINSM activities – RA1 – RA5 – was difficultly measurable mainly due to
the fact of absence of a professional monitoring system.
18. Therefore the question whether the SINSM produced any impact cannot be answered in a
professional way. Anecdotal evidence exists but is methodologically not representative.
19. The school feeding programme produced a positive impact despite the short
implementation period of 1 year. It fed 47,000 learners, it increased school attendance, it
increased the enrolment of girls and it produced also evidence based information on
models how to implement a low cost school feeding policy with optimal community
involvement and participation that also promotes nutrition awareness.
Likely continuation of achieved results (Sustainability)
20. The SINSM, despite its poor implementation and poor impact, produced enough
information on how to implement a programme that aims at giving “Support to Improved
Nutrition Status of Vulnerable Groups in Malawi” and in particular on how not. Key
words are decentralisation of responsibilities and duties to the Districts, independent and
professional monitoring, role of central government ministries is coordination, strategy
development, training and capacity building.
21. The lessons learnt through the AAH-UK managed emergency IFNSSS and the tentative
effort of the DNHA to create a public managed food and nutrition security surveillance
system indicates the creation of a semi-public surveillance system that is professional and
independent. It must dispose of highly skilled professionals and a large budget.
Mutual reinforcement (coherence)
24
22. The need for activities implemented by the SINSM is generally recognized by all
development partners. The implementation and the results generated by the SINSM show
the GOM and the development partners how to guarantee optimal results for
implementation.
EU value added
23. The lesson learnt for the EU is the way the Support to Improved Nutrition Status of
Vulnerable Groups in Malawi is not optimal through the way it was now implemented.
24. A number of member states operate already mainly through private or church based
organisations and also through UN organisations such as UNICEF, WFP or FAO.
Support through the SUN movement is also an efficient way to support the GOM.
25. The school feeding programme implemented by the MOE and two NGO’s resulted in
new programmes funded by Germany’s GIZ.
26. The lesson learnt for the GOM is to stimulate private investments in education, health,
poverty reduction through private organisations but under serious control and
coordination of the GOM.
6.2 Recommendations
Recommendations will be given per stakeholder or group of stakeholders such as EU, NAO,
DNHA, GOM and line ministries.
1. GOM and EU: Programmes such as the SINSM are too complex to be implemented by
only one GOM entity such as the DNHA jointly with line ministries. Components like
“capacity building in nutrition”, “food and nutrition security surveillance systems”,
“school meals” must preferably be implemented by independent entities or PMU within
or jointly with ministries and NGO’s.
2. GOM, MOH, DNHA: Capacity building in nutrition for communities and for
government services and other stakeholders has been successful in Malawi – given the
low wasting rates of 3.8% in 2014 and the presence of nutrition officers in all ministries
also at District level– but it must become clear under who’s responsibility this activity
this activity resorts – DNHA or MOH – since the DNHA resorts under the MOH.
3. GOM, EU, DNHA: If food and nutrition security or food security and nutrition both on
household level is still a priority for the GOM it should be under the responsibility of a
special department preferably under the Office of the President and Cabinet (OPC) jointly
with the Ministry of Health (MOH), the Ministry of Agriculture, Irrigation and Water
Development (MOAIWD) and the Ministry of Gender, Children, Disability and Social
Welfare (MOGCDSW). The DNHA was created for this aim under the OPC but shifted to
the MOH. It should preferably return under the OPC and putting more emphasize on the
component household food security.
4. GOM and EU: The importance of a central INFSSS that enables tracking of malnutrition
and also food insecurity for timely and rational response for the GOM and the donors is
generally recognized. The experiences gained with AAH-UK and now with the DNHA
learnt that such a system must house under a PMU that is independent but controlled by
the GOM, independent academic institutions and donors. This PMU needs a team of
25
highly qualified professionals with enough funds. The budget for this activity under the
DNHA under PE1 and PE2 was fairly too small to guarantee any impact.
5. GOM, MOE and EU: The school meals component learnt how to include NGO’s in this
activity in a way that positive results were obtained. It also learnt how to maximize
community involvement in an optimal way in order to improve ownership and decrease
its price. It also learnt that external funding is always needed for this activity.

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Draft Final Report (3)

  • 1. Framework Contract Beneficiaries2013 Lot 1 European Union Delegation to Malawi END-TERM REVIEW “SUPPORT TO IMPROVED NUTRITION STATUS OF VULNERABLE GROUPS IN MALAWI” - SINSM” Contract N°2015/366502 DRAFT FINAL REPORT December 2015 This project is funded by the European Union Project implemented by The contents of this publication is the sole responsibility of AESA Consortium and can in no way be taken to reflect the views of the European Union AESA Consortium Lot1@aesagroup.eu
  • 2. 2 EUROPEAN UNION DELEGATION TO MALAWI End-Term Review “Support to Improved Nutrition Status of Vulnerable Groups in Malawi” - SINSM” Contract N°2015/366502 Framework Contract Beneficiaries2013– LOT 1 DRAFT FINAL REPORT December 2015 Team Composition: Team Leader: Aart VAN DER HEIDE KE 2: Cyridion AHIMANA This report was prepared with financial assistance from the Commission of the European Communities. The views expressed are those of the consultant and do not necessarily represent any official view of the Commission or the Government of this country
  • 3. 3 TABLE OF CONTENTS ACRONYMES..............................................................................................................................................................................4 1. EXECUTIVE SUMMARY ..................................................................................................................................................7 2. INTRODUCTION............................................................................................................................................................10 3. ANSWERED QUESTIONS/ FINDINGS ........................................................................................................................13 3.1 PROBLEMS AND NEEDS (RELEVANCE) ................................................................................................................................13 3.2 ACHIEVEMENTOF PURPOSE(EFFECTIVENESS)....................................................................................................................14 3.3 SOUND MANAGEMENT AND VALUEFOR MONEY (EFFICIENCY) ............................................................................................16 3.4 ACHIEVEMENTOF WIDER EFFECTS (IMPACT)......................................................................................................................16 3.5 LIKELY CONTINUATION OF ACHIEVED RESULTS (SUSTAINABILITY).........................................................................................18 3.6 MUTUAL REINFORCEMENT (COHERENCE) ..........................................................................................................................19 3.7 EU VALUEADDED.............................................................................................................................................................19 4. VISIBILITY. .....................................................................................................................................................................19 5. OVERALL ASSESSMENT...............................................................................................................................................21 6. CONCLUSIONS AND RECOMMENDATIONS............................................................................................................22 6.1 CONCLUSIONS..................................................................................................................................................................22 6.2 RECOMMENDATIONS ...............................................................................................................................................24
  • 4. 4 ACRONYMES AAH-UK Action Against Hunger or Action Contre la Faim (ACF) AIDS acquired immune deficiency syndrome CADECOM Catholic Development Commission CSB Corn Soya Blend CMAM Community Management of Acute Malnutrition DAC Development Assistance Committee DADO District Agriculture Development Officer DCO District Council Office DDO District Development Officer DEO District Education Officer DHO District Health Officer DEM District Education Manager DNHA Department of Nutrition, HIV and AIDS DP Development Partner(s) DPO District Planning Officer ECDC Early Childhood Development Centre EDF European Development Fund ETR End of Term Review EU European Union EUD European Union Delegation FAO Food and Agriculture Organisation FIS Food Security Index FISD Foundation for Irrigation and Sustainable Development FSP Food Security Programme GAM Global Acute Malnutrition
  • 5. 5 GIZ Gesellschaftfür Internationale Zusammenarbeit of Germany GoM Government of Malawi INFSSS Integrated Nutrition and Food Security Surveillance System INGO International Non-Governmental Organisation M&E Monitoring & Evaluation MKz Malawian Kwacha MoAIWD Ministry of Agriculture, Irrigation and Water Development MoE Ministry of Education MoG Ministry of Gender MoH Ministry of Health MoU Memorandum of Understanding MUAC Mid Upper Arm Circumference MVAC Malawi Vulnerability Analysis Committee MwK Malawian Kwacha NAO National Authorising Officer NGO Non-Governmental Organisation OECD Organisation for Economic Cooperation and Development OPC Office of the President and Cabinet PE Programme Estimate PLHIA people living with HIV and AIDS PMU Programme Management Unit RA Result Area ROM Results Oriented Monitoring SAM Severe Acute Malnutrition SINSM Support to Improved Nutrition Status of Vulnerable Groups in Malawi SNIC Support for Nutrition Improvement Component SUN Scaling Up Nutrition
  • 6. 6 TL Team Leader TM Team Member ToR Terms of References UN United Nations UNICEF United Nations Children Fund VAM Vulnerability Analysis and Mapping WASH Water Sanitation and Hygiene WFP World Food Programme WHH Welhungerhilfe or German Agro-Action WVI World Vision International
  • 7. 7 1. EXECUTIVE SUMMARY Key purpose of the end term review. In accordance to the Term of Reference (TOR ) , The purpose of this End Term Review (ETR) was to carry out a comprehensive assessment of each of the four contracts (Programme Estimate 1 and 2 and two grants)in order to establish progress made towards the achievement of the objectives and also the expected results. It was also requested to assess the relevance of the design, the efficiency and effectiveness of the project implementation and the sustainability of their impact and last but not least to draw the lessons learnt. Based on the findings recommendations will be made that will guide the Government of Malawi (GoM) and the European Union (EU) on how to sustain the interventions introduced by the SINSM1. This was detailed again in 2.2 of the Terms of Reference (ToR). It is also requested to award the project and each component (PEs and Grants) a grade between A-Dsimilar to the EU Results Oriented Monitoring (ROM) methodology. The SINSM programme. The EU Food Security Programme (FSP) for Malawi 2004 – 2006 was launched among others to support the nutritional status of the most vulnerable groups. The SINSM or the “Support to Improved Nutritional Status of Vulnerable Groups in Malawi” was financed by the FSP budget line for a total amount of € 7,650,000. During 3 years – 2008 until 2011 - the Department of Nutrition and HIV/AIDS (DNHA), the National Authorizing Office (NAO) and the European Union Delegation (EUD) negotiated a new PE. Agreement resulted in a new programme with the name “Support to Improved Nutrition Status of Vulnerable Groups in Malawi” that was coordinated by the Department of Nutrition and HIV and AIDS. The SINSM was implemented through 2 Programme Estimates (PEs) (PE1 and PE2) and 2 Grants to the Foundation for Irrigation and Sustainable Development (FISD) and Welthungerhilfe (WHH). PE1 was implemented from the 1st of February 2011 – the 30th of September 2012 and PE2 from the 1st of November 2012 – the 31st of October 2014. The 2 Grants for school feeding through the NGO’s were implemented during the year 2014. The programme’s total allocated amount through two (2) MoU was € 7,650,000. Under PE1 + 48% of the total budget was absorbed and under PE2 + 77%. The DNHA used € 4,840,000 and the Grants for school feeding €1,500,000 and an extra Grant for CSB of € 172,000 was allocated. Therefore the expenditure for the whole SINSM (2011-2014) was € 4,840,000 + € 1,500,000 +€ 172,000 = € 6,510,000. This is 85% of the total allocated amount. The SINSM was implemented in ten (10) Districts in Malawi. In each district the SINSM had a food and nutrition focal point, one in the District’s Health Office and one in the District’s Agriculture Development Office. The school feeding programme was implemented by the District’s Education Management (DEM) Office through the School Health and Nutrition Officers. Each PE had five (5) Result Areas (RA): 1) Support to nutritional products distribution to vulnerable groups (PE1) and Support to school meals programme (PE2); 2) Strengthen capacity in nutrition for the communities and other stakeholders; 3) Nutrition Surveillance System strengthened to enable tracking of malnutrition for timely and rational response; 4) Capacity of health facilities to manage nutritional rehabilitation improved and 5) Project coordination and management activities improved. 1The final auditoftheSINSMPEs 1 and 2 were already undertaken in order to establish, among other things, the exact eligibl e and ineligible expenditures. The recovery ofall ineligible costs has also been done.
  • 8. 8 The main analytical points.  Relevance: Great relevance given the current food and nutrition situation in Malawi where stunting is still high (<40%), wasting low (<5%), the food situation is still insecure and rural communities still vulnerable to food and nutrition insecurity, WASH insecurity and poverty.  Effectiveness: 1. RA1: The support to nutritional products distribution to vulnerable groups programmed for PE1 was not carried out. The school feeding programme proposed to carry out in the PE2 under the RA1 was carried out in 2014 – only one year – through WHH and FISD with rather positive results. 2. RA2: All pilot Districts had nutrition officers in the Ministry of Agriculture District Service (DADO), the Ministry of Health (DHO), the Ministry of Education (MED) and the District Council (DC) etc. They were permanently involved in the strengthening of the capacity in nutrition for communities and other stakeholders. The SINSM programme carried out a number of capacity building programmes for District’s nutrition officers but how these capacity building activities impacted the capacity was not measurable. No professional monitoring system was set up. 3. RA3: Under PE1 and PE2 a total amount of € 113,000 or MwK 37,383,179 was spent on the INFSSS. Only 3 bulletins were published with incomplete information. The DNHA was supposed to develop a Geographical Information System (GIS) database and website for nutritional data. The INFSSS stopped activities in 2013 according to the final report due to “interruption of funding” but according to the NAO and the EUD funding was not interrupted. The project’s expected results - to enable tracking of malnutrition for timely and rational response - were not attained. 4. RA4: Under PE1 an amount of + € 63,800 (Mk 14,659,008) was spent and under PE2 + € 89,000 (Mk 35,482,025). The expected result was improvement of capacity of health facilities to manage nutritional rehabilitation. However the DNHA and the MOH realised various capacities building improvement trainings under various programmes (SUN movement, SNIC, MOH etc.) The specific impact of SINSM was neither monitored nor measured. The low wasting figure – in 2014 only 3.8% - for Malawi is objective evidence that the specific attention for nutrition worked. To what extend SINSM contributed is not demonstrable because it was not monitored in a quantitative way. 5. Under PE2 + € 89,000 (Mk 35,482,025) had been spent. The result area aimed at improvement of project coordination and management activities. The SINSM suffered of various external political developments among others the change of a new president belonging to a different political orientation, the move of the DNHA from the OPC to the MOH. Internally the SINSM had 4 different liaison officers. The budgetary amounts for each RA were objectively too limited to guarantee optimal impact. The DNHA mentioned also the strict rules of EU funding inhibited flexible management. The quality of the coordination role of the DNHA was questionable.  Efficiency: The efficiency of the SINSM was very poor except from the school meals grants to WHH and FISD. It must be recognized that the DNHA as coordinating agency was subject to political changes, the shift from the OPC to the MoH, the frequent change of imprest2 officers (for the PE1 and PE2) four (4) imprest officers but also due to the low budgets for the various components. The example of the INFSSS that was budgeted for 2The imprest system is a form offinancial accounting system. Thebase characteristicofan imprest system is that a fixedamount is reserved, which aftera certainperiodoftime or when circumstances require, becausemoneywas spent, it will bereplenished.
  • 9. 9 only € 113,000 for a pilot programme for 4 years was unrealistic. The needed decentralisation proposed in the PE1 was not carried out.  Impact: except from the school meals component, the overall impact of this programme is not measurable in an objective way since no professional monitoring system was set up. The two final reports of PE1 and PE2 mention that the programme was a “success” but the success could not be validated by concrete and quantitative results. No progress reports were found by the evaluation team in order to measure the expected impact.  Sustainability: The school meals component through the two Grants for WHH and FISD jointly with the MoE had a positive impact not only it supplied school meals to more than 47,000 learners during the year 2014 but also produced new strategies on how to involve the communities in an optimal way. It also worked in a positive way to stimulate school enrolment in general and of girls in particular and the improvement of the nutritional situation of leaners in schools targeted by the two grants.  Coherence: The coherence with other programmes, donor’s strategies and GoM policies was not questionable.  EU added value: The EU member states operate in Malawi mainly through the UN agencies UNICEF and WFP, the support to the SUN movement and international NGO’s active in poverty reduction, education, health, WASH etc.  Grades3 awarded to the project and each component (PE’s and Grants) Capacity building nutrition C (=problems) INFSSS D (serious deficiencies) School feeding: B (= good) General coordination and communication: C (= problems) Decentralisation C (= problems) District’s involvement and participation: C (= problems) Monitoring and evaluation: D (= serious deficiencies) Data collection: D (= serious deficiencies) SINSM general C/D (=problems and serious deficiencies) Main conclusions. The ETR was carried out one (1) year after termination of the SINSM. The Relevance of the SINSM was generally recognized given a vulnerable food and nutrition security situation in Malawi. The two final reports - Nutrition PE1 and PE2 Report – came to the conclusion that the SINSM was a success but the ETR does not agree with it (see “grades awarder to the project and each component). The review team is of the opinionthat political changes and shift from Office of the President and Cabinet (OPC) to the Ministry of Health (MoH) affected the results of the programme in a negative way. Another reason was that too many different activities or Result Areas were brought together in one programme. The INFSSS was interrupted in 2013 and did not perform any results. The available budget of € 113,000 for such a pilot programme was also far too low. The food security element was weakened after the shift from the OPC towards the MoH excluding in this way the MoAIWD. Weak management by the coordinating institution (DNHA) affected the programme also negatively (4 imprest officers in 4 years). A weak and non-professional monitoring system resulted in the impossibility to measure impact. The PE1 intended a strong decentralisation towards the Districts but that was not achieved. The only activity that performed positively were the two Grants for WHH and FISD for the school meal programme jointly with the MoE on national 3Grades are as follows: A=very good, B =good; C =problems and D =serious deficiencies.
  • 10. 10 level and strong involvement of the DEM on District level. The role of the steering committee was not possible to assess. Minutes of the three (3) meetings of this committee were not fund. In general terms the SINSM was not very successfully. Main lessons learnt. The main lesson learnt is that despite the relevance of the different components of the SINSM a combined programme must not be carried out by a coordinating institution that is part of only one (1) ministry. The capacity building component for the community and for the Districts health facilities can be carried out by the MoH jointly with the DNHA. The INFSSS – its relevance is generally recognized - must be implemented by a semi-public institution controlled by the GoM, preferably the OPC or the cabinet of the prime minister, by independent academic institutions and by donors. It must have at its disposal sufficient funding and highly qualified and competent staff. The school meals programme was implemented in a rather successful way despite its short implementation period – only in 2014 – and the symbiosis between the MoE, the DEM and the NGO’s was successful. Specific recommendations. 1. Decentralisation of programmes is necessary for fully involvement of the District Counsels. 2. Capacity building in nutrition under the responsibility of the MoH. 3. INFSSS implemented by an independent institution controlled by the GoM, independent academic institutions and donors with enough funding and competent and professional staff receiving acceptable salaries. 4. School meal programmes under the MoE with help of NGO’s. 5. Systematize first findings of community involvement in order to diminish the costs. 2. INTRODUCTION. This report contains the outcome and conclusions of the end-term review (ETR) of the Support to Improved Nutrition Statusof Vulnerable Groupsin Malawi (SINSM) carried out from the 26thof October till the 20thof November 2015. The SINSM programme was a pilot programme implemented by the Department of Nutrition and HIV and AIDS (DNHA) in conjunction with the line Ministry of Health (MOH), Ministry of Agriculture, Irrigation and Water Development (MAIWD), Ministry of Gender (MOG) and Ministry of Education (MOE) and two NGO’s - “Welthungerhilfe” (WHH) and the Foundation for Irrigation and Sustainable Development (FISD). The SINSM programme aims to contribute towards the improvement of the nutritional status of all Malawians with special emphasis on vulnerable groups such as pregnant and lactating women, children below the age of 5 years, both school aged and school going children, orphans and people living with HIV and AIDS through improved service delivery systems in 10 selected Districts in Malawi. In each district the SINSM had a food and nutrition focal point: one in the District’s Health Office and one in the District’s Agriculture Development Office. The school feeding programme was implemented by the District’s Education Management (DEM) Office through the DEM education health and nutrition officer. The SINSM programme consisted of two Programme Estimates (PE): PE1 from 01/02/2011 - 30/09/2012 and PE2 from 01/11/2012 - 31/10/2014, each having five Result Areas (RA): Support to nutritional products distribution to vulnerable groups (PE1) and to the school meals programme (PE2);
  • 11. 11 1. Strengthen the capacity in nutrition for the communities and other stakeholders; 2. Nutrition Surveillance System strengthened to enable tracking of malnutrition for timely and rational response; 3. Capacity of health facilities to manage nutritional rehabilitation improved and 4. Project coordination and management activities improved. In PE21 two (2) Grants of each € 750,000 (+ € 172,000) were allocated to WHH4 and FISD5 to implement the school meals programme. The programme’s total allocated budget through two (2) MOU was € 7,650,000. Under PE1 about 48% of the total budget was absorbed and under PE2 about 77%. The DNHA used € 4,840,000 and the Grants for school feeding € 1,500,000 and an extra Grant for CSB of € 172,000 was allocated6. Therefore the expenditure for the whole SINMS (2011-2014) was € 4,840,000 + € 1,500,000 + € 172,000 = € 6,510,000. This is 85% of the total allocated amount. The two main purposes of the SINSM according to the Terms of Reference (TOR in annex 1) were: 1. To make an overall independent assessment of the performance of the SINSM programme with special attention to the analysis of relevance, efficiency, effectiveness, impact, sustainability, coherence and the EU added value of the programme. 2. To analyse the feasibility of the programme design and the implementation for reaching the stated objectives. Introductory phase. The ETR was carried out in two main phases including the inception phase, the field work and the validation workshop during which key findings were presented. The first week of the ETR was an inception period (26-30 October 2015). An inception meeting took place on the 2nd of November with the EUD, NAO, DNHA, MOH, MOAFS etc. An official inception report with a more detailed work plan and methodology was presented and sent to the EUD. Field work During the second and third week of the assignment, i.e. from Monday 2nd of November till Friday 13thof November, nine (9) out of the ten (10) SINSM Districts7 were visited. During the field visits all the implementing partners8were extensively interviewed. Based on the results of the implementation phase, visits to health facilities, schools and involved communities were scheduled as far as feasible given time constraints, distances and availability of the beneficiaries themselves etc. All questions related to the SINSM service implementation, its Surveillance system and backstopping from the DNHA were intensively assessed. Based on the results of the assessment complementary field visits to health facilities and involved schools were planned. Each visit to a District started with a visit to the District’s 4Supporting improved nutritionandhealthand building institutional capacity for sustainable homegrown school mealprogrammes in Malawi'(01/01-31/12/14). 5 Sustainable School Meals Initiative (SSMI) (01/01-31/12/14). 6 TheexpenditureforthetwoGrants€1,500,000wereunderSpecialCommitmentandnotincludedinthePE2expendituresummary.TheSchoolMealsProgramme alsobenefitedonaSupply Contractfor CornSoya Blend(CSB) –value€172,000(source:NAO). 7khatabay,Rhumpi, Dowa, Salima, Mangochi, Phalombe, Chikhwawa,Chiradzulo, Neno, Dedza. 8 District Agriculture Development Office(DADO), DistrictNutritionSINSMfocal point,District Education orDEMSINSMfocalpoint, District M&Eofficer.
  • 12. 12 Council office to officially inform the District Commissioner and the District Planning Director on the objective of the visit. The ETR-team made a final District’s Assessment Fiche for each District in which main findings and results were capitulated. The ETR-team used the District Assessment Fiches as a basis to write up the general impressions in a concessive way. The overall findings of the field work can be found in Annex 7.5. Final Validation Workshop The fourth week, the 16-20thof November, was used for writing of the aide memoire, debriefing and a final validation workshop in which all partners on Central and District’s level participated. The workshop aimed at presenting the findings of the ETR to the main stakeholders, to check the factual basis of the evaluation and to discuss the draft findings, conclusions and recommendations made by the ETR-team. The Terms of Reference (TOR) for this ETR detail in part 2.3 the requested services in five different (5) points the so called DAC evaluation criteria (see chapter 3 “answered questions). Each point has a bulleted number of “guidelines” to concentrate on and to be answered based on available information. This ETR faced the following constraints in conducting the ETR:  According to the TOR, ten (10) of the implicated Districts were to be visited while only nine (9) effective days were only available for conducting the field visits. Therefore, workdays of more than 8 hours were mainly used for long distance travels and interviews. However, most District’s services have an official working hours from 7.30 AM – 4.00 PM. This was also the case for the schools and the health facilities.  In a number of Districts involved staff members of Government services were new and had never been involved in the implementation of the SINSM programme, which ended in October 2014. Given that there had never been a central coordination entity on Districts level no district’s institutional memory was in place either.  According to the TOR, the ETR is to provide the reader with sufficient explanation on the methodology used during the review in order to enable the reader to gauge the credibility of the conclusions and to acknowledge limitations or weaknesses, where relevant. This can only be done once we have analysed the optimal implementation of the programme and on condition that the DNHA supplied optimal support to the Districts. It also means that if the Districts were in a position to support the sentinel sites in an optimal way and a good working surveillance system, the nutritional status of the vulnerable groups in these sites would have been improved substantially. The ETR-team can only assess this during the visits to the Districts. Only if the Districts and also the DNHA were in a position to provide clear data on the nutritional and the food security status in the concerned Districts, the assessment could point out whether the programme was able to meet its objectives. If this was not or only partially implemented by the Districts and DNHA, the ETR has to find out why it was not implemented as planned. The programme was, however, to piloting or testing how the proposed activities were able to improve the food and nutrition security status of the proposed vulnerable groups. If these data are not readily available, it will be difficult for the ETR-team to assess the relevance, the efficiency, the effectiveness, the impact and certainly the sustainability and the coherence in an objective way. In summary it must be pointed out that the lack of produced reports was a real constraint.
  • 13. 13  The ERT-team would like to point out the results and recommendations made during the 2008 final evaluation of ACF-UK as listed in annex 7.6. It is important to know how the first emergency food and nutrition security surveillance system performed and what the recommendations were on how to implement the surveillance system by the GOM.  Important background documentation for this review included the PE1 and PE2 official documents and the two (2) final progress reports. A number of documents were not available or difficult to find. This was felt by the ETR team as a really constraint in order to make conclusions based on some written evidences. For example the written minutes of the steering committee were not available. The PE1 provided the ETR-team with information on the Human Resources that were made available for this programme and the “ORGANOGRAM” or organisational chart, the role of the steering committee as well as its implementation structure at the District level (see annex 7.7). 3. ANSWERED QUESTIONS/ FINDINGS The methodology used to answer the evaluation questions and to formulate the main findings is described in annex 3 – detailed assessment method – and also the documents mentioned in annex 5. In annex 6.2 the Implementation Progress Templates of PE1 and PE2 show the results according to the DNHA final reports. 3.1 Problems and needs (Relevance) To what extent were the objectives of the development intervention of the SINSM programme consistent with the beneficiaries' requirements, the country needs, the global priorities and also the GOM and the EU's policies? The overall objective of the SINSM was to contribute to the improvement of the nutritional status of all Malawians, with special emphasis on vulnerable groups such as pregnant and lactating women, children below the age of 5 years (under-five children), both school aged and school going children, orphans and people living with HIV and AIDS (PLHA) through improved delivery systems. The purpose was to strengthen the institutional and stakeholders capacity at national, district and community levels in the delivery of the nutrition service management, coordination, implementation and monitoring and evaluation (M&E) of the nutrition programmes, projects and services. The general food and nutrition security situation in Malawi is according to many sources alarming as official stunting – in 2014 >40% - whereas wasting – 3.8%9 - figures for the whole country give partly the lie this concern. The rather high stunting levels urge systematically interventions according to standards. The acceptable and rather low wasting levels (< 5%) indicate the impact of the intensive GOM emphasize on nutrition and especially the introduction and strengthening of Community Based Management of Acute Malnutrition program (CMAM). The vulnerability to poverty but also the poor WASH situation explains partly the high stunting rates. The Food Security Index (FSI) developed by the Action Against Hunger-UK managed INFSS was a useful indicator to predict food insecure situations on district level. The SINSM planned according to the PE1 to use and eventually to improve this indicator. 9 which is acceptable according to theinternationalWHO standards
  • 14. 14 The school meals initiative component was a pilot programme managed by the MoE on national level and the DEM on District’s level with help of NGO’s WHH and FISD. It aimed at promoting better school enrolment, promoting school attendance especially for girls, promoting better nutrition awareness through learners, their parents and although the whole community using school feeding The DNHA was a department directly under the Office of the President and Cabinet (OPC). It came in 2012 under the MOH. Its mandate is to provide visionary guidance and strategic direction for the implementation of the national response to nutrition disorders, HIV and AIDS in the country. The SINSM proposed a necessary form of decentralisation to the Districts aiming at promoting ownership to nutrition and food security interventions on District’s level for development planning with the help of a professional monitoring system through the INFSSS. The general conclusion is that the SINSM was a good programme consistent with the requirements of the beneficiaries, the needs of the country, the global priorities and the policies of the GOM and the EU. 3.2 Achievement of purpose (Effectiveness) To what extent were the project’s results attained, the project’s specific objectives achieved or expected to be achieved? The SINSM Programme Estimate 1 and 2 expected to yield each five (5) results: Result Area 1: Support to nutritional products distribution to vulnerable groups (PE1) and support to school meals programme improved (PE2). Result Area 2: Strengthen capacity in nutrition for communities and other stakeholders (PE 1 & 2). Result Area 3: Nutrition surveillance system (PE1) and INFSSS (PE2) strengthened to enable tracking of malnutrition for timely and rational response. Result Area 4: Capacity of health facilities to manage nutritional rehabilitation improved (PE 1 & 2). Result Area 5: Project coordination and management activities improved (PE 1 & 2). The Result Area 1 for the PE2School Meal Grant Contract for “Welthungerhilfe” or WHH (in 2014 for an amount of € 750,000) aimed to support improved nutrition and health and building institutional capacity for sustainable home grown school meal programmes in Malawi. The school meal grant contract for the FISD (in 2014 an amount of € 750,000) aimed at improving the nutritional status of 80, 000 pre-schoolers and school going children, Increasing enrolment, attendance and retention in primary schools as well as ECD centres by 40% and building the capacity of community structures to sustainably run school meals program. N.B An extra grant of € 172,000 was allocated for CBS purchase. The question is whether the project’s results were attaint and the specific objectives achieved? The answer to this question is as follows: Result area 1 for PE1 and PE2: The support to nutritional products distribution to vulnerable groups programmed for PE1 was not carried out. The school feeding programme proposed to
  • 15. 15 carry out in the PE2 under the RA1 was carried out in 2014 – only one year – through WHH and FISD with rather positive results. Result area 2 for PE1 and PE2:All pilot Districts had nutrition officers in the Ministry of Agriculture District Service (DADO), the Ministry of Health (DHO), the Ministry of Education (MED) and the District Council (DC) etc. They were permanently involved in the strengthening of the capacity in nutrition for communities and other stakeholders. The SINSM programme carried out a number of capacity building programmes for District’s nutrition officers but how these capacity building activities impacted the capacity was not measurable. The DNHA and the MoH carried out other capacity building activities with help of the SUN movement and now with help of the SNIC programme. Result area 3 for PE1 and PE2:Under PE1 an amount of +€ 35.000 (Mk 14,018,467) was spent on the INFSSS and under PE2 €58,000 (Mk 23,363,712). Only 3 bulletins were published with incomplete information. The DNHA was supposed to develop a Geographical Information System (GIS) database and website for nutritional data. The INFSSS stopped activities in 2013 according to the final report due to “interruption of funding” but according to the NAO and the EUD funding was not interrupted. The project expected results - to enable tracking of malnutrition for timely and rational response - were not attained. Result area 4 for PE1 and PE2:Under PE1 an amount of + € 63,800 (Mk 14,659,008) was spent and under PE2 + € 89,000 (Mk 35,482,025). The expected result was improvement of capacity of health facilities to manage nutritional rehabilitation. However the DNHA and the MOH realised various capacities building improvement trainings under various programmes (SUN movement, SNIC, MOH etc.) the specific impact of SINSM was neither monitored nor measured. The low wasting figure – in 2014 only 3.8% for Malawi is objective evidence that the specific attention for nutrition worked. To what extend SINSM contributed is not demonstrable because it was not monitored in a quantitative way. Result area 5 for PE1 and PE2:Under PE2 + € 89,000 (Mk 35,482,025) had been spent. The result area aimed at improvement of project coordination and management activities. The SINSM suffered of various external political developments among others the change of a new president belonging to a different political orientation, the move of the DNHA from the OPC to the MOH. Internally the SINSM had 4 different liaison officers and although continuity and sustainability was not guaranteed. The budgetary amounts for each RA were objectively too limited to guarantee optimal impact. The DNHA mentioned also the strict rules of EU funding inhibited flexible management. The coordination role of the DNHA was questionable. Results for the school meal contract: This activity under RA1 was only carried out under PE2 in 2014 by two NGO’s – WHH and FISD. The collaboration at district level with the DEM was good. The DEM was fully involved and did all the coordination and planning activities. Both NGO’s analysed jointly with the DEM how school feeding activities could be integrated in a new policy aiming at optimal community involvement. And also ownership for school feeding, the two NGO’s produced each a good final evaluation report in which activities were clearly explained but also the way forwards indicated how community involvement can be stimulated and realized. Both NGO’s also produced a detailed baseline study in which more background information and data were collected. A total number of 47,000 learners got one (1) meal per day during one year. This makes an average cost of € 35 per beneficiary child10. The general impact of school feeding has improved school enrolment in general and particularly of girls. It also improved learner’s performance. The good joint cooperation between the DEM and the 10 Total funds used for this activity was € 1,672,000 for 47,000 learners (schools +ECDC pre-schoolers). WHHwas operationalin 4 Districts in 20 primary schools and 9 pre-schools. FISDwas operationalin 5 Districts in 25primaryschools and 25pre-schools.
  • 16. 16 two NGO’s also made clear that the maximum community involvement only can cover 30% of the annual food needs. External support will always be necessary. The expected results were attained. The costs for school feeding are now known. The optimal community involvement has been found out but external support will always be necessary. 3.3 Sound management and value for money (Efficiency) The question is how well did the various activities transformed the available resources into the intended results that sometimes referred to as outputs, in terms of quantity, quality and timeliness but also compared against what was planned. The PE1 describes in its management structure of the SINSM the distribution of tasks between the national and the District’s level a sound structure. However, the management structure on DNHA level is from merely project management view poor: one (1) imprest officer, one (1) accountant, one (1) liaison officer. The GOM should assign two (2) staff to coordinate the implementation (deputy directors for nutrition and for planning) plus every time members of staff of various categories when required. At the District level there was very limited staff except from the focal points from the MOH and the MOA. The District Council is officially not involved according to this organogram except from the two focal points of the MOH and the MOAIWD. Involvement of at least the District Planning and Development officer and the M&E officer had been highly necessary in order to guarantee the planned use of data for the District’s development strategy. This was mentioned in the PE1 and not realized. For the school feeding programme in 2014 the DEM had also a nutrition officer. These two focal points work together with the District Assembly and the District Council. In the organogram of annex 7 the staff management does not mention the district DNHA coordination presence and the involvement of the District Council and the District Planning Director or the M&E officer. The poor management on national level was also mentioned in the final PE report as “frequent shift in management11” while the PE proposal mentioned a strong coordination unit on central level. In footnote the names of the imprest officers are mentioned and also the period in charge. The lack of a professional data manager and also a staff especially in charge of training etc. was also a reason that caused the weakness of the programme. The final progress report of PE2 mentions on page 3 that “lack of cooperation by implementing partners and frequent changes in management affected the implementation of some activities due to absence of political will”. This means that the DNHA recognizes the findings of this ETR. However, the DNHA mentioned also the rigidity of EUD procedures to timely release of money for implementation activities and procurement of materials and equipment which were given almost at the end of the project in 2014. However, the release of funds was delayed due to noncompliance with EU procurement procedures leading to delays in contracting supplies contract. This affected implementation of the programmes. 3.4 Achievement of wider effects (Impact) The question is what the relationship was between the project’s specific and overall objectives referring to what the SINSM effects or what influence it had. The overall objective of the SINSM Programme was to contribute to the improvement in the nutritional status of all Malawians, with special emphasis on vulnerable groups such as pregnant and lactating women, children below the age of 5 years, both school aged and school going children, orphans and people living with HIV and AIDS through improved 11 During the operational period 2011 –2014ofPE1 and PE2 theSINSMhadfour (4) different imprestofficers: Mary Shawa, Felix PensuloPhiri(3 months), Janet Cuita (4 months) andJeanChilemba (6 months).
  • 17. 17 service delivery systems. The purpose of the project was to strengthen the capacity of households and communities to recognise, manage and prevent malnutrition through strengthening institutional and stakeholders’ capacity at national, district and community levels in the delivery of the nutrition service management, coordination, implementation, monitoring and evaluation of the nutrition programmes, projects and services. Impact of a programme that ran for 18 months like PE1 – officially from 1st of April 2011 till September 2012, cannot produce direct impact. PE2 ran 24 months from the 1st of November 2012 till 31st of October 2014 therefore “outcomes” should be a better word for PE1. Impact for the PE1 and 2 including the school feeding programme is however not measurable due to various reasons: absence of systematic monitoring system specifically for the SINSM, lack of a professional food and nutrition surveillance system at the district level. There is not a monitoring system and surveillance system that compares impact of the involved districts with not involved districts. However, it must be mentioned that the general wasting figure for 2014 was 3.8%. That is a very low figure and considered by WHO-standards The surveillance system INFSSS was stopped in 2013. According to the final PE2 report because of “lack of funding” but this was not the real reason. Since funds were already made available through the NAO “lack” cannot be the official reason. According to our findings there was a lack of coordination in the DNHA. The “absence of political will” was mentioned in the final PE2 report confirms our findings but this conclusion needs more analysis in order to make it objectively verifiable. The global reason was lack of real leadership and the presence of an independent professional Programme Management Unit. The various District officers involved were not able to do their work properly. This was mainly due to the fact that the programme had no coordinator in the District and the District Council was not officially involved. In general lack of leadership, lack of coordination and communication were the main reasons that achievements of wider effects (impact) were not measurable and assessable. However, in some visited communities, we have met only healthy children who were part of the project area. We also can confirm that most mothers with young children use the services provided by the health facilities. The low figure of 3.8% for wasting was confirmed by evidence based observations during the visits. Some of the households were taught how to produce their own seeds like pumpkin seeds, okra. Some of the few fruit trees were told to be given by the project. It is hardly to say that the many positive impressions are due to the SINSM activities. It is not possible to do a counterfactual analysis because the programme didn’t develop a professional monitoring system. The Districts where SINSM was not implemented should be compared with the Districts where the SINSM was implemented. This needs the existence of a professional data bank. Since the creation of the INFSSS pilot by the DNHA failed and the DNHA does not dispose of a professional experienced data analyst the question cannot be answered. The capacity building support activities mentioned in RA 2 and 4 were part of many other core activities such as the DNHA managed SUN movement programme and now the World Bank funded SNIC programme. The school feeding activity produced however clear impact: learners received 1 meal a day, kitchens were built, ways of improvement of better community involvement were analysed and last but not least the school feeding programme built up a good M&E system.
  • 18. 18 3.5 Likely continuation of achieved results (Sustainability) The question is to what extent the positive outcomes of the project and the flow of benefits were likely to continue after external funding ends or non-funding support interventions such as policy dialogue, coordination? This question will be answered per Result Area and also generally. RA1 Support to nutritional products distribution to vulnerable groups and to the school feeding programme: The support to nutritional product distribution has never been carried out. The school feeding has implemented a good programme for only one year. The MOE and the DEM have now clear ideas how to implement a feasible school feeding programme. WHH will continue this activity jointly and under the responsibility of the MOE with funds from the German Government. FISD negotiates new funding. RA2 Strengthening capacity in nutrition for communities and other stakeholders: With support of UNICEF, the SUN movement and now the SNIC programme the MOH jointly with its DNHA continue through the District’s Council this activity. To indicate whether SINSM contributed to it and in what extend cannot not be evaluated because all these programmes were support programmes and no professional monitoring system to answer these questions was ever setup. RA3 Strengthening the INFSSS to enable tracking of malnutrition for timely and rational response: No surveillance system was set up. The pilot failed. Therefore the DNHA did not develop an instrument that aimed at tracking malnutrition for timely and rational response. The need for such a system is still high. The fact the DNHA shifted from the OPC to the MOH caused less attention for the food security component. RA4 Strengthening capacity of health facilities to manage nutritional rehabilitation: The health facilities monitor the nutritional status of under-five children in an acceptable way. The low wasting rate of 3.8% on national level is the evidence of it. How far the MOH and the DNHA can guarantee permanent training was not the mandate of this ETR. RA5 Improvement of project coordination and management of activities: However the DNHA recognized frankly the need for improvement of coordination and management of activities this activity could not be realized due to external most political problems but also due to the proper identity of the DNHA. Change of government, shift from OPC to MOH, internal organisation of the DNHA, emphasize on efforts how to decentralise activities to the Districts but also incompatibility between the DNHA organisation and the way EDF could support it all contributed to the non-compliance of the SINSM. School meals programme (RA1): The school feeding despite its one year implementation produced not only positive results but also produced models how to implement simple school feeding programme with full community involvement and external support. The way public and private cooperation – NGO’s worked and produced effective ways to improve nutrition to vulnerable groups.
  • 19. 19 General: The SINSM must be considered as a complementary programme to support on- going DNHA activities. The pilot INFSSS failed not only because of low funding but in the first place due to the fact food and nutrition security surveillance systems only can be implemented by semi-independent professional entities with enough funding and professional and well paid staff. The needed capacity improvement services both on national, district and community level exist already with tangible results. SINSM was supposed to support this activity. It did it but lack of a professional internal M&E system and specialist to analyse this could although not justify any evidence based impact. 3.6 Mutual reinforcement (coherence) The undertaken activities allow certainly the main stakeholders (proposed action for EU) to achieve its development policy objectives without internal contradiction or without contradiction with other EU policies. Since the achieved activities were implemented by the GOM and elaborated in accordance with GOM policies and other Development Partners' (DPs) interventions full coherence exist. Since wasting is low now and stunting still high but lowering the work DNHA does will certainly produce positive results. However, since the direct official link with the MOAIWD was interrupted – due to the shift from OPC to MOH – the food security component was eliminated. This programme despite its not direct tangible results demonstrated the need for an organisational assessment of the DNHA in order to make it more productive and efficient in policy development but also service providing towards the Districts. 3.7 EU value added In order to answer the question what the connection was to the interventions of Member States and other Key Development Partners (DPs) it must be clear what EU member states do. A number of member states work in programmes aiming at improving food and nutrition security at household level. Others are involved through support to health delivery systems or general programmes that aim at improvising family incomes or poverty reduction. It must be recognized that member states prefer to work directly with non-profit development organisations both faith or non- faith based. Also UN organisations such as UNICEF and WFP benefit of funds from EU member states. The reason that EU member states prefer to work through nongovernmental or UN channels is based on experiences in the past. The conditions linked to the EDF use of funds influenced in a certain way the member states justification. 4. VISIBILITY. Visibility is the assessment of the proposed project’s strategy and activities in the field of “visibility, information and communication” and also the results that were meant to be obtained and the impact to be achieved with these actions in both Malawi and the European Union countries. Normally the visibility limits to some posters, T-shirts or stickers with the name of the project. Concerning this the visibility was quite poor. Except from the WHH school feeding sticker and the shirts distributed where the programme had the name “Programme Estimate” no other “visible” testimonies were left. In all the 9 districts visited the name “SINSM” was not known. However, the DNHA was well known through other activities and programmes such as the World Bank funded SNIC programme or the SUN movement that both intend to improve nutritional status of the population.
  • 20. 20 It must be recognized that the overall activities carried out by the DNHA since its creation in the districts was very “visible”. In all governmental districts governmental services a “nutrition officer” was employed to promote good nutrition. This is of great importance because it shows the intention of the GOM to take nutrition seriously into consideration. Main performances of these nutrition officers in the MOH, MOAWAI, MOG, MOE etc. at district’s level is to promote nutrition and nutrition related activities. The impact of the work of this strategy has never been assessed in a systematic was. However, general wasting or GAM figures are now 3.8% in Malawi and that is a clear indicator that the nutrition policy of the government works. On the other hand wasting is still very high - >40% - and that indicates that promoting good nutrition, good WASH and poverty alignment has a high priority. It must be recognized that the SINSM programme was a complex programme because it was composed out capacity building in nutrition components, the INFSSS component and also the school feeding component. The capacity building in nutrition component was mainly carried out by the DNHA and the MOH and was in a certain way complementary to the SUN movement activities and the SNIC activities. The SUN movement activities and the SNIC activities were well known in all districts while the SINSM’s activities not. The INFSSS did not achieve what it pretended to become – creating a strong national and professional nutrition and food security surveillance system – and also as a pilot programme did not produce the impact it intended. The school feeding component despite its short implementation period – only operational in 2014 – was in all districts were it was operational very well known. The involved schools still had their kitchens and stores. The MED’s were optimally involved. New plans were designed. In general terms the school feeding component was very “visible” and the cooperation between the MOE and two NGO’s – WHH and FISD – in general good. It must be mentioned that in the EU the efforts achieved by the Malawian government in reducing wasting figures till under 5% - in fact now 3.8% - with support of donors among which the EU but also UNICEF and the SUN movement is not generally known. The information circulating in the media in the various member states of the EU is still the high rates of under-nutrition and the high rates of starving people in the rural areas. The ETR field mission to the 9 districts didn’t provide any evidence. The interviewed nutrition officers in the districts also couldn’t confirm this. The so called “visibility” to be obtained and to be achieved by the actions of the SINSM in particular and the other programmes is therefore in general quite absent. This should be and become a core activity of the DNHA.
  • 21. 21 5. OVERALL ASSESSMENT In this chapter all answers to assessment questions are synthesised aiming at articulating all the findings, conclusions and lessons learnt in a way that reflects their importance and articulates the key issues of concern to stakeholders, thus optimising the focus and utility of the assessment. It must be repeated again that this assessment is also done to provide the GOM and the EU ideas on more effective ways to realize stated objectives. Synthesis of the answers to the evaluation questions. The findings of this ETR in terms of DAC criteria show us in general the great relevance of the SINSM for Malawi but it was a multi-activity programme of which the different result areas where not always congruent with each other. The logic of the programme is mainly that such a programme should be coordinated by only one entity or stakeholder necessarily on governmental level. In thiscase the DNHA under the OPC was a logic choice. The implementation of the different result areas should not necessarily be achieved by one entity or stakeholder. In the case of the SINSM programme the five (5) RA were all implemented by the DNHA and the school feeding programme was implemented by the MOE jointly with two NGO’s. The grading scores according to the DAC criteria indicate for the general coordination and communication, the decentralisation, the District’s involvement and participation, the monitoring and evaluation and also the highly needed data collection were all “weak to poor” (chapter 6 conclusion 2). However, the school feeding scored “good”. The reasons for this low scoring have also been clear: political changes in the country shift from the OPC to the MOH, no continuity in management due to the high number of imprest officers etc. and according to the DNHA and other involved line ministries also the “rigorous rules” of EU funding conditions12. The expected effectiveness, efficiency and also the impact within the proposed way of implementation in the PE1 and PE2 and also the not compliance of the needed decentralisation were all reason that the programme did not achieve expected results. In fact the SINSM had apart from RA5 – project coordination and management activities improved – three (3) main activities: 1) capacity strengthening in nutrition for communities, other stakeholders and health facilities (RA 2 and 4), 2) INFSSS and 3) school feeding. It needed effective to bring them all together in one programme. The DNHA main role should have been coordination and the needed organisation. The school feeding activity was in fact “outsourced” to the MOE and two NGO’s with full implementation of the DEM. This should also have been done with the INFSSS. National INFSSS only work effective and efficient if implemented by a professional and independent structure that is controlled by the government, academic institutions and donors. Experiences in other countries show also that funding should not be a constraint. A good example is the Somalia Food and Nutrition Analysis Unit FSNAU managed by the FAO that receives multi-donor funding13. Another example is the Mozambican SETSAN – a governmental institution comparable with the DNHA – that monitors the food and nutrition security situation nationwide and also was responsible for the 2013 national food security baseline study. The FSNAU and also the SETSAN show us that food security monitoring systems must be carried out not by governmental institutions because of lack of flexible structures and the need of highly 12 One important stakeholderofa line-ministry participating in the data collection oftheINFSSS mentioned the procedures necessaryto fulfil the duties; in order toget thedata from the fieldit takea 5 days mission and toget themoney needed for thatmission it takes 2 months etc. 13 The Somali FSNAU managed by the FAO has a budgetof24 million €for four years while theINFSSS disposed only of€ 250,000 for PE1 and PE2 (2011-2014).
  • 22. 22 qualified professionals. The school feeding programme was successful mainly due to a good cooperation between public and non-governmental structures. 6. CONCLUSIONS AND RECOMMENDATIONS. 6.1 Conclusions The programme used + 85% of the allocated funding. The final reports of PE1 and PE2 mentioned that the two programmes were a success without any justification. These reports also mention that the programme suffered from “lack of cooperation by implementing partners and frequent changes in management affecting the implementation of some activities due to absence of political will”. However, it does not detail what lack of political will means and how far EU procedures or regulations are concerned. The conclusions of the ETR are the following: General 1) The general conclusion regarding the SINSM is that despite its good objectives it resulted in poor impact. The reasons are multiple: 1) too many result areas; 2) too limited budget for five result areas including two grants for a school feeding programme; 3) chances in the political situation in Malawi; 4) shift of the DNHA from the OPC to the MOH; 5) incompatibility of a multi-purpose programme as SINSM with the organisational structure of the DNHA; 6) lack of a professional unit with high skilled staff and budget to implement such a programme; 2) The overall grading of the PE1 and PE2 is as follows14: General coordination and communication: C (= weak) Decentralisation C (= weak) District’s involvement and participation: C (= weak) Monitoring and evaluation: D (= poor) Data collection: D (= poor) School feeding: B(= good) Problems and needs (Relevance). 3. Highly appreciated and relevant programme. 4. Very coherent with ongoing nutritional situation in Malawi – high stunting >40% and low wasting <5%. 5. Still food insecure situation nationwide. 6. Uses existing governmental structures both nationally but also on district level. 7. Good cooperation model between governmental structures – MOH, DNHA, MOAIWD, MOG etc. - on national and district level jointly with NGO’s. Achievement of purpose (Effectiveness) 8. Too many result areas (for PE1 4 and for PE2 5) in one programme. 9. Rather small budget for 5 Result Areas during an implementation period of 4 years. 14Grading basedon OECD DACcriteria.
  • 23. 23 10. Improvement capacity building both for communities and for District services of agriculture and health has been carried out by the DNHA, the MOH and the MOAIWD but impact not known due to absence of professional monitoring system. 11. IFNSSS pilot implementation was not achieved mainly due to underestimation of needed institution and also needed budget. 12. DNHA does not have the organisational capacity or the technically qualified staff to build up a professional and independent IFNSSS. 13. The effectiveness of the SINSM due to the lack and therefore the weak decentralisation was poor. 14. The school feeding activity despite its short implementation period – only one year in 2014 – was effective. It cost an average of € 35 or MWK 21,000 per year. It fed + 47,000 learners. It was a good example how public and private non-governmental organisations can cooperate in a effective way. It generated also information how to improve community participation and ownership. Sound management and value for money (Efficiency). 15. The management for the result areas 1 – 5 was questionable. The frequent shift of imprest officers – during the PE1 and PE2 a number of 4 imprest officers were in function - and the short period for them to be in charge - for 3 imprest officers from 3 – 6 months – made the SINSM a poorly managed programme. 16. The school feeding programme was implemented under two separate grants. It was a good managed programme. The cohabitation between the MOE and the DEM one side and the two implementing NGO’s the other side was fruitful and efficiently carried out. This has been a good decentralized programme. Achievement of wider effects (Impact). 17. Impact of the SINSM activities – RA1 – RA5 – was difficultly measurable mainly due to the fact of absence of a professional monitoring system. 18. Therefore the question whether the SINSM produced any impact cannot be answered in a professional way. Anecdotal evidence exists but is methodologically not representative. 19. The school feeding programme produced a positive impact despite the short implementation period of 1 year. It fed 47,000 learners, it increased school attendance, it increased the enrolment of girls and it produced also evidence based information on models how to implement a low cost school feeding policy with optimal community involvement and participation that also promotes nutrition awareness. Likely continuation of achieved results (Sustainability) 20. The SINSM, despite its poor implementation and poor impact, produced enough information on how to implement a programme that aims at giving “Support to Improved Nutrition Status of Vulnerable Groups in Malawi” and in particular on how not. Key words are decentralisation of responsibilities and duties to the Districts, independent and professional monitoring, role of central government ministries is coordination, strategy development, training and capacity building. 21. The lessons learnt through the AAH-UK managed emergency IFNSSS and the tentative effort of the DNHA to create a public managed food and nutrition security surveillance system indicates the creation of a semi-public surveillance system that is professional and independent. It must dispose of highly skilled professionals and a large budget. Mutual reinforcement (coherence)
  • 24. 24 22. The need for activities implemented by the SINSM is generally recognized by all development partners. The implementation and the results generated by the SINSM show the GOM and the development partners how to guarantee optimal results for implementation. EU value added 23. The lesson learnt for the EU is the way the Support to Improved Nutrition Status of Vulnerable Groups in Malawi is not optimal through the way it was now implemented. 24. A number of member states operate already mainly through private or church based organisations and also through UN organisations such as UNICEF, WFP or FAO. Support through the SUN movement is also an efficient way to support the GOM. 25. The school feeding programme implemented by the MOE and two NGO’s resulted in new programmes funded by Germany’s GIZ. 26. The lesson learnt for the GOM is to stimulate private investments in education, health, poverty reduction through private organisations but under serious control and coordination of the GOM. 6.2 Recommendations Recommendations will be given per stakeholder or group of stakeholders such as EU, NAO, DNHA, GOM and line ministries. 1. GOM and EU: Programmes such as the SINSM are too complex to be implemented by only one GOM entity such as the DNHA jointly with line ministries. Components like “capacity building in nutrition”, “food and nutrition security surveillance systems”, “school meals” must preferably be implemented by independent entities or PMU within or jointly with ministries and NGO’s. 2. GOM, MOH, DNHA: Capacity building in nutrition for communities and for government services and other stakeholders has been successful in Malawi – given the low wasting rates of 3.8% in 2014 and the presence of nutrition officers in all ministries also at District level– but it must become clear under who’s responsibility this activity this activity resorts – DNHA or MOH – since the DNHA resorts under the MOH. 3. GOM, EU, DNHA: If food and nutrition security or food security and nutrition both on household level is still a priority for the GOM it should be under the responsibility of a special department preferably under the Office of the President and Cabinet (OPC) jointly with the Ministry of Health (MOH), the Ministry of Agriculture, Irrigation and Water Development (MOAIWD) and the Ministry of Gender, Children, Disability and Social Welfare (MOGCDSW). The DNHA was created for this aim under the OPC but shifted to the MOH. It should preferably return under the OPC and putting more emphasize on the component household food security. 4. GOM and EU: The importance of a central INFSSS that enables tracking of malnutrition and also food insecurity for timely and rational response for the GOM and the donors is generally recognized. The experiences gained with AAH-UK and now with the DNHA learnt that such a system must house under a PMU that is independent but controlled by the GOM, independent academic institutions and donors. This PMU needs a team of
  • 25. 25 highly qualified professionals with enough funds. The budget for this activity under the DNHA under PE1 and PE2 was fairly too small to guarantee any impact. 5. GOM, MOE and EU: The school meals component learnt how to include NGO’s in this activity in a way that positive results were obtained. It also learnt how to maximize community involvement in an optimal way in order to improve ownership and decrease its price. It also learnt that external funding is always needed for this activity.