Liberia - Strengthening integrated systems for management and prevention of malnutrition in greater Monrovia
This is one of 50 Harvesting Nutrition project case studies. Harvesting Nutrition was a contest held in 2012 and 2013 that showcased active projects working to improve the impact of agriculture and/or food security on nutrition outcomes. Co-sponsors were SecureNutrition, Save the Children UK, and the Global Alliance for Improved Nutrition (GAIN). Learn More.
The objective of this programme was the reduction of morbidity and mortality from malnutrition in children under five years old in Greater Monrovia, by creating a link between food security and nutrition and particularly the links between eating a diverse range of food and improving a child’s health.
Whereas prevention activities at the household level were intended to reduce the underlying and immediate causes of malnutrition (inadequate dietary intake, inadequate care for children and women, unhealthy environment), activities in Health facilities and at county and national levels such as advocacy, technical assistance and nutrition training aimed to directly tackle the outcome of malnutrition.
Impact of project:
By the end of the project, over 90% of households were adopting new methods and best practices in agriculture which permitted to increase their production and their consumption of vegetables. A handful of households with larger plots were selling surplus for additional income. The findings showed as well that newly introduced varieties and vegetables were successfully grown and consumed by households. The orange flesh sweet potato variety was one of the crops successfully introduced, i.e. 51% of surveyed households indicated that they produced and consumed this new variety for the first time. Cowpea (protein-rich crop) was also introduced, with 62.2% of surveyed households producing for consumption. 88.3% of children in households interviewed were fed at least four varieties of food per day compared to 70% prior to the intervention. Increase in dietary diversity was also observed, although to a lesser extent, for the participating pregnant and lactating women. Feeding frequency (more than three times a day) for children aged 6-24 months the feeding increased for 28% of the households surveyed between baseline and end line.
From a beneficiary perspective, the project was successful in introducing new inputs and techniques to improve the productivity and diversity of existing garden plots. It also provided key information relating to nutrition, food security and improving the health of a child. The sustainability of garden activities was not fully ensured due to limited and relatively expensive seeds.
Why this project is a Good Practice example:
The program aimed at addressing under-nutrition in an integrated way tackling some of its underlying causes - food security, health, maternal and child care. It took a two-pronged approach (treatment and prevention) and acted at different levels (national, community, household and individual), looking for synergies, while programs usually remain sectorial with little coordination between different approaches. The project also had a specific and explicit nutritional objective, using a nutrition lens for design, implementation and monitoring.
Impact evaluation completed
1. Internal coordination within ACF:
- Coordination at planning and implementation stage between FSL and Nut Units facilitated effective integration of FSL and Nut interventions in the field.
- FSL team was trained on ENA messages and contributed to strengthen ENA messages dissemination
2. Effective participation of Health facilities
- Using the health facility as the entry point of the community and as the main point for beneficiary registration helped influenced care givers to bring their sick children to the clinic, expecting to be targeted by the project.
- Health facility staff promoted production and consumption of nutritious food through demonstration plots installed at health centers and provided ENA messages.
3. Effective ways of promoting gardening and nutrition practices
- Cultural performances were very effective for disseminating gardening and nutrition messages, especially to pregnant and lactating women.
- Mothers that already adopted gardening and/or nutrition practices were effective promoters of these practices among “new” pregnant and lactating women.
- The use of community members to co-facilitate (mainly in the local dialect) during training session increased the understanding of participants
- Improvement in nutrition knowledge and practice was higher when people were engaged in garden activities.
- Methods of message delivery could have been more participatory and more innovative methods such as community theatre and film should have been considered.
Funders: Action Contre la Faim (ACF), Swiss Agency for Development and Cooperation (SDC)
Primary Contact: Marie Sardier, Food Security & Livelihoods Advisor, ACF France / Julien Morel, Food Assistance & Policy Senior Advisor, ACF France
Project Dates: 2011-2012 Interventions: Incorporate explicit nutrition objectives and indicators, Incorporate nutrition promotion and education, Target the vulnerable and improve equity, Collaborate and coordinate with other sectors,
Target Population: Urban households, Parents,
Project Stage: Completed
Geographic Coverage: Village/Municipality