Delay in payment of CNWs and inadequate tools: Lack of timely payment of CNWs and provision of tools to all CNWs is discouraging to community mobilization efforts. Previous program rejection: Previous program rejection of children who were not yet within the admission criteria has discouraged some caretakers from seeking assistance from the nutrition programs. Community, caretakers KII, FGD Specific to BSFP Lack of continuous monthly admissions and discharges. Lack of monthly admissions and discharges has seen lack of coverage of eligible children due to “inadequate food” or opportunity for new admissions. Community, caretakers FGD, KII Overcrowding during distributions: Overcrowding particularly in the IDP camps during distributions has made the process disorderly and discouraging to some caretakers. Community, CNW, program staff FGD, KII, informal discussions 4.2 STAGE 2: HYPOTHESIS TESTING From the data collected in stage 1, the coverage survey established three hypotheses for further investigation as regards the TSFP: #1: Coverage is different in the different contexts: high in IDP and town sites due to higher density and low in rural set-ups due to the scattered nature of the communities. #2: Coverage is high in near sites and low in distant (approximately 2 hours walk). #3: There is double registration of children in BSFP and TSFP/OTP. Five (5) site areas were purposively selected to test the hypotheses with each hypothesis tested using 2 villages. Door to door case finding was used in identification of MAM children. The decision rule (90% for camp, 70% for urban and 50% for rural setups) was applied in assessing coverage amongst the different contexts. TSFP hypotheses assessment The findings per village are presented in table 4 below. Table 4: Small area survey findings - TSFP Village Village profile Current covered Current not covered Recovering Total (covered and covered current cases only) Decision rule Decision Total in program (covered and Total (Covered and Decision rule Point coverage Single coverage estimate Jazira 2 Town 11 11 6 22 15 <70% 17 29 20 Banbala IDP 12 3 15 15 13 <90% 27 31 27 Tulasharaf Rural 5 0 25 5 2 >50% 30 30 15 Hanoy Distant (rural) 12 7 11 19 9 >50% 23 31 15
Benefits of the TSFP and BSFP in management of malnutrition Sensitization by CNWs on the highlighted areas on-going. Breastfeeding groups in the camps have in addition utilized to pass messages. Seconded staff from MoH were recruited and have supported in mobilization activities Monitoring and evaluation There is need to have a position tasked with monitoring of the nutrition program. Ensure adherence to monitoring of the recommended indicators of nutrition programs. Conduct capacity building for implementing staffs on relevant nutrition M&E aspects. WV and WFP Program has M&E persons tasked with monitoring activities of different programs. From February program assigned a person to work closely with the 3rd party partners. The nutrition program is yet to have a district technical nutrition field person to follow-up on implementation of nutrition aspects on a day-to-day basis. Recruitment is however on-going. There are still gaps in the monitoring of indicators and implementation of program. It is however projected the WFP mobile based tool will enhance monitoring of the indicators. Training conducted on various general aspects to include IMAM, compliance standards and M&E Coordination and integration Enhance coordination on the TSFP and BSFP between all program stakeholders namely; CEDA, MoH, UNICEF, WFP and WV. Enhance integration of the OTP and TSFP by: Establishing a process and tools for referral and follow up of identified moderately malnourished CEDA, MoH, UNICEF, WFP and WV Coordination efforts on-going through cluster and monthly partner meetings. The new recruited MoH seconded staff will play a key role in coordination of all partners. Use of referral books and ONA application developed by WFP expected to enhance coordination of referrals