Title MITRA Youth: Weekly Iron Folic Acid Supplementation for prevention and reduction Iron Deficiency Anaemia among school-going adolescent girls, in selected districts in two provinces of Indonesia: East Java and East Nusa Tenggara Team Leader Rt statements Indicators Baseline Target Data sources Data collection methods Frequency Responsibility Ultimate outcome 1000 Impact: Reduced iron deficiency anaemia in school-going adolescent girls. % of school-going adolescent girls with haemoglobin below 120 g/L TBD (Baseline Survey) 15% Evaluation Baseline and end line survey Once Nutrition International / Independent agency Enabling environment- Intermediate outcome 100: Enabling environment: Public sector policy makers renew leadership of and commitment to more effective implementation of WIFA program for adolescent girls. Specifically to provide iron and folic acid (IFA) supplements to school-going adolescent girls including improved policies, guidelines, product standards and increased budget allocations Standards and Guidelines: % of districts that are implementing program with product standard-consistent with new revised guideline on WIFA from MoH guidelines that are consistent with the new revised WIFA guidelines from MoH Budget allocation: # of districts where there is an increase in budget allocation (supplies/training /operational cost) for the WIFA program. 0% 80% 15 of 20 districts Policy documents - Policy documents - District Development Planning Board documents Review of documents and policy statements District program action plans Once Annual Nutrition International / DHO Nutrition International / DHO Enabling environment – Immediate outcome
1110 Knowledge, Skills and Capacity: Policy makers have committed to revitalizing and strengthening WIFA program through changes in policy instruments, and to increase budgets to effectively plan, implement and monitor these programs. Plan and implement: # of districts with policy makers who know how to plan and budget appropriately for national and district procurement of WIFA supplies (e-procurement) improving service delivery to increase coverage of WIFA program Monitoring: # of districts that have modified HMIS to track key coverage and stock indicators. 0 0 20 districts 20 districts FGDs with policy makers Revised HMIS Analysis of FGDs Modified HMIS tools Once Once Nutrition International Nutrition International / DHO Enabling environment – outputs 1111 Key information received: Policy makers have received information about gaps in WIFA program (including product; packaging; dosage, service quality etc); and on the scope for improvement based on the results from the Nutrition International demonstration projects # of provincial program launching organized to inform policy makers and influencers 0 2 launchings Advocacy meeting minutes Review of minutes of the meeting Once Nutrition International / MoH 1112 received: policy makers have received updated guidelines and approaches to monitoring to help them plan and implement these programs effectively # of districts in which key policy makers and influencers received relevant tools 0 All 20 districts Distribution records Review of distribution records Once Nutrition International / MoH/ PHO/DHO 1113: Learning completed: Policy makers have received briefing on the above # of workshops conducted for policy makers at national level # of workshops conducted for policy makers at provincial level # of workshops conducted for policy makers at district level 0 0 0 2 (1 per year) 2 (1 per year) 2 (1 per year) Minutes of the meeting Review of minutes of the meeting Annual Nutrition International / MoH/ PHO/DHO
Provision – Intermediate outcome 1200: Provision: improvements in the extent to which health workers, supervisors and health service managers, prioritize the timely provision of IFA supplements to school-going adolescent girls and are capacitated for effective planning, monitoring, management, and appropriate counselling to adolescent girls Capacity for monitoring: # of districts that actively compile HMIS data on Stock and Coverage of MN supplements 0 20 districts Revised HMIS Modified HMIS tools/ directives from DHO Once Nutrition International Adequacy of supplies: % of districts with adequate supplies of WIFA available at the DHOs 0 100% (all 20 districts) District procurement records District procurement offices/ District Pharmacies Annual update Nutrition International Planning and monitoring: % of districts conducting annual planning and quarterly program review meetings on micronutrient programs to identify gaps and potential solutions 0 100% (all 20 districts) Minutes of meetings Review of minutes of meetings Annual update Nutrition International F18.4Provision – Immediate outcome 1210: Knowledge, Skills and Capacity health workers, supervisors and managers, and school health program teachers have recognized the importance of prioritizing WIFA program through improved capacity for timely provision of adequate amounts of supplements and effective planning, monitoring, management and appropriate counselling. % of health workers who can correctly describe dosage, duration, benefits and side effects of WIFA TBD from baseline survey Increase by 50% Program evaluation Baseline and end line surveys Once Nutrition International / Independent agency Provision – Outputs
1211: Supplies ensured: bottlenecks and gaps in supply IFA tablet stock assessment is undertaken with consultation with provincial and district staff % of IFA tablet supplies provided Stock outs: % of districts with stock out of IFA supplements at frontline distribution points 0 0 80% 20% Hand over certificate HMIS data - Review of HMIS data - Annual update Nutrition International and DHO Nutrition International and DHO 1212: Tools received: puskesmas staff and school health program teachers supported by their supervisors and managers have effective system, tools, curricula, etc for improving skills in provision of IFAs and nutrition counselling to adolescent girls % of managers, supervisors, health workers and school health program teachers who receive an improved package of tools 0 80% Dissemination records/ training reports Review of dissemination records or estimates Annual update Nutrition International and DHOs 1213: Learning completed: puskesmas staff and school health program teachers have completed participatory training on skills forecasting, recording and reporting of stock, modified HMIS system, use of job aids for appropriate and effective counselling for adolescent girls of IFA supplementation and nutrition education a. formal training # or % of managers and supervisors trained on improved package of tools # or % of puskesmas staff and school health program teachers trained on improved package of tools b. on the job training % of manager, supervisors, health workers and school health program teachers provided on the job training during program review meetings 0 0 0 116 480 (80% of the 600) 60% Training reports Project Monitoring reports Review of training reports Review of project MIS Annual update Monthly Nutrition International and DHOs Nutrition International Consumption – Intermediate outcome
1300: Consumption: Adolescent girls have improved receipt and adherence of WIFA supplement IFA Coverage: % of adolescent girls who received the recommended course of IFA tablets in a year. (12 supplements over 6 months/ or 24 over 12 months) Utilization: % of adolescent who consumed the recommended number of IFA tablets in a year. 0 0 80% 60% Program evaluation Baseline and end line surveys Once Nutrition International / Independent agency Consumption – Immediate outcome 1310: Knowledge, Skills and Capacity: adolescent girls are willing and able to correctly consume and report, as well as for influencers who provide social support are supportive on IFA supplementation for adolescent girls program % of adolescent girls who can describe one benefit to consuming IFA supplement % of all adolescent girls who can explain how to overcome at least one typical barrier/side effect to IFA consumption TBD from baseline survey TBD from baseline survey Increased by 40% Increased by 40% Program evaluation Baseline and end line surveys Once Nutrition International / Independent agency Consumption – Output 1311: Evidence-informed BCI approaches uptake and use : BCI strategy and IEC materials focusing on nutrition education and increasing awareness on the importance and benefit of taking IFA supplements for girls are to be made available BCI plan reviewed and revised Existing BCI BCI plan reviewed and revised - - Once Nutrition International / MoH/ DHO 1312: Messages received on correct use: school-going adolescent girls are willing and able to correctly consume and report, as well as for influencers who provide social support are supportive on IFA supplementation for adolescent girls program % of adolescent girls who received correct messages on benefits and mitigation of side effects for IFA supplementation TBD from baseline survey Increased by 60% Program evaluation Baseline and end line surveys Once Nutrition International / Independent agency
Supporting PHO and DHO in estimating requirements of IFA supplements to facilitate provision of adequate IFA supplement at the health centres NI, PHO, DHO X X X X X X X X Advocate with the DHO and the pharmacy at the district level through the district coordinator to facilitate adequate and timely supply of IFA supplements at the district level and further to the puskesmas and school level NI, DHO X X X X X X X X Facilitate provincial and district project progress reviews to troubleshoot problems in supply chain for e.g. facilitate pharmaceutical district manager to check stocks of IFA supplement on a regular basis to ensure uninterrupted services to the health facility and catalyse distribution of IFA supplements from the buffer stock maintained at the province in case of inadequate availability of supplies at the central pharmacy NI, PHO, DHO X X X X X X X X 1212: Tools received: puskesmas staff and school health program teachers supported by their supervisors and managers have effective system, tools, curricula, etc for improving skills in provision of IFAs and nutrition counselling to adolescent girls Review and modify the existing training manual to focus on use and importance of WIFA supplements, estimation of supplies, provision of WIFA supplements, dose, benefits, how to handle side effects and effective counselling for better compliance, program monitoring and reporting NI X Printing of training module NI X Distribution of training module NI, DHO X