Table 2. Actions and Nutrition-Sensitive Agriculture Outcomes for EAIN Value Chains SOLUTION IMPLEMENTING PARTNER ACTIONS NUTRITION-SENSITIVE AGRICULTURE OUTCOMES (1) Gender- equitable access to water for off- season production of NRVCCs Fresh Salone Improved saving or diverting technologies for off-season production; supporting actions include assistance with securing business loans to adopt technology: drip irrigation water systems water collection/pump system mulching Adoption of improved technologies  Less time and energy requirements for who traditionally collect water from water points and irrigates the crops  Improved caregiving resources (time, energy). Adoption of improved technologies  Increased yields  More income for women who traditionally cultivate groundnuts and horticulture  Increased household income controlled by women. Adoption of improved technologies  Increased yields  More produce available year round in local markets  Improved access to diverse foods by households. (2) Training and access to appropriate technology for on-farm production WARC No-till cultivation reducing land preparation tasks Safe use of herbicides (and other chemicals) and environmental safety Adoption of no-till cultivation  Less time and energy requirements for men and women who perform or contribute to these tasks  Improved caregiving resources (time, energy) in the household (a) Safe use of herbicides  Reduced risk of toxin contamination (b) Safe use of herbicides  Less time and energy requirements for women who traditionally perform weeding  Improved caregiving resources (time, energy). (3) Training and access to appropriate technology for post-harvest handling and processing Fresh Salone Environmental safety, hygiene, aflatoxin mitigation (groundnuts) Sorting and grading for local and distant markets (i.e., grades A and B) Safe use and handling practices  Reduced risk of contamination and/or disease burden Adoption of sorting and grading practices  Increased marketing of safe B produce in local markets  Improved availability and affordability of safe, nutritious foods in local markets  Improved access to diverse foods by households. SOLUTION IMPLEMENTING PARTNER ACTIONS NUTRITION-SENSITIVE AGRICULTURE OUTCOMES
WARC iii. Mechanical threshing, milling (rice), shelling (maize) iii. Adoption of technology  Less time and energy requirements on who traditionally perform or contribute to these tasks  Improved caregiving resources (time, energy). ACDI/VOCA iv. and quality processing (e.g., dried okra, groundnut paste, pumpkin-gari, dried chili) (a) Value addition in commodities  Increased income-generating opportunities for women  Increased household income controlled by women. Processing of NRVCCs to shelf- stable food products  Increased year-round availability of nutritious foods in local markets  Improved access to diverse foods by households. Safe and hygienic processing of commodities  Increased availability of safe, nutritious food products  Reduced disease burden. Processing of NRVCCs to shelf- stable, semi-processed food products  Easier, convenient preparation for home consumption  Reduced time demands on caregivers  Increased demand and consumption of nutritious food products. (4) Availability and promotion of NRVCCs to consumers HKI/SPRING Communications to increase consumption of NRVCCs (through radio programs and other communication channels) Promotion of NRVCCs  Improved NRVCC appeal/demand in local markets and/or desirability among consumers. (5) Gender- equitable access and linkages to larger, higher- value buyers ACDI/VOCA i. Direct procurement from smallholders i. (a) Direct market linkages  Direct payments to women  Increased household income controlled by women. (b) Direct market linkages  Increased volumes and improved quality of produce; embedded transport costs  Increased revenue and revenue streams through stable markets  Improved year-round cash flow and cash management for households  Increased year-round expenditures on diverse nutritious
POTENTIAL ENTRY POINTS FROM STUDY PRIORITIZED ACTIONS FROM DAY 2 DISCUSSIONS BEHAVIOR STATEMENTS POTENTIAL OUTCOMES ACDI/VOCA Value added and quality processing Gender-equitable marketing Community Policy advocacy* Value-added and quality processing Community agro-dealers (CAD) for quality inputs and entrepreneurship Gender equity and marketing FBOs identify credible buyers such as to You, Project Peanut Butter, Sierra Mix, to sell to throughout the year FBOs do proper sorting and standardization of crops (e.g., vegetables, pumpkin, groundnuts) immediately after harvest Men and women always come together to access loans from community banks and FSAs Community Agro-Dealers (CAD) enterprises provide quality agricultural inputs (e.g., fertilizer, vegetable seeds) at affordable prices to FBOs year round CADs access loans to buy quality inputs year round FBOs access loans to buy improved seeds/inputs to increase production for marketing Increased household income for Increased availability in local markets of nutritious food Improved access to diverse nutritious foods by households Increased supply and demand for consumption of nutritious food products POTENTIAL ENTRY POINTS FROM STUDY PRIORITIZED ACTIONS FROM DAY 2 DISCUSSIONS BEHAVIOR STATEMENTS POTENTIAL OUTCOMES SALONE Water technologies Environmental safety and hygiene Sorting and grading Good agronomic practices (farming calendar, site selection, land preparation, seed selection, nursery management, planting time, Tamaraneh FA at Masugbory through the farming calendar help them to produce pumpkin, squash, French beans throughout the year (Jan – Dec) Matombo women’s farmer use savings to buy Access to diverse food and income Time and energy Reduced toxin contamination Reduced disease burden Safety
Recommendations for Moving This Strategy Forward It is our recommendation that the consortium should name a partner to manage all SBCC resources including those for agriculture, nutrition-sensitive agriculture, and MIYCN. This could be CRS as the lead partner or another partner. The strategy should be revisited at least annually to be updated with all partners. In Appendices 5 and 6 are tools for developing SBCC activities. Appendix 5 includes specific frameworks for the prioritized practices to help guide programming to address identified barriers and enablers to each practice based on formative research. Appendix 6 provides examples of creative briefs developed to guide SBCC activities to promote nutrition-sensitive agriculture practices regarding pumpkin and fish. Partners should also conduct small-scale formative research to uncover barriers and enablers to the uptake of specific agriculture practices. Monitoring and Evaluation for Behavior Change Note: The following should be consistent with the final EAIN PMP and ongoing monitoring and evaluation activities for the project. Priority nutrition-sensitive agriculture categories of practices FY2017 IPTT Indicator # (May 14, 2017) Indicator Adopt improved water saving or diverting technologies for production. Supporting actions include assistance with securing business loans to adopt technology. Technologies include: drip irrigation water systems, water collection/pump system, or mulching. 9 10 Number of farmers and others who have applied improved technologies or management practices with U.S. Government assistance (RAA) (WOG) Number of hectares of land under improved technologies or management practices with U.S. Government assistance Promote the consumption of NRVCCs 21 Total quantity of targeted nutrient-rich value chain commodities produced by direct beneficiaries with U.S. Government assistance that is set aside for home consumption Promote no-till cultivation reducing land preparation 9 10 Number of farmers and others who have applied improved technologies or management practices with U.S. Government assistance (RAA) (WOG) Number of hectares of land under improved technologies or management practices with U.S. Government assistance
Appendix 1. Review of Existing Regional SBCC Materials on MIYCN, WASH, MCH, and Nutrition-sensitive Agriculture March 1, 2017 and publisher of material Topics addressed Key messages or key practices promoted Description of key images Target population Intended user Partners/ organizations that use or have recently used the material. Concern Worldwide Health seeking behavior If your is under five and has bloody diarrhea, more than 3 watery stools, fever or a cough, take him or her to a health center Mother/caregiver holding her child seated at the health center of children five Health workers Concern Worldwide Concern Worldwide WASH Wash your with soap and clean water A woman and a boy over five years of age washing their hands from a veronica bucket of children under five Health workers Concern Worldwide Concern Worldwide Diarrhea Give ORS if your child has diarrhea Mother preparing ORS with a child on her lap of children under five Health workers Concern Worldwide Concern Worldwide Water storage Store your water in a clean container Woman tightening the lid of a clean container with water in it of children under five Health workers Concern Worldwide Concern Worldwide treatment Treat drinking water effectively Woman boiling water on locally made cold pot of children five Health workers Concern Worldwide
IMC/SNAP (C-MAPs) Counseling Cards For IMC/SNAP program Men Are Partners (Abridged Modules) Men giving support to women on MIYCN practices Cover page: A circle of community members having community meeting with support from a man and community mobilizers Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA Module I: Immediate and Exclusive Breastfeeding Breast milk is best Role of men as partners in early initiation of breastfeeding A young infant is placed directly on mother’s skin and attached to the breast within the 1st hours after birth health worker and a newly born baby Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA Program Focused Introduction to the program Image shows mother and children Mothers, fathers and health workers Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA Men participating in community meetings of women Role of men as partners in promoting nutrition education sessions in communities. Women are meeting in circle learning from a leader who holds a flipchart. The woman in the front looks like the rest of the other women. One of the from the group is visiting her neighbor’s house. She is explaining the materials to the husband, grandmother and others. and community members Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA
Module II: Complementary Feeding and micronutrients Role of men as partners in complementary feeding A man supporting his wife during complementary feeding of a child of children under five Health workers, MSGs, MAPs, and IPs IMC/SNAP and Quantity of food for each feeding at six months Quantity of food for each feeding at six months. A diagram of a spoon-feeding her baby in her hands of children under five Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA Module 3: Essential Hygiene Actions Role of men as partners in hygiene promotion: men as champions in promoting hygiene practices; men to discourage families from the practice of open defecation; men to encourage community members in promoting handwashing before feeding the child; hygiene promotion to be championed by men A father giving support to a mother in feeding the baby; an image of a mother controlling a child defecating in a child’s stool; a mother emptying the stool in a toilet; and a mother washing hands and supporting the baby in washing its hands under the tippy tap of children under five Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA A good latrine Who is responsible for building a latrine for the what is needed and when to start of children under five Health workers, MSGs, MAPs, and IPs IMC/SNAP and SILPA
Module 4: Family Planning Men are partners in family planning. All men should have an informed knowledge about family planning methods/contraceptives. Child spacing to be of importance for all men. Men to cater for children daily bread. [Men must provide for the daily needs of their children] The health condition of both children and mother to be of importance to all men Images of a disorganized, unhappy and unhealthy family Image of a well-planned family of four living happily; and an area of the card showing two children (a boy and girl) sitting a long bench eating. of children five Health workers, MSGs, MAPs, and IPs IMC/SNAP and SNAP/MoHS C-MIYCN (Counseling Cards for Sierra Leone) MIYCN – National Counseling Cards for community workers NA of children under five Health workers, MSGs, UNICEF IPs MoHS-DFN Maternal nutrition Card 1a: Counseling during pregnancy Card 1b: Counseling during lactation A pregnant woman and a lactating mother with her baby sitting on mats and eating food respectively; a counselor counseling a husband and his pregnant wife Mothers/fathers and in-laws/family relatives MoHS/DHMT; nutrition partners, health workers and MSGs MoHS-DFN, HKI IMC-
Card 5a: Breastfeeding positions Card 5b: Good attachment Six photos of mothers demonstrating the different positions of breastfeeding; and two photos illustrating how to best attach a suckling baby to the breast Mothers/fathers and in-laws/family relatives and children under two years old MoHS/DHMT; nutrition partners, health workers and MSGs MoHS/DHMT at PHU and community levels, / UNICEF, and other nutrition partners Card 6: Breastfeeding a (small) babies Three photos: Two illustrating better ways of breastfeeding a low birthweight child; and one showing a mother using a kangaroo method Mothers/ caregivers and children under five years old MoHS/DHMT; Nutrition Partners, health workers and MSGs MoHS/DHMT at PHU and community levels/UNICEF, and other Nutrition Partners Card 7a: How to hand express breastmilk and cup feed. Card 7b: Breastfeeding and working mothers Card 7c: Feeding a sick baby less than six months of age Card 7d: Feeding a sick baby more than six months of age Card 7e: Good hygiene practices 7a: A father holding a baby and a mother massaging the breast for milk expression; a mother expressing milk from one of her breasts into a cup; a cup with a lid placed on a table in an open bowl of water; a caregiver cup-feeding a baby; a father cup-feeding the baby 7b: A working mother: breastfeeding a baby; a mother expressing breastmilk into a cup; a caretaker cup-feeding the baby; a mother with a hoe heading to a farm; the mother on the farm breastfeeding the baby. Mothers/fathers and in-laws/family relatives and children under two years old MoHS/DHMT; nutrition partners, health workers and MSGs MoHS/DHMT at PHU and community levels/UNICEF, and other Nutrition Partners
the MUAC of a sitting child in the lap of his mother; (2) shows testing for pitting edema; (3) thumbs have been lifted off after the edema test community and children two years old workers and MSGs and other Nutrition Partners Module 5: Essential Hygiene Practices C.14a: Handwashing using flowing water and soap C14b: Steps of hand washing C.14c: Transmission of diarrhea C.14d: Managing diarrhea 14a: Three images: (1) a constructed toilet with an arrow pointing at a tap of flowing water; (2) handwashing; (3) and a woman washing her hands using a lever tippy tap 14b: Shows eight images of handwashing steps 14c: Shows four images: (1) a child sitting in an unpleasant environment with flies over his hands and feeding cup; (2) a child defecating in a stream and a woman fetching water from the same stream; (3) a child defecating in a poo; (4) a sitting child feeding from a cup with a grapefruit in his/her left hand 14d: Shows how to manage diarrhea. It has four images of which the first two are a mother breastfeeding a child plus some fruits. the other set of two are a mother/health worker administering a cup of ORS and or zinc solution to the child; and lastly a Mothers/fathers and in-laws/family relatives, community and children under two years old MoHS/DHMT; nutrition partners, health workers and MSGs MoHS/DHMT at PHU and community levels/UNICEF, and other Nutrition Partners
the last image is a house to where the two people are taking the fetched water to for family use. Module 6: Birth spacing C.16: Birth spacing methods Photos showing a happy family of four (father, mother, a boy and a newborn child in the arms of the father. It also shows nine different birth spacing methods/devices. Mothers/Fathers, health workers, Teenagers, and relatives, community MoHS/DHMT; nutrition partners, Health workers, families and community members; and MSGs MoHS/DHMT at PHU and community levels/UNICEF, and other nutrition partners