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GAIN – TOT FORTIFICATION
WORKSHOP
Monitoring and Evaluation of GAIN-Assisted
Food Fortification Programs
Fabian RohnerSenior Associate Performance Measurement and Research
DakarDecember 2009
• GAIN’s Logic Model and Framework
• M&E of National FFP
• Monitoring the Supply and Quality of Fortified Foods
• Monitoring Access, Utilization, Reach and Coverage of
Fortified Foods
• Evaluation of Health an Nutrition Impact
• GAIN Guidelines
Overview
PRODUCTION
AND
DISTRIBUTION
OF HIGH
QUALITY
FORTIFIED
FOOD
INCREASED
ADVOCACY (legislators, politicians
universities, teachers,
industry, retailors)
DEVELOPMENT AND
IMPLEMENTATION OF
STRATEGY FOR
INFORMATION,
COMMUNICATION,
AND EDUCATION
CONSUMERS
KNOW/
DEMAND
FORTIFIED
FOOD
DOMESTIC
AVAILABILITY
OF
FORTIFIED
FOOD
INCREASED
PURCHASE AND
PRESENCE
OF
FORTIFIED FOOD
IN HOUSEHOLDS
INCREASED
80% OF
TARGETED
INDIVIDUALS
CONSUMING
FORTIFIED
FOODS
INTAKE OF
VITAMINS AND
MINERALS
IN TARGET
GROUPS INCREASED
IMPLEMENTATION OF
EXTERNAL MONITORING
(TECHNICAL AUDITING
AND INSPECTIONS)
DEVELOP GUIDELINES AND
PROCEDURES FOR
EXTERNAL MONITORING
PRODUCTION:
EQUIPMENT / PREMIX
PROCUREMENT
AND TRAINING
ESTABLISHMENT OF
DISTRIBUTION CHANNELS
SEMI ANNUAL REPORTINGMonitoring the Supply
and Quality of Fortified Foods
Evaluation of Health
and Nutrition Impact
Monitoring Access, Utilization,
Reach and Coverage of Fortified Foods
IMPORTED
FOOD
ADEQUATELY
FORTIFIED
ACCESS TO QUALITY
FORTIFIED
FOOD IN
LOCAL MARKETS
INCREASEDESTABLISHMENT OF INTERNAL
QUALITY ASSURANCE AND QUALITY
CONTROL (INDUSTRY)
ESTABLISHMENT OF
POLICIES/LAWS THAT ENABLE
FOOD FORTIFICATION
POLICIES/LAWS
THAT ENABLE
FOOD FORT.
DRAFTED AND
SUBMITTED TO
DECISION
MAKERS
LEGISLATION IN
PLACE
OUTPUTSLONG-TERMMID TERMSHORT TERM
ACTIVITIES IMPACTS
REDUCTION IN
MORTALITY DUE
TO VIT A & ZINC
DEFICIENCIES BY
20%
REDUCTION IN
PREVALENCE OF
VIT A, IRON, ZINC,
AND FOLATE
DEFICIENCIES BY
1/3
REDUCTION IN
NUMBERS OF
WOMEN AND
CHILDREN
SUFFERING
FROM IMPAIRED
PHYSICAL/
COGNITIVE
PERFORMANCE
FROM IRON DEF.
BY 30%
REDUCTION OF
NEURAL TUBE
DEFECTS BY 30%
AMONG
NEWBORNS DUE
TO FOLATE
DEFICIENCY
OUTCOMES
EXTERNAL
MONITORING
ESTABLISHED
NAT’L COMM
STRATEGY
DEVELOPED
PR
OD
UC
TIO
N A
ND
DIS
TR
IBU
TIO
NL
EG
ISL
AT
ION
AN
D E
XT
ER
NA
L
QU
AL
ITY
MO
NIT
OR
ING
SO
CIA
L M
AR
KE
TIN
G A
ND
CO
MM
UN
ICA
TIO
NS
GAIN’s Log Model
ADVOCACY
STRATEGY FOR IEC
IMPLEMENTATION
OF EXTERNAL
MONITORING
PROCEDURES FOR
EXTERNAL MONITORING
EQUIPMENT / PREMIX
PROCUREMENT
DISTRIBUTION
CHANNELS
INTERNAL
QA/QC
POLICIES/LAWS
PR
OD
UC
TIO
N A
ND
DIS
TR
IBU
TIO
N
LE
GIS
LA
TIO
N A
ND
EX
TE
RN
AL
QU
AL
ITY
MO
NIT
OR
ING
SO
CIA
L M
AR
KE
TIN
G
AN
D
CO
MM
UN
ICA
TIO
NS
PRODUCTION
AND
DISTRIBUTION
OF HIGH
QUALITY
FORTIFIED
FOOD
INCREASED
DOMESTIC
AVAILABILITY
OF FORTIFIED
FOOD
INCREASED
IMPORTED
FOOD
ADEQUATELY
FORTIFIED
POLICIES/LAWS
THAT ENABLE
FOOD FORT.
DRAFTED AND
SUBMITTED TO
DECISION
MAKERS
LEGISLATION IN
PLACE
EXTERNAL
MONITORING
ESTABLISHED
NAT’L COMM
STRATEGY
DEVELOPED
GAIN’s Log Model
CONSUMERS
KNOW/
DEMAND
FORTIFIED
FOOD
PURCHASE AND
PRESENCE
OF
FORTIFIED FOOD
IN HOUSEHOLDS
INCREASED
80% OF TARGETED
INDIVIDUALS
CONSUMING
FORTIFIED FOODS
INTAKE OF
VITAMINS AND
MINERALS
IN TARGET
GROUPS INCREASED
ACCESS TO QUALITY
FORTIFIED
FOOD IN
LOCAL MARKETS
INCREASED
GAIN’s Log Model
REDUCTION IN
MORTALITY DUE TO VIT
A & ZINC DEFICIENCIES
BY 20%
REDUCTION IN
PREVALENCE OF VIT A,
IRON, ZINC, AND FOLATE
DEFICIENCIES BY 1/3
REDUCTION IN
NUMBERS OF WOMEN
AND CHILDREN
SUFFERING FROM
IMPAIRED PHYSICAL/
COGNITIVE
PERFORMANCE FROM
IRON DEF. BY 30%
REDUCTION OF
NEURAL TUBE
DEFECTS BY 30%
AMONG NEWBORNS
DUE TO FOLATE
DEFICIENCY
GAIN’s Log Model
PRODUCTION
AND
DISTRIBUTION
OF HIGH
QUALITY
FORTIFIED
FOOD
INCREASED
ADVOCACY (legislators, politicians
universities, teachers,
industry, retailors)
DEVELOPMENT AND
IMPLEMENTATION OF
STRATEGY FOR
INFORMATION,
COMMUNICATION,
AND EDUCATION
CONSUMERS
KNOW/
DEMAND
FORTIFIED
FOOD
DOMESTIC
AVAILABILITY
OF
FORTIFIED
FOOD
INCREASED
PURCHASE AND
PRESENCE
OF
FORTIFIED FOOD
IN HOUSEHOLDS
INCREASED
80% OF
TARGETED
INDIVIDUALS
CONSUMING
FORTIFIED
FOODS
INTAKE OF
VITAMINS AND
MINERALS
IN TARGET
GROUPS INCREASED
IMPLEMENTATION OF
EXTERNAL MONITORING
(TECHNICAL AUDITING
AND INSPECTIONS)
DEVELOP GUIDELINES AND
PROCEDURES FOR
EXTERNAL MONITORING
PRODUCTION:
EQUIPMENT / PREMIX
PROCUREMENT
AND TRAINING
ESTABLISHMENT OF
DISTRIBUTION CHANNELS
SEMI ANNUAL REPORTINGMonitoring the Supply
and Quality of Fortified Foods
Evaluation of Health
and Nutrition Impact
Monitoring Access, Utilization,
Reach and Coverage of Fortified Foods
IMPORTED
FOOD
ADEQUATELY
FORTIFIED
ACCESS TO QUALITY
FORTIFIED
FOOD IN
LOCAL MARKETS
INCREASEDESTABLISHMENT OF INTERNAL
QUALITY ASSURANCE AND QUALITY
CONTROL (INDUSTRY)
ESTABLISHMENT OF
POLICIES/LAWS THAT ENABLE
FOOD FORTIFICATION
POLICIES/LAWS
THAT ENABLE
FOOD FORT.
DRAFTED AND
SUBMITTED TO
DECISION
MAKERS
LEGISLATION IN
PLACE
OUTPUTSLONG-TERMMID TERMSHORT TERM
ACTIVITIES IMPACTS
REDUCTION IN
MORTALITY DUE
TO VIT A & ZINC
DEFICIENCIES BY
20%
REDUCTION IN
PREVALENCE OF
VIT A, IRON, ZINC,
AND FOLATE
DEFICIENCIES BY
1/3
REDUCTION IN
NUMBERS OF
WOMEN AND
CHILDREN
SUFFERING
FROM IMPAIRED
PHYSICAL/
COGNITIVE
PERFORMANCE
FROM IRON DEF.
BY 30%
REDUCTION OF
NEURAL TUBE
DEFECTS BY 30%
AMONG
NEWBORNS DUE
TO FOLATE
DEFICIENCY
1
2
3
4
5
6
7
9
10
OUTCOMES
EXTERNAL
MONITORING
ESTABLISHED
NAT’L COMM
STRATEGY
DEVELOPED
PR
OD
UC
TIO
N A
ND
DIS
TR
IBU
TIO
N
4
LE
GIS
LA
TIO
N A
ND
EX
TE
RN
AL
QU
AL
ITY
MO
NIT
OR
ING
SO
CIA
L M
AR
KE
TIN
G A
ND
CO
MM
UN
ICA
TIO
NS
8
11
Country-level logic framework
Level of Data Measurable Indicators
IMPACT:
Reduce maternal and
child morbidity, disability
and mortality associated
with micronutrient
deficiencies and enhance
productivity of
populations through
expanding the reach of
food fortification
programs
Prevalence of vitamin A , iron, zinc and folate
deficiencies
Child mortality due to vitamin A and zinc
deficiency
Number of children and women suffering from
impaired physical activity due to iron deficiency
Rate of neural tube defects such as spina bifida
among newborns due to folate deficiency
OUTCOMES:
Consumer awareness and
demand increased
% of target consumers that correctly recall health
messages associated with logo / fortified foods /
specific micronutrient deficiencies
Purchase and presence of
fortified food in
households increased
Reach: Absolute numbers of individuals
consuming fortified foods
Regular consumption of
fortified food among 80%
of target groups
Coverage: Numbers (and %) of target populations
consuming fortified foods (disaggregated
according to age-sex groups most affected by
specific deficiencies and by income)
1
2
3
4
5
6
7
Country-level logic framework
Level of Data Measurable Indicators
OUTPUTS:
Fortification legislation
passed
Existence of legislation
Domestic availability of
fortified food increased
Absolute amount (and market share) of fortified
foods available (domestic production and imports)
% of samples of fortified foods that pass external
inspection
% of imports adequately fortified
8
9
10
11
Household / Individual
ConsumptionAdequate
M&E of National Fortification Programs
Household / Individual
Consumption
Successful
production
Adequate
Sufficient
Coverage
Health Impact
Adequate
Supply of Fortified Foods
Adequate production/
importation
Health Impact
Successful
Program
Result
Household / Individual
ConsumptionAdequate
M&E of National Fortification Programs
• Absolute amount of fortified food
available
• % vehicle produced which is fortified
• % vehicle produced which is
adequately fortified
• Target pop recall and know about
fortified food and logo
• Reach
• Coverage
• Prevalence of micronutrient
deficiencies
• Rate of NTD
Household / Individual
Consumption
Successful
production
Adequate
Sufficient
Coverage
Health Impact
Adequate
Supply of Fortified Foods
Adequate production/
importation
Health Impact
Successful
Program
Result Indicator
Household / Individual
ConsumptionAdequate
M&E of National Fortification Programs
Monitoring production/importation
• Internal quality control
• External confirmation
• Regulary monitoring
Routine coverage surveys
KAP studies
Special qualitative studies
National cross-sectional surveys
– Baseline
– Following Implementation
(3-5 years)
• Absolute amount of fortified food
available
• % vehicle produced which is fortified
• % vehicle produced which is
adequately fortified
• Target pop recall and know about
fortified food and logo
• Reach
• Coverage
• Prevalence of micronutrient
deficiencies
• Rate of NTD
Household / Individual
Consumption
Successful
production
Adequate
Sufficient
Coverage
Health Impact
Adequate
Supply of Fortified Foods
Adequate production/
importation
Health Impact
Successful
Program
Result Indicator M&E activity
Timeline of M&E Activities
0 12 24 36 48 60 72 MONTHS
0 12 24 36 48 60 72 MONTHS
GAIN GRANT SUSTAINABILITYD
EVEL
OP
AN
D V
ALI
DA
TE P
RO
CED
UR
ES A
ND
INST
RU
MEN
TS
FOR
M&
E D
ATA
SO
UR
CES
REF
INE
M&
E P
LAN
MONITORING SUPPLY AND QUALITY OF FORTIFIED FOODS
INDUSTRY RECORDS & FOOD CONTROL INSPECTION REPORTS
MONITORING ACCESS, UTILIZATION, COVERAGE AND REACH OF FORTIFIED FOODS
EVALUATION OF HEALTH AND NUTRITION IMPACT
Project baselinesurvey
Qualitative research
Project endline survey
Coveragesurvey
Launch of fortified food productionProject end
Coveragesurvey
GAIN M&E Toolkit
• Volume 1: Guidelines
• Chapter 1: GAIN Performance Measurement Framework
• Chapter 2: Country-level Food Fortification M&E Systems
• Chapter 3: Monitoring the Supply and Quality of Fortified
Foods
• Chapter 4: Monitoring Access, Utilization, Reach and
Coverage of Fortified Foods
• Chapter 5: Evaluation of Health an Nutrition Impact
and Program Impact
• Volume 2: Instruments
Thank you!