USAID/Tufts UniversityFood Aid Quality Review

Programming: Results and Recommendations

IFADC Kansas CityJune 28, 2011

Goals• Describe and assess current uses of FBFs

• Review evidence of effectiveness and challenges in programming– Focus on effectiveness for explicit nutritional goals– Programming is as important as product mix and

composition

• Recommendations for uses, and new products in the evolving context of Title II programming

Data Sources• USAID Title II Program documents

– MYAPs, SYAPs, Program Evaluations, PREPS, Results Reports

– Program guidance from USAID, WFP (Country Guidance, Food Aid and Food Security Assessment (FAFSA), Bellmon Analyses (BEST), TRM, CRG)

• Published and unpublished literature

• Survey of Agencies Implementing Title II programs

• Qualitative interviews with senior officials and other key informants

• USAID and USDA officials

Results

Implementing Partner Survey Uses of CSB

• Main use is in MCHN and HIV+/TB programming

• Used in general family rations

– To enhance nutritional quality

• Used as incentive or pay in FFW/FFT

Implementing Partner Survey: Ration Size

• Ration sizes vary widely by beneficiary type and by technical sector

• Basis for ration size is variable– expect sharing; – calculate as residual in CRG

• Suggests fine-tuning of micronutrient composition must be balanced against the need for wide tolerances

Range of FBF Quantities, by Program Type

17

50

30

50

17

40

24

300

480

227

150

50

100

100

0 100 200 300 400 500 600

SupplementaryFeeding

TherapeuticFeeding

FFW/FFA/FFT

FFE

General Relief

Disaster Relief

Safety Net

Pro

gra

m T

yp

e

Quantity (grams/person/day)

Maximum

Minimum

Preparation of FBFs (survey data)

• Of programs using CSB– 76% instruct participants to prepare with

another food– Of these, 29% are told to prepare it with oil– 18% with sugar– About 2/3 with ‘regular family food’

• Almost 100% of programs providing CSB that also provide fortified vegetable oil

Programming Guidance• Increasing level of technical assistance in

program design– Food security analyses– BEST analyses

• Increasingly prescriptive (viz. PM2A)• Emphasis on evidence base• Shifting priorities (nutrition, agriculture)• Guidance at times inconsistent and out of date,

and issued late; proliferation of documents

Recommendations

Match “product to purpose”: use nutritionally enhanced products for nutritional goals

Recommendations

Match Product to Purpose

• Improve micronutrient profile of CSB and oil

• Target CSB for health and nutritional purposes only

• Provide CSB with oil

– Implies need for bcc

• Use enhanced cereals, not a different CSB to improve quality of general ration

Recommendations

Strengthen evidence base for innovations in products, programming approaches, and institutional processes

Recommendations

Strengthen Evidence Base• Increase evidence base for programming

– Experiment with approaches to bcc

– Experiment with packaging to affect use, sharing

• Incorporate sustainability concerns

• Incorporate cost-effectiveness

– Not cost per ton or per ‘mouth’ but cost per effect achieved

Recommendations

Strengthen Evidence Base

Seek input from end users:• Increase input from the field• Program design should incorporate local

knowledge and experience• Support implementing partners to incorporate

local data into the design of rations and programs

Recommendations

Strengthen Evidence BaseConduct rigorous field-based studies:

• Sharing• Assumptions about self targeting• Use of any new commodities

Assessment and monitoring is needed in field settings at scale

USAID should improve training on needs assessment and on monitoring and evaluation methods

Recommendations

Provide clear programming guidance, including improved decision tree tools

Recommendations

Improve Guidance• Update and harmonize operational guidance

• Invest in new behavior change communication

• Issue programming guidance six months before proposals are due

• Facilitate field-initiated program and product innovations

• Incorporate sustainability concerns

• Incorporate cost-effectiveness

– Not cost per ton or per ‘mouth’ but cost per effect achieved

Recommendations

Enhanced guidance should be prepared (such as decision tree tools) to enable agencies to better select commodities for programming.• Implement flexibly: constraints and local

contexts differ

• Emergency programs may face different constraints Need to meet needs of an entire population Often very limited access to food Often higher incidence of severe malnutrition

Recommendations

Improve Guidance

INSERT FLOW CHART AND DECISION TREE HERE?

Decision Tree Example

Thank you