final evaluation report enauc hp&unicef

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ENAUC project Final Evaluation

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TABLE OF CONTENTS I. Executive summary

II. Introduction III. List of acronyms IV. The project and its development context V. Findings and Conclusions

VI. Project Formulation VII. Project Implementation

VIII. Results IX. Recommendations X. Lessons learnt

XI. Evaluation report Annexes Table 1: Populations targeted by the project and their size

Table 2: Logical Framework of the Interventions of the ENAUC

Table 3: Joint Work Plan

Table 4: Key ENAUC Project Milestones/Events and Chronology

Table 5: Rapid-Assessment Matrix _ Damaged PCNB_September 24, Storm THOMAS

Table 6: Strategies of Intervention

Table 7: Pool of Camps IDPs chosen for the final evaluation

Table 8: Number of People Interviewed and Files analyzed

Table 9: Project General Observation

Table 10: Strengths/Benefits and Weaknesses/Gaps of the ENAUC Project

Table 11: ENAUC Targets met – 3-month report form (Column: Total % project target met)

Table 12: Monthly reporting Rhythm

Table 13: capacity Building – type and number of training completed

Table 14- Matrix of Qualitative & Normative Evaluation Of The Nutritional Interventions

Table15: Observation of sustainability process

Figure1- Mothers/PLW Interviewed

Figure2- CHV Interviewed

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Figure3- Community Leaders Interviewed

Figure4- PCNB Personnel Interviewed

Figure5- Normative and Qualitative evaluation Terms of Reference

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I. EXECUTIVE SUMMARY

A. CONTEXT AND PURPOSE OF THE EVALUATION

The Management of the Emergency Nutritional Assistance to 12 Underserved Camps Project, called for a final evaluation to assess progress towards for its stated goals and outcomes; its results will either have to instruct future decisions, about the appropriate interventions to bring to the project targets as a follow-up of the ENAUC. This final evaluation report in charge of the firm Groupe Support GS, was being realized in a challenging context where project life cycle ended since 2 months, and where the GS evaluation team have to consider a changing environment and produce recommendations that understand that the different clusters and government agencies commit themselves to strategically move humanitarian beneficiaries from IDP camps back to the ménages.

B. BRIEF DESCRIPTION OF PROJECT

The project ENAUC of Haiti Participative and Unicef was to contribute to relief and humanitarian efforts in Haiti by

delivering nutrition interventions in 12 identified underserved camps in Port au Prince metropolitan area outside

of the coverage of the humanitarian assistance, focusing on malnutrition prevention in children under five

through 12 Points of Counsel in Nutrition for Baby (PCNB). Those nutritional interventions are based on three

main axes: axis1: Community Empowerment in combating malnutrition; axis2: Increase of Exclusive breastfeeding

& Improvement of general Feeding practices of Infant and Young Child; axis3: Detection of malnutrition cases and

facilitation of access to treatment, besides direct treatment of diarrhea in screened infants/children. Besides, the

ENAUC project aimed at contributing to reduction of experienced inequalities in the underserved camps.

C. MAIN CONCLUSIONS, RECOMMENDATIONS AND LESSONS LEARNT

1. MAIN CONCLUSION

A single basic conclusion to this evaluation of the ENAUC project, would be that it was clearly worth undertaking to the profit of a group of Internally Displaced People outside of the humanitarian coverage at that time. It addressed a real threat, it was effective and brought satisfaction for the community. This is unanimous in the view of the major stakeholders and confirmed by the GS evaluation team, and with an adequate continued support from the cooperated partners, HP and Unicef, it will contribute significantly to improve the nutritional status of the beneficiaries accompanying them from the camps to the ménages according to the national inter-cluster recovery plan. Further, with a dedicated effort outside of the camps over a period of time, it has a potential to extend benefits to broader underserved community and come out with sustained interventions and positive visible changes in the targets traditional feeding practices of infants and young child. Similarly to the evolution of the attainment of results beyond expectations through the 3-month Mid-Term evaluation report, the final evaluation noticed that “the intended project outputs are largely beyond realization”. The high number of products resulting from the interventions along with a high rate of appreciation of the project overall activities by the majority of the beneficiaries on field revealed through interviews (see annex: Fig.-1, 2, 3, 4).

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2. LESSONS LEARNT

That said, there is a wide range of lessons learnt and very well informed views about the strengths and challenges of the ENAUC Project, which should be taken into account in any future nutrition Project planning. The most important are provided in the lessons learned chapter at the end of this document. The Project as originally proposed was realistic in its aims and objectives, all the expectations prove to be realistic enough, as well as in its general emphasis on the emergency of assisting the identified underserved camps. In Summary, the community volunteers’ involvement or engagement when well regulated and inspired with trust contribute considerably to the success of a project.

3. RECOMMENDATIONS

The recommendations that have emerged from this evaluation are presented with the intention of being applicable to a continuation or expansion of ENAUC activities. They are as follows:

a) AXE1: COMMUNITY EMPOWERMENT IN COMBATING MALNUTRITION;

In any continuation of the ENAUC project

(1) TRAINING FOR COMMUNITY EMPOWERMENT SHOULD BE EXTENDED TO MORE

VOLUNTEERS IN THE BROADER NEEDED COMMUNITIES.

(2) COMMUNITY EMPOWERMENT TRAININGS SHOULD HAPPEN IN THE EARLY

STAGES OF THE PROJECT

(3) SHOULD BE DEVELOPED A STRATEGY TO DOCUMENT THE REGULAR

PARTICIPATION OF THE COMMUNITY VOLUNTEERS IN THE NUTRITIONAL

INTERVENTIONS.

(4) THE PARTICIPATION OF THE COMMUNITY VOLUNTEERS IN THE SCREENING

ACTIVITIES SHOULD BE MORE REGULATED ACCORDING TO THE NORMS OF THE NATIONAL

PROTOCOL.

b) AXE2: INCREASE OF EXCLUSIVE BREASTFEEDING & IMPROVEMENT OF GENERAL

FEEDING PRACTICES OF INFANT AND YOUNG CHILD;

(1) THE PCNBS SHOULD BE MOVED FROM CAMPS TO THE COMMUNITY IN

PROXIMITY IN ORDER TO SERVE THE LARGER COMMUNITY WHILE SUPPORTING THE

CLUSTERS STRATEGY OF RETURN TO THE NORMAL LIFE IN COMMUNITY.

(2) THE WELCOME OF THE MOTHERS IN THE PCNB OR THE MOTHER-CLUBS

SHOULD BE IMPROVED.

(3) FUTURE TRAININGS SHOULD CONTRIBUTE TO IMPROVE THE “EXITS”

CONFORMITY TO THE NATIONAL PROTOCOL.

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c) AXE3: DETECTION OF MALNUTRITION CASES AND FACILITATION OF ACCESS TO

TREATMENT, BESIDES DIRECT TREATMENT OF DIARRHEA IN SCREENED INFANTS/CHILDREN.

(1) FUTURE TRAININGS SHOULD HELP IMPROVE THE CONFORMITY OF THE

REFERENCING TO PNS ACCORDING TO THE NATIONAL PROTOCOL.

(2) ENAUC CONTINUATION SHOULD DEVELOP A STRATEGY TO FACILITATE

AVAILABILITY OF ACCESS TO TREATMENT.

d) GENERAL

In any continuation of the ENAUC on any form:

(1) TO REDUCE RISKS OF MASSIVE LOSS OF PCNB FILES IN EMERGENCY CONTEXT,

FILES MUST BE TRANSFERRED MONTHLY TO THE MAIN OFFICE OF THE PROJECT.

(2) MANAGERS OF THE PROJECT AND SUPERVISORS SHOULD MAINTAIN AND

CENTRALIZE COMMUNICATION WITH COMMUNITY LEADERS THROUGH A FOCAL POINT

AND AVOID ANY UNREALISTIC EXPECTATION IN THEM. ESTABLISH MORE DETAILED

PROTOCOLS FOR COMMUNITY DISPUTE RESOLUTION.

(3) THERE MUST BE EARLY ATTENTION TO DEFINE AND CLARIFY AUTHORITIES,

TERMS, AND INDICATORS OF SUCCESS, LESSONS LEARNT, DECISION-MAKING, AND

ROLES IN A JOINT SESSION.

(4) FINANCIAL PROCEDURES, BUDGETING AND FUNDS ALLOCATION PROCEDURES

SHOULD BE REVIEWED FOR MORE SIMPLIFIED AND FORESEEING APPROACHES. THIS

COULD BE ACCOMPLISHED BY: INVOLVEMENT OF PROJECT MANAGEMENT AND

AGENCIES STAFF IN THE REVIEW OF BUDGETING, WITH A VIEW TOWARDS REVISIONS

THAT WILL STREAMLINE BOTH ENAUC AND INDIVIDUAL AGENCY PROCESSES AND

PROCEDURES.

II. INTRODUCTION

A. PURPOSE OF THE EVALUATION

The Management of the Emergency Nutritional Assistance to 12 Underserved Camps Project called for a final evaluation of the Project funded partially by HP and mostly by UNICEF at about 80% to assess progress towards its stated goals and outcomes; The main objective of the evaluation is to review progress towards ENAUC project objectives and goals, to measure the effectiveness and efficiency of project activities in relation to the pre-stated objectives and provide recommendations to inform future endeavors, and to learn. The primary users of the Final Evaluation are the Senior Managers at the HP emergency office, executing the project called the Bureau Programme Urgence of Haiti Participative (BPU/HP), the two partners Joint Working Group (JWG), MSPP, HP and UNICEF-Haiti as partner and priority donor, as well as agencies staff or sections attached to Nutrition cluster.

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B. KEY ISSUES ADDRESSED

The ENAUC project conceived in the context of the emergency caused by the disaster of the January 12 earthquake in Haiti, addressed key issues related to the nutrition perspective and those of a general perspective:

- Issues from nutrition perspective o Additional vulnerabilities created by the disaster for the children living in conjectural IDP camps

exceedingly prone to health hazards and to increased risk of morbidity and mortality called for a support into maintaining breastfeeding in the worse conditions to prevent malnutrition reduce risks of disease and malnutrition.

o Deteriorated pre-existing health and nutrition needs in children 0-5 years.

o Pregnant and lactating women

o deterioration to Haiti’s previously weak health and nutrition infrastructure, hence

limiting immediate emergency response capacity and causing large unmet needs to date

o Community incapacity to detect malnutrition

o Non-awareness of the best practices of feeding and misinterpretation of some problem

related to the breastfeeding.

- Issues from General perspective o Coordination and coverage of humanitarian assistance in some areas called under-served IDP

camps experiencing a situation of visual inequity in unmet needs.

C. METHODOLOGY OF THE EVALUATION

After the analysis of the project challenges, the GS evaluation team noticed that the regular monthly and periodic

reporting dealt well with the quantitative evaluation of the gathering data, but had a breach that called up to

concentrate efforts to generate a more qualitative evaluation of the project interventions during this final

evaluation. The evaluation used a mixed methods approach of documentation review and observation on field,

used strategic questionnaires and interviewing individuals from the major stakeholders of the project. The

interviewees were 108 mothers/PLW, in majority those reached by the project interventions, 5 IDP camps leaders,

and 18 PCNB personnel. It held 1 focus group of 30 beneficiaries, with consideration for only those of the eligible,

that provide responses. The team chose a representative pool of the project targeted camps that gather about

72% of beneficiaries, it conducted field-visits and interviews, and consulted a number of 250 files related to the

different project stakeholders, besides project documentation; and made some important observations. (See

annex: Table 7: Pool of Camps IDPs chosen for the final evaluation and Table 8: Number of People Interviewed and

Files analyzed) Thanks to the project staff that recorded every detail including phone numbers about

mothers/PLW reached, the evaluation team was able to get in touch with the very beneficiaries of the project

interventions.

The evaluation was conducted by a team of 3 evaluators and two on-field facilitators, with a work breakdown dividing: (a) interviews and instruction (b) normative and qualitative evaluation (c) financial evaluation (d) general evaluation and finalization.

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As foreseen in the ToR, The evaluation exploited the monthly reports shared regularly with UNICEF and the 3-month reports produced during the project life-cycle, the feedback of an evaluation visit on field conducted by a Unicef representative. The work of the evaluation experts helps to provide ratings to project achievements for the ToR five main criteria: 1.Relevance 2.Effectiveness 3.Efficiency 4.Results 5.Sustainability.

D. KEY ENAUC PROJECT MILESTONES & EVENTS

The ENAUC project, in many respects, is defined by its milestones and events. Key milestones have been start point for major achievement on field and through which the project realized its major undertakings and results, and that have been the basis for management and implementation planning. Among these, is a key event that has threatened and influenced the project run and has affected project outcomes to date (see Table below). Table4- Key ENAUC Project Milestones/Events and Chronology 2010 Activities

July Installation of 12 PCNBs

Project Start up

August Recruitment of community volunteers and Launching of Community movement

September Brief interruption of 10 Baby-tents by Thomas-Storm of September 24 in Pap.

Rehabilitation and continuation of the 10 disrupted PCNB

Training for Personnel

Mid-Term Evaluation

December Training and Capacity Building for Community Health Volunteers

ENAUC Project final-evaluation

III. LIST OF ACRONYMS

A. BPU/HP BUREAU PROGRAMME URGENCE OF HAITI PARTICIPATIVE

B. CHV COMMUNITY HEALTH VOLUNTEERS

C. ENAUC EMERGENCY NUTRITIONAL ASSISTANCE TO 12 UNDER-SERVED CAMPS

D. HP HAITI PARTICIPATIVE

E. HW HEALTH WORKERS

F. IDP INTERNALLY DISPLACED PEOPLE

G. IT INFORMATION TECHNOLOGY

H. IYCF INFANT AND YOUNG CHILD FEEDING

I. JWP JOINT WORK PLAN

J. M&E MONITORING & EVALUATION

K. MOU MEMORANDUM OF UNDERSTANDING

L. MSPP MINISTERE DE LA SANTE PUBLIQUE ET DE LA POPULATION

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M. MUAC MID-UPPER ARM CIRCUMFERENCE

N. NGO NON-GOVERNMENTAL ORGANIZATION

O. OCHA UNITED NATIONS OFFICE FOR THE COORDINATION OF HUMANITARIAN

AFFAIRS

P. PCA PROGRAMME COOPERATION AGREEMENT

Q. PCNB POINT OF COUNSELING IN NUTRITION FOR BABY

R. PDNA POST-DISASTER NEEDS ASSESSMENT

S. PLW PREGNANT AND LACTATING WOMEN

T. PTA PROGRAMME THERAPEUTIC AMBULATORY

U. R RATED

V. TOR TERMS OF REFERENCE

W. UNICEF UNITED NATIONS CHILDREN EMERGENCY FUNDS

X. USN UNIT OF STABILIZATION NUTRITIONAL

Y. US UNSATISFACTORY

Z. SA SATISFACTORY

AA. VS VERY SATISFACTORY

BB. WH WEIGHT/HEIGHT

IV. THE PROJECT AND ITS DEVELOPMENT CONTEXT

A. PROJECT START AND ITS DURATION

The ENAUC project of cooperation was concluded with Unicef for a duration of 6 months, to start June 30, and to book on December 31 2010.

B. PROBLEMS THAT THE PROJECT SEEK TO ADDRESS

The ENAUC project was conceived in the context of the emergency caused by the disaster of the January 12

earthquake in Haiti Port-au-Prince Metropolitan area, that stroke with a magnitude of 7.3 and provoked a massive

destruction in sort of injury, and death, collapse of the main infrastructures including health facilities and caused

an estimated 223,000 dead, 300,000 injured and 1.3 million internally displaced people. It addressed key issues

related to the nutritional health of children of 0-5 years and pregnant and lactating women living in IDP camps,

mainly the underserved. The ENAUC highlighted that the disaster created additional vulnerabilities for the

children living in conjectural IDP camps of fabric family tents with no access to electric, water and basic health

services, concerns about infants and Young Children under five including numerous thousands of new-born in

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IDPs for the majority non-desired exceedingly prone to health hazards and to increased risk of morbidity and

mortality.

Along with the community Non-awareness of the best practices of feeding and misinterpretation of some

problems related to the breastfeeding, the community incapacity to detect malnutrition and mothers

having to maintain breastfeeding in the worse conditions. Besides, deterioration to Haiti’s previously

weak health and nutrition infrastructure, hence limiting immediate emergency response capacity and

causing large unmet needs.

In targets approach, the ENAUC project either addressed an issue related to the coverage and

Coordination of humanitarian assistance in some areas called under-served camps, experiencing a situation of

visual inequity in unmet needs. The situation of inequity is due to a combination of reasons: i) population size in

these camps tends to be relatively small, compared to much larger concentration areas. However, there is a moral

and humanitarian principle in reaching out to smaller, yet considerably at risk, populations; ii) lower visibility due

to population size and location may cause these size to be less attractive to relief agencies, hence excluded from

service provision; iii) higher insecurity is a deterrent for many relief agencies who may wish to engage in these

areas, such as Cité Soleil, yet are driven away due to fear of increased risk to their staff and assets. The UC targets

became the primary focus of the ENAUC interventions.

C. IMMEDIATE AND DEVELOPMENT OBJECTIVES OF THE PROJECT

The ENAUC project was conceived with the objective to combat the malnutrition in 12 targeted underserved camps of displaced people, by promoting exclusive breastfeeding & Infant and Young Child Feeding (IYCF) best practices, and contribute to malnutrition case management by MUAC screening and referring cases to the appropriate health structure while supporting follow-up until treatment. One of Its immediate objectives is to ensure community empowerment through the ENA-UC by implementing a set of activities and trainings, required to integrate community members into the planning, management and sustainability of the ENA-UC nutrition services to the community. The project key stakeholders identified in the project are:

- The mothers/Pregnant and lactating women targeted - The community leaders or camps committees - The community volunteers trained or involved in the project activities - The personnel of the ENAUC project personnel - The Ministère de la Sante Publique et de la Population (MSPP) - The cooperated partners on the ENAUC project, HP and UNICEF

D. RESULTS EXPECTED

The expected results of the ENAUC project were would be attained on a population initially estimated to approx.

58,000 populations:

1) Approx. 3,130 children 0-24 months are reached with breastfeeding protection, promotion, and support services, especially exclusive breastfeeding for approx. 760 children 0-6 months, through baby tents in 12 underserved camps;

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2) Approx. 80% of diarrhea cases expected in children 0-59 (roughly 3.800 cases over 6 months project) treated for with oral rehydration solution and zinc supplementation.

3) Approx. 6,830 children 6-59 months and approx. 1,630 pregnant and lactating women are screened for acute malnutrition based on MUAC and referred for treatment;

4) Contribute in expanding nutrition capacity by training 120 community health volunteers, 12 health workers (nurses), and 12 social workers in Infant and Young Child Feeding and screening for acute malnutrition;

5) Contribute in expanding coverage of Vitamin A supplementation and de-worming treatment during the Child Health Week (November 2010 round).

The annexed table1- presents the names of the 12 targets, their size and location.

V. FINDINGS AND CONCLUSIONS Findings and conclusions incorporates the most important revelations about project strength or benefits and

weaknesses or gaps in accordance to in-depth analysis of the project activities and milestones. It provides

brief ratings for the 5 main criteria of the ToR while making a cross reference to the document chapters that

provide inputs and analysis for the ratings.

A. PROJECT STRENGTH AND WEAKNESSES

The project strength and weaknesses have been assessed through the experiences of the implementation of the ENAUC project and summarized in a single table (annex: table 10- Strength/benefits and weaknesses/Gaps of the ENAUC project). It provides the main and grounds that explain buttress them.

1. THE MAIN WEAKNESSES/GAPS:

a) DISCREPANCIES BETWEEN BENEFICIARIES’ INTERESTS AND LEADERS INTERESTS.

Grounds

The 20% of community leaders unsatisfied does not wish the project to continue. Among the files consulted are one incident

report where PCNB materials and tents were seized in exchange for a pay from a camp leader, and a formal letter from a

camp committee requesting a contribution sum of $ht 8,000. This constitute of a discrepancy between the benefits of the

community and those of a few community leaders. Thus, a challenging to project continuation inside a few camps as

community beneficiaries wished, unless outside.

b) COMMUNITY EMPOWERMENT TRAINING HAPPENING LATE

Grounds

Although the primary objectives community empowerment were to ensure in-community capacity to continue project

activities after its duration and that hosted at the end of the project did not disturb the goals attainment, it is clear and

obvious that the community participation would be more productive and would be streamlined, if the formal training

happened earlier during the project life-cycle.

c) MISSING FILES FOR THE 1ST THREE MONTHS IN 3-PCNBS.

Grounds

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Three of the PCNBs seriously affected by the storm Thomas, were completely crushed or uprooted by the storm violence.

Thus, patients’ files for the first 3-month stored in the PCNB either vanished away along with other materials.

d) DIFFICULTY TO ACCESS TREATMENT CONVENIENTLY UPON REFERRAL (TO PNS, PTA,

USN)

Due to unavailability of proximity treatment services around several underserved camps, lack of capacity to respond

promptly to transport/commute needs.

2. THE MAIN STRENGTH/BENEFITS:

a) TRUST BUILDING

Grounds

Trust building generates satisfaction in community and facilitate community participation in the activities implementation

In the interaction between project personnel and the community beneficiaries, 0% is left unsatisfied, 25% satisfied and the

major 75% percent very satisfied of the relationship with the Project personnel. See figure1

The majority of the volunteers enrolled as CHW were previously satisfied mothers active and regular in the PCNB, now taking

deeper engagement as Community Health Volunteers.

20% of community leaders interviewed said unsatisfied of their relationship with the project personnel and reject the idea of

continuation, while 40% express satisfaction and another 40% extreme satisfaction. See Figure3

Among results of the good Collaboration with the 100% at the beginning and fallen to 80% of the community leaders at the

end, we note contribution in: introducing the project team into the community, facilitating the installation of the PCNBs,

managing risks and security issues related to materials and on-spot personnel.

b) COMMUNITY MOBILIZATION

Grounds

Community Mobilization ensures good awareness about the project activities and the benefits, and makes the bridge

between the PCNB and the beneficiaries.

36% of the 111 Community Health Volunteers trained were interviewed and revealed: 62.5% satisfaction and 37.5% extreme

satisfaction in the trained Community Health Volunteers about their participation level in the interventions. See figure 2

The GS Evaluation team thinks that it concords with the data of the Mid-term evaluation report and may somehow explains

why on 3-month the project went above expected results – based on community mobilization – reaching 169% of the 1,620

PLW targeted, 89.47% of the 760 0-6months and 77% of 3,130 o-24months targeted for the project duration.

c) COMMUNITY EMPOWERMENT

Grounds

Training to community members enhanced the perception of the project benefits in the Underserved Communities and

empowered them to sustain and continue project interventions in the community during and after project life-cycle, beside

the mothers counseled bi-weekly in the mother-clubs.

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Of the Community Health Volunteers trained by CEPAM and interviewed, all the beneficiaries said believe in the easiness and

their assimilation of the training modules and demonstrations enabling them to bring more significant interventions (87.35%

expressed a simple satisfaction and 12.65% extreme satisfaction). See figure2

d) UNICEF CAPACITY TO MOBILIZE RESOURCES QUICKLY IN DISASTER CONTEXT TO HELP

PARTNER CONTINUE WORKING

Grounds

In the after-math of September 24 Thomas storm, UNICEF showed interest and capability to and effectively provided 10 new

tents in a laps to the staff of the Project ENAUC, that helped to shortly restart servicing the population that needed more

support in the context. See Table5

e) HP CAPACITY TO REACT QUICKLY & APPROPRIATELY IN DISASTER CONTEXT

Grounds

The September 24 storm happened after 4:00hr pm and seriously affected 84% of the ENAUC infrastructure. While the

assessment reporting standard is 24hrs in emergency, HP staff realized a complete rapid-assessment available 2-hour after

the event and shared assessment matrix with the Cluster and UNICEF immediately for quick response.

f) HOME-VISIT AND FOLLOW-UP

Grounds

Support to Treatment follow-up toward improvement and the decreasing rate of abandon, requires individual connections

with Mothers and lactating women and home-visits.

Over 70% of Mothers PLW interviewed revealed among other, that their satisfaction relates considerably to the devotion of

the personnel and the support that they are provided in the follow-up of the child/infant treatment, they interpret the home-

visits from personnel, as an implication into their life in form of a caring family-member and a proof of focus on nutritional

improvement.

g) MSPP COMMITMENT TO COORDINATION AND PARTNERS CAPACITY

Grounds

Enhance partners’ capacity to bring interventions through training of trainers in taking in charge IYCF promotion and acute

malnutrition, and ensuring the availability of an updated National Protocol of taking in charge acute malnutrition and

promotion of IYCF best practices.

h) BROUGHT TO LIGHT SOME LESSONS LEARNT

Grounds

Lessons learnt through the project have been tracked to serve as resource for future actions and for sharing with other NGOs.

i) PROJECT ABILITY TO GENERATE SATISFACTION AND VISIBLE CHANGE IN THE

BENEFICIARIES’ BEHAVIOR

Grounds

Of the interviewed mothers/PLW 25% are satisfied and 75% very satisfied of the visible changes that the project generated in

the beneficiaries behavior in the community. Besides, the interviews with CHV about visible changes do not differ much, but

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with satisfaction. Besides, they are all advocating the continuation of the activities, 66% of them advocate it with

considerable insistence.

B. FINDINGS ABOUT THE 5 MAIN CRITERIA PRIORITIZED IN THE TOR WERE REVEALED

THROUGH THE INPUTS AND ANALYSIS OF THE DIFFERENT SECTORS OF THE CHAPTERS “VI. -

PROJECT FORMULATION” AND “VII. - PROJECT IMPLEMENTATION”.

1. RELEVANCE; DEFINED AS THE EXTENT TO WHICH THE ENAUC PROJECT CONTRIBUTES TO LOCAL

AND NATIONAL DEVELOPMENT PRIORITIES DEFINED IN THE NUTRITION CLUSTER WITH MSPP,

INCLUDING CHANGES OVER TIME, IS RATED VERY SATISFACTORY. SEE CHAPTER VI.

2. EFFECTIVENESS; DEFINED AS THE EXTENT TO WHICH THE OBJECTIVES HAVE BEEN ACHIEVED, IS

RATED SATISFACTORY. SEE CHAPTER VII.

3. EFFICIENCY; DEFINED AS THE EXTENT TO WHICH RESULTS HAVE BEEN DELIVERED WITHIN THE

PRE-DEFINED LIMIT OF THE RESOURCES, IS RATED VERY SATISFACTORY. SEE CHAPTER VII.

4. RESULTS; THE POSITIVE AND NEGATIVE, AND FORESEEN AND UNFORESEEN, CHANGES TO AND

EFFECTS PRODUCED BY THE PROJECT. RESULTS INCLUDE DIRECT PROJECT OUTPUTS, SHORT-TO MEDIUM

TERM OUTCOMES, AND LONGER-TERM IMPACT INCLUDING GLOBAL ENVIRONMENTAL BENEFITS,

REPLICATION EFFECTS, ARE RATED VERY SATISFACTORY. SEE CHAPTER VII

5. SUSTAINABILITY; DEFINED AS THE LIKELY ABILITY OF THE ENAUC INTERVENTIONS TO CONTINUE

TO DELIVER BENEFITS FOR AN EXTENDED PERIOD OF TIME AFTER COMPLETION, IS RATED SATISFACTORY.

PROJECT NEED TO BE ENVIRONMENTALLY AS WELL AS FINANCIALLY AND SOCIALLY SUSTAINABLE. SEE

CHAPTER VII.

MAIN CONCLUSION A single basic conclusion to this evaluation of the ENAUC project would be that it was clearly worth undertaking to the profit of a group of Internally Displaced People outside of the humanitarian coverage at that time. It addressed a real threat and was effective and brought satisfaction for the community. This is unanimous in the view of the major stakeholders and confirmed by the GS evaluation team, and with an adequate continued support from the cooperated partners, HP and Unicef, it will contribute significantly to improve the nutritional status of the beneficiaries accompanying them from the camps to the ménages according to the national inter-cluster recovery plan. Further, with a dedicated effort outside of the camps over a period of time, it has a potential to extend benefits to broader underserved community and come out with sustained interventions and positive visible changes in the targets traditional feeding practices of infants and young child.

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VI. FORMULATION

CONCEPTUALIZATION/DESIGN (R). The conceptualization of the problematic addressed by the ENAUC project

is reflected in the project proposal. Its approach is assessed for appreciation with accordance to general standards known for problematic approach. The problems addressed are leveled up with the situation or real picture of the needs on-field of the pool of camps chosen for the evaluation to measure their level of appropriateness. To avoid discrepancies and to catch differences over time, pictures shouted during the screening activities were either analyzed, beside the cluster general situation reports, to facilitate evaluation. The problematic and the logical framework approaches are

satisfactory in meeting the general standard requirements for project problematic approach and the design used is the form developed by Unicef specialist. The project conceptualization took in account the mainly similar issues faced by MSPP and partners of the nutrition cluster during that time, along with particular situation of the IDP camps experiencing the challenges of the emergency as a so called UC. The need of nutrition protection for children 0-5years addressed is appropriate to the real threats on field. During PCNB routine screening activities in cite-soleil the team pictured in September 2010, a 6-months children suffering severe acute malnutrition depicted with complication and respiratory infection which confirms a visible threat for the children of 0-59months.

a- LESSONS LEARNT FROM PREVIOUS EXPERIENCE Project design either incorporated lessons about

community mobilization, implication of community leaders in interventions, additional point of catchment in PCNB and other, generated from recent experience in working with the very same targets for months after the earthquake. The different project components and activities proposed to achieve the objective were appropriate, viable and conform to the national strategy defined by the government through MSPP. The indicators defined for guiding implementation and measure achievement are basically: number of children screened by MUAC or weight/height properly per age group in the targets 0-5 years old, including mothers screened and number of reference processed for treatment to appropriate health structure; number of exits; number of mothers counseled regularly; number and evolution of the exclusive breastfeeding in 0-6months and number of appropriate feeding 6-24 months, the evolution of changes in behavior of the beneficiaries, number of community agents and community health workers trained in detection of malnutrition, promotion of exclusive breastfeeding and IYCF best practices for community empowerment, the degree of nutrition services awareness in community. The results will be analyzed later to measure the level of achievement of objectives.

b- HAITI NUTRITION SECTOR-OWNERSHIP/DRIVEN. Considering the logical framework (See annex:

table2)and the MSPP national protocol for nutritional interventions in Haiti, the evaluators understand that the project interventions and strategies have only been resulted totally from a national perspective of the cluster and MSPP and may only incorporate some difference in implementation strategy. Each

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activity that partners developed in the project contribute appropriately to the achievement of the expected results related to the developed objectives of the ENAUC project.

c- STAKEHOLDER PARTICIPATION (R) the evaluation team estimates that the participation of the different

stakeholders in the design stages of the project have been effective and very satisfactory. The participation of the MSPP in the design is effective, in its usual way for all humanitarian projects through the cluster and the compliance of the project concept to the national protocol. Several workshops took place among the cooperated partners HP and Unicef through a chosen focal points to come out with an agreed final version of the ENAUC project proposal. As mentioned in the project conceptualization section, the community beneficiaries participated actively in the decision-making about the selection of their IDP camps for the ENAUC project interventions. The evaluation team thinks that the beneficiaries participation it the ENAUC design stage is somehow similar to the community pledge at the end of the ENAUC, where the field agents conducting interviews on sites on the behalf of the GS evaluation team, received a real advocacy from community members for the restart or continuation of the ENAUC project in their sites to the benefit of the children.

d- REPLICATION APPROACH. The lessons learnt during the ENAUC project are displayed in further sections

of the evaluation, they are very important for the project stakeholders and any humanitarian partner that brings intervention in nutrition. The way that they should be replicated will vary on each particular project and the environment. Replication should be processed through a special analysis and results will take the form of recommendation. Nevertheless, those that should be replicated in any continuation of the ENAUC project on any form, were determined and guided through the recommendation section.

e- DUPLICATION APPROACH. (R) The ENAUC project was Satisfactory in contributing to the whole

coordination of nutrition interventions by avoiding duplication. Cooperated partners worked with the coordination of the nutrition cluster on the project targets for an effective approval to ensure that humanitarian efforts are not, in any form a duplication of other nutritional services furnished or available in the covered areas for the same population. It is obvious, for existing files/reports from the nutrition make it clear that the cluster was kept informed of and accepted any change and updates about ENAUC sites and activities.

VII. PROJECT IMPLEMENTATION

IMPLEMENTATION APPROACH (R). This part of the evaluation assesses and appreciates the implementation

approach adopted by the ENAUC project management personnel in implementing the project. It addresses the

effective use of the logical framework and preset strategies during implementation, the changes made to the

initial strategies on course of action, the use of electronic information technologies to support implementation,

participation and monitoring, as well as other project activities. It either assesses the general operational

relationships between the institutions involved and others and how these relationships have affected positively or

negatively the implementation and achievement of project objectives. Finally the evaluators will consider the

availability of the technical capacities associated with the ENAUC project and their role in project development,

management and achievements.

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1. THE ENAUC IMPLEMENTATION APPROACH IS BASED ON THE LOGICAL FRAMEWORK AND A

MATRIX OF A SET OF STRATEGIES FOR THE INTERVENTIONS (SEE TABLE6: STRATEGIES OF INTERVENTION).

THE 3-MONTH REPORTS DATA AND ACTIVITIES HAVE BEEN COMPARED TO THE ACTIVITIES DISPLAYED IN

THE LOGICAL FRAMEWORK, AND THEY WERE TYPICALLY SIMILAR IN FORM AND CONTENTS AND TARGETS.

THIS CONFIRMS THAT THE LOGICAL FRAMEWORK WAS USED AS A MANAGEMENT TOOL DURING PROJECT

IMPLEMENTATION. THE STRATEGIES OF INTERVENTIONS DISPLAYED IN THE TABLE 6 BELOW SUMMARIZES

AND DIVIDE THE PROJECT INTERVENTIONS IN 3 AXES AND DEFINED A SET OF STRATEGIES FOR EACH.

THOSE STRATEGIES ARE THE SAME IMPLEMENTED ON FIELD ACCORDING TO EVALUATION TESTS AND

CONTRIBUTED VERY SATISFACTORILY TO STREAMLINE ENAUC PROJECT PERFORMANCE INTO MEETING

GOALS.

Table 6- Strategies of Intervention

Axis1 interventions: Community Empowerment in combating malnutrition

- Recruitment of volunteers & Health workers in community; - Training to CHW, CHV in community mobilization, breastfeeding

promotion, detection of malnutrition in community and referencing process as part of sustainability;

- Organizing units of CHV;

Axis2 Interventions: Increase of Exclusive breastfeeding & Improvement of general Feeding practices of Infant and Young Child

- Education in mother-clubs, - Messages dissemination through Community/Social Mobilization; - Messages dissemination through home-visits and screening

activities; - Séances of counseling & psychosocial assistance to PLW in mother-

clubs to resolve problems related to breastfeeding;

Axis 3 Interventions: Detection of malnutrition cases and facilitation of access to treatment Treatment of diarrhea in screened infants/children

- Activities of mobile screening (MUAC screening and Weight/Height door-to-door) and cases referral to PCNB

- Referring diarrhea cases identified during community activities to PCNB

- PCNB on-site screening and malnutrition cases referral to PTA, USN or PNS

- PCNB on-site treatment of diarrhea cases - Accompanying the referee chargé to referred health structure. - Home-visits for follow-up

Chosen Sites

- Underserved Camps IDPs (difficult to reach, with less visibility, affected by the January 12 earthquake, gathering poorest households)

Mobilized Resources - PCNB Personnel - CHW - CHV - Community leaders

2. NO MAJOR CHANGES HAVE BEEN MADE TO THE PROJECT STRATEGIES OR PRIMARY APPROACH AS

A NEED OF ENHANCEMENT FOR BETTER ACHIEVEMENT. BUT, WAS ONLY CONSIDERED AN IMPORTANT

SUGGESTION FROM THE M & E MID-TERM EVALUATION REPORT TO INCREASE THE NUMBER OF

VOLUNTEERS FOR THE CHV: DEVELOPING A STRATEGY OF SHOWING THEM SIMPLE INCENTIVES AS

TRAINING AND RECRUITING THE BENEFICIARIES (MOTHERS/PLW) THAT REGULARLY ATTEND THE PCNB

ACTIVITIES ACTIVELY.

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3. THE PROJECT USED THE EXISTING PLATFORM OF ELECTRONIC IN (IT) INFORMATION

TECHNOLOGIES TO COMMUNICATE AND INTERACT WITH COOPERATED PARTNERS OF THE ENAUC

PROJECT, TO PLAN REGULAR MEETING WITH THE CLUSTER PARTNERS AND MSPP, AND SHARE WITH

THEM REGULAR ACTIVITY REPORTS AND INCIDENT LIKE THE EVENT OF THE THOMAS STORM OF

SEPTEMBER 24 AND AS WELL AS INTERNALLY TO FACILITATE STAFF COLLABORATION ON THE PROJECT

ACTIVITIES.

4. THE GENERAL OPERATIONAL RELATIONSHIPS INTERNALLY AND BETWEEN THE COOPERATED

PARTNERS INVOLVED AND THE MAJOR STAKEHOLDERS WERE ASSESSED AND APPRECIATED AS SHOWN IN

THE TABLE9- ENAUC PROJECT GENERAL OBSERVATIONS. AND HOW THESE RELATIONSHIPS HAVE

CONTRIBUTED TO EFFECTIVE IMPLEMENTATION AND ACHIEVEMENT OF PROJECT OBJECTIVES.

a) COLLABORATION ON ENAUC ACTIVITIES JWP (VERY SATISFACTORY)

The evaluators used the conducted interviews and activity reports, and weighted the results with JWP of the

project proposal to understand and rate the level of collaboration between involved stakeholders and understand

its contribution to the project achievements.

MSPP collaboration was effective on strategic level in contribution to the effective orientation, coordination and

regulation of the undertaken activities. MSPP either jointly prepared the ENAUC personnel in capacity to

implement the project. But, MSPP did not involve in anything on field foreseen in the JWP.

Unicef collaboration was effective as foreseen in the ENAUC JW in Funding Resources, provision and technical

support. Unicef jointly prepared the ENAUC personnel into having the capacity of implementing nutritional

interventions. Unicef goes beyond by assisting in supervision and Risk/Disaster management.

Haiti Participative fulfilled everything foreseen in the ENAUC JWP about implementation satisfactorily.

Another part of collaboration not well addressed in the JWP, is the community leaders involvement that helped

effectively in the ENAUC project introduction and operational start-up on sites of the 12 IDP camps.

b) FINANCIAL OPERATIONS & BUDGETING (SATISFACTORY)

To appreciate the Financial Operations & Budgeting, the GS evaluation team understands that Periodic financial

reports have been produced each 3-month and submitted to UNICEF in the event of disbursements; and the Initial

Budget if revised should provide revelatory explanations about discrepancies.

The Initial Budget had been early subject to revision to adjust the amount of two sections which were sub-

evaluated: Section3- Training & Capacity Building and Section 5- Transport. Collaboration at this level was

satisfactory for it allowed the partners to quickly clarify and understand that the adjustment was necessary to

facilitate achievement.

The first financial report was accepted by Unicef and made possible the disbursement of the second tranche.

Collaboration at this level at this level revealed to be not satisfactory enough because, in spite of a clear

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correspondence early from Unicef explaining to HP the steps for an early disbursement of the second tranche, the

personnel managing the ENAUC project did misunderstood Unicef financial procedures and took it that they could

not submit justification and ask for anything until each dime of the first tranche was spent. The explanation

furnished let understand that normally every first cooperation incorporates relatively higher risks and requires

more time and efforts to have every little thing clear and smooth.

Besides, the so-called letter of non-objection from Unicef and the effective issuance of the second tranche

disbursement check after submission of the justification files about the expenditures, let interpret that the

financial operation was satisfactory

c) COMMUNICATION AND DATA SHARING (SATISFACTORY)

GS evaluation team rated Satisfactory the communication and data sharing in the implementation of the ENAUC

Project by analyzing the flow of information sharing electronically and in hard paper, the Monthly reporting

rhythm and earliness and the reports about activities and updates. The all sorts of reporting upper have been

noticed and used the existing platforms of communication, mostly electronic format, as mentioned earlier.

Monthly reporting was regular, but some delays of 2 to 3 days have been noticed in 50% of the reports submitted,

17% before hand and 30% on-time as displayed in the

Table 12- Monthly reporting Rhythm.

Reporting Date Status (late, on-time, before-time)

July August 09, 2010 Before time

August September10, 2010 On time

September October 12, 2010 Late (two days)

October November 10, 2010 On time

November December 13, 2010 Late (tree days)

December January 12, 2010 Late (two days)

d) GOVERNANCE AND MANAGEMENT (SATISFACTORY)

The results of the analysis of the Use of the JWP planning and agreed provision in the management and

governance during the implementation of the ENAUC project, including Interview with Project Personnel

representative allowed to rate it Satisfactory.

e) FIELD ENGAGEMENT/ COMMUNITY INVOLVEMENT (VERY SATISFACTORY)

The rating very satisfactory is from the assessment of results of the Interviews with community agents and PCNB Personnel, results effectiveness of the activities based on community mobilization that went far above expectations admitting that as drawn in the Results section.

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Table 9- ENAUC project general observations Collaboratio

n on ENAUC activities JWP

Financial Operations & Budgeting

Communication and data sharing

Governance and Management

Field engagement/ community Involvement

ENAUC General Observation Rating

Very Satisfactory

Satisfactory Satisfactory Satisfactory Very Satisfactory

Source Interviews, Activity reports, Joint Work Plan

Project Initial and revised budget, Mid-term and Final financial reports, Letter of non-objection from Unicef

Monthly reporting rhythm analysis, activities reports emails sharing flow, Use of existing networks platforms for communication both internally and externally

Use of Work planning in implementation, Interview with Project Personnel, Management standards used

Interviews with community agents and PCNB Personnel, results effectiveness of the activities based on community mobilization

5. Monitoring and evaluation (R). MONTHLY REPORTING WAS REGULARLY MADE ABOUT THE

ALL ACTIVITIES ON FIELD IN THE 12 IDP CAMPS AND A 3-MONTH MID-TERM REPORTING PRODUCED

THEN A FINAL EVALUATION REPORTING, WHAT IS ESTIMATED ADEQUATE. DAILY REPORTS, TWICE-A-

WEEK SUPERVISION AND HIGHER OVERSIGHT VISITS INSTRUCTED M&E DURING THE PROJECT EXECUTION.

THE COMMUNITY STRATEGY SHIFTING PARTLY THE FOCUS TO THE ACTIVE MOTHERS ATTENDING THE

PCNB IN ORDER TO INCREASE THE COMMUNITY VOLUNTEERING POOL IS A PROOF THAT ACTION HAS

BEEN TAKEN ON THE RESULTS OF THIS

MONITORING OVERSIGHT AND EVALUATION

REPORTS.

6. Community Stakeholder

participation (R). THE EVALUATION

ASSESSED THE LEVEL OF STAKEHOLDERS’

PARTICIPATION AND WEIGHTED IT WITH THE

BENEFICIARIES’ PERCEPTION OF THEIR

EFFECTIVE PARTICIPATION, THEN RATED IT VERY

SATISFACTORY. FIGURES 1,2,3 IN ANNEX

SHOW THE RESULTS OF INTERVIEWS WITH THE

COMMUNITY STAKEHOLDERS. THE

ATTAINMENT OF GOALS THAT ARE BASED ON

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COMMUNITY MOBILIZATION IS AN IMPORTANT INDICATOR, WHICH SHOWS POSITIVITY ABOUT THE

ENAUC PROJECT. THE FORM ADOPTED BY THE PROJECT STAFF FOR DISSEMINATING INFORMATION IN

THE COMMUNITY AND COMMUNICATING WITH BENEFICIARIES WAS WORD OF MOUTH TO EAR IN

INDIVIDUAL INTERACTION, MASSIVE COMMUNICATION WITH MEGAPHONES AND WRITTEN NOTICES

STUCK IN THE PCNB.

(1) THE ESTABLISHMENT OF PARTNERSHIPS AND COLLABORATIVE RELATIONSHIPS

DEVELOPED BY THE PROJECT WITH LOCAL AND CONCERNED ENTITIES RANGE FROM THE

RELATIONSHIP BETWEEN THE COOPERATED PARTNERS HP AND UNICEF, THE MSPP AND

THE COMMUNITY LEADERS AND THE COMMUNITY VOLUNTEERS. THE PARTNERSHIPS

EFFECTS THEY HAVE HAD ON PROJECT IMPLEMENTATION WAS QUITE VISIBLE, MAINLY

THE EFFECTIVE INTRODUCTION AND ESTABLISHMENT OF THE PCNB IN THE

COMMUNITIES, THE CONSUMPTION OF THE SERVICES BY THE TARGETED BENEFICIARIES

AND THE COMMUNITY FULL PARTICIPATION IN MULTIPLICATION OF TARGETS REACHED

ON SITES. THE MOTHER-CLUBS HAD A FULL PARTICIPATION AND CONSTITUTED OF A

COMMUNITY GATHERING FRIENDLY SPACES FOR THE MOTHERS.

(2) INVOLVEMENT OF MSPP WAS EFFECTIVE AT STRATEGIC LEVEL, BUT LEFT A

NON-VISIBLE CONTRIBUTION ON FIELD. THE EXTENT OF GOVERNMENTAL SUPPORT TO

THE PROJECT ACTIVITIES WAS FORESEEN IN THE ENAUC PROJECT JWP FROM

PARENTING AND SUPPORTING THE TRAINING TO THE COMMUNITY HEALTH WORKERS

TO THE TRAINING OF COMMUNITY VOLUNTEERS, THE SUPERVISION OF ACTIVITIES

IMPLEMENTATION ON FIELD. MSPP EITHER HAD TO HOST THE ACTIVITIES OF THE CHILD

WEEK. DUE TO UNKNOWN CONSTRAINTS NONE OF THESE HAVE BEEN EFFECTIVE AND

ALL THE OUTCOMES RELATED IN THE LOGICAL FRAMEWORK REMAINED NON-

APPLICABLE (N/A).

b) FINANCIAL PLANNING/FINANCIAL MANAGEMENT AND BUDGETING:

(1) THE ENAUC PROJECT BUDGET ORIGINALLY ESTIMATED TO USD185, 182

AFTER REVISION INCREASED TO USD216, 869 AND AFTER DEDUCTION OF IN-KIND

SUPPORT FROM UNICEF, THE UNICEF FINANCIAL CONTRIBUTION RESULTED IN AN

INCREASE FROM USD130, 459 TO USD153, 900. THE BUDGET FORMAT USED HAD

SOME SPECIFIC ADVANTAGES BUT MAKE IT DIFFICULT TO BREAKDOWN THE PROJECT BY

OBJECTIVES. HOWEVER, TO DEVELOP A GOAL DIRECTED MEASUREMENT, THE GS

EVALUATION TEAM UNDERSTOOD THAT MOST OF THE OUTCOME INDICATORS ARE

EXPECTED TO 80% OR BELOW, THE ONLY OUTCOME INDICATORS THAT ARE SET TO 90%

ARE DIRECTLY RELATED TO THE CHILD WEEK THAT WAS NOT ORGANIZED AND DID

NEITHER FORECAST TO CONSUME ENAUC PROJECT RESOURCES, THUS SUGGESTING

THAT ENAUC PROJECT WOULD MEET A COST-EFFECTIVENESS IN ACHIEVEMENTS IF AT

LEAST THE 80% OF THE PROJECT OBJECTIVES CONSUMED THE 100% OF THE ALLOCATED

BUDGET. AT FIRST DISBURSEMENT OR FIRST TRANCHE, THE ENAUC PROJECT TEAM

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RECEIVED THE AGREED 50% OF THE INITIAL BUDGET, WHICH REPRESENTS 43,38% OF

THE REVISED BUDGET AND REALIZED, ACCORDING TO THE ENAUC PROJECT MID-TERM

EVALUATION REPORT DATA (SEE ANNEXED TABLE 11- ENAUC TARGETS MET -3-

MONTH REPORT FORM), THE ENAUC PROJECT ALREADY MET FORM 77% TO OVER

100% FOR MOST OF THE ACTIVITIES OF THE LOGICAL FRAMEWORK. AT THE END OF THE

PROJECT LIFE-CYCLE, THE FINAL REPORTS GATHERED DATA FROM MONTHLY REPORTS

AND FOUND OUT THAT THE DIARRHEA TREATMENT (ONLY ONE OF THE TARGETS) WAS

LEFT TO 57, 56% WHILE THE OTHER TARGETS WERE REACHED FROM 92, 5% TO 323,

3% AS A TOTAL PROJECT TARGETS MET WITH ABOUT 98,4% OF THE MONEY,

SUGGESTING A FAR UNEXPECTED ATTAINMENT OF OBJECTIVES. GS EVALUATION TEAM

CONCLUDES THAT THE ENAUC PROJECT ACHIEVEMENTS WERE MET WITH COST-

EFFECTIVENESS VERY-SATISFACTORILY.

(2) FINANCIAL MANAGEMENT (INCLUDING DISBURSEMENT ISSUES) AND CO-

FINANCING ISSUES WERE ADDRESSED IN EARLY SECTION, AND INCLUDED IN ENAUC

PROJECT GENERAL OBSERVATIONS OF TABLE-9.

c) SUSTAINABILITY. THE SUSTAINABILITY OF THE ENAUC PROJECT NUTRITIONAL

INTERVENTIONS IN THE COMMUNITY DURING AND MOSTLY AFTER THE PROJECT LIFE-CYCLE WAS

ONE OF THE PRIORITIES ADDRESSED IN THE PROJECT PROPOSAL THE TABLE 15 DESCRIBE THE

SUSTAINABILITY APPROACH IMPLEMENTED ON FIELD.

Table 15- Observation of sustainability process Interventions per Axis Activities supporting Sustainability


- Training in exclusive breastfeeding promotion and IYCF best practices, including awareness of problems related to breastfeeding for 24 CHW & 111 CHV

- Training in techniques of community mobilization for 120 CHV

- Implication of CHV in project mobilization to develop their skills


- Training in Detection of malnutrition with MUAC screening and how to process referral of detected cases

- Creation of CHV Units equipped with MUAC - Involving CHV in project screening activities to

develop their skills

According to the observations of the Table 15, of the three axes of interventions, two required and effectively had

been subject to sustainability: Axis1 and axis2. The Axis one aiming at Increasing the Exclusive breastfeeding &

Improve the general Feeding practices of Infant and Young Child in the community achieved its sustainability goal

through the Training in exclusive breastfeeding promotion and IYCF best practices, including awareness of

problems related to breastfeeding for 24 CHW & 111 CHV which was chosen from IDP camps on the basis of

equity – number of households in each IDP camp. The axis two of which sustainability should focus on the

continuation of the detection of malnutrition cases and facilitation of access to treatment, achieve it partially

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0% 20% 40% 60% 80% 100%

Aspect1

Aspect3

Aspect5

Aspect7

Qualitative & Normative evaluation of the ENAUC project interventions

Unsatisfactory Satisfactory Very Satisfactory

through the same training for the targeted CHV and CHW in Detection of malnutrition with MUAC screening and

how to process referral of detected cases. It was complemented with the Creation of CHV Units equipped with

MUAC in charge of detection in community and Involving CHVs in project screening activities to develop their

ability to operate properly after the project life-cycle with no supervision.

Although, the project did not develop a further approach that address establishment of financial and economic

instruments and mechanisms, and the conditions in which the CHV will have to continue the nutritional

interventions in the community. The trainings provided covered the areas of the project interventions as

summarized in the table 13-.

Table 13 capacity building – number and type of trainings completed

Training type Beneficiaries type Number of beneficiaries

Facilitator

Promotion IYCF Best practices/PCNB interventions CHW 24 CEPAM

CHV 111 CEPAM

Community Mobilization techniques CHV 120 HP

Mathematically on the basis of the initial 58,000 populations targeted, it makes 1 CHV for 87 families, which is

admissible. 24 CHW empower each IDP camp to have health personnel that have the capacity to sustain the

nutritional activities in PCNB for the duration of the project life-cycle. As a medium term project initiated in an

emergency context, the GS evaluation team accepts the level of its sustainability as Satisfactory.

d) QUALITATIVE AND NORMATIVE EVALUATION.

In this, the evaluators consider the effectiveness of the agreed standards and norms of the national protocol in operating the nutrition interventions in the targets, including assignment of community members in the interventions; the quality and timeliness of inputs for the project and the extent to which this may have affected the smooth implementation of the project. The annexed table 14- matrix of qualitative & normative evaluation of the nutritional interventions – addresses on 8 aspects and provide ratings based on evaluation conducted on the chosen pool of camps for the ENAUC project evaluation.

Aspect1: Filling the mothers/

PLW files; rated

unsatisfactory or need

considerable improvement

in 40% targets, Satisfactory

in 40% targets and Very

Satisfactory in 20% targets.

Aspect2: Conformity of the

taking in charge of the

diarrhea; Rated satisfactory

in 20% of the targets and

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very satisfactory in 80% of the targets. So 100% conformity depicted.

Aspect3: Conformity of the referencing to PNS; rated unsatisfactory in most of the targets about 60% and conform

referencing in only 40 % of the targets. Thus reflecting a referencing of a poor quality or non-conform to the

national protocol in most of the targets. This has either been depicted by Unicef during an evaluation visit in a

PCNB located in the vicinity of the IDP camp Lamy located of Delmas 95, Petion-ville.

Aspect4: Conformity of the referencing to PTA; rated satisfactory in 40% of the targets and very satisfactory in

60% of the targets. Suggesting 100% conformity.

Aspect5: Conformity of the referencing to USN; rated satisfactory in 40% of the targets and very satisfactory in

60% of the targets. Suggesting 100% conformity.

Aspect6: Conformity of the home visits according to the protocol; rated unsatisfactory in about 20% of the targets,

satisfactory in 40% of the targets and very satisfactory in 40% of the targets.

Aspect7: Strategy of involvement of the community in the screening activities; rated unsatisfactory in about 20%

of the targets, satisfactory in 40% of the targets and very satisfactory in 40% of the targets. Thus

Aspect8: Conformity of the EXITS according to the protocol; rated unsatisfactory in 40% of the targets and

satisfactory in 60% of the targets.

The GS evaluation team keeps those ratings reliable and conforms to the guidelines, norms and quality standards of the Haitian national protocol for the interventions in nutrition.

7. RESULTS

The timeliness and extent of the results achievements of the ENAUC project have been rated by comparing the overall results of 6-months data compiling with the outcome indicators in the annex Table11-.

Expected result1: Approx. 3130 children 0 to 24 months are reached with PCNB services -Support service

specially exclusive breast feeding for approx. 760 children 0 to 6 months;

Project target1a (rated very satisfactory) 12 Priority UC in PAP, Cite Soleil, Carrefour, Delmas, PV; percent of target

met: 100.00% (rated very satisfactory)

Project target1b: 3130 children 0 to 24 months enrolled in baby tents services; percent of target met: 180.35%

rated very-satisfactory or above expectations.

Expected results2: Approx. 6,830 children 6-59 months and approx. 1,620 pregnant and lactating women are

screened for acute malnutrition based on MUAC appropriately referred for treatment monthly.

Project target2a: 6830 children 6-59 months screened for acute malnutrition based on MUAC; percent of target

met: 115.24%, rated very-satisfactory or above expectations.

Project target2b: 1,620 pregnant & lactating women screened for acute malnutrition based on MUAC. Percent of

target met: 323.33% rated very satisfactory above expectations.

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Expected results 3: ENA-UC contribute to an appropriate UC and Regional Timely nutritional assessment and

surveillance-systems reinforcement

Project target 3a: 6 monthly data reports produced and shared with MSPP thru the nutrition cluster; percent of

target met: 100.00%, rated satisfactory.

Expected Results 4: Contribute in expanding in-country capacity for nutrition.

Project target4a: 120 CHV and 24 Health & Social workers trained on IYCF, MUAC screening, and supplementary

feeding; percent of target met: 92.50% rated satisfactory.

Project target4b: 34730 individuals of the UC house hold aware of the Nutritional services; percent of target met:

137.07% rated satisfactory.

Project target4c: 288 events in 12 PCNB focusing on nutrition; percent of target met: 125.35%, rated satisfactory.

Expected results 5: Contribute in expanding coverage of immunization, Vitamin A supplementation, diarrhea

treatment and de-worming treatment in children under 5 during National campaign.

Project target5a: 1897 children 0-59 months treated for diarrhea with ORS and zinc; percent of target met:

57.56%; rated less satisfactory. ENAUC project team was supplied with zinc but ORS was not supplied by Unicef as

convened in project document.

Child Health Week was not realized by MSPP then all the 3 related outputs are non-applicable.

A large number of outputs are produced by the ENAUC project not only completely above expectations but either

within the respect of the timeliness.

VIII. RECOMMENDATIONS The recommendations that have emerged from this evaluation are presented with the intention of being

applicable to a continuation or expansion of ENAUC activities. It includes corrective actions to follow up or

reinforce initial benefits from the project Proposals for future directions underlining the three main axes of the

interventions then the General considerations.

They are as follows: axe1: Community Empowerment in combating malnu trition;

In any continuation of the ENAUC project

A. TRAINING FOR COMMUNITY EMPOWERMENT SHOULD BE EXTENDED TO MORE VOLUNTEERS

IN THE BROADER NEEDED COMMUNITIES. B. COMMUNITY EMPOWERMENT TRAININGS SHOULD HAPPEN IN THE EARLY STAGES OF THE

PROJECT

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C. SHOULD BE DEVELOPED A STRATEGY TO DOCUMENT THE REGULAR PARTICIPATION OF THE

COMMUNITY VOLUNTEERS IN THE NUTRITIONAL INTERVENTIONS. D. THE PARTICIPATION OF THE COMMUNITY VOLUNTEERS IN THE SCREENING ACTIVITIES

SHOULD BE MORE REGULATED ACCORDING TO THE NORMS OF THE NATIONAL PROTOCOL. axe2: Increase of Exclusive breastfeeding & Improvement of general Feeding practices of Infant and Young Child;

E. THE PCNBS SHOULD BE MOVED FROM CAMPS TO THE COMMUNITY IN PROXIMITY IN

ORDER TO SERVE THE LARGER COMMUNITY WHILE SUPPORTING THE CLUSTERS STRATEGY OF

RETURN TO THE NORMAL LIFE IN COMMUNITY. F. THE WELCOME OF THE MOTHERS IN THE PCNB OR THE MOTHER-CLUBS SHOULD BE

IMPROVED. G. FUTURE TRAININGS SHOULD CONTRIBUTE TO IMPROVE THE “EXITS” CONFORMITY TO THE

NATIONAL PROTOCOL. axe3: Detection of malnutrition cases and facilitation of access to treatment, besides direct treatment of diarrhea in screened infants/children.

H. FUTURE TRAININGS SHOULD HELP IMPROVE THE CONFORMITY OF THE REFERENCING TO

PNS ACCORDING TO THE NATIONAL PROTOCOL. I. ENAUC CONTINUATION SHOULD DEVELOP A STRATEGY TO FACILITATE AVAILABILITY OF

ACCESS TO TREATMENT. General In any continuation of the ENAUC on any form:

J. TO REDUCE RISKS OF MASSIVE LOSS OF PCNB FILES IN EMERGENCY CONTEXT, FILES MUST

BE TRANSFERRED MONTHLY TO THE MAIN OFFICE OF THE PROJECT. K. MANAGERS OF THE PROJECT AND SUPERVISORS SHOULD MAINTAIN AND CENTRALIZE

COMMUNICATION WITH COMMUNITY LEADERS THROUGH A FOCAL POINT AND AVOID ANY

UNREALISTIC EXPECTATION IN THEM. ESTABLISH MORE DETAILED PROTOCOLS FOR COMMUNITY

DISPUTE RESOLUTION. L. THERE MUST BE EARLY ATTENTION TO DEFINE AND CLARIFY AUTHORITIES, TERMS, INDICATORS OF SUCCESS, LESSONS LEARNT, DECISION-MAKING, AND ROLES IN A JOINT SESSION. M. FINANCIAL PROCEDURES, BUDGETING AND FUNDS ALLOCATION PROCEDURES SHOULD BE

REVIEWED FOR MORE SIMPLIFIED AND FORESEEING APPROACHES. THIS COULD BE ACCOMPLISHED

BY: INVOLVEMENT OF PROJECT MANAGEMENT AND AGENCIES STAFF IN THE REVIEW OF

BUDGETING, WITH A VIEW TOWARDS REVISIONS THAT WILL STREAMLINE BOTH ENAUC AND

INDIVIDUAL AGENCY PROCESSES AND PROCEDURES.

IX. LESSONS LEARNT

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A. THIS TAKES IN ACCOUNT THE BEST AND WORST PRACTICES IN ADDRESSING ISSUES RELATING

TO ON-GOING IMPLEMENTATION, RELEVANCE, PERFORMANCE AND SUCCESS, TO MAKE OUT THE

MAIN LESSONS LEARNT AS FOLLOW:

1. FURTHER INTEGRATION OF THE MOST ACTIVE BENEFICIARIES (MOTHERS/PLW) AS CHV OR

COMMUNITY AGENTS IS A PROVEN STRATEGY TO BOOST COMMUNITY VOLUNTEERING INTO THE

NUTRITIONAL INTERVENTIONS WHILE INCREASING THE PRODUCTIVITY AND EFFICIENCY. BABY ITEMS AS

GIFT REPRESENT A GOOD INCENTIVE FOR THEM.

2. THE IMPLICATION OF COMMUNITY LEADERS IN EARLY STAGES OF THE PROJECT IS CRUCIAL TO

THE EFFECTIVE IMPLEMENTATION OF THE PROJECT INTERVENTION, BUT IT IS A MUST TO CLEARLY DEFINE

EXPECTATIONS AND INTERESTS TO AVOID DEVELOPMENT OF NON-REALISTIC EXPECTATIONS THAT MAY

LATELY THREATEN THE CONTINUATION OF THE ACTIVITIES ON FIELD. TALKS SHOULD BE CENTRALIZED

THROUGH A UNIQUE FOCAL POINT AND DEFINE AGREED STANDARDS TO RESOLVE DISPUTES OR CLARIFY

MISUNDERSTANDING.

3. IYCF SERVICES THROUGH PCNB TENTS OFFER AN ADDITIONAL ENTRY POINT FOR DIARRHEA

TREATMENT AND HYGIENE PROMOTION OR CHOLERA PREVENTION IN THE TARGETED HOUSEHOLDS TO

THE BENEFIT OF THE 0-5 YEARS CHILDREN.

4. PART OF THE BENEFICIARIES WILL BE MORE EXPECTING FOODS STOCKS FROM THE PCNB AND

TEND TO DISCOURAGE ATTENDING THE PCNB ACTIVITIES. FOCUS COUNSELING ON FAMILIAL AND

ECONOMIC BENEFITS OF THE SERVICES FOR THE HOUSEHOLD WHERE MOTHERS PRACTICES

BREASTFEEDING AND RESOLVING TRADITIONAL PROBLEMS RELATED TO BREASTFEEDING PROVE TO BE

EFFECTIVE IN CONTRIBUTING TO RETAIN THE VISITING-MOTHERS.

Groupe Support (GS)


X. EVALUATION REPORT ANNEXES

Table 1: Populations targeted by the project and their size

No. NAME LOCATION COMMUNE

POPULATION SIZE

# households

# people

1 Centre Shemalie Rue Shemalie et Germain, Sarthe Cite-Soleil 107 642

2 Camp Cité Jeremie Delmas 31, Cité Jérémie Delmas 120 720

3 Camp Adventiste Delmas 31, Rue Xaragua Delmas 480 2,880

4 Camp CFVF 3e,Bld Rue Rapatrie Cite-Soleil 425 2,550

5 Centre H.Jacquet Aubry Jacquet toto, Petion Ville Petion-Ville 234 1,404

6 Camp Benediction Carradeux, Puit-Blain, Delmas 75 Delmas 200 1,200

7 Centre d’hebergement provisoire de secours

Seminaire Theologique, Mon repos 46 #2

Carrefour 620 3,720

8 Ansanm nou fò Blvd. Truthier, Rappatrie Cite-Soleil 428 2,568

9 Centre pasteur Willès 2e.Blvd, rappatrie Cite-Soleil 325 1,950

10 Camp Demichel 64, Demichel, Brochette 99, Rivière Froide.

Carrefour 230 1,380

11 Camp Haut Canaan Haiti Bon-Repos, Cite-Soleil 478 2,868

12 Camp Acra-Sud Delmas 33, Apres Commissariat, Zone Adoquin

Delmas 6,000 36,000

13 Camp La Grenade A proximite du Cimetiere de Carrefour

Carrefour 150 900

Total 9,647 57,882

http://prov.de/

http://prov.de/

Groupe Support (GS)


Table 2: Logical Framework of the Interventions of the ENAUC

Expected Results Activity Output Indicators Outcome Indicators

1. Approx 3,130 children 0-24 months are reached with breastfeeding protection,

promotion, and support services, especially exclusive breastfeeding

for approx 760 children 0-6 months, through baby tents in 12

underserved camps

Establish 12 PCNB/counseling points and associated community based IYCF services in 12 Priority Underserved-Camps (UC).

# of baby tents/counseling points set up in 12 Priority underserved camps

70% infants 0-6 months in underserved camps are exclusively breastfed.

Provide mothers and pregnant women with appropriate Infant and Young Child Feeding counseling, and support.

# Children 0-24 months living in the 12 underserved camps enrolled in baby tents services.

60% infants and young children in underserved camps continue to breastfeed up to 24 months and they are fed with appropriate food in quantity and quality.

Facilitate and supervise Mothers-Club activities with PCNB personnel of 3 persons per underserved camp

# of monthly supervision reports produced by Nutrition officers

48 supervision reports produced by nutrition officers monthly

2. Approx 6,830 children 6-59 months and approx 1,620 pregnant and lactating women are screened for acute malnutrition based on MUAC appropriately referred for treatment monthly.

Screen for acute malnutrition based on MUAC for children 6-59 months and pregnant/lactating women

# children 6-59 months screened for acute malnutrition based on MUAC

80% trained CHV and HW conduct MUAC screening monthly

3. ENA-UC contribute to an appropriate UC and Regional

Timely nutritional assessment and surveillance-systems

reinforcement

Report monthly CMAM screening data into the Regional and Partners-Network report sharing in the Nutrition Cluster and with MSPP.

# pregnant lactating women screened for acute malnutrition based on MUAC

At least 80% acute malnutrition cases in children 6-59 months and pregnant/lactating women referred for treatment

# monthly data reports produced and shared with MSPP

Consistent use of data for decision making, action planning and implementation.

4. Contribute in expanding in-country capacity for nutrition

In Partnership with UNICEF and MSPP, recruit and Conduct training of 120 community health agents (sub-distribution based on needs) and 12 health workers (nurses), and 12 social workers in IYCF counselling and support, MUAC screening for malnutrition, and referral to appropriate treatment.

# of CHV and HW trained on IYCF, MUAC screening, and supplementary feeding

80% trained CHV and HW correctly conduct IYCF assessment and provide key counselling messages

Develop & implement a communication, social mobilization and participation strategy for

nutrition

# population reached by communication/social mobilization messages

80% trained CHV and HW correctly refer children for appropriate treatment.

# community events held focussing on nutrition

60% households in underserved camps aware of nutrition services availability and purpose

5. Contribute in expanding coverage of immunization, Vitamin

A supplementation, diarrhoea treatment and de-worming

treatment in children under 5 during National campaign

In collaboration with MSPP and partners, support implementation of one round of the Child Health Week in targeted underserved

camps

# community mobilization events conducted for child health week promotion

90% children 6-59 months supplemented with Vitamin A

# children 6-59 months supplemented with Vitamin A

90% children 12-59 months de-wormed

# children 12-59 months de-wormed

25% children 0-59 months treated for diarrhea with ORS and zinc

# children 0-59 months treated for diarrhea with ORS and zinc

90% children vaccinated against measles

# children 0-59 completely immunized

90% children fully immunized

Groupe Support (GS)


Table 3: Joint Work Plan

Results* Activities Time frame in months* Responsible Partner

Jul

'10

Aug

'10

Sep

'10

Oct

‘10

Nov

‘10

Dec

‘10

Appropriate infant and

young child feeding

(IYCF) support is

provided to affected

women and children in

12 Underserved Camps

(UC) in large Port-au-

Prince.

During 6 months: Establish 12 PCNB/counseling

points and associated community based IYCF

services in 12 Priority Underserved-Camps

(UC). Ensuring mothers are provided with

appropriate infant feeding counseling, nutritional

support and protection to optimize infant and

child nutrition. Animating Mothers-Club activities

with PCNB personnel of 3 persons per UC.

HP

Community Members

UNICEF-Haiti (Funded

Resources )

MSPP (supervision)

During 6 months: In Partnership with UNICEF,

recruit and Conduct capacity building including

training and sub-sequent refresher sessions/on-

the-job supportive supervision for 120

community health volunteers (10 per UC) on IYCF

services, MUAC screening and referral for

malnutrition.

UNICEF-Haiti

(technical support)

HP (project

implementation)

MSPP (parenting,

backup certification)

Children 0-5 years with

diarrhea will be treated

with oral rehydration

solution and zinc

During 6 months: oral rehydration solution and

zinc stocks will be available at PCNB for children

0-5 years enrolled in IYCF services and through

outreach activities in the camps.

HP

MSPP

UNICEF

Children 0-59 months

and women 15-49 years

access Vitamin A and

iodine

supplementation, de-

worming treatment,

and diarrhea treatment

with oral rehydration

therapy

During 1 week: support MSPP in expanding

coverage of Child Health Week activities in

targeted camps and health facilities

UNICEF-Haiti

(provider)

HP (hosting, co-

provider)

MSPP (supervision)

Non-profit &Public

Health facilities

Children and women

access relevant

information about

nutrition Project

activities and are

sensitized to

participate.

During 2 months: develop & implement a

strategy for nutrition communication in

collaboration with community leaders, and

committees, and other stakeholders focusing on

nutrition promotion and increased demand for

IYCF services

HP (hosting)

Community Member

integrated

Contribute into

nutrition surveillance

data availability

During 6 months:

Conduct and report monthly MUAC screening for

acute malnutrition

HP (hosting)

MSPP (supervision)

& Partners cluster

1 month: conduct a final project evaluation

focusing on service uptake and coverage of

optimal IYCF practices populations.

HP

Groupe Support (GS)


Table 4: Key ENAUC Project Milestones/Events and Chronology

2010 Activities

July Installation of 12 PCNBs

Project Start up

August Recruitment of community volunteers and Launching of Community movement

September Brief interruption of 10 Baby-tents by Thomas-Storm of September 24 in Pap.

Rehabilitation and continuation of the 10 disrupted PCNB

Training for Personnel

Mid-Term Evaluation

December Training and Capacity Building for Community Health Volunteers

ENAUC Project final-evaluation

Table 5: Rapid-Assessment Matrix _ Damaged PCNB_September 24, Storm THOMAS

No

Commune/Zone PCNBs SITUATION (Endommagés/ Détruits) BESOINS

1 Cité- soleil camp rapatrié Endommagé. Tapis de la toiture disparu. Autre couverture pour la tente

2 Cite-soleil camp shemalie Endommagé. Les barrages en tapis de tout le périmètre déchiré.

Autre couverture pour la tente

3 carrefour Camp Mon repos 46

Endommagé. Toiture déchiré, et le reste en mauvais état.


4 Carrefour, platalie

Camp La grenade Endommagé. Tout le tissu déchiré et le reste en très mauvais état.

Une autre tente

5 Delmas 31, Camp Adventiste et Camp Cite Jérémie

Endommagé. Beaucoup d’eau et de boue à l’intérieur


6 Delmas 33 camp acra sud Endommagé, Les tissus déchirés et les fers courbés

Une autre tente

7 Delmas 89 camp lindor Endommagé, Les tissus déchirés Autre couverture pour la tente

8 Delmas 95 Camp Lami Détruite, perte de tous les dossiers et matériels de dépistage endommagés

Une autre tente, une balance plate

9 Pétion-ville, Carradeux

Camp Bénédiction Détruite, perte de tous les dossiers Une autre tente, toise, balance

10 Carrefour, Rivière Froide

Camp Demichel Détruite, perte de tous les dossiers et des matériels de dépistage

Une autre tente, balance, toise, bureau.

Groupe Support (GS)


Table 6: Strategies of Intervention

Table 6- Strategies of Intervention

Axis1 interventions: Community Empowerment in combating malnutrition

- Recruitment of volunteers & Health workers in community; - Training to CHW, CHV in community mobilization, breastfeeding

promotion, detection of malnutrition in community and referencing process as part of sustainability;

- Organizing units of CHV;


- Education in mother-clubs, - Messages dissemination through Community/Social Mobilization; - Messages dissemination through home-visits and screening

activities; - Séances of counseling & psychosocial assistance to PLW in mother-

clubs to resolve problems related to breastfeeding;


- Activities of mobile screening (MUAC screening and Weight/Height door-to-door) and cases referral to PCNB

- Referring diarrhea cases identified during community activities to PCNB

- PCNB on-site screening and malnutrition cases referral to PTA, USN or PNS

- PCNB on-site treatment of diarrhea cases - Accompanying the referee chargé to referred health structure. - Home-visits for follow-up

Chosen Sites

- Underserved Camps IDPs (difficult to reach, with less visibility, affected by the January 12 earthquake, gathering poorest households)

Mobilized human Resources - PCNB Personnel - CHW - CHV - Community leaders

Table 7: Pool of Camps IDPs chosen for the final evaluation

No. Camp IDP Location Location

POPULATION SIZE

# households # people

1 Ansanm nou fo Blvd. Truthier, Rappatrie Cite-Soleil 428 2,568

2 Lagrenade

Platalie, Ti-sous, A proximite du Cimetiere

Carrefour 150 900

3 Benediction Carradeux, Puit-Blain Delmas 253 1520

4 Acra-sud

Delmas 33, Apres Commissariat, Zone Adoquin

Delmas 6,000 36,000

5 Lamy

Delmas95,Jacquet toto, Petion Ville

Petion-Ville 234 1,404

Total 7065 42,392

Chosen Pool Represents about 73,24% of the project targeted populations.

Groupe Support (GS)


Table 8: Number of People Interviewed and Files analyzed

Stakeholder/type Individual Focus group Files consulted

Mothers/PLW/IYC 108 1 (30 mothers) 209

Community leaders 5 2

Community Health Volunteers 40 1

Project Management Team members 2 28

Donor UNICEF 1 2

MSPP - Cluster 0 2

Table 9: Project General Observation

Collaboration on ENAUC activities JWP

Financial Operations & Budgeting

Communication and data sharing

Governance and Management

Field engagement/ community Involvement

ENAUC General Observation Rating

Very Satisfactory

Satisfactory Satisfactory Satisfactory Very Satisfactory

Source Interviews, Activity reports, Joint Work Plan

Mid-term and Final financial reports, Letter of non-objection from Unicef

Monthly reporting rhythm analysis, activities reports emails sharing flow, Use of existing networks platforms for communication both internally and externally

Use of Work planning in implementation, Interview with Project Personnel, Management standards used

Interviews with community agents and PCNB Personnel, results effectiveness of the activities based on community mobilization

Groupe Support (GS)


Table 10: Strengths/Benefits and Weaknesses/Gaps of the ENAUC Project

STRENGTHS/BENEFITS GROUNDS WEAKNESSES/ GAPS

GROUNDS

Trust building Trust building generates satisfaction in community and facilitate community participation in the activities implementation In the interaction between project personnel and the community beneficiaries, 0% is left unsatisfied, 25% satisfied and the major 75% percent very satisfied of the relationship with the Project personnel. See figure1 The majority of the volunteers enrolled as CHW were previously satisfied mothers active and regular in the PCNB, now taking deeper engagement as Community Health Volunteers. 20% of community leaders interviewed said unsatisfied of their relationship with the project personnel and reject the idea of continuation, while 40% express satisfaction and another 40% extreme satisfaction. See Figure3 Among results of the good Collaboration with the 100% at the beginning and fallen to 80% of the community leaders at the end, we note contribution in: introducing the project team into the community, facilitating the installation of the PCNBs, managing risks and security issues related to materials and on-spot personnel.

Discrepancies between beneficiaries’ interests and Leaders interests.

The 20% of community leaders unsatisfied does not wish the project to continue. Among the files consulted are one incident report where PCNB materials and tents were seized in exchange for a pay from a camp leader, and a formal letter from a camp committee requesting a contribution sum of $ht 8,000. This constitute of a discrepancy between the benefits of the community and those of a few community leaders. Thus, a challenging to project continuation inside a few camps as community beneficiaries wished, unless outside.

Community Mobilization

Community Mobilization ensures good awareness about the project activities and the benefits, and makes the bridge between the PCNB and the beneficiaries. 36% of the 111 Community Health Volunteers trained were interviewed and revealed: 62.5% satisfaction and 37.5% extreme satisfaction in the trained Community Health Volunteers about their participation level in the interventions. See figure 2 The GS Evaluation team thinks that it concords with the data of the Mid-term evaluation report and may some how explains why on 3-month the project went above expected results – based on community mobilization – reaching 169% of the 1,620 PLW targeted, 89.47% of the 760 0-6months and 77% of 3,130 o-24months targeted for the project duration.

Community Empowerment

Training to community members enhanced the perception of the project benefits in the Underserved Communities and empowered them to sustain and continue project interventions in the community during and after project life-cycle, beside the mothers counseled bi-weekly in the mother-clubs. Of the Community Health Volunteers trained by CEPAM and interviewed, all the beneficiaries said believe in the easiness and their assimilation of the training modules and demonstrations enabling them to bring more significant interventions (87.35% expressed a simple satisfaction and 12.65% extreme satisfaction). See

Community empowerment training happening late

Although the primary objectives community empowerment were to ensure in-community capacity to continue project activities after its duration and that hosted at the end of the project did not disturb the goals attainment, it is clear and obvious that the community participation would be more productive and would be streamlined, if the formal training happened earlier during the project life-cycle.

Groupe Support (GS)


figure2

UNICEF capacity to mobilize resources quickly in Disaster context to help partner continue working

In the after-math of September 24 Thomas storm, UNICEF showed interest and capability to and effectively provided 10 new tents in a laps to the staff of the Project ENAUC, that helped to shortly restart servicing the population that needed more support in the context. See Table5

Missing files for the 1st three months in 3-PCNBs.

Three of the PCNBs seriously affected by the storm Thomas, were completely crushed or uprooted by the storm violence. Thus, patients’ files for the first 3-month stored in the PCNB either vanished away along with other materials.

HP capacity to react quickly & appropriately in disaster context

The September 24 storm happened after 4:00hr pm and seriously affected 84% of the ENAUC infrastructure. While the assessment reporting standard is 24hrs in emergency, HP staff realized a complete rapid-assessment available 2-hour after the event and shared assessment matrix with the Cluster and UNICEF immediately for quick response.

Home-Visit and Follow-up

Support to Treatment follow-up toward improvement and the decreasing rate of abandon, requires individual connections with Mothers and lactating women and home-visits. Over 70% of Mothers PLW interviewed revealed among other, that their satisfaction relates considerably to the devotion of the personnel and the support that they are provided in the follow-up of the child/infant treatment, they interpret the home-visits from personnel, as an implication into their life in form of a caring family-member and a proof of focus on nutritional improvement.

MSPP Commitment to coordination and Partners capacity

In the project conceptualization and localization, and the partners readiness to implement the project, the MSPP through the cluster played a key-role in:

1- Coordination of the humanitarian partners interventions in a way to avoid duplication

2- Cooperating with UNICEF to enhance partners’ capacity to bring interventions through training of trainers in taking in charge IYCF promotion and acute malnutrition, and ensuring the availability of an updated National Protocol of taking in charge acute malnutrition and promotion of IYCF best practices.

Brought to light some lessons learnt

Lessons learnt through the project have been tracked to serve as resource for future actions and for sharing with other NGOs.

Project ability to generate satisfaction and visible change in the beneficiaries’ behavior

Of the interviewed mothers/PLW 25% are satisfied and 75% very satisfied of the visible changes that the project generated in the beneficiaries behavior in the community. Besides, the interviews with CHV about visible changes do not differ much, but with satisfaction. Besides, they are all advocating the continuation of the activities, 66% of them advocate it with considerable insistence.

Difficulty to access treatment conveniently upon referral (to PNS, PTA, USN)

Due to unavailability of proximity treatment services around several underserved camps, lack of capacity to respond promptly to transport/commute needs

Groupe Support (GS)


Table 11: ENAUC Targets met – 3-month report form (Column: Total % project target met)

ANNEX 4 – THREE MONTHS REPORT: UNICEF Haiti and _Haiti Participative (HP) ________________ Civil Society Organization / Partner

PCA Reference No.___________________________

Reporting Period: From_______ October _______to ______ December ________ Project Duration: From July 01, 2010 to December 30, 2010________

% Project Duration Passed___ 100% _______________ Total UNICEF Contribution ________________ % Project funding spent ______________________

Expected Results Activities Indicators Data Source

Project Target

Total Total % Project Target Met

Issues / Constraints / Comments

Necessary Actions

(this reporting period)

(since project started)

1. Approx. 3130 children 0 to 24 months are reached with PCNB services -Support service specially exclusive breast feeding for approx. 760 children 0 to 6 months

Establish 12 PCNB/counseling points

-# of baby tents/counseling points set up in 12 priority underserved camps

Registry PCNB

12 Priority UC in PAP, Cite Soleil, Carrefour, Delmas, PV

12 PCNB (Reinforced)

12 PCNB 100.00% - camps relocation -the Storm of September 24 stroked severely all the Tents

Tents were moved to the spot of relocation or to other priority UC. -Unicef provided 10 new tents

Provide mothers and pregnant women with appropriate Infant and Young Child Feeding counseling, and support.

-# children 0-24 months living in the 12 underserved camps enrolled in baby tents services

3130 children 0 to 24 months

3236 child. 0-24 months enrolled

5645 180.35% Mothers that prefer food assistance from counseling

Focus counseling on familial and economic benefits of the services

Facilitate and supervise Mothers-Club activities with PCNB personnel of 3 persons per underserved camp

760 children 0 to 6 months

1484 child 0-6 months

2164 284.74%

2. Approx. 6,830 children 6-59 months and approx. 1,620 pregnant and lactating women are screened for acute malnutrition based on MUAC appropriately referred for treatment monthly.

Screen for acute malnutrition based on MUAC for children 6-59 months and pregnant/lactating women

# children 6-59 months screened for acute malnutrition based on MUAC

Registry PCNB

6830 children 6-59 months

4985child 6-59 months

7871 115.24%

# pregnant lactating women screened for acute malnutrition based on MUAC

Registry PCNB

1,620 pregnant & lactating women

2500 Pregnant and lactating women.

5238 323.33%

3. ENA-UC contribute to an appropriate UC and Regional Timely nutritional assessment and surveillance-systems reinforcement

Report monthly CMAM screening data into the Regional and Partners-Network report sharing in the Nutrition Cluster and with MSPP.

# monthly data reports produced and shared with MSPP

Registry PCNB

6 monthly data reports

3 monthly data reports produced and shared with MSPP thru the Nutrition Cluster

6 100.00% Some cells of the monthly report format were difficult to catch

following up technical assistance from Unicef

Groupe Support (GS)


4. Contribute in expanding in-country capacity for nutrition

In Partnership with UNICEF and MSPP, recruit and Conduct training of 120 community health agents (sub-distribution based on needs) and 12 health workers (nurses), and 12 social workers in IYCF counseling and support, MUAC screening for malnutrition, and referral to appropriate treatment.

# of CHV and HW trained on IYCF, MUAC screening, and supplementary feeding

Training attendance sheet & Training report produced by animator (CEPAM)

120 CHV and 24 Health & Social workers

24 Health & Social workers in IYCF, MUAC screening and supplementary feeding

111 92.50% low interest of the CHV to work with no fare to cover meals and drinks while servicing.

developing a strategy to show them other incentives and recruiting the beneficiaries that regularly attend the PCNB activities actively

# population reached by communication/social mobilization messages

Mobilization Report

34730 individuals of the UC house hold aware of the Nutritional services

16428 individuals of the UC household

47604 137.07% Due to the issues not yet resolved with CHV, PCNB personnel were shifting often to community mobilization, lowing their service capacity in the Tent.

Expectation to regularize by the next 3-month period with the implementation of the new incentive strategy for the CHV

# community events held focusing on nutrition

PCNB Workbook data

288 events in 12 PCNB

133 361 125.35% September 24 break events in 10 PCNB

Follow up with Unicef to and effectively replace the tents

5. Contribute in expanding coverage of immunization, Vitamin A supplementation, diarrhea treatment and de-worming treatment in children under 5 during National campaign

In collaboration with MSPP and partners, support implementation of one round of the Child Health Week in targeted underserved camps

# community mobilization events conducted for child health week promotion

??? n/a n/a n/a n/a Child Health Week not realized by MSPP

n/a

# children 12-59 months de-wormed

??? n/a n/a n/a n/a Child Health Week not realized by MSPP

n/a

# children 6-59 months supplemented with Vitamin A

??? 6147 n/a n/a n/a Child Health Week not realized by MSPP

n/a

# children 0-59 completely immunized

??? 7590 n/a n/a n/a Child Health Week not realized by MSPP

n/a

Treatment for diarrhea thru Rehydration with ORS and supplementation in zinc

# children 0-59 months treated for diarrhea with ORS and zinc

Registry PCNB

1897 780 1092 57.56% Limited stock of ORS supplemented thru HP Medical section

Follow up to increase stock from donation

Groupe Support (GS)


Table 12: Monthly reporting Rhythm

Reporting Date Status (late, on-time, before-time)

July August 09, 2010 Before time

August September10, 2010 On time

September October 12, 2010 Late (two days)

October November 10, 2010 On time

November December 13, 2010 Late (tree days)

December January 12, 2010 Late (two days)

Table 13: capacity Building – type and number of training completed

Training type Beneficiaries type

Number of beneficiaries

Facilitator

Promotion IYCF Best practices/PCNB interventions

CHW 24 CEPAM

CHV 111 CEPAM

Community Mobilization techniques

CHV 120 HP

TABLE 14- MATRIX OF QUALITATIVE & NORMATIVE EVALUATION OF THE NUTRITIONAL INTERVENTIONS

QUALITATIVE APPROACH

Camp

Location

Volet 1 Volet 2 Volet 3 Volet 4 Volet 5 Volet 6 Volet 7 volet 8

Filling the mothers/ PLW files

Conformity of the taking in charge of the diarrhea

Conformity of the referencing to PNS

Conformity of the referencing to PTA

Conformity of the referencing to USN

Conformity of the home visits according to the protocol

Strategy of involvement of the community in the screening activities

conformity of the EXITS according to the protocol

Benediction demas 75 haut carradeux

sa vs us vs vs sa vs sa

Platalie CARREFOUR, la grenade tisous

us vs us sa sa vs sa us

Ansann nou fo

village rapatries CITE-SOLEIL

us sa us sa sa us us us

Acra sud DELMAS, Delmas 33

sa vs sa vs vs sa sa sa

Lamy PETION-VILLE, Delmas 95, jacquet toto

vs vs sa vs vs vs vs sa

SOMME

Unsatisfactory 2 0 3 0 0 1 1 2

Satisfactory 2 1 2 2 2 2 2 3

Very Satisfactory

1 4 0 3 3 2 2 0

Groupe Support (GS)


Table15: Observation of sustainability process

Interventions per Axis Activities supporting Sustainability


- Training in exclusive breastfeeding promotion and IYCF best practices, including awareness of problems related to breastfeeding for 24 CHW & 111 CHV

- Training in techniques of community mobilization for 120 CHV

- Implication of CHV in project mobilization to develop their skills


- Training in Detection of malnutrition with MUAC screening and how to process referral of detected cases

- Creation of CHV Units equipped with MUAC - Involving CHV in project screening activities to

develop their skills

Annex:

Figures of the Evaluation Interviews

Figure 1

0% 20% 40% 60% 80% 100%

project benefits to the nutritional statusof children and women in the…

project visible change on thebeneficiaries behavior

relationship/interaction with PCNBPersonnel

Support to follow-up until treatment

Decision to keep actrivities on going

Fig.1- Mothers PLW Interviewed

US

SA

VS

Groupe Support (GS)


0%20%40%60%80%

100%A

xis

Titl

e

project benefits tothe nutritional

status of childrenand women in the

community

Easy explanationand demonstrationabout the training

modules by thetrainers

agent participationin the ENAUC

nutritionalinterventions in the

community

Decision to extendtraining

opportunities tomore CA

VS 20 5 15 0

SA 20 35 25 40

US 0 0 0 0

Fig.2- CHV interviewed

0%

20%

40%

60%

80%

100%

Conception ofproject benefits tothe Community atlarge in nutrition

improvement

Relationship &Interaction with

the projectpersonnel

One's contributionto the project'sinterventionseffectiveness

Decision to keepactrivities on going

Fig3.- Community Leaders Interviewed

US SA VS

Groupe Support (GS)


project benefitsto the

nutritionalstatus of

children andwomen in the

community

One'srole/interventions in the PCNB

Training andsupportacquired

Decision to keepactrivities on

going

VS 6 9 9 3

SA 12 9 9 15

US 0 0 0 0

0%10%20%30%40%50%60%70%80%90%

100%

Axi

s Ti

tle

Fig.4- PCNB Personnel Interviewed

Groupe Support (GS)


TERMS OF REFERENCE PCA between Haiti Participative (HP) - Bureau Program Urgence and Unicef-Haïti “Emergency Nutritional Assistance to 12 Underserved Camps (ENA-UC)” Introduction

The Final evaluation in the context of the ENAUC project is a final approach form the Monitoring and Evaluation principle developed in the project writ. It is initiated in the perspective of: a) Promoting accountability for the achievement of the project objectives through the assessment of results, effectiveness, processes and performance for the project activities, with emphasis on their contribution to the large underserved community benefits. b) Promoting the learning and sharing on results and lessons learned among the HP Emergency Bureau and the nutrition cluster of OCHA in Haiti; either as basis for decision-making on the HP nutrition section’s strategies, program and project management, and performance improvement. This will either instruct the necessary follow-up thru other projects to be implemented on the medium and long run. The evaluation expert work will observe five main criteria:

1. Relevance – the extent to which the project contributes to local and national development priorities defined in the Nutrition Cluster of the OCHA with MSPP, including changes over time.

2. Effectiveness – the extent to which the objectives have been achieved. 3. Efficiency – the extent to which results have been delivered within the resources limit pre-defined. 4. Results – the positive and negative, and foreseen and unforeseen, changes to and effects produced by the project. Results include direct project

outputs, short-to medium term outcomes, and longer-term impact including global environmental benefits, replication effects and other, local effects.

5. Sustainability – the likely ability of an intervention to continue to deliver benefits for an extended period of time after completion. Projects need to be environmentally as well as financially and socially sustainable.

The “Emergency Nutritional Assistance to 12 Underserved Camps (ENA-UC)” project of cooperation were concluded with Unicef to start June 30, and effectively started implementation on July 01, 2010 with the objective to combat the malnutrition in 12 targeted underserved camps of displaced people, by promoting exclusive breastfeeding & Infant and Young Child Feeding (IYCF) best practices, and contribute to malnutrition case management by MUAC screening and referring cases to the appropriate health structure while supporting follow-up. One of Its immediate objectives is to ensure community empowerment through the ENA-UC by implementing a set of activities and trainings required to integrate community members into the planning, management and sustainability of the ENA-UC nutrition services to the community. The ENA-UC project focused on protection, promotion, and support of Infant and Young Child Feeding and undertakes the following main activities in order

to realize its expected results:

Protect infants and young children from entering the cycle of malnutrition by delivering the following services: optimal breastfeeding support including exclusive breastfeeding for children 0-6 months and early initiation of breastfeeding through PCNB, where mothers will receive a safe space to breastfeed and receive nutrition education.

Treat diarrhea in children 0-59 months with oral rehydration solution and zinc supplementation.

Screening for acute malnutrition in children 6-59 months and pregnant/lactating women based on MUAC, and appropriate referral for treatment according to protocol.

Train 120 community health volunteers (CHVs), 12 nurses (HWs), and 12 social workers in IYCF assessment, counseling, and support. The project document was signed in June 2010 and implementation started at about the exact proposed start-time. The total project budget is estimated to US$ 216,869 convened to be taken in charge by the partners as follow: HP envelope US$ 27,025 for about 12.46% and Unicef-Haiti envelope US$ 189,844 for about 87.54%. The cash contribution transfer from Unicef to the implementation Bureau (BPU/HP) would totalize $US 154,061. The convened Executing Agency for the project is the Nutrition Section of the HP Emergency Bureau. Unicef-Haiti & Haiti Participative - Bureau Programme Urgence (BPU/HP) expected for the ENA-UC the results that follow: Emergency Nutrition Assistance in Underserved Camps (ENA-UC) with approximately 58,000 population:

6) Approx. 3,130 children 0-24 months are reached with breastfeeding protection, promotion, and support services, especially exclusive breastfeeding for approx 760 children 0-6 months, through PCNB in 12 underserved camps;

7) Approx. 80% of diarrhea cases expected in children 0-59 (roughly 3.800 cases over 6 months project) treated for with oral rehydration solution and zinc supplementation.

8) Approx. 6,830 children 6-59 months and approx 1,630 pregnant and lactating women are screened for acute malnutrition based on MUAC and referred for treatment;

9) Contribute in expanding in-community nutrition capacity by training 120 community health volunteers, 12 health workers (nurses), and 12 social workers in Infant and Young Child Feeding and screening for acute malnutrition;

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10) Contribute in expanding coverage of Vitamin A supplementation and de-worming treatment during the Child Health Week (November 2010 round).

The mid-term (3-month) evaluation report for the project was conducted in end of September 2010. It was composed of one technical data compilation and one narrative report (provided in annex) . It provided a context, a summary of the constraints, cross cutting issues, project target met, data source, indicators and necessary actions to undertake, future work-plan. The mid-term evaluation provided the following results as a provision for the project ratings as per the final evaluation five (5) main criteria: Main Results for the first 3 months at 12 PCNB: 3,130 children aged 0 - 24 months out of 2409 were seen. They were serviced with, screening of malnutrition, management of diarrhea, and have enjoyed the benefits of breastfeeding. Of 760 children of 0-6 months, 680 were seen and have benefited from the promotion of exclusive breastfeeding, screening for malnutrition, management of diarrhea. 6,830 out of 2,886 children aged 6-59 months were screened for malnutrition. Hygiene promotion and management of diarrhea. Of 1620 pregnant and lactating women and 1620 have been seen and received psychosocial support, focus group discussion at mothers clubs, and promotion of breastfeeding. Over 25% of children 0-59 months with diarrhea 12 PCNB were detected and assumed 16.92%. * Note: screening based on taking anthropometric measurements (weight, height, PB) Final Evaluation Audience This Final Evaluation of the ENA-UC Project “Emergency Nutritional Assistance to 12 Underserved Camps is initiated by HP Emergency Bureau and will be fully realized through an independent expert contracted as the Implementing person, admitting that he may be supported independently by needed professionals. It aims to provide managers (at the ENA-UC Administration, project cooperated partners, the nutrition cluster partners, HP and Unicef-Haiti Project Office) with strategy and policy options for more effectively and efficiently replicating successful project initiatives or for filling gaps not filled during the project or the policies related in the project. It also provides the basis for deep understanding, learning and accountability for ENA-UC managers and stakeholders. Objectives of the Evaluation The overall purpose of the evaluation is to measure the effectiveness and efficiency of project activities in relation to the pre-stated objectives. The evaluation is expected to produce possible recommendations on: • The key elements of success of the project and further steps to be taken to secure successful results and initiatives; • Any gaps remaining after the project implementation to be addressed in further initiatives by the partners; • Identifying risks to the sustainability of the project initiatives to be considering by the partners in future development of the ENA-UC. The Final Evaluation is to consider the currently evolving environmental, demographic and economic climate in consideration of the risks and the further development of the initiatives as the external pressures on results. The emphasis of the evaluation should be the following: Project indicators The evaluators will assess the achievement of indicators and review the work plan, planned duration and (initial and revised) budget of the project. Implementation The evaluation will assess the implementation of the project in terms of quality and timeliness of inputs and efficiency and effectiveness of activities carried out. Also, the effectiveness of management as well as the quality and timeliness of monitoring and backstopping by all parties to the project should be evaluated. In particular the evaluation is to assess the Project team’s use of adaptive management in project implementation and the Project team’s fulfillment of Management responses to evaluation recommendations made during the mid-term evaluation in September 2010. Project outputs, outcomes and impact The evaluation will assess the outputs, outcomes and impact achieved by the project as well as the likely sustainability of project results. This should encompass an assessment of the achievement of the immediate objectives and the contribution to attaining the overall objective of the project. The evaluation should also assess the extent to which the implementation of the project has been inclusive of relevant stakeholders and to which it has been able to create collaboration between different partners. The evaluation will also examine if the project has had significant unexpected effects, whether of beneficial or detrimental character. The Final Evaluation will also cover the following aspects: Progress Towards Results Changes in development conditions. Address the following questions, with a focus on the perception of change among stakeholders: - Have critically endangered beneficiaries been properly and adequately served and protected within the ENA-UC? - Have there been changes in local stakeholder behavior (i.e. threats, infant feeding practices, conception of the nutrition counseling) that have contributed to clear improvement of the nutritional situation of the population? If not, why not? - Has awareness on IYCF best practices and subsequent public participation in sensitization and promotion of PCNB activities increased as a result of the project? And other questions related necessary to be pointed out by the evaluator. Measurement of change Progress towards results should be based on a comparison of indicators before and after (so far) the project intervention. Progress can also be assessed by comparing conditions in the project site to conditions in similar unmanaged sites. Project strategy How and why outcomes and strategies contribute to the achievement of the expected results.

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- Examine their relevance and whether they provide the most effective route towards results. Sustainability Extent to which the benefits of the project will continue, within or outside the project domain, after it has come to an end. Relevant factors include for example: development of a sustainability strategy, establishment of instruments and mechanisms, sustaining at a level, project objectives. Gender perspective Extent to which the project accounts for gender differences when developing and applying project interventions. How are gender considerations mainstreamed into project interventions? To what level are women involve into the project at all levels. Project’s Adaptive Management Framework

1. Monitoring Systems - Assess the monitoring tools currently being used: Do they provide the necessary information? Do they involve key partners as convened? Are they efficient? - To what level the monitoring system, including performance indicators, are acceptable. Apply SMART indicators as necessary.

Typically accepted values for SMART are:

Letter Major Term Minor Terms

S Specific Significant, Stretching, Simple M Measurable Meaningful, Motivational, Manageable A Attainable Appropriate, Achievable, Agreed, Assignable, Actionable, Action-oriented, Ambitious, Aligned, Aspirational R Relevant Realistic, Results/Results-focused/Results-oriented, Resourced, Rewarding T Time-bound Time-oriented, Time framed, Timed, Time-based, Time-boxed, Timely, Time-Specific, Timetabled, Time limited, Trackable, Tangible

2. Risk Management

- Stating whether the risks identified in the project are appropriate as per the implementation. If not, explain why. Describe any additional risks identified and suggest risk ratings and possible risk management strategies that were to be adopted. - Assess the project’s risk identification and management systems and provide recommendations.

3. Project Joint-Work Planning and Logical Framework - Is the project Joint-work-plan acceptable? - Assess the use of the project logical framework as a management tool during implementation and any changes made. - Ensure the logical framework used a set of standards in terms of format and contents. - Assess the use of routinely updated workplans. -Assess the use of electronic information technologies to support implementation, participation and monitoring, as well as other project activities. - Are work planning processes routine acceptable and modified jointly? - Consider the agreed budget and the financial management of the project, with specific reference to the cost-effectiveness of interventions. Any irregularities must be taken in account to come to a conclusion.

4. Reporting - Assess how adaptive management changes have been reported by the project management - Assess how lessons derived from the adaptive management process have been documented, shared with key partners and nutrition cluster.

5. Underlying Factors - Assess the underlying factors beyond the project’s immediate control that influence outcomes and results. Consider the appropriateness and effectiveness of the project’s management strategies for these factors. - Re-test the assumptions made by the project management and identify new assumptions that should be made - Assess the effect of any incorrect assumptions made by the project

6. Partnership Strategy - Assess how partners are involved in the project’s adaptive management framework: Involving partners and stakeholders in the selection of indicators and other measures of performance Using already existing data and statistics Analyzing progress towards results and determining project strategies. - Identify opportunities for stronger substantive partnerships; - Assess how local stakeholders participate in project management and decision-making. Include an analysis of the strengths and weaknesses of the approach adopted by the project and suggestions for improvement if necessary. - Consider the dissemination of project information to partners and stakeholders and if necessary suggest more appropriate mechanisms. Scope of the evaluation The Final evaluation will consider that monthly reports have been produced and a mid-term evaluation has been completed and that the management of the project has prepared management response to this evaluation and to a certain degree, tailored further activities in the ENAUC project in order to take into

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consideration the recommendations from the mid-term evaluation. It is understood that while being technical, the mid-term evaluation made in late September 2010 was brief and did not concentrate on most of details that the final evaluation is called to scrutinize. Due to project objectives and the number of structures (12 PCNB) in different communities where the project focuses, it is important for the evaluators to be careful in selecting stakeholders to be included in the evaluation to form as relevant and objective a picture of the project results, accomplishments and remaining challenges as possible. Ownership of the project processes and outcomes by the key stakeholders will be one of the key factors in project success to achieve project sustainability and thus the evaluators are asked to make an objective assessment of the ownership of the project outcomes/results by the key stakeholders. Products expected from the evaluation The key product expected from this final evaluation is a comprehensive analytical report in English or French that should, at least, include the following contents: Executive summary • Brief description of project • Context and purpose of the evaluation • Main conclusions, recommendations and lessons learned Introduction • Purpose of the evaluation • Key issues addressed • Methodology of the evaluation • Structure of the evaluation The project and its development context • Project start and its duration • Problems that the project seek to address • Immediate and development objectives of the project • Main stakeholders • Results expected Findings and Conclusions In addition to a descriptive assessment, all criteria marked with (R) should be rated using the following terms: Highly Satisfactory, Satisfactory, Marginally Satisfactory, and Unsatisfactory. Project Formulation Conceptualization/Design (R). This should assess the approach used in design and an appreciation of the appropriateness of problem conceptualization

and whether the selected intervention strategy addressed the root causes and principal threats in the project area. It should also include an assessment of the logical framework and whether the different project components and activities proposed to achieve the objective were appropriate, viable and responded to contextual institutional, legal and regulatory settings of the project. It should also assess the indicators defined for guiding implementation and measurement of achievement. It should either indicate whether lessons from other relevant projects (e.g., same focal area) were incorporated into project design.

Haiti Nutrition sector-ownership/Driven. Assess the extent to which the project idea/conceptualization had its origin within the national Cluster of the

OCHA in Haiti in with the Directions of MSPP, and development plans and focuses on national environment and development interests directed by the government agencies.

Stakeholder participation (R) Assess information dissemination, consultation, and “stakeholder” participation in design stages. Replication approach. Determine the ways in which lessons and experiences coming out of the project were/are to be replicated or scaled up in the

design and implementation of other projects. Duplication approach. (R) Determine whether this project services were in any form a duplication of other nutritional services furnished or available in

the covered areas for the same population. Project Implementation Implementation Approach (R). This should include assessments of the following aspects: (i) The use of the logical framework as a management tool during implementation and any changes made to this as a response to changing conditions and/or feedback from M and E activities if required. (ii) Other elements that indicate adaptive management such as comprehensive and realistic work plans routinely developed jointly between implementing partners, that reflect adaptive management and/or; changes in management arrangements to enhance implementation. (iii) The project's use/establishment of electronic information technologies to support implementation, participation and monitoring, as well as other project activities. (iv) The general operational relationships between the institutions involved and others and how these relationships have contributed to effective implementation and achievement of project objectives. (v) Technical capacities associated with the project and their role in project development, management and achievements. Monitoring and evaluation (R). Including an assessment as to whether there has been adequate periodic oversight of activities during implementation to establish the extent to which inputs, work schedules, other required actions and outputs are proceeding according to plan; whether formal evaluations have been held and whether action has been taken on the results of this monitoring oversight and evaluation reports.

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Stakeholder participation (R). This should include assessments of the mechanisms for Information dissemination in project implementation and the extent of stakeholder participation in ENA-UC, emphasizing the following:

(i) The production and dissemination of information generated by the project. (ii) Local resource users and NGOs participation in project implementation and decision-making and an analysis of the strengths and weaknesses of the approach adopted by the project management. (iii) The establishment of partnerships and collaborative relationships developed by the project with local, national and international concerned entities and the effects they have had on project implementation. (iv) Involvement of MSPP in project implementation, the extent of governmental support of the project. Financial Planning: Including an assessment of: (i) The actual project cost by objectives, outputs, activities (ii) The cost-effectiveness of achievements (iii) Financial management (including disbursement issues) (iv) Co-financing Sustainability. Extent to which the benefits of the project will continue, within or outside the project domain, after it has come to an end. Relevant

factors include for example: development of a sustainability strategy, establishment of financial and economic instruments and mechanisms, mainstreaming project objectives into the economy or community production activities.

Execution and implementation modalities. This should consider the effectiveness of the agreed standards in selection, recruitment, assignment of

experts and national staff members and in the definition of tasks and responsibilities; quantity, quality and timeliness of inputs for the project with respect to execution responsibilities, enactment of necessary legislation and budgetary provisions and extent to which these may have affected implementation and sustainability of the Project; quality and timeliness of inputs by ENA-UC management staff and other parties responsible for providing inputs to the project, and the extent to which this may have affected the smooth implementation of the project.

Results Attainment of Outcomes/ Achievement of objectives (R): Including a description and rating of the extent to which the project's objectives were

achieved using Highly Satisfactory, Satisfactory, Marginally Satisfactory, Unsatisfactory ratings. If the project did not establish a baseline (initial conditions), the evaluators should seek to determine it through the use of special methodologies so that achievements, results and impacts can be properly established.

This section should also include reviews of the following: - Sustainability: Including an appreciation of the extent to which benefits continue, within or outside the project domain - Contribution to upgrading skills of the national staff, capacity building.

Recommendations Corrective actions for the design, implementation, monitoring and evaluation of the project Actions to follow up or reinforce initial benefits from the project Proposals for future directions underlining main objectives Lessons learnt This should highlight the best and worst practices in addressing issues relating to on-going implementation, relevance, performance and success. Evaluation report Annexes Any evaluation documents of reference The length of the final evaluation report shall not exceed 34 pages in total (not including annexes). Final Evaluation chargé An independent expert will conduct the evaluation. The evaluator (s) selected should not have participated in the project preparation and/or implementation and should not have conflict of interest with project related activities. The evaluation will be in charge of one National or International expert. The expert(s) shall have prior experience in evaluating similar projects and prove deep knowledge and experience in project management, monitoring and Evaluation. It is necessary for the evaluator to demonstrate strong knowledge of the national protocol for PCNB or at no additional fares to the institution, contract the services of a nutrition specialist with the necessary knowledge. Former cooperation with the partners involved in the project is a plus. Team Qualities: (i) Recent experience with result-based management evaluation methodologies; (ii) Experience applying participatory monitoring approaches; (iii) Experience applying SMART indicators and reconstructing or validating baseline scenarios; (iv) Recent knowledge of the general Monitoring and Evaluation Policies; (v) Knowledge of general results-based evaluation policies and procedures (vi) Competence in Adaptive Management, as applied to nutritional or medical management projects (able to be complemented thru services); (ix) Demonstrable analytical skills; (x) Work experience in relevant areas for at least 5 years; (xii) Project evaluation experiences within NGO’s system will be considered as a plus; (xiii) Excellent English and French communication skills. The contracted Evaluator will perform the following tasks, among others:

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Realize a finished final evaluation documents that meet all the known international standards; -manage all tasks related to the evaluation mission but outsourced or obtained thru support services of external expert or professional(s) while ensuring that they bind to the standards regarding all support services acquired as a complement to the evaluator competence as set by the partners owning the project; drafting the terms of reference of additional professionals needed. Design the detailed evaluation scope and methodology (including the methods for data collection and analysis); Assist in drafting terms of reference of the subcontracted experts or consultant(s) Decide the division of labor within the evaluation team; Conduct an analysis of the outcome, outputs and partnership strategy (as per the scope of the evaluation described above); Draft related parts of the evaluation report; and Finalize the whole evaluation report. Individual experts or consultants are invited to submit applications together with their CV. Applications are welcome from anyone who feels they can ensure the accomplishment of the Evaluation because he/she possess most of the listed qualities. Obviously the more qualities that can be demonstrated, the better the chance of selection. The cost of the whole work may not exceed US$ 3,000 (including all the sub-contracted services related to the evaluation) The evaluation will be undertaken in regards to the following principles:

• Independence • Impartiality • Transparency • Disclosure • Ethical • Partnership • Competencies and Capacities • Credibility •Utility

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Final Evaluation Report of the Project ENAUC

The evaluator must be independent from both partners involve in the project. Therefore applications will not be considered from evaluators who have had any direct involvement with the design or implementation of the project. This may apply equally to evaluators who are associated with organizations or entities that are, or have been, involved in the ENA-UC policy-making process and/or delivery of the project. The expert or firm contracted will be held responsible for the delivery and quality of the evaluation products and therefore has responsibility for management arrangements. Methodology or evaluation approach Must be provided by the evaluator, an outline of the evaluation approach. The methodology to be used by the evaluation team should be presented in the report in detail. It shall include information on: Documentation review (desk study) Interviews to be held Field visits; Questionnaires; Participatory techniques and other approaches for the gathering and analysis of data and more as applicable. Implementation Arrangements The implementation partner of the ENA-UC project has a key to play in facilitating this evaluation, such as: liaising with the project team to make possible the stakeholder interviews, liaising with communities for field visits and co-ordinate with the Executing Agency and other counterparts. Although the contracted evaluator is the sole responsible for delivering on time the due work; thus will be considered additional written proposition of alternatives from the evaluator for any facilitating support possible from the ENA-UC implementation partner (BPU/HP) that is causing a delay. BPU/HP will contract the evaluator and ensure the timely provision of fares as per disbursement conditions. The Project implementation unit will be responsible for liaising with the evaluation team to set up stakeholder interviews, arrange field visits. Timeframe for submission of first draft of the report: 3 weeks upon signing the contract. The evaluation should be completed by February 15 2011, under reserve of approval comments made by the partners for clarifications or improvement and follow-up by the evaluator. Prior to approval of the final report, a draft version shall be circulated for comments to partners owning the project thru the project management (The Project Manager or Director of the ENA-UC Administration, Mrs. Sandrine Edouard and members of the project management group members representing the BPU/HP and Unicef-Haiti. If any discrepancies have emerged between impressions and findings of the evaluation team and the aforementioned parties, these should be explained in an annex attached to the final report. The activity and timeframe breakdown table must be provided prior to the execution of the tasks with the following parts: Activity Timeframe and responsible party Tasks/Duration/responsible Desk review/x day /evaluator expert, Briefings subcontracted experts/x day/ subcontracting position Visits to the field, interviews, questionnaires, debriefings/x day/subcontracting position Preparation of draft report, validation of preliminary findings with stakeholders through circulation of initial reports for comments/x day/ position of the responsible 4 days by the evaluation team Finalization of the evaluation report/ x day/ responsible (Incorporating comments received on first draft) Other tasks as due. This list of activities in the timeframe will not be limited to the example of activities listed above. Working Days: 22 days

final evaluation report enauc hp&unicef

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