Report on the EU+ Roundtable on Nutrition in Pastoralist areas

28 October 2016, Addis Ababa, EU Delegation

Opening

Pierre-Luc Vanhaeverbeke from the EU Delegation explained that this meetings stems from the efforts of the EU+ Joint Programming on Nutrition of EU Member States. Particularly the Italian and German governments were interested to coordinate efforts in nutrition in pastoralist areas, which is the main objective of this meeting.The meeting should further identify important next steps to advocate for mainstreaming nutrition in existing and future programmes in pastoralist areas.

Andrea Ghione from the Italian Development Cooperation Agency emphasized the importance of supporting the livelihood of pastoralists, which is based on mobility. The first principle of programs in pastoralist areas should be avoiding harm done through enforced settlement, which is not only true for nutrition but for all basic services.

He also mentioned the IGAD strategy (IDDRSI), which was adopted in 2011. The strategy includes natural resource management, services to pastoralists, health services for humans and livestock, access to market etc. In this strategy, for the first time, government has recognized the principle of mobility as a key component of pastoralist communities. One challenge working with the government is that there is a dual structure managing pastoralist issues: - a pastoralist directorate under the Ministry of Federal Affairs and-a pastoralist directorate under the Ministry of Livestock and Fisheries (chair of the Pastoralist Task force of RED&FS SWG). Approaches towards pastoralists can differ between these two ministries.

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Presentation on the “Milk Matters” Project from Adrian Cullis, Tufts University

As part of the Africa Region Pastoral Initiative, Save the children conducted a literature review of “Pastoralist Nutrition and Programming Responses” in 2008.The objective of Phase II of the project was to evaluate the impact of community-defined livestock interventions on child nutritional status during the dry season.We tried to explore how we could do better in child nutrition with livestock interventions.

Since milk is a key component of the diet and central to pastoral livelihoods, the focus on milk could provide a new lens by linking child nutrition and the livestock sector in drought management.The findings of the literature review were:

- Milk is key to dietary quality of women and children in pastoral areas - Little work done to improve milk supply to pastoral children- Evidence will guide livestock interventions in pastoral areas - Child nutrition in pastoral areas of international concern

Findings of the action research were that different types of milk are fed to children and the strong positive perception of milk for the diet of children (protection from infections, better growth etc).The research also showed that camel milk is better for availability in terms of quantity, but goat milk is better for accessibility due to the shorter distances goats migrate as opposed to camels.

Milk intake is highest in the wet season: 65% of energy from milk for a one-year old child and drops to 20% of the energy in the dry season. Furthermore, after a drought milk availability can fall by 50% in the following wet season. Since diets are mostly milk-based, the reduction in milk intake in dry season is accompanied by an increased grain and meat consumption.

There are different causes for lack of milk, some are related to wealth (poorer families have fewer animals), animal diseases, mobility as well as lack of water and pastures during dry seasons.

Research questions of Milk Matters II were: 1. What is the impact of livestock interventions on children’s milk

consumption over one calendar year? 2. What is the impact of livestock interventions on children’s nutritional

status over one calendar year? 3. What is the cost benefit of early livestock interventions vs. the treatment

of acute malnutrition in children

The study was very robust with monthly data collection, including anthropometry, consumption, infections etc. Six sites were chosen purposively from amongst communities located in Liben and Shinile Zones of Somali Region, Ethiopia.

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Two livestock interventions were designed. In two of the four designated intervention sites, the milking animals were given a daily ration of supplementary feed over the dry season. In the other two intervention sites, the milking animals were given a daily ration of supplementary feed plus a package of vaccinations and de-worming medications at the outset of the dry season.

Each participating household kept either one cow plus calf or 3-4 goats plus kids for the duration of the intervention.

One of the main findings of the study was that there was a significant increase in milk off-take during the dry season for animals in the intervention. While this was not a remarkable finding, the fact that no interventions had previously addressed the issue of additional feeding in the past, was remarkable.

The study further identified general benefits:- protection of livestock – improved survival rate of dams and suckling

calves- more free time and reduced workload for women

Positive benefits for children were that more milk was allocated and consumed and the milk consumption made a significant contribution to the daily nutrient requirement. In one of the intervention sites (Washaqabar), children consumed an additional 400ml per day, which equals an additional 264 kcal as well as 13g of Protein per day.

Within the intervention sites, children who continued to consume some milk throughout the intervention time period maintained higher average nutritional status than those from control areas or who did not receive any milk.

The intervention also included a cost-benefit analysis and concluded that the direct costs of the intervention were estimated to be 45 to 75 percent less than those estimated for therapeutic feeding (48 USD vs 145-200 USD).

Presentation on the PRIME project from Vimbay Chishanu, Mercy Corps

The project “Pastoralist areas Resilience Improvement through Market Expansion” (PRIME) has the aim to increase household incomes and enhance resilience to climate change through market linkages.

Intermediate expected results of the project are:• Improved productivity and competitiveness of livestock and livestock

products;• Enhanced pastoralists’ adaptation to climate change;• Strengthened alternative livelihoods for households transitioning out of

pastoralism;• Enhanced innovation, learning and knowledge management;• Nutrition status of households improved through evidence based

interventions.

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PRIME is mainly addressing the underlying causes of malnutrition:- Inadequate access to food: e.g. are we producing enough? Is there enough

cash to buy the food?- Inadequate care: e.g. if food is available, is the environment enabling

enough?- Insufficient health services: e.g. do we have enough hygiene to achieve

optimal nutrition outcomes?

Nutrition was integrated through nutrition specific as well as sensitive activities.

The intermediate result of the project “Improved Household Nutritional outcomes” is being achieved through interventions in different sectors:

1. Climate Change Sector (Natural Resource Management) - Improved rangeland management for sustainable and competitive

livestock production- Improved water resources management for improved household access

to potable water for humans, agriculture, and livestock- Feed and Fodder production for healthier livestock and increased milk

production

2. Livestock Sector - Improved household income for increased purchase of nutritious food

and accessibility to food all year round - Improved milk production for increased accessibility and availability of

milk for household consumption and increased household income

3.Alternative Livelihoods Sector - Improved access to finance and financial services for better incomes that

is used to procure nutrition food for the household hence improved household nutritional outcomes

- Diversification of livelihoods (poultry production) and off-farm income streams (Village Savings and Lending Associations (VSLAs) for resilient income and nutrition outcomes

Different approaches are being taken to improve dietary diversity:- Mother to mother support groups- Nutrition education and counseling- Cooking demonstrations- Promotion of post-harvest storage and reduction of post-harvest losses- Promotion of food preservation- Facilitate market access to agriculture-input suppliers- Increase production through key hole gardening

The project also has an important Social Behavior Change Communication (SBCC) component, which address social norms and religious believes through community conversations, radio soap operas, circus/dramas as well as interpersonal communication.

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What works in pastoralist areas?• Combination of nutrition specific and nutrition sensitive activities with

SBCC cutting across activities• Need for investing in livestock, natural resource management, and WASH

activities BUT with close linkages to nutritional outcomes • To sustain activities – “Systems Development” should be the major focus-

area in order to reduce dependency on external support • Activities should be cost-shared by implementing partners, government,

and communities whenever possible: get community and government involved

• Women empowerment alongside Male involvement or participation from activity design should be considered seriously: for nutrition outcomes male involvement is also very crucial

• Integration of field-level activities between sectors (health and agriculture): how can we get different bureaus involved: how do we get the Ministry of Livestock and Fisheries as well as Education to participate

• Adaptive Management: Projects should be designed in a way that allows for flexibility when the need or situation changes

• Alternative livelihoods /financial services that are made nutrition sensitive

Challenges with implementing nutrition interventions in pastoralist areas:

• Mindset change from emergency to development programming: Strategic office holders, community leadership, and communities: starts from institution: and a focus on development nutrition, not just treatment of malnutrition

• During Emergencies: pressure to convert development money to respond to emergencies

• Multi sectorial programmatic coordination platforms need strengthening: especially for pastoralist communities

• Constant change in strategic government officers• Lack of harmonized approaches across partners including training

packages and training tools not contextualized: a lot of partners use different approaches and they are conflicting: e.g. PRIME and ENGINE developed joint SBCC materials in Somali region

• Constant movements in search of grazing lands• Socio-cultural and religious barriers preventing effective adoption of

nutrition practices• Enabling Environment/Sustainable government systems or channels: Not

very active: there are many differences among pastoralist communities: not one strategy can fit all pastoralist areas

Presentation on Drought Resilience and Sustainable Livelihoods Programme from Anna Calavita, Italian Development Cooperation Agency (AICS)

This project stems from the IGAD strategy and is linked to the Ethiopian Country Programme Paper (CPP) to end drought emergencies in the Horn of Africa and is

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linked with programmes from World Bank (Regional Pastoral Livelihoods and Resilience Program) and the African Development Bank (Regional Drought Resilience and Sustainable Livelihoods Programme).

The specific objective of the programme is to enhance drought resilience and improve sustainable livelihoods of pastoral and agro-pastoral communities in selected Woredas of the Afar region.

Main project components are:1. Natural resource management: improved access to water resources for

the pastoral community and their livestock; sustainable land management2. Access to markets and trade: improved market infrastructure and

information systems of markets; improved access to markets; improved access to quality financial services

3. Support to livelihoods and basic services: improved veterinary services, use of new technologies and practices for feed production

4. Research and knowledge management5. Capacity building: administrative capacity at federal and local level

All interventions will be implemented through a participatory process.The programme wants to give particular attention to the nutrition and gender components.The programme is implemented by the government of Ethiopia and each level will have a coordination unit, at federal, regional and woreda level.The programme has 12 Mill EUR for16 months, which will be a loan to the government.

Discussion

- Mastitis : while the Milk Matters project assessed the full range of livestock diseases, there was not special focus on mastitis. This could be added in future work though.

- Gender perspective : the Milk Matters project did not have a particular gender perspective, but since women are responsible for the milk in the household, for milking and child nutrition, women were the main focal point for the project. The project was further only focused on child nutrition, not on women’s nutrition. Though there have been clear benefits for women as well in terms of time allocation and increased availability of milk in the household, though milk consumption of women was not assessed.VSF Germany has done some work on meat and got very relevant findings on the benefit of meat for women.

- Social norms : in pastoralist communities exclusive breastfeeding is a challenge: colostrum, the first milk, is not given to infants and initiation of breastfeeding does not happen within the first hour. There are also beliefs about fish, which is not considered for consumption.

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- Reduced food intake by pregnant women : pregnant women in pastoralist settings often do not eat enough to avoid having too big babies, which could cause complications during delivery. This safety practice causes some women to literally starve themselves in the third trimester to avoid complications during child labour.

- Migration in extreme droughts : in extreme droughts, majority of animals go far distances, for instance from Siti zone, they migrated to Somali region. Women then stay behind and have no access to the milk of their animals. This has led to numerous IDPs from Siti zone since livestock in some cases migrated several 100 km.

- Comparisons of households based on economic status : it was not a strong enough component of Milk Matters. The situation now is a lot more differentiated. In the past there was milk available and almost everybody had access to it. Now there are different types of pastoralists. There are people moving up and out of pastoralism. There are pastoralists with almost zero access to milk, who could, if they had access to supplementary feeding for their animals, make a difference. In terms of costs, even if supplementary feed was provided, the costs would still be lower than for treatment of severe acute malnutrition.

- Adaptation of livelihoods: Programmes in pastoralist areas have to consider that there are new categories of pastoralists: mobile pastoralists, as well as agro-pastoralists and mixed categories. People are adapting and former pastoralists move into producing fodder using irrigation schemes, some have only one or two cows and join other herds during lactation.

- Dietary diversity: we might need to reconsider the dietary diversity indicators for pastoralist communities. In these communities where dietary diversity is very low and diets are mostly comprised of milk and meat, the global standards might not be applicable. Maybe there is a need to develop more contextualized indicators instead of the WHO ones for dietary diversity. Keyhole gardening was mentioned as an intervention trying to increase a more diverse availability of foods, but pastoralists perceive such interventions as a step to push them out of their mobile pastoralist livelihood.A study was quoted that found better dietary diversity in settled pastoralists but worse nutritional status than in mobile communities.

- Dried fruits and vegetables : there are experiences from other countries, such as Mongolia, where dried fruits and vegetables are promoted in nomadic communities. With the increased shelf life and the reduced weight, they are easily transportable by such communities and can be added to soups, stews etc.

- Cash/food transfers : it is difficult to avoid dilution since feed for animals might always be shared with others and it will be difficult to control this.

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In Milk Matters there were feeding centers and animals had an identification to make sure that they were covered under the project and eligible for the supplements. This requires however the presence of a full-time animal health worker.

Updates from organizations working/planning to work in pastoralist areas

UNICEF/PSNP

PSNP IV is nutrition sensitive and implemented in 63 woredas in Somali and Afar, with about 2 million beneficiaries. The nutrition mainstreaming is not done across the country and in Somali and Afar, no nutrition linkages are implemented yet.Nutrition sensitive materials (SBCC etc) have been developed for the highlands, so adaptation would have to be done for the lowlands.Organizations that already work in PSNP woredas could use different entry points to link with the programme:

- Public works can be more nutrition sensitive, but it would require capacity building and it depends on what is locally needed, e.g. access to water, fodder etc

- PSNP has lots of gatherings: Public work clients are paid to attend SBCC sessions on nutrition and sanitation: there are opportunities, where NGOs could tap in and support the PSNP

- Nutrition Taskforce, which is chaired by the government, where NGOs are usually not present, but could be invited to share specific experience

- UNICEF can share experience and documents from the highland areas; harmonizing of nutrition BCC materials is currently ongoing and coordinated by FMoH, where it will be important to consider the materials PRIME has already developed for pastoralist areas

- Main challenge of the PSNP is that it is a federal programme without specific provisions for local contexts: it is implemented in the whole country simultaneously

ENGINE

ENGINE is implemented by Save the children, which was one of the implementing partners in Somali region for the Milk Matters project. With USAID funding, we are trying to implement the recommendations from Milk Matters in 16 woredas. It is mostly interventions on household level (6000 HH with milking animals). Supplementary feeding and fodder is part of the project, but we use a voucher system to avail supplementary feed and fodder. The project is also increasing access to fodder in the community and households can then access it through a voucher system.The main challenge is that you need the fodder production during the wet season to get the fodder during dry season. There is also a dilution problem: if a household has more than one animal, fodder is shared across all livestock.

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Milk preservation is key to have the milk available for longer during the dry season. We need technologies to keep the milk for 3-4 months.There is a lot of fodder during the wet season, therefore we need to put more effort in haymaking, storage, etc, which is all not common in pastoralist areas.Main recommendations:

- WASH: we should not design a nutrition project without a WASH component in pastoralist areas: WASH can be very expensive, so if there is no WASH component built in a project, it is important to link up with WASH programmes that are already in place

- Dependency on aid: it is important to change the mentality: to give supplementary feed through voucher system and to avoid the free handout approach, which still exists.

- Crisis modifier: was in-built in most projects, where money can be used to prevent the loss. It is not enough to have a development project, it is also necessary to have flexible funds to cover unexpected needs during an emergency period

- We need to differentiate what we implement at household level and private sector level: ENGINE works mostly at household level, but more needs to happen in value chain development

- We need to differentiate between agro-pastoralist and pastoralist areas and move away from the sole focus on nutrition specific interventions, mostly focusing on treatment of malnutrition.

CARE

CARE implemented a project over the last 6 months, responding to the drought in Afar, using a multisectoral approach, including WASH. This project was also a good opportunity to sensitize about nutrition.CARE has a mobile emergency health team, which reports findings to the concerned bodies and identifies malnourished children for referral to supplementary and therapeutic feeding centers.The community in Afar is good for project implementation since the clan system helps to transfer messages and information that will help for behavior change. Training clan leaders on nutrition is therefore crucial.The infrastructure is not as strong as in other regions: health posts and facilities are very small: organizations that use existing government structures to implement their programme will face challenges.Furthermore, in Afar, there are few staff and few facilities and the staff is also not educated. So taking a new approach and institutionalize it, will be challenging.

ACPA (Aged and children pastoralists association)

ACPA has been implementing a USAID funded Camel milk value chain project in Somali region, which got an extension to also include nutrition interventions.The aim of the project is to increase productivity, milk hygiene and market linkages. The nutrition component focuses on improving household dietary diversity as well as improving breastfeeding practices by building capacity of health extension workers.

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Challenges are the lack of knowledge related to breastfeeding, as well as low performance in health care services due to disbursed settlements.Main focus is going to be enhancing the health perceptions in the community: trying to create an approach to change behavior.We also have a manual on hygiene in local language.The project also has milk market cooperation for beneficiaries, particularly for women who deal with milk trading to help them get better market access. The aim is not only to improve the fodder but also help them get an alternative product by selling their milk, to be able to buy more diverse foods to feed their family.The focus of the project is on milk sufficiency, to create a source of income as well as on behavior change.

GIZ

GIZ is working in Afar since 2013 and started in Somali region this year. Next week a new project is starting, which has a WASH component. Even if people are agro-pastoralists, livestock is a main part of their life. The basis for all interventions of the GIZ project is natural resource management.Afar is very diverse, so solutions have to be diverse too. While most of the region benefits from both the highland and local rains, measures need to be put in place to be able to use the water and avoid erosion.Dry stone walls is one of the main anti-erosion measure used, which only require manpower and helps to keep moisture and water: trees are green earlier and longer. Stone walls can be very long and the community can take part in the work.The project also works on flood based soil moisture harvesting to produce fodder and food. First findings show an increase in biomass.The project also aims at protecting the infrastructure by controlling floods, which will help improve access to social services and water infrastructure.Another activity is ground water recharge (increase in the water table), where we try to find shallow wells: can recharge up to 10km downstreamThe project also works with clan based cluster farming, where plots are shared and crops can easily be changed.Setting up nurseries with fruit trees will help improve dietary diversity on the long-term.The WASH component of the project includes water filters, which were tested in Afar and are used at schools and health points, but can also be used for transport since it is important to ensure that water, which is transported by pastoralists is safe. Behaviour change is also a central part of the WASH component to avoid open defecation and improve hygiene.

ILRI

Animal source foods are highly nutritious and can contribute to reductions in hunger, hidden hunger and malnutrition. There is an obvious link between having livestock and improved nutrition.

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However milk consumption can also be linked to health risks, such as food borne diseases. Pastoralist communities are rarely aware of these risks and consider milk as always healthy and safe for consumption.Observations of milk handling and processing practice revealed unhygienic conditions. E. coli was detected in 51.7% of the analysed samples. These findings highlight the need to promote hygienic practises and measuring the effect of these. In addition there is a need to closely engage with local communities to improve their understanding on milk safety risks and thus to facilitate a change in practices.

ILRI also conducted a study looking at the impact of small ruminant diseases in terms of economic and financial loss, loss of productivity, impact on human health, migration for other jobs, wastage of time treating the animals, children drop out of school, malnutrition, social and psychological impact. Overall it was shown that small ruminant diseases affect women more seriously compared to other household members. The most common reason for this was that women bear most of the responsibility of taking care of sick animals and children. These findings highlighted the need to take gender into account when designing small ruminant health interventions and provided entry points to do so.

The role of livestock goes beyond nutritional benefits and health risks (see chart below). For more than one billion poor people worldwide, livestock are a key livelihood resource. Thus poor animal productivity does not just lower food production, it also undermines a wide range of livestock-related benefits, such as resilience, animal power and fertilizer. Livestock are also used for transport and considered as social capital. While sheep are often considered as “the cash in the pocket”, cattle are perceived as “the bank” for owners.

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ILRI also supports baseline surveys of different projects, such as the Regional Pastoral Livelihood Resilience Project (RPLRP) of Ethiopia, Pastoral Community Development Project (PCDP III) and Drought Resilience and Sustainable Livelihoods Prgram (DRSLP II). Looking at nutrition indicators in these surveys could be crucial.

IRC (International Rescue Committee)

IRC does not implement large scale nutrition programmes, but has long presence in pastoralist areas, working in both emergency and developmental WASH and health.IRC also manages emergency response funds for ECHO, which has sub-grants for funding for nutrition.IRC works strongly on health systems strengthening, related to maternal and child health and communicable diseases, training of health extension workers on proper screening for acute malnutrition, breastfeeding promotion etc.IRC mostly uses health extension workers and agriculture development agents as entry points.With regard to WASH, IRC is not implementing nutrition related activities, but considers the linkages between WASH and nutrition: e.g. safe water supply in pastoralist areas is important not only for people but also for their livestock.One of our projects in Afar (implemented with CARE), also has small scale irrigation component for crops both for consumption or sale. The linkages between livestock, nutrition and WASH are not just about coordination between two nutrition projects but about multisectoral coordination.

LVIA (Lay Volunteers International Association)

LVIA is working in Afar since 2013, in a consortium as part of the EU RESET project. The activities are similar to what the PRIME project is implementing, with a focus on WASH and animal health.The multispectral approach has been pushed by ECHO for some time. In the consortium we share responsibilities, e.g. LVIA is focusing on WASH and animal health, while AMREF works on health and Save the Children on nutrition.It is very positive to see that there is a lot of consensus and similarities of interventions, but there is still a lack of coordination. While coordination within RESET as well as within the different USAID projects is working, the coordination between EU and USAID funded projects is weak. Donors need to strengthen their coordination. Coordination is also needed at regional and lower levels.The targeting of pastoralist communities is key as there are different types of pastoralists and we need to be aware of our target group before we implement a project.

There has been a lot of talk about interventions and the right type of interventions. While we have overall a consensus and implement similar approaches, we are still missing a second level, which needs to address the system and the institutional level, at federal, regional and lower levels.

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Government institutional capacity, coordination and infrastructure are very weak.

ACF

ACF has conducted nutrition causal analyses, looking at all causes of malnutrition, where a key finding was that most causes of malnutrition are related to gender issues. Therefore ACF works with a nutrition and gender lens.

DISCUSSION

1. Which nutrition interventions should we prioritize in pastoralist areas?

- It will depend on the project and the expertise of the organization: not every organization can work in every sector.

- It will be important to have more evidence before making recommendations on priority actions: e.g. related to perma-gardening it would be interesting to learn what works. Also the issue around dietary diversity in pastoralist communities might need further research.

- The interventions we recommend will depend on our findings and vary from household to household. Cultural norms based on gender perspective and perceptions need to be identified before we design interventions.

- We also need to clearly define the target groups: most organizations work with agro-pastoralists, because they are more accessible. It will create confusion if we just talk about “pastoralists” without distinction of the different types.

- It is also very important to consider the context, since pastoralist communities in Afar are very different from communities in Oromo region and there are many differences within one region.

- Interventions will also have to be tailored according to age-groups

- Most organizations have been working on animal health services, but we have never measured the impact on nutrition and gender. Same for WASH: if we provide potable water, we assume it will have an impact on nutrition, but we have not measure it. So if there is an assumption that there is an impact on nutrition, we need to measure it and propose gender sensitive indicators for it in the project proposals and to follow them in the monitoring and evaluation process.

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- Pastoralist communities are very particular, e.g. the issue of dietary diversity. There is a need to have more contextualized nutrition recommendations for pastoralists, especially for women. Maybe we need a LANCET series on nutrition in pastoralist areas?

- It will be important to share information on what is available and how can we collaborate: e.g. what are the options that new programmes can tap in e.g. one programme working on animal health and another one on human health: how can we link them? It will be important to take stock of what is available (materials, research findings etc) and how can we interact.

- Breastfeeding needs to get more attention. Breastfeeding rates are very low, so we need BCC related to breastfeeding, starting with understanding the barriers to breastfeeding, etc.

- In pastoralist areas, we need an integrated model, not have projects doing only emergency or only development.

- Fodder production is the focus of many projects. It is a very slow way to increase feeding. Concentrates could fed with a better impact instead, but the challenge is to access concentrates due to limited market linkages, retailers and cash availability. The advantage of fodder production is that it can be done at household and community level and does not rely on markets. Projects need to look more into the use of concentrates in the future.

- There is no livestock vaccination protocol in Ethiopia, which would be very crucial to have in place, which this group could help advocate for.

2. What do we need to do to strengthen the government system and advocate for nutrition mainstreaming in government programmes?

- We should not create new structures but work through existing ones, such as the MoLF Pastoralist Taskforce or the PSNP Nutrition Taskforce.

- Also the structure under the National Nutrition Programme (NNP), the

National Nutrition Coordination Body (NNCB) should be central in the discussion on nutrition in pastoralist areas, but the functionality of the NNCB is questionable.

- In the Pastoralist taskforce, it would be crucial to lobby for nutrition, to ensure linkages are made to NNP, to PSNP etc. Donors could play an important role here. The Pastoralist taskforce itself also needs to be strengthened since it has not been that active and meetings have been irregular.

- Also the MoANR Nutrition case team should be part of the pastoralist taskforce and nutrition should be included in the mandate of the taskforce.

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- On the implementation level, we need to work with existing systems, e.g. nutrition counseling through health system. The government needs to coordinate and could build the capacity of that system.

- Baselines of new projects in pastoralist areas need to include gender analysis in order to identify gender-sensitive nutrition indicators, to better evaluate the impact at the household and community level. We also need qualitative studies to understand what causes malnutrition in that community. CARE has a tool to assess social change.

- Information NGOs collect needs to be harmonized and fed-back to government to ensure we send the same messages

- BCC materials are currently being harmonized by FMOH and it would be important to include messages tailored for pastoral groups. Even if NGOs are not part of that group, they could be invited to the Nutrition Taskforce.

Recommendations and next steps

It was agreed that this group should be retained and meet on a quarterly basis, discussing specific topics in every meeting. Recommendations on how to better link with PSNP and other programmes could evolve from more detailed discussion in future meetings. In the meantime the PSNP Nutrition Taskforce could invite NGOs to share experiences from the lowlands.At the same time it was agreed that the organizers should approach the MoLF Pastoralist taskforce to advocate for nutrition mainstreaming in that group

The aim of this group should be to meet few times a year, on specific topics to be able to go deeper into some subjects and identify speakers, who have experience to share on those topics. This should help strengthen the knowledge management in nutrition in pastoralist areas.

Action Points:

- EU to share the report of the meeting and powerpoint presentations as well as relevant background documents (Milk Matters project, etc.)

- EU to share outcomes of this event at next Nutrition Development Partner Forum (NDPF) to initiate better coordination between EU and USAID in pastoralist/resilience projects

- EU to facilitating sharing of materials:, e.g. SBCC materials from PRIME, PSNP BCC materials as well as the CARE tool: social change

- Next meetings should also include VSF and APDA

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